Back in my head…

I’ve posted about my journey of recovery and PTSD in the past. In fact, this blog was started for that and to help me my thought out of my head. Honestly, it’s getting pretty crowded in there lately.

I’ve known for a long time that my emotions were mostly shut down, except for the safe ones. “What are safe emotions?”, you probably didn’t ask. Well, anger is safe. Except for the violence it can let out. Maybe on special occasions a flash of amusement, but not much, that can lead to happiness and that’s always risky. If I’m happy something will come along and crush it. Satisfaction is usually okay, if it’s from something that I’ve accomplished. I like the feeling of completion. It just doesn’t last either. I mean what have I done lately?

The only other emotions that I feel regularly and recognize are sadness and love. Nostalgia is in there somewhere, for the lost innocence of childhood and feeling like I was safe. I don’t get envy or hatred; they take too much energy. Appreciation and gratefulness show up and punch me in the gut sometimes, when someone just does something nice. It really is stunning. Loyalty is strong. I may not keep in touch with people as well as I should, but I will drop everything to help a friend.

I feel like the slow kid in class who is trying to color, but all I have are the fat five color crayons that kindergarten kids use and everyone else is using the big 64 color set. You remember the ones, with the cool sharpener in the back. I just don’t understand. I can’t feel the rest. Are there anymore emotions out there? Compassion, empathy, fear? What is contentment like? I don’t trust it. To squishy.

Fear came up recently. It is likely why I’m awake at 3 A.M. writing instead of sleeping. I was talking to a counselor today, trying to describe why my lack of fear was an issue and admitting that I put people in danger because I lack the common sense of pond scum. I got people hurt and killed, put people in bad situations because I was too stupid to be afraid or think about them. I keep reliving incidents, walking into a riot with my partner, just the two of us. No fear, nothing can hurt me. But Stephanie, about half my size, with a daughter at home. Ed following me into an apartment with a shooter inside. Omar trusting me to get him out and holding his hand while he died. What about the kids I trained? Did they try to imitate me and my stupid, reckless behavior?

It feels like I was screaming; “Look at me! I’m too stupid to be afraid! You should be just like me!”

Shit it’s crowded in here.

I did a brave thing today.

I was sad today. It seems like a simple statement to write but is profound in the description of what I experienced.

You see, I have had PTSD for close to fifty years. You learn to cope. One of the tricks is to shut down your emotions, more like ignore them. Since I retired a couple years ago, I’ve started healing. Last summer, I was stunned when I realized that I was happy. For no reason I was smiling and just happy. The really stunning part was it took a while for me to realize what I was feeling. Is it true that people feel like this all the time? Are there other visceral emotions? How will I know?

I found out today. I realized that I was sad. I started crying and it washed over me in shaking waves and I started to push it back where it belongs, deep down. Instead, I stopped and let it come. I let myself feel sad. It wasn’t a cathartic purge of all bad feelings or jagged out of control, snot bubble weeping. It was pure and soft, the things I couldn’t afford to be in the Army or Police Department. It’s too vulnerable.

I guess this is following a pattern I set up, like a 12 step program for PTSD. When it happens, tell others. It’s okay to feel, good and bad feelings. Stop being afraid of being hurt by what is inside. We were so brave for so long, carrying burdens, risks, loss and fear. Always fear. For me it was losing my people, not being able to protect someone. More terrifying were the emotions I kept as far down as possible. I never thought I was brave or a hero.

Today, I was brave.

Not Quite 12 Steps (Addicted part II)

This is a big piece about a tough subject. I’m putting it out hoping for feedback on the process I am suggesting. Every little bit helps.

PTSD2At my worst, I was a basket case.  A rolling chassis with bits and pieces still hanging off and a bunch of pieces in a plastic bucket.  Probably an old five-gallon pickle bucket with grease on the side.  I remember the absolute fear that would hit me when anyone asked me what was wrong.  “No!  I’m not ready!  I can’t even think about that.” How can you explain to someone what it’s like to hold the hand of another man while they died, from a wound they took following your orders?  Looking down the sights at a living person who is nothing more than a target.  It’s not even math anymore, at that point it’s just survival.

In the early stages of my counseling, I found a book by Dr. Abraham Twerski, “Addictive Thinking” (Hazelton Press, 1990).  It was on a discount rack in the mall, and I just wanted something to read.  It turned into a personal guide to recovery.  As I read, there were constant points where I saw my own life in the pages.  Making excuses for my actions, trying to hide what I was doing from others, binging on rage and violence, shame and remorse in the aftermath.  There were even co-dependents and facilitators, family and friends who helped me make excuses.

