The Trouble with Positive Thinking

Today I’d like to talk to you about positive thinking. It’s a popular concept, right? You hear about it all the time: “Just think positive!” It’s supposed to make you feel better and get you out of a rut if you’re feeling stuck.

Well – it’s not quite that simple. And sometimes, “just thinking positive” is not actually a good thing. Let me try to explain that with an example.

When you’re feeling concerned about something, that nagging ‘what-if’ experience is a bit like fearing that there might be a grizzly bear standing behind you. “Thinking positive” is like telling yourself to ignore the possibility of A BEAR, and just look at the pretty meadow in front of you.

…First of all, it doesn’t work. It’s a BEAR. Expecting yourself to ignore your fear under these circumstances is ridiculous!!! You can’t get your mind off the bear, no matter how hard you try to make yourself think of the meadow instead. And when you can’t do it, you feel like a failure. So now, you’re feeling scared of the bear, pressured to not feel scared of the bear, and ashamed that you can’t stop feeling scared of the bear. Gee, that’s a much bigger mess than just being scared of the bear, now isn’t it?

…Second – trying to force the bear out of your mind is exhausting. It takes up all of your energy, and makes it hard to focus on anything else.

…And third – it’s basically avoidance. Avoidance feeds the fear, and keeps it growing.

So – what can you do instead?

Well – I’m guessing that most of your concerns are a little more complicated than imaginary bears. You can’t just make the concern go away by checking behind you or under the bed.

Start by acknowledging your feeling of fear. Then, ask yourself – what kind of a fear is it?

If it’s a “what-if” that you’re afraid of, then mindfulness is a tool that might help you to re-focus your energy away from the fear of a potential future event that hasn’t happened yet, andback onto the present.

If your fear is a reaction to something that is really happening, remind yourself that feelings are natural, healthy reactions to events. It’s understandable and human to feel that way. Then, at least you aren’t piling shame and guilt on top of the worrying. That doesn’t fix whatever you’re worried about, but at least it frees up some mental space for problem-solving…

Blog from bro

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.

**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 Wojtek Rajski, and I’d like to thank him for generously allowing me to use his work. Please do not copy content, including photographs, from Coming Back Home without permission.

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Your Love-Hate Relationship with your Anxiety

In past posts, I’ve talked about relaxation – how important it is; how and why to relax; when to do it. For some people, the basic information on when, how, and why is all they need to start a habit of healthy mental hygiene.

If you’re thinking, “good for those people”, then this post is for you.

When anxiety has been a big part of your life for a long time, you and your anxiety become so tangled up in each other that it gets hard to imagine yourself without it. You develop a love-hate relationship with your anxiety:

In many ways, you see your anxiety as a hindrance: it prevents you from being able to sleep; it turns your stomach inside out when you try to eat; it makes you clench your jaw and grind your teeth. You’re exhausted and in pain, and a part of you is so sick of your anxiety that you just want to get rid of it.

On the other hand, you might feel like there were times in your life when being on high alert saved your bacon (or times when you got hurt that you blame on not being alert enough). So, a part of you may feel like your anxiety is an asset that keeps you safe, and just the thought of letting it go might make you feel exposed and vulnerable to danger.

If this is you, then step #1 is to stop thinking of it as all-or-nothing. Start thinking of your anxiety on a scale of 0-10, with 0 being none and 10 being the worst possible anxiety. Where on this scale might you be on a typical day?

Try to imagine turning the dial back by just a smidge – maybe 1/4 of a point, or even less if that seems like too much. You’re still alert enough to react quickly when necessary, but you’re starting to very gently balance that, so you can work towards being able to sleep better and have less pain.

The idea is to very slowly dial back your anxiety, one tiny bit at a time, and help yourself learn to tolerate calm. Gradually, you will teach yourself that you don’t need to be wound so tight to stay alert and keep yourself safe.

Simple, right? Yeah, but simple and easy are two very different things… Be patient with yourself. And if you have trouble doing it all alone – please seek out a professional to help you.

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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.

