PTSD, Guilt, and Shame

Whether the trauma is something that happened to you, or whether it was something you witnessed and were unable to stop – feelings of guilt and shame are a very common reaction. Often, you end up going over and over in your head what you could/should/would have done differently, endlessly punishing yourself for whatever you did or didn’t do.

…Ever wonder why that is?

Well – I have an answer for you.

I’ve written previous posts about how PTSD is based on a survival reflex going awry (and if you’ve missed those, go to the “start here” button at the top of the page – they’re all there and you can catch up).

Basically – PTSD is based on a survival reflex. When something bad happens, your survival reflex kicks in to figure out, “How can I protect myself from going through something like this again?” That’s what your survival reflex is supposed to do – figure out how to keep you safe.

…The problem is, sometimes you did nothing wrong. Sometimes, there’s nothing you could have done differently. The reality is that the world is sometimes unpredictable, bad things sometimes happen to good people, and sometimes, we don’t have control over our circumstances.

Unfortunately, our survival reflex simply isn’t designed to understand any of that – it has one job, and that is to keep us out of harm’s way. When it can’t, it assumes that we did something wrong and we should have done something different – so, it sends our mind in relentless circles of should/could/would haves, and fills us up with feelings of guilt and shame over whatever actions we took.

Feelings don’t create facts; if they did, then everybody buying a lotto ticket because they’re feeling lucky would be a millionaire.

So – just because your survival reflex makes you feel guilt and shame, doesn’t actually mean that you did anything wrong. Those feelings, as intense as they sometimes are – those feelings are simply a byproduct of how reflex works. Your survival reflex is trying to make sense of what happened. It’s trying to do its job and protect you, and it’s getting stuck.

Do your best to keep that in mind; it’ll help to put the guilt and shame in perspective.

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

 

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is the copyrighted property of Larry M. Jaipaul; please do not copy images without permission.

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PTSD: Why It’s so Hard to Talk To Your Loved Ones

One of the worst things about PTSD is how it cuts you off from those who want to be there for you: your spouse, and closest friends and family.

When you’re suffering, your loved ones want to help. They might ask what’s wrong. You know they’re trying to help… Only, you feel like you can’t talk to them.

Your loved ones can’t understand why you won’t talk about it. They might feel shut out and rejected; their feelings might be hurt that you won’t let them be there for you. And that might make you feel guilty, which doesn’t help: now you’re feeling guilty on top of suffering, and your loved one is feeling rejected and helpless. Yikes!

…If this scenario sounds familiar to you, then I invite you to read this post, and then share it with your loved one. Hopefully, it’ll help both of you understand what’s going on and why. And it’ll help both of you feel better.

A big piece of PTSD is avoidance. Basically, that means even thinking about “that stuff” is about as easy as staring directly into the sun without squinting: just like the glare of the sun, the glare of your feelings around the trauma is too intense. It’s not that you’re trying to shut out your loved one; first and foremost you’re trying to shut yourself out, because thinking about your trauma just feels so awful.

Now, add to the pain of thinking about the trauma, the idea of sharing it with your loved one. That takes it to a whole new level: it feels like taking your most horrible, painful thoughts and feelings, and inflicting them on someone you care about. You can’t bring yourself to do it because you can’t bear to even think about that stuff, can’t bear to hurt them, and can’t bear to watch how it hurts them to know what happened to you.

It’s not a choice, it’s a symptom. So, stop beating up on yourself about it – the shame and guilt just makes you feel worse for something you can’t control right now. Instead tell your loved one something like, “Thank you for caring about me. Your support means a lot. I wish I could talk to you about it, but right now I just can’t. Even thinking about it to myself is too much.”

If you’re the loved one on the other end of this, understand that it can be too painful for the person with PTSD to talk about their trauma. It’s not a choice; it’s not a reflection of how much they trust you, so please don’t make it a test of your relationship. Know that if they could, they would tell you. Let them know that you support them, and ask how you can be helpful. Realize that sometimes, being helpful might mean backing off, or helping them distract from their feelings.

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is the copyrighted property of Larry M. Jaipaul; please do not copy images without permission.

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Getting through November 11th: A brief how-to guide

Note to my American Readers: In Canada, November 11th is Remembrance Day. It’s a bit like Memorial Day, but without the mattress sales or backyard cookouts; it’s a somber occasion that can be challenging to cope with. 

