Sticky: Guide to the blog

Latest Post: alternatives to 12 step and why addiction recovery is crucial to PTSD recovery

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This is sort of the "best of" section where I'll link to the blog entries people seem to read the most. Perhaps I ought to have a page on "What is PTSD" but lots of others have already done that, so I'll just my favorite, a glossary from the Sidhran Institute [link checked 7/12/20].

Two notes before we begin.  First, I am not a professional.  I have kept this blog to share my experience with PTSD, but I cannot help you directly if you are suffering from PTSD.  I only check in here intermittently and it breaks my heart to see someone plea for help and get no response.  Please, if you are in crisis, call 911.  If you are looking for treatment or direct help, please contact the Sidran Institute. They are an excellent resource and can help you find appropriate treatment.  If you are finding out about PTSD in yourself or another and want to know what my experience has been, read on.

Second, if you make comments that contain negative statements about people at various facilities by name, I will not publish them.  Stay general, and even say there are problematic people to avoid, but no names.  Probably best to leave out names of people you consider praiseworthy too.  Self-promoting comments or links to link farms or anything that is the least bit suspicious will be deleted.  I err on the side of caution.  That said, there is a wonderful compendium of knowledge and wisdom in the comments, so thank you to all who have shared there over the years, and please feel free to continue commenting as you see fit.  They are one of the great rewards of writing this blog!

People in crisis often want to know where they can get help. Grounding exercises for PTSD can help get us through the short term. Here is a way of finding US and global treatment centers that specialize in PTSD. That is of course assuming you are privileged enough to have access to these resources. Not everyone is. And in case I forget next winter, here are some tips on PTSD and the holidays.  One of the most disturbing symptoms of PTSD is flashbacks, especially when they result in "non-epilectic seizures" or what a doctor might have called "pseudo-seizures," though there is nothing "pseudo" about them.

If you are looking to help a loved one diagnosed with PTSD, you might want to read my open letter to someone looking to help a loved one with PTSD. My partner, who is a key part of my loving and supportive network of friends, has been absolutely critical to my ongoing recovery, and I share some of the ways she has both helped me when I could not help myself and some of the unfortunate costs she has paid as a result of my PTSD.  It is a hard road, but we have come through stronger than ever, so there is hope.

Picking a therapist can be difficult for someone with PTSD, because often times the PTSD itself messes with our pickers. Through necessity and trial and error and generous borrowing of other people's wisdom, I've come up with a brief subjective guide on how to choose a therapist for ptsd. It contains links to some other, less subjective guides too.

Along with getting medical and psychological help, medication helped get me stabilized even though I was really resistant to it because of being a recovering addict. I wasn't resistant to trying Effexor, and kind of wish I had been (see Battle of the Effexor and Joy of Meds: Effexor withdrawal) I have quite a bit to say about PTSD and 12-step programs. While 12-step programs saved my life, I found that their one-size-fits-all model did more harm than good after the initial haze of the drugs and alcohol wore off. There is more than one type of addict (and some more on the subject here). And although it claims not to hew any one denominational line, it is based on Christianity in some ways that were harmful to my recovery. I finally decided to leave 12 step approaches, a difficult decision. In hindsight, however, some of the most exploitative folks I ever met were from the halls of twelve step rooms and the addictions recovery industry. Spiritual and psychological abuse are real and create huge barriers to recovery. Just to be sure, I tried a few alternatives to 12 step approaches that were promising but fizzled out, so I tried again, home group and everything,  The results were the same, but magnified in a way that really drove the point home.  For the past few years, I have found an Al-Anon home group that takes care to welcome everyone and not get caught up in "my way or the highway thinking.  It turns out that my main problem, as long as I don't pick up, is not with substances, but with addicted dysfunctional people, so this Al-Anon has turned into a real home group for me. Might not work for everyone, but it is working for me.

Betrayal bonds form a major part of PTSD as I have experienced it, so I've spent a lot of time writing about them. You might have heard of this as Stockholm syndrome. They take a number of different forms. Fully understanding the nature and effects of betrayal was key to beginning my recovery from PTSD. While the guy who wrote the book on betrayal bonds associates them with sexual addiction, I have found this ain't necessarily so.

