Dr. Dee Rajska, C. Psych

PTSD and Relaxation: When and Why

Published on August 14, 2013July 12, 2022 by Dr. Dee Rajska, C. Psych1 Comment

So – have you noticed that lately, I’m talking a lot about relaxation…?

Well – today I’d like to talk to you a bit why relaxation is important, and how to use it to manage your symptoms.

If you’re like most of the patients that I work with, you might think of relaxation as something you do when you’re feeling really wound up to bring yourself back down.

If you use relaxation this way, that’s a great start. The next step is to get into a routine of doing some sort of relaxation every day, even when you aren’t feeling really wound up and you don’t think that you need it.

Think of doing relaxation the same way as you think of brushing your teeth: you don’t wait until you have a toothache to brush your teeth. You do it regularly because it helps to prevent a toothache. Same with relaxation: try an exercise like this every day. If you prefer to relax by imagining a hike in the woods, you can do this instead.

Here’s why: when you have PTSD, even at your most calm, you are probably still pretty wound up and vulnerable to stress as compared to a person without PTSD. That increased vulnerability can be pretty stressful in itself – you might spend much of your time worrying about how you cope with unexpected stress, or feeling embarrassed about how you react to stressful events.

Put simply, doing relaxation exercises regularly can help to rebuild your resilience. It can help you feel calmer and more centered, so that you can handle stressful events with more confidence. It’s not a miracle; it’s a skill, and just like any other skill, it takes time and practice to get better at it. But it’s worth it – over time and with practice, relaxation can make a difference.

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.

Guided imagery exercise #2: By the water

Published on August 9, 2013July 12, 2022 by Dr. Dee Rajska, C. Psych5 Comments

Everyone – this blog is meant to be your space. Expressing your needs and preferences is valued here.

Thank you for providing me with the feedback that not everyone here finds the view of the woods to be relaxing.

So, I’d like to walk you through the guided imagery exercise again, but with a different view, for those who prefer to look at water to relax.

If there’s one thing you’ve learned from your own experience with PTSD, it’s that your brain is pretty good at imagining (that you’re in danger). Well – guided imagery is basically taking the brain’s ability to imagine, and using it to help you relax rather than to rev you up.

First, a word about skills: they do not develop overnight. Tying your shoelaces is a skill; you can do it today because – as a little kid with clumsy fingers – you practiced.

This is no different – getting good at it will take practice. So, if your mind wanders the first time you try it, keep trying. You will get better at it with practice.

You can imagine any kind of restful place. Today we’re going to use a walk along the water.

If these images are not relaxing for you, you can imagine a different place that you find restful.

First, find a quiet place where you can sit for at least 20 minutes without being interrupted.

Imagine that you’re standing on a dock, overlooking the water:

Guided imagery is about imagining the space as vividly as you can — everything you can see, hear, smell, and feel.

Feel the wooden dock under your feet.

Feel the breeze on your skin.

Hear the waves gently lapping at the shore.

Listen to the seagulls.

Look out on the water.

Smell the fresh, clean air.

Take in a slow, big, deep breath… and let it out slowly…

Slowly walk down toward the beach.

Feel the sand under your feet.

Walk along the beach. Take time to explore some driftwood that you come across:

Feel the sand and let the water lap gently at your feet.

Feel the warm sunshine on your face.

Take your time to slowly explore these pictures, to imagine, as vividly as you can, being in that place. Include sights, sounds, smells, and your sense of touch.

Don’t worry if you sometimes zone out or lose track of where you are – that happens, and it’s all good.

You may also find that your arms or legs feel stiff or heavy; you might have small, involuntary muscle movements. You might cough or yawn. Don’t sweat it – that happens too.

When you’re ready, slowly bring yourself back into the present.

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

**Really fine print: The content of Coming Back Home is copyrighted; please feel welcome to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photos gracing today’s post were 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.