Hi, everyone!

With less than a week to go before Remembrance Day, some of you might be looking at the calendar and hearing that music from JAWS playing in the back of your head.

I know – you don’t want to think about it. But, not thinking about it means you rob yourself of the opportunity to prepare.

Here’s a few ideas for how to get through it:

Start with a review of what you did last year. Who did you spend the day with? What did you do? What parts of that worked, and what parts need improving? This is your best starting point for getting a sense of what you need: if you spent the day with friends but felt exhausted by the end, then perhaps you need some more time to yourself. If you were by yourself but felt isolated, then consider spending part of the day with people.

This is going to sound cheesy, but: give yourself permission to feel. Military culture means that you expect yourself to be this unwavering wall of steel, where nothing gets under your skin. Well – this is a day that’s supposed to get under your skin, because you care.

So – this year, instead of telling yourself to suck it up harder and make sure you don’t choke up or let a tear slip out – tell yourself something like this: “Hey, you know what? This day is to remember all the sacrifices. Yeah, I’m going to get choked up – and if anyone’s got a problem with that, then they need to get their compassion chip adjusted!!!”

That way, you don’t have to worry about getting emotional – it takes a lot of pressure off of yourself, and might make it easier to get through the day.

 

Now – that’s all pretty light and fluffy so far, right? Heads up – this next part digs deeper, so give yourself some time to read it in a quiet space. 

 

Lots of people struggle with a sense of guilt and shame about fallen comrades, because you lived and they didn’t so, somehow, your brain twists this into being all your fault. Maybe you even realize that these feelings don’t make logical sense, and you kick yourself to stop feeling this way but can’t let it go. That makes getting through this day particularly tricky.

If this is you, then here’s a tough question to ask yourself: what are you doing to remember and honour the fallen today… and what are you doing just to punish yourself for having lived?

There’s a difference. If it feels like you’re punishing yourself, then you’re not genuinely honouring anyone.

So – switch gears. Work hard to remember one happy memory about your friend. Try to remember it in as much detail as you can. Do your best smile like you mean it. Spend a little less time and energy on punishing yourself.

There – you’ve just honoured and remembered them. Well done.

 

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Please feel free to share this post, and any other on this blog, with anyone who might benefit.

I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by M & C Charbonneau, and I’d like to thank them for generously allowing me to use their work. Please do not copy photographs from Coming Back Home without permission.

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Relaxation to Control Panic: What You’re Doing Wrong

So – we’ve been talking about panic – where it comes from, and some basic fears and facts.

You may have read those posts, tried some of the strategies, and concluded that they don’t work.

If that’s the case – let me assure you that they do work; let’s just tweak how and when you use them.

Let’s put anxiety on a scale of 0 to 10. 0 means you’re so relaxed that you’re barely conscious; 10 is a full-blown panic attack.

If you’re living with PTSD, then chances are, you never actually get all the way down to 0; your best day is a 5. Your average day is more like a 7.

That means that on an average day, you’re already over two-thirds of the way to panic. (Yes, this is precisely why I keep carrying on about relaxation – because if you do some sort of relaxation exercise regularly, it will help to bring down that average. Even if you get your average down to a 6, you’ve already given yourself a little extra breathing room).

So – on a typical day, even something small is enough to get your anxiety to start creeping up.

You feel the familiar tell-tale signs – your heart starts beating a little quicker. Your muscles start to tense up. You feel a little more nervous.

And what do you do? Well, if you’re like most of the patients that I work with, you do your best to ignore it.

It’s kind of like a really annoying neighbour. The kind who talks your ear off about nothing, boring you to tears. If that guy is knocking on your door, you might decide to sit really quietly, pretend you aren’t home, and hope he goes away.

Well – it might work with your neighbour. But with anxiety? Here’s what your head is doing while you’re trying to ignore anxiety:

“Uh oh… I know that feeling… Oh crap, are we gonna do this again? CRAP. I really, really don’t want this to happen again. Please, please, please, not this nonsense again….”

Yeah. Just reading that makes you feel a little nervous right? Stop. Breathe. You’re okay.

