As most who follow my art and blogs know I have had Complex PTSD from early childhood. It wasn’t until the West had been at war in the Middle East for over a decade that the treatments for PTSD took centre stage in public health. Finally, we are seeing real progress in the treatment and prevention of trauma not just in those who serve but in those who have been exposed to significant life altering trauma that historically has left us disabled, unable to function and locked in isolation.
In my next post I am going to write more on NEUROCIRCULATORY ASTHENIA or as Mendez Da Costa (1833-1900) called it “irritable heart”. PTSD isn’t simply an injury to the brain it affects our entire bodies, especially our electrics, our auto-immune systems and ultimately, I believe it can kill us. This post however will focus on the MOOD DISORDER/PSYCHOLGOICAL aspects of PTSD rather than the physical. Before I leave this paragraph however I will re-iterate what I say to anybody fighting PTSD whether in your own body/brain or for a loved one, make sure you have seen a cardiologist, neurologist and rheumatologist. If you need details on reasons behind that, message me privately, but I will explain in a later post this week.
What are the Psychological risks of PTSD?
- Depression: Major Depressive Disorder (MDD) is 3-5 times more likely to appear in those with PTSD (one study across military and civilian put the number at 52%)
- Anxiety: this almost seems ridiculous to mention given how PTSD affects our brains
- Substance Abuse: surveys put the risk of developing an addiction if you have PTSD at 63%
- Suicide Risk
- Poor Social Functioning
- Difficulty adhering to and following a treatment or therapy
- Chronic Pain Syndromes
The quick n dirty diagnostic tools used to diagnose PTSD (known in DSM-5 as the four “clusters”)
- Intrusive thoughts or images, memories, dreams and flashbacks
- Avoidance of things from every day tasks to anything that might remind us of the events.
- Negative moods or thoughts which include paranoia, low self esteem, self sabotage, fear, guilt, shame, alienation and detachment (bordering on and often including dissassociation) and a difficulty in being “happy”. For some of us even a fear of feeling happy or content as if by so doing we are simply asking for the sh*t storm to start again.
- Self destructive behaviours (thrill seeking, adrenaline junky), reckless or aggressive tendencies, sleep disturbances, hyper vigilance …. ah the list is such a fun one.
Can PTSD be cured?
No. Sorry but no, it can’t be entirely eradicated from your brain or your body, it is an injury that you will live with for the rest of your life.
Can the symptoms of PTSD be reduced and managed?
Yes. Absolutely and I believe, those of us who live with PTSD are simply better humans. We have suffered and suffer, it makes us humble and open to the pain of others, we find our salvation in supporting others. Acceptance of the injury and the fact that it is part of who you are now is the biggest challenge to be honest. I have never had to do this as I have never known a time when I wasn’t a bit cracked, a lot cracked or completely free falling into bat sh*t crazy. For those who knew what it was to have an unbroken brain, I feel immensely empathetic towards the struggle to accept this.
Cognitive Behavioural Therapy (CBT)
This is the go-to of the psychological community. Sadly it requires a functioning cognitive brain to work, so there’s buggar all point in it until you have rooted out the trauma that flips your brain into its lizard states shutting down those front synapses that do the logical rational thinking that is a requirement of CBT. You can train your calm thinking brain all you like but if you haven’t got a handle on your triggers and your PTSD episodes it isn’t going to help you much.
Sorry but that’s a fact.
CBT is great once you can control your PTSD responses, once you can haul the tiger back into the cage and connect to your frontal lobes.
What is CBT? Two things combined there is “cognitive processing therapy” and “prolonged exposure therapy”
CPT focuses on acknowledging the negative thoughts, feelings surrounding the trauma and understanding how that trauma can cause stress, manipulate our thoughts and reactions. It requires a thinking brain and a deep honesty. There is no point doing CPT if you’re going to treat your sessions like a beauty parade. If you aren’t prepared to dump all of the ugly in that room and be completely honest don’t waste your time or money.
Prolonged Exposure Therapy (PE) is ugly and to my mind, pointless. Psychologists argue that it has a 60% effectiveness and perhaps it has if you are following the models developed by the likes of the Veteran Transition Network UBC Head doctors, but if you’re simply going to a regular Psychologist who wants you to repeat over and over again the traumas in the hope that you will become less attached to it… Ugh. Avoidance is one of our biggest stumbling blocks, exposing ourselves in measured ways to the things we are avoiding and pushing our boundaries is really important but I’ve seen far too many quacks out there use PE like trauma whores who just want to hear all the gore without ever helping their patient. Be very sure you choose a PE therapist who tells you exactly how it will work, how long it will take and what the outcomes are. Not a therapy to be entered into lightly with a first year Psych professional.