The excuse, “no one else understands”, let me continue to associate with other PTSD Addicts.  There was comfort in their presence.  There is a real feeling of belonging and safety with others who had “been there”.  The same as with high-risk behavior, it fed the disease.  We were self-medicating out of a bottle or popping pain pills that some got hooked on after an injury.  Anything to numb the pain and let us pretend to be normal.  Denial is still denial, no matter how you dress it up.

Internal conversations reinforced our denial patterns.  How can there be a problem if I’m still able to function in society?  Sure, there are some rough spots.  Relationships are destroyed, but that happens to everyone.  New job?  Just a change of scenery, they didn’t like me being gone for a year, either.  Uncontrolled emotions.  Not a problem.  I can deal.

Here are the modified 12 steps I came up with to work my way towards recovery.  It has been fifteen years in the making and there is still work to do.  

Step 1.  Admit that there is a problem.

That was the hardest part.  Like most addicts, it took a situation and moment of clarity, waking up with your belly on fire, head pounding, feeling your body dying from the abuse you’ve poured into it.  Admitting weakness, injury or not being strong enough is anathema to most soldiers.  Mine was road rage where I was going to shoot someone for changing lanes to quickly.  

This needs to be public to a group, in a way that can’t be contested later.  There is a point of saying, “Hi, my name is Butthead.  I have PTSD and I’m hurting myself and others.  I need help.”  If we make it public, it is harder to deny that you have a problem.  Just the effort of saying it out loud, hearing your own voice and confront reality is significant.  

If it helps, the people who know you already know that you are having problems, you’re not fooling them.  There will be some that can’t or won’t understand why you don’t just get over it.  You can’t explain it but try anyway.  

Step 2.  Commit to the change every day.

You are going to have tough days and episodes no matter what you do.  Be prepared for them and dedicate yourself to getting better every day, sometimes every hour.  It may help to make a list of how you are harming yourself and others.  I write, so I kept a journal, documenting my episodes and how I responded.  What I could do better.

Have a friend, or professional you can call when you’re feeling overwhelmed, or join a support group.  

Meditation, without all the mystic mumbo-jumbo, just means a quiet time to think about your day and goals.  In the morning it is a way to review your tools and prepare yourself.  At night, a way to look back on your day and see where you have made progress and where you need to work harder.  

Step 3.   Be honest about what PTSD means and what it has done to you, your life and those who share your life.

Most of the people who love you haven’t been to war or shared the trauma, they can’t understand.  It is also true that they won’t have a chance to understand unless you try to explain.  Apologies are probably in order as well.  You’ve been through hell and put them through the hell of watching you suffer. Acknowledge that you have hurt others.

Step 4.  Make amends.

In a lot of situations, you can’t.  The hurt and injury you have caused are to those who are closest to you.  Just saying “I’m sorry”, won’t cover it.  Be prepared for some of them to reject your efforts, don’t rage against them.  You need to accept that they may never forgive you and that’s their choice.  Respect it.  Accept it.  Move on.  For the ones who let you, try to be better.

I made a lot of phone calls and had some very hard conversations.  Since I lied for so long about what I did and what happened, I had to correct the record.  It was harder to say, “I lied.  What I really did was … It changed me.  It hurt me and I hurt you.”  There will probably be some pissed off people, wanting to know why you lied in the first place.  They have a right to be angry and hurt.  Ask if they can hold off on lashing out at you, so you have a chance to get past the moment.  But give them the chance to say their piece.  

It has been pointed out that you are going to have a hard time with this and will probably slip up a lot.  Make it a point to recognize when you have hurt those around you and apologize, every time.  Even when they don’t want to hear it, say it.  It is part of recognizing and admitting that you have a problem. 

Step 5. Live the changed life.

You are trying to reprogram your brain.  It won’t happen overnight or in the first few years.  You will have PTSD for the rest of your life.  The only way to avoid relapse is to change those things that are your personal triggers.  I know, to easy.  

Life models – you have to pick a person who has gone through the process, or you respect for who they are and copy what you admire about them.  It doesn’t have to be everything about them, their ability to laugh or how courteous they are, copy it.  Find someone and something else and add that to your list.   

This also means avoiding the risky lifestyle behaviors.

Drinking – numbs the pain until you try to sleep and have to wake up hungover.  I am not saying don’t drink.  I am saying don’t drink to excess.  We tend to socialize in clubs and bars, part of our lives and all that, don’t walk in with a bunch of money in your pocket, leave the credit cards at home.  Set limits and stick to them.