The point is – thinking that way makes you feel completely helpless, and that makes the panic worse. So, while you’re busy trying to ignore your panic – it just builds and builds. And then, when you get to a 9.5 out of 10 – then you think: “Oh, crap. It’s coming. Quick – what was I supposed to do? Breathe, and tell myself some reassuring stuff? How did that go again?”

Folks – by the time you get to 9.5, trying to remember what you’re supposed to do to relax is a lot like trying to hold back Niagara Falls with a paperclip. It’s not going to do much to help you out at that point.

Your timing’s off. You’re doing the right things, at the wrong time.

Here’s how to tweak it to get more control: the moment you start to feel your anxiety inching up – right when you start to get the urge to try to ignore it – that is when you need to remind yourself that you are not helpless. Now is your chance to be proactive and take control. Yes this will be unpleasant – but it can’t hurt you, and the more you focus on taking control, the more you’ll be successful in making this kind of thing shorter and less frequent.

…And when you start your slow, deep breathing, keep breathing – your panic will make you want to give up after just a few seconds and go, “It’s not working, it’s not working!!! I can’t do this!”

Hey – it’s not working yet, okay? It works. Keep doing it. Give it at least ten minutes of good, focused, slow, deep breaths. It’ll work. And with practice, it’ll get easier.

MC Charb 1

I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by M & C Charbonneau, and I’d like to thank them for generously allowing me to use their work. Please do not copy photographs from Coming Back Home without permission.

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“Why do I push people away when I need them the most?”

The title of this post is a question that was sent to me a little while ago; it comes up often enough, and seems to be something that a lot of people can relate to.

When we’re at our loneliest and most vulnerable – precisely when we need support the most – often seems to be exactly the time when we work the hardest to push people away. It doesn’t seem to make any sense, and we often kick ourselves for acting this way.

There’s actually some important reasons why we tend to act this way.

One is reflex: when we feel hurt and vulnerable, our defenses go up. When that happens, it’s harder to trust and let people in.

Two is history, especially childhood: When we’ve been hurt, our antennas go up and we find it a lot harder to trust; so the more lonely we feel, the more vulnerable we feel. When we feel vulnerable, our instinct is to not trust because we’re afraid of being hurt again. It’s a vicious cycle – we feel alone, so we feel vulnerable, so we push people away,  which makes us feel alone, which makes us feel vulnerable, which makes us push people away…

Three is culture, especially if you’re from a military background: you’re used to being tough and doing your best to act even tougher. Trying to let your guard down to let someone else actually look after you makes you feel… Vulnerable. You don’t want anyone to see you when you’re hurting, so even though you really need them to be there for you, you push them away.

The trick to breaking the pattern is:

One, understand that your reflex is making you feel less trusting – it’s colouring your outlook, and making you more crusty and prickly than you normally would be. So, know that the reason you’re pushing people away is because you really need them.

Two, realize that you got hurt back then, and this is now. It’s important to remind yourself that not everyone is like the person/people who hurt you; it will take work to slowly allow yourself to let people in.

UPDATE: Since it was published, this post has been one of the most read on this blog, and many readers have asked me to write more on the topic. Here’s a link to part 2 on this topic; here is part 3.

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is the copyrighted property of Larry M. Jaipaul; please do not copy images without permission.

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Holidays, Part 3: Why is it so hard at this time of year?

So – how’s everybody doing?

Look folks – there’s a million reasons that this time of year is so hard on people. But in a nutshell, here’s how it works: the rest of the year, you may be struggling. You may have PTSD, or depression, or a disability or chronic pain. Even if you don’t, you might have financial worries, or your marriage might be teetering on the brink, or you may be estranged from your family. Hey – your life might be like a country song, and you may have checked off everything on this list and then some…

But, the rest of the year, it’s easier to see that other people’s lives aren’t perfect either, even if it feels like they aren’t struggling anywhere near as much as you are.

Then – along come The Holidays. Christmas carols start playing nonstop on the radio, and suddenly – it seems like all these other people start getting happy and excited about the holidays. It feels like overnight, the whole world took a magic happy pill or something.