In brief this therapy uses the body and brain’s healing mechanisms to break down the trauma to bite sized digestible pieces that can be worked on and discarded, a bit like a foreign body entering the body would be. It’s based on REM sleep. Yup. That old sausage: sleep. The body’s go to healing process 101. Rapid Eye Movement (REM) are used by an EMDR specialist to pull out those traumas, shake them out and place them in a cognitively accessible place in the brain rather than hidden in our survival pack that we go to whenever triggered.
The awesome thing about EMDR (after you get over the weirdness of it all: the holding the left n right electric zappers in your hands or the blue light flicking left to right in your eyes) is that you DON’T have to pull your pants down in every session and show the therapist your vulnerable bits. You don’t need the therapist to interpret or even to understand the event, you don’t have to describe it, you only have to connect to it and feel it whilst having the light shone in your eyes or being zapped left to right. No the zap doesn’t hurt, it’s just a tickle and to be honest I found the stronger the zap the better and quicker I processed but then I was on a mission.
You have to dedicate yourself to this therapy. If you are like me and you are not dealing with just one trauma but a lifetime of them, from all manner of sources, be wary. Before you start do the following:
- Set up your support team, these are people who know when your appointments are and know to check in on you for the next 72 hours after each session.
- Your support team needs to know that you will at some point try to avoid further sessions, the deeper EMDR digs the harder it will be to go.
- Sleep for two hours after each session
- Do not plan to be functional for 72 hours after a session, great if you are but don’t expect it
- Make sure your therapist is recommended and accredited. This is not a therapy to be entered into lightly if you have Complex PTSD
- Discuss suicide risk with your therapist, know the signs and make sure you have a safety plan in place. The trauma you are digging up was hidden by your body from you for a reason, don’t be a fool as I was and think you’re tough enough, teflon coated and bullet proof, to get through anything. You aren’t and you may die. So, set up the safety steps. If you need help with this message me.
- Research, read and talk to others who have been through the process.
Phase 1 of EMDR should include a history taking (it doesn’t have to be detailed), an in-depth interview and completely frank, honest discussion with your therapist. There is NO POINT in entering into this if you arent’ going to be completely straight forward, honest and dedicated to healing. The therapist once they have the history should be able to tell you how many sessions this will take: unless you are like me with decades and multiple traumas, which is almost impossible for anybody to say I can do it in X hours. 5 hours is generally the number for a single adult traumatic event to be cleared and made open for CPT.
Phase 2 of EMDR is establishing safe places to go, safe thoughts and escapes. You will need them. Focus everything on this stage. Understand the techniques you are taught and ask questions. Techniques I still use:
- counting left to right, anything from tiles to handles
- describing my surroundings in detail
- two points about 4 ft apart at eye leve that I look at from left to right repeating phrases that reassure me, depending on the flashback or memory they differ
- walking and talking, simply put, the electric pulses sent from my feet (left foot, right foot) aren’t that different to the electric zaps in EMDR, it relaxes our brains and allows us to move forward (cognitively)
- if the trauma haunting me has to do with my childhood I have trained my brain to visualize my adult self simply pick that child self up and carry her out of harms way. I have taught some first responder and military friends to do this with the kids they couldn’t save or were forced by war to shoot dead. The ability for me today to step into the trauma of the past stored in my brain and actively save the child-me has been extremely powerful and allowed me to heal in impossible ways.
Phase 3 to 6 can be described as experiencing or tapping into the trauma (or traumas) pulling them forward and acknowledging or finding the negative belief or feeling around this trauma (guilt, fear, pain, whatever), finally realizing where in your body you feel that trauma (yes our body keeps score) and the related emotions. These are then isolated and replaced with positive thoughts, survival techniques and beliefs replace the ones that were trying to drown us.
Phase 7 and Phase 8 are the closure and the summary … if you are here you can now go to CPT and learn how to re-enter the world. You will need to do CPT as for as long as you have had Comlex PTSD you have learnt to live and be in ways that aren’t that healthy, now is the time to replace those behaviours with positive and life enhancing ones.
Repetitive Trans cranial Magnetic Stimulation (rTMS)
I asked my friend and Psychological guru if he happened to know of a washing machine I could pop my brain into for a while. He said yes and I have a neat little machine (expensive at $800+) which literally rinses my brain, I run it at the highest charge possible to electrodes attached to each ear lobe and I sleep for an hour, waking up with a rinsed brain.