 If you are interested, I can tell you more about my PTSD. Some days are still rough (skin-crawling, time-wasting, losing time, etc) but I have found a certain amount of recovery, and my life is once again bearable, even enjoyable on good days. And I'm still here, yes still here, and even now, still here.  Partly it depends on which dogs I feed. It also helps to have a loving and supportive network of friends. Oh, and to stay far away from toxic relationships.

An open letter to someone looking to help a loved one with ptsd

Hi,

Since you did not post anonymously and wanted to get a hold of me I won't publish your comment but will respond to your email.  If you want to repost anonymously, you might get some help that way too, so if it comes through again anonymously I'll publish the comment.  I never had Electro Convulsive Therapy (ECT), and have heard nightmarish stories about it, even in the new and improved version.  If it is not having a helpful effect, please reconsider it!

First off, sorry to hear you and your wife are having such a tough time.  When I went through the worst of the flashbacks and other stuff I was very difficult to deal with and a real burden.  I am fortunate my wife recognized what was going on as similar to what happens to battered women (she had done some work in the domestic violence field) and people who have been abused, but we had no idea when it went down what PTSD or flashbacks were.  It was incredibly frightening...I thought I had just gone crazy.  That is why I publish the blog, so that if people are hunting around they will know that what is happening is not unique and that there are ways through it.  The only way out, unfortunately, is through.

It put me out of work for 1 and 1/2 yrs, and I had to go to inpatient.  We basically maxed out credit cards and borrowed from friends and my wife's family.  Insurance would not cover anything.  I looked into but did not get social security for a disability, we were too busy with the symptoms to be able to go through with that when it actually could have helped.  My family of origin was in such denial they did not help and went on a sort of in-the-family PR campaign to discredit me and my wife.  I don't talk to them at all any more.  That whole things was weird, because the immediate causes of my ptsd were not directly anything to do with family other than raising me so I couldn't recognize psychopaths when I encountered them.  We had ok credit but not much income at the time and basically maxed out the 0% introductory offers and juggled them around for a couple of years before paying them off.  No fun, but it worked.

If you can go that route, do careful research on the place.  I went to Life Healing Center in New Mexico.  Some people, like me, have gotten a lot out of it, others, not so much.  It did not cure me, but it did give me enough tools to manage the worst of the symptoms and set up a structure of recovery, which slowly happened (with lots of work from me) over the next five years.  I have not had a flashback in bout five years, but I know that seems like forever from the other side.  With help though, it can and does get better.  Without help it will not ever get better, and would have resulted in incapacitation, institutionalization, and death for me if left untreated any longer.  It kills lots of people through suicides and addictions, and the stigma prevents the experience from helping others.

About the careful research, look at the comprehensive list of treatment centers.   You might contact Life Healing Center and ask where to go or what you can do.  They were supportive when we called.  The Sidran Institute that is listed at the top of that page serves as a clearinghouse of info and advice on getting help with PTSD.  They have a great help desk.  I would also check "how to choose a therapist" on the blog.  While setting up longer term plans, try to get short term support in place.  If Kaiser will pay for therapy, try to get a referral for PTSD.  There are lots of positively harmful mental health professionals, I would say the majority of them, so if you get a bad vibe with one try another.  It is not you!  Other people I know on Kaiser have managed by trial and error to keep trying the therapist they assign and if that one does not work ask for another.  Make the first session an interview.  You may want to attend with your wife, because if she is now like I was a few years ago, I would pick abusive therapists!  Ultimately though it has to be someone she feels she can work with, so you can only support, not do it for her. But she has a right to get appropriate treatment specific to her case, and might need help to do that.

Kaiser may want to do an economy one-size fits all solution, but you have the right to get the help you guys need.  Especially be careful with psychiatrists prescribing meds.  If you get a sense they are just prescribing this week's pharmaceutical company offering and not listening to you either before during or after you start on meds, clear out fast!  I'd say psychiatrists approach closer to 90% incompetent.  I really had to hunt to get a good one that would actually listen.  My wife helped me find a good one, and the "how to pick a shrink" page is what we learned about how to find one and interview her or him.  Meds are an important part of my recovery today though.  But if one gets overmedicated, it is just zombifying, and if your wife gets on the wrong meds and the psychiatrist does not listen, it is horrible.

Also, check the laws in your state.  In my state, major depression, which I had from the PTSD, qualified for more intensive treatment and the insurance company had to pay for unlimited sessions, not just the usual 24/yr or whatever.  The insurance company of course will not tell you this, so check the laws and the fine print of your policy on it.  I went twice a week sometimes when things were just starting to get better.