It feels like everyone but *YOU* got the happy pill; they’re all suddenly excited about the holidays, and you’re still feeling exactly as awful as you were before.  Only now, seeing how happy everyone else seems just makes you feel all the more alone. It was easier to blend in and mask your misery somehow when everyone else was just “okay”; when they’re this happy, it might make you feel like you just stick out like a sore thumb. And it all just reminds you of how much you’re hurting.

…And that, in a nutshell, is why this time of year is so hard on people who are struggling to begin with.

So – what do you do about it?

First – and most importantly – realize that this feeling, like you’re all  alone and no one else understands how you’re feeling – that’s part of how depression messes with your head. The fact is – $11 billion was spent on antidepressants last year, and they were the most frequently dispensed medication.

Folks – that’s a whole lot of people who don’t feel happy, and they all feel worse at this time of the year.

You are far from alone. But, depression makes you feel alone. It makes you feel lonely; but, it also makes you want to crawl under a rock and be all alone.

So, coping is a gentle balance – it involves not pushing yourself to do too much, but also not feeding the depression monster by giving in and just crawling under a rock.

There’s no quick, easy fixes – especially at this time of year. But, it’s a seasonal thing, so it’s especially important that you don’t stop doing things that were working for you before, and reach out for help when you need it.

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

 

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by Murray Chappell, and I’d like to thank him for generously allowing me to use his work. Please do not copy photographs from Coming Back Home without permission.

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PTSD: Dissociative Symptoms

Holy feedback!

As soon as I put up the last blog post, there was a stampede of comments and emails saying, “Yes! Talk about this more!!!”

Okay.

So we left off talking about how the “freeze” response is part of the fight/flight/freeze reflex. It’s how we defend ourselves when we can’t fight or run away; it dulls the pain of whatever is happening.

Let’s put this together with some information we have from before, about how reflex learns: it learns that any reminder of the trauma is a sign of danger.

So – a reminder of your trauma might set off a “freeze” reaction.

Here’s what it feels like: you might feel like you’re not really in your body so it’s not really happening to you (this is called depersonalization); or you might feel like the whole thing is a dream, a movie, or happening in slow motion like it’s not real (this is called derealization). You might feel like you’re just losing chunks of time – ‘waking up’ and not knowing how you got to be wherever you are.

Here’s what it feels like to have PTSD do this to your life: it’s terrifying. You feel like you have no control over your mind or body. You want to do everything you can to grip onto reality, but you get sucked into this rabbit hole. You might feel angry at your mind for betraying you this way.  You might feel guilty, weak, and ashamed for not being “strong enough” to somehow hang on tighter and not let this happen to you. It can leave you feeling traumatized again and again, every time it happens, because being helpless to stop yourself from dissociating can remind you of being helpless to stop your trauma when it happened. You might feel depressed, useless, worthless.

…Boy, sounds like fun, doesn’t it?

Look – I won’t try and tell you that getting out of this is going to be quick or easy. If your PTSD includes dissociation, research suggests that, as far as PTSD goes, yours is bigger and harder to heal.

What makes it worse is, every time it happens, you might feel disappointed in yourself, like you should be stronger. This just erodes whatever self-respect you have left. You’d never say stuff like that to a buddy to encourage them when they’re struggling…

You need to start by realizing that this happens to you because you don’t feel safe; so, how you start to fix it, is to work on increasing your sense of safety.

The ability to feel safe is like a muscle – and yours is, well… It’s not so strong. You strengthen it with exercises – stuff like relaxation. Grounding skills. These are your drills: practice this stuff. Be patient with yourself: this might mean that, for now, don’t purposely put yourself in circumstances that you know will be overwhelming for you. What you’re trying to accomplish here is very hard work, so give it time.

Finally – you know that fine print I put at the end of every post? You know, the stuff that you never read, because you don’t think there’s anything important under the pretty picture?

Yeah; it says that this blog is not a substitute for therapy. If you’re dealing with PTSD with dissociative symptoms, it’s extremely difficult to try and heal that on your own. Please consider getting help to give yourself the best chance of recovery.

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

 

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is the copyrighted property of Larry M. Jaipaul; please do not copy images without permission.

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PTSD: Reflex and The “Freeze” Response

…You know I’m all about feedback, right? You know this is YOUR blog, and I’ll write about whatever you need?

Well – my stats tracker thingy tells me somebody ended up on Coming Back Home by Googling “PTSD + Freeze response”.

