prolonged exposure – Coming Back Home

PTSD: Dissociative Symptoms

Published on October 19, 2013July 19, 2022 by Dr. Dee Rajska, C. Psych7 Comments

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.

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.

The many flavours of PTSD: It’s not a competition!

Published on October 11, 2013July 29, 2022 by Dr. Dee Rajska, C. Psych14 Comments

Today – by request – we’re going to talk a bit about what trauma actually is.

It turns out, different people have different ideas about what’s awful enough to be “real trauma”.

You might have a buddy who went through some really messed up stuff. You might think, he or she “earned” their right to have PTSD because of what they went through.

In comparison, what you went through might not seem as bad. Maybe you have nightmares, and you avoid things that remind you of what happened. And you get angry at yourself. You start telling yourself that if you should be able to handle it, and what’s wrong with you that you can’t.

Worse still – it might be other people telling you this stuff. They might they have a different flavour of PTSD than yours, because they went through different stuff. Somehow they might think that their trauma is bigger and better than yours, and yours isn’t “real” enough.

… It’s not a competition.

To put it in perspective, imagine it was a broken leg. You could break your leg getting hit by a stampeding hippopotamus. (Hey, you never know). Or, you could trip over your kid’s toy and fall down the stairs. The difference is, with scenario #1 you get an awesome story… story #2 doesn’t sound as cool. Leg’s still messed up though.

Trauma that causes PTSD is sort of like that too – sometimes, it’s a hippopotamus – it comes with the type of “Rambo” story that movies are made of. Other times, it doesn’t make for a great story.

(HEADS UP: I’m going to describe the kinds of stuff that might cause PTSD. I’m NOT going to use examples, but it still might be tough to read. If you get unsettled, remind yourself that what happened is over. If you need more help coping, try these. )

A “traumatic event” is any situation where you’re exposed to actual or threatened death, serious injury, or sexual violence.

Actual or threatened means that even if it doesn’t end up happening, if you were scared because there was a real risk that it was going to happen, that can still mess you up.

It doesn’t have to happen to you; you can witness it happening to someone else, and be helpless to stop it.

Even if you aren’t there when it happened, learning the gory details of what happened to someone else can mess with you.

This is the way your brain works; trauma comes in many different flavours.

Maybe you didn’t get your PTSD from combat. Maybe you weren’t even deployed. So, it might seem that your trauma isn’t quite as “sexy” as someone else’s.

Really, people: It’s trauma. It ain’t lingerie. It don’t need to be sexy.

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 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.

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.

**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 the copyrighted property of Larry M. Jaipaul; please do not copy images without permission.