Thrill Seeking –   The behavior that gets more people killed than any other.  Riding a motorcycle fast, driving through slower traffic, pushing the edge of your talent or the machines tolerance, the rush!  For just a minute, you feel alive.  It’s not just your life you are risking, there are others around.  You are risking them for your own entertainment.  You shake off the honking horns and shouts with a dismissive response of, “Screw ’em.  They need to get out of my way, or I’ll move ’em.”  Is disregard for human life manly or selfish and stupid?  Just asking for a friend.

Fighting – This one is hard for me.  I like it, always have.  Keep it where it is legal.  Join a gym that has a fight night.  Join the UFC and get paid to have someone punch you in the face.  If you do it in public, just walk around and look for trouble, you will find it.  You will also find someone better or carrying a gun, or a jail cell.  

Here is one more point.  Don’t try to be someone or something you are not.  In this case, “Fake until you make it”, is just setting yourself up for failure.  Work at being different, don’t pretend to be different to appease others.  

Step 6.  Get help.

I know, I’m repeating myself.  Find a friend.  Go to a meeting.  Get counseling.  It takes a while for some things to sink in.

You can’t do this by yourself.  Find someone who you can trust and talk to.  It doesn’t have to be a professional, but it does have to be someone who is committed to the process.  Another plus to professionals is detachment.  Your significant other can be easily hurt by what you say and do.  It is important that you be able to vent sometimes, more often in the early stages than the later ones.  Group therapy is another tool that can help a lot.  Hearing others who hurt and are fighting the same demons reminds you that you are not alone.  There is a chance that you might even pick up a partner in healing or a trick that someone else is having success with.

Step 7.  Use the tools.

It’s stupid to try to tough it out unless you have to.  I don’t recommend meds because your body tends to adapt.  I AM NOT A DOCTOR, so don’t take that as a prescription.  On top of that, you can’t reset your brain chemistry if you keep artificially adjusting it.  As a short-term assist, they work to give you a break, room to catch your breath.  Not every therapy will work for you.  If you honestly try something and it doesn’t work, go to the next one.

Counseling and Groups are the most common tools, whether it is one on one with a trained clinical psychologist or going to the local VFW for a weekly meeting.  Have someone to hold you accountable and force you to confront what is going on.  

Cognitive Behavioral Therapy (CBT) is a method of processing what is going on inside your head.  Some of it may seem strange or be beyond your ability.  I can’t draw for crap, but I believe that I write well.  It gets the garbage out of my head and on paper, the same as painting.  

8.  Faith or a higher power.

This is another tough one.  Not everyone has a religion to lean on.  The idea is solid, a way to give up the struggle and take the strength of God for forgiveness, for healing, to be strong when you can’t.  Belief doesn’t mean that you aren’t still responsible for your actions, or you don’t have to put in the work.  A church family can also provide another source of support, people who have put in the work already.  There are a lot of veterans out there.  Different wars, same wounds.

9.  Forgive yourself.

Again, this isn’t carte blanche to go on hurting others or continue with self-destructive behavior.  It is simply a way for you to let go of the burdens that are keeping you in a dark place.  If you are a veteran, you have probably seen or done things that most haven’t.  You were in an extraordinary situation, forced to do terrible things, seeing the aftermath of IEDs or counter battery fire, fire fights that left you feeling dirty.  

Another group that is in the same position, the guys inside the wire.  They had to live through mortar attacks and random harassment and not respond.  Just take it every day.  Yep, we called them Fobbits or POGS, but they ate it every day.  Then when the guys outside the wire came in stinking and filthy, demanding more ammo, new uniforms, hot chow, and Motrin.  They took care of us, fed us, patched us up and put up with our crap.  They tried to talk to us, and we looked down on them and made stupid jokes.    

10.  Practice love and trust.

For a long time, I felt that I didn’t deserve love. I rejected it and everyone who tried to love me.  The funny thing was that I acted like it was everyone else rejecting me.  The ability to trust was lost.  For a long time, the only one I trusted was the man who rode with me every day.  He had my back and pulled me back before I went too far.  

Practice means you have to make a conscious effort to be open to being vulnerable.  Trust that the ones you are opening up to won’t try to hurt you.  Even if you try and fail, you need to keep trying. That is the practice part, doing the same thing over and over until you get it right.  Don’t stop after you get it right one time.  Practice until you can’t get it wrong.

11.  Find Someone until you are Someone.

In most support and recovery groups, you have a sponsor who has already gone through the steps and work of healing.  Since what we are talking about is a little less structured, a sponsor isn’t an automatic thing.