And I thought, Huh – I don’t really have a good article on that. I mean, if I was Random Google Person, I’d be a little disappointed.

So – good suggestion, Random Google Person! This post is for you!

If you recall from previous discussions, PTSD is basically a survival reflex stuck in a loop with no off switch. This reflex has three parts, depending on what kind of threat you’re up against:

fight is where you respond to a threat by beating up on it. Military training works to strengthen this part of your survival reflex.

flight is where you run for the hills to get away from the threat.

freeze is what you do when neither of the above is an option.

In this post, we’re going to discuss the freeze response, the way it happens in the face of an actual threat. Next post, we’ll talk about dissociation, which is what happens when the “freeze” reaction gets stuck, like in PTSD or dissociative disorder.

It’s like this: imagine a goldfish.

It’s in a fishbowl. The cat just jumped on the table and stuck his paw into the bowl. What’s the fishy gonna do?

He’s can’t fight off the cat, and he can’t run away, because he’s in a fishbowl. Poor little fishy. The cat is about to enjoy some fresh sushi.

So – what does the fish do? He freezes; freezing helps him feel less pain, both physically and emotionally.

Freezing might feel like time has slowed down; like what’s happening isn’t real; or like he isn’t really there. The goldfish might feel like he’s floating above his body, watching the cat enjoy his sushi.

Feeling this way is a normal reaction to a situation of extreme, life-threatening danger, where you can’t fight and can’t get away.

If you’re a goldfish who’s about to get eaten by a cat, feeling like you’re floating above your body and the whole thing is not really happening is less terrifying, which is why our reflex is built this way.

But – suppose just as the cat is scooping up the goldfish, someone comes along and screams, startling the cat. Poor little fishy lives, but is scarred by this near-death experience: he might get stuck in this “freeze” reaction. He might end up with severe PTSD, and symptoms that we call dissociation. We’ll talk a bit more about that in the next post.

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

 

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is the copyrighted property of Larry M. Jaipaul; please do not copy images without permission.

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Sexual Dysfunction and Relationships, Part I

*Disclaimer: This is a really broad topic, and I’m not a sex therapy expert, so unfortunately, I won’t be able to cover everything that’s relevant. Most of my patients are male and heterosexual, so I’m addressing the topic from that perspective. I don’t mean to leave anyone else out, I just try to stick to writing about what I know.  

So… Judging by the number of pageviews on the last post, it looks like some of you find it less awkward to discuss sexual dysfunction on the blog than in person.

Good – you need to have access to this information, even if you feel too embarrassed to ask about it face-to-face.

You know, I briefly considered writing the last post about Dave the Zebra. I thought, maybe that would be less awkward for people?

However – Dave the Zebra is actually named after Dave the Dude. I value my friendship with Dave the Dude. Somehow, he didn’t like the idea of putting his name in the same sentence as sexual dysfunction, in a blog read by thousands of people. Go figure, eh?

Well – let’s talk about it. (Dave the Dude, you can relax. I’m keeping you totally out of this…)

In the last post, we talked about how and why PTSD can mess up your sex life.

Today, we’re going to discuss how the mess in your sex life can have a ripple effect on the rest of your life.

Sexual dysfunction messes up your relationships, starting with the relationship that you have with yourself.

(Hey – can we try to focus please? I’m talking about the emotional relationship with yourself – not the five-knuckle-shuffle relationship with yourself! …Not that there’s anything wrong with that…)

Look – who you are in bed is part of your identity. You don’t need to go through life being Mr. Don Juan – even if you’re a relatively vanilla kind of dude, you have a sense of how your plumbing works and what you enjoy doing with it.

When that changes, it can have a big impact on how you feel about yourself. We live in a culture where, as a guy, you’re supposed to be obsessed with sex, or so the media would have you believe. So a lot of guys end up feeling like they’re somehow less of a man when stuff like this happens. You might feel angry and ashamed, and try not to think about it.

If you’re a single dude, this might really have an impact on your confidence about getting into a new relationship. You might question whether a woman would want to be with you, if things don’t quite work the way they used to.