Finding Solid Ground When You’re Triggered

Published on August 7, 2013July 11, 2022 by Dr. Dee Rajska, C. Psych11 Comments

Hi!

Today, I want to tell you about grounding skills – the kind that you use when you’re being triggered, and you’re starting to feel sucked into an ugly old memory. Those of you who are getting help probably have a few of these already; for everyone else, these are your life jacket when you feel that you’re drowning. Learning to use these is an important investment in your well-being.

The key in this type of a situation is to use whatever tricks or strategies you can, in order to remind yourself that you are here in the present and the danger is over.

Some ideas for doing that include:

– look around the room; notice and name some of the things that you see. Becoming more aware of where you are now helps you fight off being sucked back into the past.

– rub the palms of your hands together. Pay attention to the sensation of warmth that this creates in your hands. Usually, our hands get cold and clammy when we’re nervous – so this little trick makes you feel calmer by changing how your hands feel.

– listen to music. You can pick either soothing, calming music to relax you, or you can pick something loud that you can sing along to, something that reminds you of a pleasant memory. (Singing out loud also makes you breathe deeper – and since we often hyperventilate when we’re triggered, this helps too).

– do any kind of physical activity that your pain and/or physical ability allows. Focus on how it makes your body feel. Your muscle tension will go down as you do this, and that will make you feel calmer.

– if you have a pet – touch your pet’s fur, talk to your pet, and/or hug your pet.

– carry something meaningful in your pocket, something that reminds you that you are here now, and that the danger is over. Touch it to re-orient yourself. If you didn’t have your current car or home when the trauma happened, your car or house keys will do: touch them to remind yourself that you are here now, and that event was in the past.

– remind yourself of today’s date. If you carry a cell phone, looking at your phone can be a good trick for this – look at today’s date, remind yourself of the date when the bad memory happened, and then firmly tell yourself, This is now, that was then; I am here now. Feeling scared is not the same as being in danger; I may be reminded of back then, but I am here now and the danger is over.

(Of course, if the anniversary of the trauma is what’s triggering you – looking at the date is NOT the way to calm yourself. Here‘s some tips on how to get through it).

These are skills – so the more you practice, the better you get at using them…

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

**Really fine print: The content of Coming Back Home is copyrighted; please feel welcome 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.

Let’s go for a walk in the woods! (Guided imagery relaxation exercise)

Published on August 5, 2013July 11, 2022 by Dr. Dee Rajska, C. Psych2 Comments

Hi!

If there’s one thing you’ve probably learned from your own experience with PTSD, it’s that your brain is pretty good at imagining (that you’re in danger).

Well – today we’re going to take your brain’s ability to imagine, and use it to help you relax rather than to rev you up.

This exercise is a type of guided imagery.

First, a word about skills: they do not develop overnight. Tying your shoelaces is a skill; you can do it today because, as a little kid with clumsy fingers, you practiced.

This is no different – getting good at it will take practice. So, if your mind wanders the first time you try it, keep trying. You will get better at it with practice.

You can imagine any kind of restful place. We’re going to use a walk in the woods, because juicy delicious pictures of the woods are what the photographer is serving today.

If the woods are not a relaxing image for you, you can imagine a different place that you find restful.

First, find a quiet place where you can sit for at least 20 minutes without being interrupted.

Imagine that you’re standing at the foot of a trail, going for a walk in the woods:

Guided imagery is about imagining the space as vividly as you can — everything you can see, hear, smell, and feel.

If the first thing that jumps out at you is the trail marker – you’re not failing! You’re on the green trail; what else do you see? What can you imagine feeling, hearing, smelling if you put yourself in that place?

Feel how rocky that trail feels under your feet.

Look at how peaceful those trees look. Smell those pine trees…

Are wild blueberries in season? Can you find some on these bushes?

Listen to the sounds of that stream. Touch it – think of how cold it would feel on your fingers.

Can you hear birds chirping in the background?

Take, a big, deep breath of that clean air. Fill your lungs with it.