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

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PTSD and the science behind why you can’t just “get over it”

This question comes up a lot. If it’s something you ask yourself, please read this. If other people ask you why you aren’t over it yet – please share this with them, and maybe it will help them to understand.

Trauma memories aren’t like other memories – they don’t fade over time. Every time you think of them, they feel like they just happened yesterday (or worse – like they’re happening now).

Here’s why, in a nutshell:

Think of your brain as having two main parts:

Part 1 is your “Thinking Brain”. The thinking Brain is smart, rational and fact-based. We’re conscious of the thoughts it comes up with. It plans, organizes, and problem-solves.

When it stores a memory, it’s like a librarian – it organizes by theme and date. So, its memories of your senior year of high school might include the music you liked that year; the person you had a crush on; the part-time job you worked; and, oh dear, that goofy haircut you had that was so stylish back then. Remembering these memories feels like you’re looking through an old photo album – there’s a distinct sense of “me-now” remembering what happened to “me-then”.

Part 2 is your “Threat-Response Brain”. We’ve talked about this one before, here, here, and here; it’s not smart, it’s not rational, and you’re not consciously aware of what it thinks.

Your Threat-Response Brain stores memory very differently – and it does so on purpose.

Pretend you touched a hot stove once, as a small child; you burned your hand and cried.

To be good at predicting future threats, your Threat-Response Brain needs to know that “hot things hurt“. Time and context don’t matter: you don’t want a Threat Brain that thinks “Yeah, I hurt myself on a hot stove – but it was Grandma’s old gas stove, back when I was a kid, and she was cooking breakfast; I’m an adult now, in my house, making dinner, and my stove is electric, so let’s try touching it, because maybe it’ll feel good.”

Yeah – that really wouldn’t help much, now would it?

The way the Threat-Response Brain works is: “Every time I see/hear/smell something that reminds me of the time I got hurt, there might be danger.” The threat brain also generalizes to similar threats – so, if you hurt yourself by touching a hot stove, you don’t need to also touch a hot iron, and stick your hand in a campfire – your threat brain learns that hot = pain.

This is why memories of trauma stay fresh and vivid in your mind, even years or decades later: they are kept in a different part of your brain than other memories. The point of the Threat-Response Brain is to protect you – so it makes sure you remember danger as if it had just happened.

So – how do you cope with this stuff, when it gets triggered? You use grounding skills. Remind yourself that feeling triggered means that your Threat-Response Brain is reacting to a memory – it doesn’t mean that you’re in danger now. Tell yourself, “my threat-response brain is reacting right now because this looks/smells/sounds similar to my trauma – but that was years ago, and I’m here now, and that’s not happening anymore.” This helps you refocus on the here-and-now.

To fine-tune your Threat-Response Brain’s reactions, there are no quick and easy tricks I can teach you in a blog post – but, there are specific therapies out there (EMDR or cognitive processing for example) that can help with that.

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Please feel free to share this post, and any other on this blog, with anyone who might benefit.

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.

**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.

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Relaxation to Control Panic: What You’re Doing Wrong

So – we’ve been talking about panic – where it comes from, and some basic fears and facts.

You may have read those posts, tried some of the strategies, and concluded that they don’t work.

If that’s the case – let me assure you that they do work; let’s just tweak how and when you use them.

Let’s put anxiety on a scale of 0 to 10. 0 means you’re so relaxed that you’re barely conscious; 10 is a full-blown panic attack.

If you’re living with PTSD, then chances are, you never actually get all the way down to 0; your best day is a 5. Your average day is more like a 7.

That means that on an average day, you’re already over two-thirds of the way to panic. (Yes, this is precisely why I keep carrying on about relaxation – because if you do some sort of relaxation exercise regularly, it will help to bring down that average. Even if you get your average down to a 6, you’ve already given yourself a little extra breathing room).

So – on a typical day, even something small is enough to get your anxiety to start creeping up.

You feel the familiar tell-tale signs – your heart starts beating a little quicker. Your muscles start to tense up. You feel a little more nervous.

And what do you do? Well, if you’re like most of the patients that I work with, you do your best to ignore it.