Electric pulses and the use of magnetic fields in the treatment of psychiatric issues is not new but we no longer have to hook you up to the transfer station, in fact despite big pharma trying to stop the research (I kid you not), it’s moved forward exponentially with researchers in the University of Texas in Dallas amongst many pushing their findings into the stimulation of the vagus nerve to alleviate the symptoms of PTSD, anxiety, depression and over all mental f*ckery.
When Brian passes out we tend to hear from the doctors that it’s his vagus nerve. His guts bleed when stressed, causing severe pain and causing the vagus nerve to feel pressure which in turn knocks you out, or in this case, him. The vagus nerve is to my mind one of the keys to understanding PTSD: it oversees digestion, heart rate and a myriad of other important bodily doohickeys and whatnots.
We found evidence that treating the traumatic memory produced lasting improvements in other PTSD-like symptoms such as anxiety, arousal and avoidance.” Said Dr Christa McIntyre associate professor of neuroscience in the school of behavioural and brain sciences.
This is a very exciting treatment avenue as it allows us to avoid having to recount and relive our traumatic events. None of us want to do that.
I used to joke that I could just zap myself with a cattle prod and that’d do the trick. Over this recent camping trip whilst trying my hand at re-wiring the battery connections to our trailer (yes, the artist does that from time to time) I fixed it, the giant bank of batteries finally connected as required. How did I know that? Because I was holding them whilst connecting them. As the DC ran through my body my brain did request politely that my hands let go and stop fecking holding onto the wires. It took a while to figure that one out. My friends who found me wild eyed and slightly singed reported that I spoke remarkably fast for a while. So, take it from me, if this sounds like an interesting avenue please find somebody who knows what they’re doing and don’t try a D.I.Y. Version.
Ignroing it and hoping it will go away Therapy
This is probably the first therapy everybody tries.
It doesn’t work.
A lot of you reading this are still serving either in the military or first responder, corrections or medical … the ability to stand up and say, “I need to take some time out to handle my PTSD”. In fact it is a guaranteed way to find yourself in JPSU or desk duty til they can boot you out the door. You CAN NOT start EMDR or CBT without telling your employer, your family and your support network what you are about to go through.
Most of you in fact go to the Doctor with the primary goal of finding a way to just get by. I respect that. So does Brian. We aren’t recommending it but if this is what you have to do please reach out to us, join our private (and heavily guarded group of PTSD survivors who are vetted) group with an anonymous account. Or check in with us regularly and we will give you tips on survival until you can get the time out to deal with this thing aggressively and mark my words, these treatments are aggressive and you have to be ready to man up, step off the line and focus on getting healthy.
Whatever your line of work is we can find you others who have walked the walk and will respect your position. They will and can be there to walk by our side in the dark times. Sometimes that is all that is needed
ISOLATION KILLS US
UNTIL YOU CAN FIGHT THIS WITH THERAPIES ABOVE, FIGHT ISOLATION
ARE THERE ANY OTHERS?
Yes, there are.
Dogs are amazing. Psychiatric Service Dogs should never be a handle but a tool to get you out and about safely again. I’ve written on this before and in-depth.
Horse therapy – I can tell you now that my horses saved me. My freedom came from them and their belief in me, their strength and loyalty taught me to trust again. There are some great horse programs out there and real success stories.
Friends and Family, Spouse and Kids – speaks for itself I think. Brian and I have written about how important sex, intimacy and connections are in healing PTSD or surviving it. Can forward you those posts if you’re interested or can’t find them.
But here’s a thing: we are all different. No one therapy or doctor suits all. With PTSD you really have to suck it and see. Don’t listen to your mate who swears “it’s a cure” No it isn’t, but it might help so give it a go.
The VTN is inspirational and amazing in their work, focus, honest dedication towards the health of our veterans in Canada. This is their resource page. If you are a Canadian Veteran (or Mountie) you could get on one of their programs, please contact them or Brian (or me and I can get you in touch with those who can connect you).
I am going to ask Brain McKenna to write on this subject, I think most know how anti-benzodiazepines I am and how dangerous I think they are. He is more measured on this and can talk about Medical Marijuana which I can’t. Pharma is used in conjunction with other therapies and I would not be here without their help, but they should not be all you try or use to defeat PTSD and keep it under control.
The art piece above is one I am still working on from our trip to Golden Ears Provincial Park. That old stump is massive and is from the cutting down of the old growth cedars in late 1800’s early 1900’s. It makes me sad seeing them but also there is this sense of the infinite: there they are reminding us of their majesty and surrounded by the new growth that stands shoulder to shoulder in an emerald paradise. It gave me hope. It is about acceptance of the horror, pain and ugly.