Feel the warm sunshine on your face.

Take your time to slowly explore these pictures, to imagine, as vividly as you can, being in that place. Include sights, sounds, smells, and your sense of touch.

Don’t worry if you sometimes zone out or lose track of where you are – that happens, and it’s all good.

You may also find that your arms or legs feel stiff or heavy; you might have small, involuntary muscle movements. You might cough or yawn. Don’t sweat it – that happens too.

When you’re ready, slowly bring yourself back into the present.

~ Dr. Dee Rajska, C. Psych.

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

Where PTSD comes from, Part 3: How Reflex Messes with Your Thinking

Published on August 3, 2013March 12, 2017 by Dr. Dee Rajska, C. PsychLeave a comment

Hi there!

Today we’re going to round out our discussion of what survival reflex does, by going over how it impacts our thinking.

Keep in mind that survival reflex is designed to save our life under circumstances of immediate threat. In those conditions, every moment counts, and every ounce of your energy could make the difference.

We discussed here how your reflex works differently (and much faster) than your usual, everyday thinking; and more recently, here, we talked about how reflex is run by a different part of your brain than conscious thinking. We’ve also covered how, to save energy, the body will interrupt day-to-day functions like the digestive system and the immune system, so it can redirect all available energy toward immediate survival.

When survival mode kicks in, your reflex takes energy away from the part of your brain that’s responsible for complex thinking. It redirects this energy toward your big muscle groups, to make it easier for you to fight or run. So – in the case of Dave the Zebra beating the daylights out of that lion, his survival reflex interferes with his ability to do stuff like: analyze things, think things through, look at a situation from a number of different perspectives, prioritize, look at the big picture, and so on. And reflex does this on purpose – because complex thinking takes up time and energy, neither of which can be spared in a life-threatening emergency situation.

What your survival reflex does instead is put you on high alert, on the lookout for danger. What that means is, Dave’s attention is constantly darting around looking at everything – paying attention to every sight, every sound, evaluating everything in front of him to see whether it’s a possible threat.

If you’re in danger, taking too much time to look/listen to one thing in specific could lead you to miss a potential threat somewhere else in your environment; so, in an effort to identify a threat and save your life, your survival reflex interferes with your ability to concentrate and sustain attention on any one thing for very long. Once a threat is identified, reflex makes you go into a sort of “tunnel vision”, where all of your energy goes toward just dealing with that lion, and nothing else. Often, in highly dangerous circumstances, you tend to flip back and forth between the tunnel vision and the darting around looking for other sources of danger.

This reflex is designed to work in brief bursts, and to maximize your chances of survival in life-threatening circumstances. Your military training strengthens the “fight” part of the fight/flight/freeze response, and builds on it to help you get through some nasty situations.

In PTSD, this reflex gets stuck in a constant loop, so it’s hard to shut it off.

In learning to control it, step #1 is getting a really good understanding of it. Once you know how it works, it gets easier to work against it.

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

Finding Solid Ground (Part 2) : Photography

Published on August 3, 2013March 12, 2017 by Dr. Dee Rajska, C. PsychLeave a comment

It’s been a bit since I last posted specifically about grounding skills, so, if you can’t even remember the previous post, here’s a handy link.

In a nutshell, grounding skills are things that we do to help ourselves stay in the present when an unpleasant memory tries to suck us back into the past. They are your first, most basic tool for managing your symptoms. Usually, grounding skills are activities that keep your mind focused on something in the here and now- so, when a bad memory pops up, your grounding skills keep you… grounded.

Let’s divvy up grounding skills into two basic categories: there’s what you do to cope in an emergency (like when you’re being triggered by things like fireworks or thunderstorms ) – those situations require a specific, immediate response to help you to re-orient that that was then, and you are here now, and you are not in danger.