(Answer: yes, the right woman would still want to be with you. The right woman would love you for your sense of humour, your smile, and whatever else it is that makes you awesome in her eyes. And you can sweep her off her feet with flowers and chocolates and kisses and dancing and backrubs and… Well, when it actually comes to sex, most women like all that stuff that most guys rush through to get to the main course. So, serve up a really good appetizer, and she won’t really miss the main course, you catch my drift?)

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

 

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by Wojtek Rajski, and I’d like to thank him for generously allowing me to use his work. Please do not copy photographs from Coming Back Home without permission.

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Spouses want to know: PTSD and Sexual Dysfunction

So – guess what we’re talking about today? (Go ahead, check the title again). That’s right.

*Disclaimer: This is a really broad topic, so I won’t be able to cover everything that’s relevant. The question was originally asked by a female spouse of a male veteran. Most of my patients are male and heterosexual, so I’m addressing the topic from that perspective. I don’t mean to leave anyone else out, I just try to stick to writing about what I know.

In person, some of the patients that I work with find this really awkward to discuss.

Well – look on the bright side: this is a blog! You don’t have to ask this stuff in person! All the answers, none of the awkwardness!

The research is pretty clear that there’s a link between PTSD and sexual dysfunction. Most studies show that in veterans with PTSD, about 8 to 9 out of every 10 have some sort of sexual dysfunction. That’s much higher than combat veterans without PTSD, and higher than veterans with other mental health diagnoses. “Sexual dysfunction” can be a whole list of different problems – including having less sexual desire; erectile dysfunction; premature ejaculation, or inability to reach orgasm.

8 to 9 out of every ten. That means that, if you have PTSD and you don’t have some sort of sexual dysfunction – you’re the exception.

If you didn’t know that before, then it’s important that you know this about your body, and what PTSD can do to it. It’s not you, it’s not your fault, it’s not because you’re doing something wrong. It’s not your partner’s fault either. Add it to the long list of things you dislike about PTSD.

But – let’s talk about how and why this happens, and then, most importantly, let’s talk about what to do about it.

First, the “why”: remember that PTSD is survival reflex on overdrive; remember how we talked about reflex making all your big muscle groups tense up? Yeah – apparently, your survival reflex doesn’t consider that part of your body as a big muscle… Go figure.

Basically, reflex thinks that anything that doesn’t help you fight or flee is a waste of energy.

PTSD also makes you feel anxious and hyper-alert pretty much all the time, and that makes it hard to get in the mood and stay in the mood for long enough. Many people who have PTSD also feel disconnected and detached from loved ones, and that can make it hard for both partners to get in the right headspace. Increased anger and irritability can also put a damper on your relationship, and that can make the physical part of your relationship suffer too.

…Sounds pretty bad, huh?

Yeah… I know…

It can get better. Not magically, overnight better, but slowly and with some work – it can get better.

(Yes, pills can help. Talk to your doctor about getting some. But don’t expect pills to be a quick, easy, magic cure-all.)

First – go to therapy, and work on learning to manage your PTSD. When you learn more about how to manage your symptoms, this will make a difference.

Next – consider couples therapy. Especially if you’ve been struggling with this stuff for a long time, chances are there’s a lot of misunderstandings and hurt feelings from both of you that are driving a wedge between you. Couples therapy may help you to reconnect and feel closer, and that might help.

Third – don’t give up. Don’t lose hope. As long as you’re willing to try, things can get better.

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I’d love to have you share your thoughts, comments, and questions. If you do post a comment, please don’t give specific details of your trauma – these may be triggering to another reader. If you’d like to offer criticism, I’ll take it – I know I’m not perfect, and I’m always willing to learn. If you do offer criticism though, I’d really appreciate it if you could do so constructively (ie., no name-calling, please). Thanks…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

 

*Fine print: Please feel free to share the link to this blog wherever you think it might be helpful! Reading this blog is a good start, but it’s no substitute for professional help. It takes a different kind of courage to admit to yourself that you’re struggling. PTSD is not a sign of failure – it’s a sign that you’ve been through a lot, and have tried to stay strong for too long. If you need help – you’re in some pretty great company. Reach out, and give yourself a chance to feel better.

**Really fine print: The content of Coming Back Home is copyrighted; please feel free to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by Wojtek Rajski, and I’d like to thank him for generously allowing me to use his work. Please do not copy photographs from Coming Back Home without permission.

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