If there is addictive behavior involved, tread very carefully around 12 step programs.  They have little to no understanding of trauma issues and even if it works for the addiction, like it did for me (I went to 12-step groups for 16 years), the cure can be worse than the ailment, and charlatans and @$$holes abound.  That is not to say don't use it as a resource if it works for halting the addictions, because the addiction, particularly to drugs or alcohol, will prevent any progress in recovering from the ptsd.  Just don't drink the kool-aid that says it is a cure-all and if you are not happy joyous and free in 6 months you are doing it wrong.  That is positively harmful and very prevalent.  Get help with the PTSD elsewhere.

With that said, a number of treatment centers are incorporating trauma work into their inpatient programs.  The meadows in Arizona and the Caron Foundation rehabs in PA are two examples.  Places that work with trauma primarily often won't take a person with substance abuse issues until they have come through a rehab for that.  When I went to Life Healing Center I was already 16 years sober and had to do a bit of convincing to get in without having to go through another drug and alcohol rehab!  Without the sobriety, the other work is impossible.

I am forever grateful that my wife and my friends I had made outside of 12 step groups came through and stuck with me.  I did get better over time and returned to being a more-or-less fully functioning adult again.  It was (and still is) a long slow process, but things do get better.  My wife was for me when I was not, when I was hopeless, she supplied the hope, and we came out the other side of it fine after some couples counseling.  Don't underestimate the strain on yourself and inequitability of what is happening.  It is not fair that you should be stuck cleaning up trauma that you had nothing to do with, and Christian strategies of turning the other cheek and repressing anger will backfire, coming out sideways and destructive.  It is a tremendous strain to live with someone going through PTSD, to the point they have a name for it, secondary PTSD.  So please, if you are going to support your wife, remember that you need to take care of yourself ultimately too.  That can get lost in the cycle of crisis, but it is crucial if you are to be supportive and if the relationship is going to come through in the long run.  It can and does happen, even if it seems hopeless now.  Having come out the other side, it was an awful expereince, but once we sorted things out, with a lot of emotional work from both of us and short term guidance from a good couples therapist when we got stuck, we are stronger in the relationship than ever, and I owe my recovery in large part to my wife's unstinting support.    I'm not advocating martyrdom though, please be clear.  I had to work hard at my recovery and do a lot of work in restoring the relationship.  If I had not done that work, even when I saw no point in it, nothing would have gotten better between us.

I hope this is of some help.  I know PTSD is terrifying and awful, so please hang in there.  All the struggles and hardships paid off for us in the long run and I hope they do for you too.  I'll probably post this as an open letter on the blog without hooking it up to your comment.  Thank you for writing.

PTSD and the holidays revisited...

Holidays have always been rough for me. A lot of trauma anniversary (pdf) stuff comes between Thanksgiving and New Years for me. I didn't even realize it but my partner pointed out that I always have a hard time with holidays and depression and PTSD symptoms. This year seems better so far. I am in a place I like. I won't be alone. People who traumatized me are far away and not in contact. So maybe things will be ok this year.

Another set of holidays has started, and I need to be aware of anniversary reactions. Awareness and talking about it to the people around me (I wouldn't recommend this unless they understand PTSD and are supportive) have helped reduce the worst of the reactions, as has staying away from my abusers, and unfortunately in my case, my family of origin, who are all mightily invested in not understanding my PTSD, which several of them find pretty threatening.

Why are holidays tough for people with PTSD? Well for one thing, getting in touch with positive feelings can be really difficult, and during the holidays there is a lot of pressure to do just that...be jolly in other words. For another, some holidays a reminders of anniversaries of traumatic events. Anniverseries are proven triggers for PTSD, and they sure were for me. I finally realized I needed to cut off contact with my family of origin -- a drastic step, not for everyone, BTW -- after calling on Thanksgiving and getting off the phone and having a severe flashback. I would have never put the two together because the content of the flashback was not my family, but my partner noticed that this happened regularly with contact with them and around holidays in particular. The "joke" in our family was "OK, we're going to have a good holiday or else, godammit" which was usually followed by some drunken craziness that turned ugly.

For me, controlling whom I am around, and scaling back expectations of jolliness both help a lot.
There is a bit more on how someone with PTSD can cope with the hiolidays in About.com's PTSD section.