But – aside from these “emergency grounding skills”, there’s what we’ll call the “everyday grounding skills”: when you feel wound up, your mind is racing, and you need something to do keep yourself from getting sucked in. Hobbies that keep your hands busy and your mind focused are a good way of “everyday grounding” yourself. Photography is a great example.

You don’t need to have a super fancy camera (although if you really get into photography, you may end up buying some fancy stuff).

It keeps your mind busy because you need to think: what do you want to photograph? Where are you going to go, to take the pictures that you want to take?

Once you find some sights that you want to photograph, you need to figure out how you want to capture those sights…

Do you want to focus on the tree in the foreground?

…Or, would you rather use the tree to frame the scene, and focus on the bridge in the background?

Which image do you like better?

It’s not a trick question, and there’s no right or wrong answer. But – if you can look at both pictures and have an opinion – then photography might be a hobby for you to consider. So grab a camera (or even your phone to start with), and go out for a hike. Find some stuff you want to take pictures of.

Have fun 🙂

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

Where PTSD comes from, Part 2: Fight/Flight/Freeze Response, Emotional Symptoms

Published on July 24, 2013July 12, 2022 by Dr. Dee Rajska, C. Psych4 Comments

(Disclaimer: This topic can be a little heavy for some people, so to compensate, I’m going to step up the goofiness today. )

Hi!

So – you know what? It occurred to me that I’m trying to explain the fight/flight/freeze response using zebras and lions, and…

Zebras don’t usually fight lions.

So before we go any further, you need to know more about Dave the Zebra. He’s not your ordinary zebra.

Dave’s had it with the lion bullying his friends. (You all remember what happened to George?)

Dave’s been learning karate. He’s gotten pretty good. The next time that lion messes with any of his friends, Dave’s going to unleash some zebra fury.

When the lion comes along, Dave’s reflex takes over. He feels the adrenaline rush; he hears the theme music from Rocky playing in his head…

He feels fear. Fear is not a choice – it’s part of reflex. Fear is a signal of possible danger.

And then he feels… anger. Rage. Maybe even vicious, blind rage, like he’s never felt before.

(How are you doing? Remember – if this is uncomfortable, take a moment to breathe and remind yourself that we’re talking about a zebra, a little horse in striped pajamas…)

Like fear, feeling rage in a potentially life-threatening situation is also reflex. Rage helps Dave summon every ounce of bad-ass that he’s got, and to focus on neutralizing the threat.

(Hey – if you’re a zebra pulling karate moves on a lion, every bit of help counts, right?)

And aside from that – he feels a whole lot of… nothing. Feeling numb is also part of reflex; you see, when an animal is in danger, it may be cold, tired, weak, hungry, or injured (or arguing with its wife). All of that stuff just gets in the way when you have to focus on survival. So, numbing everything out is important to survival – it helps you focus on the danger and nothing else.

The last emotion involved in the survival reflex results from adrenaline. Adrenaline is basically a drug that the body produces itself. It’s a painkiller, so it allows Dave to keep beating up on the lion, even if Dave is exhausted or injured himself. To help do that, adrenaline makes you feel a little loopy/drunk/happy. This is part of how the body protects itself from stuff like pain or fatigue getting in the way of survival.

Later, Dave might feel ashamed and even horrified that he felt pleasure at beating the crap out of the lion. That’s why it’s really important for him to know that these feelings are a hard-wired part of reflex; they are not a choice, and he is not to blame for how he felt at the time. Shame and guilt don’t help him heal – they just feed depression and keep him stuck.

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

Where PTSD comes from, Part 1: Fight/Flight/Freeze Response, Physical Symptoms

Published on July 24, 2013July 12, 2022 by Dr. Dee Rajska, C. Psych6 Comments

We’ve spent a couple of months talking about how your survival reflex works. Well, today we’re going to talk about what it actually does.

The fight/flight/freeze response is a basic survival reflex that is built into every animal. The part of your brain that powers is is called the amygdala (uh-MIG-duh-luh. ) It’s a very primitive brain part, and we’re not consciously aware of what it does (ie., reflex is not a choice). Look at your thumbnail – that’s roughly the size of your amygdala.

