retraining – Page 2 – Coming Back Home

Sleep Strategies for PTSD

Published on August 15, 2013July 12, 2022 by Dr. Dee Rajska, C. Psych1 Comment

Well – this is NOT going to be a “Get a great night’s sleep in five easy steps!” kind of post.

I wish there were easy solutions.

The reality is, PTSD wreaks havoc with your ability to get a good night’s rest, and there’s no quick fix.

But – I’d like you to try these strategies. They’re not a miracle fix, but they may help somewhat. These are ideas and suggestions, not marching orders; try the ones that you feel comfortable with.

– Try to set a regular bedtime routine. Do something relaxing, like having a warm shower; listening to some soothing music, or drinking a cup of chamomile tea.

– Keep the temperature in your bedroom a little on the cool side. Not cold, but a little cooler than you’d want for sitting around. (Our body temperature naturally drops a little to sleep, so being too warm will actually keep you awake).

– If sudden noises from outside make you jump awake, a fan can provide a gentle soothing noise to help you sleep; soft music can also be helpful.

– Use a relaxation exercise before going to bed.

– Keep your feet and hands warm. Cold hands and feet are a signal of stress for your body – if necessary, wear socks and/or gloves to bed.

– Try to exercise regularly, but not just before bed: exercising right before bed can make you feel revved up, so it’s harder to go to sleep. There is good evidence that regular exercise improves restful sleep, so it’s important to try to get some exercise each day. Try to finish your workout at least three hours before bed.

– Try not to do stimulating activities just before bed: This includes stuff like playing a competitive game, watching an exciting movie or TV show, or having an important discussion with a loved one. Looking at your computer screen or checking your cell phone shortly before bed may also interfere with sleep, because the kind of light given off by these devices registers in our brain as bright daylight, so it makes your brain think it’s time to wake up.

– Try not to have caffeine for at least six hours before bed. This includes coffee, many teas, chocolate, sodas, etc.

– Bed is for two things, both of which start with “s”. Don’t read, watch TV, or work in bed – that will make it harder to fall asleep.

– Try not to use alcohol to help you sleep. It might help you fall asleep, but it will make you more likely to wake up a couple of hours later and have trouble getting back to sleep.

– Try not to go to bed too hungry or too full: it’s hard to sleep well after a big meal – you’ll wake up with heartburn during the night. On the flip side, going to bed hungry makes it difficult to fall asleep. Have a light, well-balanced meal at least two hours before bed instead.

Like I was saying… None of this advice will magically fix your sleep problems. But, if you keep trying, it may help a bit.

Still having trouble sleeping? You can find some ideas on what to do here.

Waking up with nightmares? Here‘s some advice on how to cope.

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.

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.

You can find me on Twitter and on Facebook.

~ Dr. Dee Rajska, C. Psych.

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.

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.