Find someone willing to be there for you any time of day or night.  It should not be a family member.  No spouse, brothers or sisters, close personal friends.  If they already care for you so that much, they aren’t going to be tough enough on you or your behavior.  The Someone in question is going to piss you off if they are doing the job.  Telling you no or calling you out for your bullshit isn’t something you need to hear from someone close to you.  This avoids the chance of picking up a co-dependent or facilitator who will accept your slips as “something you need” or “just this once”.

One day, you will wake up and discover that you are the Someone.  The someone your future self will be is strong enough to be strong for someone else.  I really hope you get there.  I’ve been there for others, on call.  It is huge honor. Just don’t try to step up until you’ve done the work yourself or you can hurt the one you’re trying to help.

There are alumni groups VFW, Foreign legion, Unit Organizations, the VA out there who are willing to help or point you in the right direction. You just need to reach out.

For those who don’t fight this daily, pass it on.  There are 22 Veterans who lose the fight every day and choose suicide.  That’s a little less than one an hour, almost a quarter of the daily suicide rate in the U.S. alone.

Help them keep fighting.

12.  Start over

You will fail.  You will give in to your rage and pain and lash out.  You will crawl back in a bottle and hide, breaking a promise or violating parole.  You will say and do hurtful things because you can’t express what is truly hurting you. You will feel ashamed of who you are or what you have done.  There is a lot of “you” in those statements for a reason.  No matter how much help you get from others, this is about you, about your healing and growth.  You are responsible for you.

If you fall, start over.  Go back to the top of the list and begin again.  

Addicted to PTSD (Addicted)

Have you ever been terrified?  I mean so scared, that for a while you couldn’t even think, not really think.  Your brain saw something, tried to classify it and all you recognized was danger?  You may have reacted or froze, trying to determine what to do, but there was no time to think your way through the situation.  Your breathing and heart rate jump, adrenaline pours into your blood, eyes dilate.   Your hearing may filter everything but one sound or a voice.  Even thinking about it today can make you feel anxious.  Welcome to your basic instincts of Fight or Flight and the potential for PTSD.

PTSD

Like so many veterans returned from overseas, I came back with a problem, Post Traumatic Stress Disorder (PTSD).  It’s not unique to the military, so I’m not trying to claim any special status.  What is unique is the way most Veterans who succumb to its effects react or the way society in general sees them.  Most people expect veterans with PTSD to look like Rambo, unemployed vagrants, wandering from town to town,  drunk or strung out on drugs because they can’t face their past.  For the majority, we return to our lives and struggle with readjustment and trying to put ourselves back together.

Here is the short explanation.  There are two types of PTSD.  Type I, is single event or short term trauma, that causes changes in behavior after the fact.  Type II, is long term events where the person adapts survival or coping methods during the event.  Think Stockholm Syndrome.  In addition to what I like to call, Inappropriate Social Responses, like violent reactions to misinterpreted stimuli, there are several other changes.  PTSD is not a single aspect disorder.  However one of the most persistent characteristics is depression and the chemical changes it causes in the brain.

The chemical change is important to understanding why it is so difficult for someone suffering from PTSD to recover.  Reprogramming survival instincts, that have been proven to work, is hard enough to start with.  Extended exposure and reinforcement over time hard-wires them into the brain.  There has been enough research to prove that depression involves chemical changes in the brain, which is why some drugs can mask the worst of the effects.  This is also where your body betrays you, it adapts.  Your body and your brain are constantly trying to maintain the status quo, homeostasis.  If you take opiates to suppress pain, your body increases you ability to feel pain. Increase the drugs and your body continues to adapt.  The same effect can be seen with anti-depressants.

It really sucks when you realize that your own body is conspiring to keep you in the cycle that is tearing you apart.

“Great!  My own brain is trying to kill me!  Now what do I do?”

“I don’t know, dude.  What worked last time?”

“We killed the shit out of the last thing that tried to killed us.”

“Sounds good.  I’m in.  Wait, aren’t we are already doing that?”

To maintain the right balance, you need the adrenaline so High-Risk Behavior gets added in.  I love skydiving, riding motorcycles fast or just danger in general.  It feels like I’m alive again.  It’s all of a piece.  My job lets me feed my addiction because I can explain it away as necessary.  The truth is, I’m getting my fix.  That took me years to understand and admit.

On a subconscious level, you make excuses for your actions and try to maintain the feeling of being whole and alive.  Like an addict, you do the things that support having PTSD.  Like an addict, we make excuses for it.  Like an addict, we are in denial.

TO BE CONTINUED