When the amygdala spots what it thinks is a sign of danger, it goes into survival mode, and activates your fight/flight/freeze response.

Think of our friend that we talked about earlier – Dave the Zebra.

Although I’m sure this might seem goofy to some of you, I want you to use him as a grounding skill: anytime the discussion starts to hit too close to home, just remind yourself – we’re talking about zebras.

ZEBRAS.

Cute little horsies dressed in black-and-white striped pajamas…

So – Dave the zebra and his buddies are out enjoying some pasture. Suddenly, Dave spots that lion hiding behind the big rock.

Dave’s amygdala goes into gear. His adrenal glands kick in, so he feels an adrenaline rush. His breathing gets faster and his heart rate speeds up. His large muscle groups tense up: the idea here is to get as much muscle strength as possible, to give Dave the best chances of survival.

When blood flow is focused on feeding your big muscle groups so you can run or fight, your extremities are not a priority. That’s why your hands and feet might get cold and clammy: they’re not getting a lot of blood flow.

You sweat because sweating is the body’s way of cooling off. Survival reflex expects you to have to run or fight, which heats the body up. So, reflex thinks that breaking out in a cold sweat is a nice, helpful little detail.

Since the survival reflex directs all available energy towards survival, it shuts down functions that are not essential to dealing with the immediate threat. So, your survival reflex will suppress your digestive system and your immune system, because these seem like a waste of energy when your survival is being threatened.

That, in a nutshell, are the main physical symptoms of the survival reflex. When you have PTSD, these symptoms can become chronic: that’s how you end up with chronic muscle pain, (and jaw pain from clenching your teeth); as well as chronic indigestion in some cases.

Next up – the emotional impact of the fight/flight/freeze response.

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

PTSD: The Role of Reflex, Part 3: Reflex has values

Published on July 7, 2013July 11, 2022 by Dr. Dee Rajska, C. Psych6 Comments

Hi again!

In a nutshell, here’s what we’ve discussed so far: reflex learns as a result of your experiences; but reflex isn’t very smart, so what it learns as “predictors of danger” is a mixed bag of good predictors and random stuff that was going on at the time that the danger happened.

Today we’ll discuss why reflex doesn’t bother filtering good from bad predictors of danger before learning them: because reflex values speed over accuracy.

To illustrate, let’s revisit our old friend, Dave the zebra.

Dave and his zebra friends are out enjoying some delicious pasture.

(I know – last we saw Dave, he was avoiding pasture, because of what happened to George. But he got help for that, and now he’s doing much better. He says thanks for asking.)

Dave catches sight of something out of the corner of his eye that might be a furry tail, like the lion’s. But he only got a glimpse, and he’s not sure.

What should he do – raise the alarm, or try to get a better look?

On the one hand, he didn’t get a good look, it could be nothing, and those other zebras can be pretty snooty if he gets it wrong.

On the other hand, taking a closer look wastes precious seconds that could be better spent getting everyone to safety.

Folks – from the viewpoint of your survival reflex, the only thing that matters is survival. Your survival reflex assumes that it’s better to make a fool of yourself by overreacting, than to hesitate and waste a second.

So – reflex learns by the principle of “better safe than sorry”, and reacts by that same principle.

This will lead to a lot of situations where your survival reflex will be convinced that you’re in life-threatening danger, even though you’re not. It’s reacting to a reminder, even if that reminder doesn’t make any sense to your “thinking” brain.

We’ve discussed how you can have a reaction to a trigger even when you understand that there’s no real danger; we’ve covered how important it is to NOT beat yourself up over this, because it’s an injury and not a personal failing or character flaw.

What you can do instead is use this knowledge to help yourself regain a sense of calm: when you’re triggered, the reaction can make it feel like the danger is very real. So it becomes really important to understand that being triggered does not mean being in danger: you can be triggered when there’s no danger.

It helps to understand that your survival reflex sometimes acts like a kid pulling the fire alarm at school when there’s no fire, but because he doesn’t want to write the math test.

Use this knowledge: when you’re triggered, remind yourself of where you are, and what you’re doing. Remind yourself that you’re safe, and it’s just your survival reflex going off, pulling the fire alarm at a faint reminder of danger. Reminding yourself of where you are and that you’re safe is a way of grounding yourself – and knowing how to ground yourself is an important coping skill.

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

PTSD Triggers: Coping with Thunderstorms

Published on July 6, 2013July 11, 2022 by Dr. Dee Rajska, C. Psych5 Comments

Hi there!

How’s everyone doing? Didya make it through the fireworks okay?

Now that the fireworks are over, a lot of people’s first instinct is to forget about it until next year. If you have a really tough time with fireworks, I can certainly respect that…

But – before you do that, please take a few minutes, and make a mental summary of what strategies worked for you this year and what didn’t. Then, use that information to plan what you’ll do the same way next time, and what you might try differently. Learning to live with this beast called PTSD is sometimes a process of trial and error, and you can get better at managing it by adapting your strategy to do more of what works, and less of what doesn’t.

And while we’re on the topic of coping with sudden loud noises that make you jump, let’s discuss thunderstorms. Chances are, thunderstorms are no longer your favourite thing. Particularly the kinds where a giant clap of thunder right outside your window makes you end up under the bed at 3 am.

Not fun.

Okay – here’s what we’re going to do about it:

– Make a habit of reading the weather forecast. If you know a thunderstorm is coming, then it can’t catch you by surprise. If the weather forecast calls for overnight thunderstorms, your plan is to go to bed reminding yourself, “I’m home. I’m safe. They’re calling for thunderstorms – so I may wake up to the sound of thunder, but I’m not in danger”. Having this little conversation with yourself won’t stop you from reacting, but it will make it easier to re-orient yourself more quickly.

– Invest in a nightlight. Get a couple of pictures of a favourite place, somewhere you go to relax. Put the pictures somewhere you’re likely to see them when you first wake up, like your nightstand. If they’re calling for thunderstorms, turn on the nightlight before you go to bed. Being able to see around the room quickly when you wake up, and seeing an image of a familiar and relaxing place, will help you to orient yourself quickly to the fact that you are home and you are safe.

– Shut the window. I know – it’s nice to sleep with some fresh air. But shutting the window will help you block out some of the noise. If you miss having a breeze in your room, get a fan – as an added bonus, the sound of the fan can help to muffle the noise of the thunderstorm.

These ideas will help you re-orient and calm yourself if you react to the sound of thunder. However – these tips are not enough to help you stop reacting to the sound of thunder. The best way to do that is a strategy called prolonged exposure.

Disclaimer: If you’re getting treatment, I’d like you to talk to your therapist and get them to help you with this. If you’re not in treatment, and you’re really struggling, I’d like you to get some help from an actual therapist, aside from just reading this blog.

If you’re mostly doing okay, but thunderstorms get to you, then this might be an exercise you can try on your own.

– sit comfortably; stretch; relax.

– set the volume on your computer to where you can barely, barely hear it.

– cue up a clip of thunderstorms on YouTube. Here’s one that I use.

– remind yourself that you are home and you are safe, and this is a sound clip on the computer. Keep doing this through the next step.

– hit play. Keep reminding yourself that you’re safe and this is a clip playing from your computer.

(If it terrifies you, and a minute into listening to the clip at the lowest volume you are still not feeling any calmer, STOP. Get a professional to help you with this.)

– if it’s only mildly unpleasant, keep doing this until it feels boring and pointless, and you’re not reacting to it. The next day, turn up the volume slightly, and repeat again until you are no longer reacting. If you keep doing this, slowly and gently, you will retrain your fear reflex that the sound of a thunderstorm is not dangerous.

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.