It’s kind of like a really annoying neighbour. The kind who talks your ear off about nothing, boring you to tears. If that guy is knocking on your door, you might decide to sit really quietly, pretend you aren’t home, and hope he goes away.

Well – it might work with your neighbour. But with anxiety? Here’s what your head is doing while you’re trying to ignore anxiety:

“Uh oh… I know that feeling… Oh crap, are we gonna do this again? CRAP. I really, really don’t want this to happen again. Please, please, please, not this nonsense again….”

Yeah. Just reading that makes you feel a little nervous right? Stop. Breathe. You’re okay.

The point is – thinking that way makes you feel completely helpless, and that makes the panic worse. So, while you’re busy trying to ignore your panic – it just builds and builds. And then, when you get to a 9.5 out of 10 – then you think: “Oh, crap. It’s coming. Quick – what was I supposed to do? Breathe, and tell myself some reassuring stuff? How did that go again?”

Folks – by the time you get to 9.5, trying to remember what you’re supposed to do to relax is a lot like trying to hold back Niagara Falls with a paperclip. It’s not going to do much to help you out at that point.

Your timing’s off. You’re doing the right things, at the wrong time.

Here’s how to tweak it to get more control: the moment you start to feel your anxiety inching up – right when you start to get the urge to try to ignore it – that is when you need to remind yourself that you are not helpless. Now is your chance to be proactive and take control. Yes this will be unpleasant – but it can’t hurt you, and the more you focus on taking control, the more you’ll be successful in making this kind of thing shorter and less frequent.

…And when you start your slow, deep breathing, keep breathing – your panic will make you want to give up after just a few seconds and go, “It’s not working, it’s not working!!! I can’t do this!”

Hey – it’s not working yet, okay? It works. Keep doing it. Give it at least ten minutes of good, focused, slow, deep breaths. It’ll work. And with practice, it’ll get easier.

MC Charb 1

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.

**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.

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Panic Attacks: Fears and Facts

As we discussed in the last post – panic attacks feel awful. Once you’ve had one, the last thing you ever want is to have another.

Unfortunately – when you start to worry about having another panic attack, you get more anxious and tense, and that puts you at higher risk of having more.

One of the reasons that people get so concerned, is that they worry about what could happen when they panic. The three biggest fears are:

–          What if I pass out?

–          What if I go crazy?

–          What if I get a heart attack and die?

It’s important and potentially helpful to know that a panic attack can’t cause any of these things.

When you have a panic attack, your breathing gets quick and shallow, which makes you feel dizzy; this can make you feel like you’re going to pass out. But – during panic, your heart beats faster, and your blood pressure goes up. You can’t pass out when your blood pressure goes up – to pass out, your blood pressure needs to drop. So, nothing to fear behind door #1.

Going “crazy” means losing your grip on reality. In a panic attack, you’re painfully aware of every detail of the reality of what’s happening to you. No danger there – you’re not going to lose your marbles from a panic attack.

Fear of having a heart attack and dying is often the biggest fear that goes with panic attacks. Look – panic feels so awful, it’s understandable to think that you must be dying. It’s pretty common for people having panic attacks to end up in the emergency room, thinking it’s a heart attack. So – let’s go through this, step by step.

–          Panic feels awful, but is not dangerous. It cannot kill you, as bad as it feels to go through it.

–          If you’re having a panic attack, using deep breathing and relaxation strategies can make you feel better in a few minutes. If it’s a heart attack, relaxation and deep breathing won’t make a difference. (Yes, this is another reason why I keep carrying on about the importance of relaxation – if you never do it, it’s hard to know how while you’re in the middle of a panic attack…)

–          Panic almost always starts with quick shallow breathing (hyperventilating). With a heart attack, you don’t hyperventilate.

–          Your body might feel tingly all over with panic. With a heart attack, this is more focused, in your left arm.

–          Chest pain is different: panic comes with a sharp pain that comes and goes. Heart attack comes with a constant, crushing pain that feels like an elephant is sitting in the middle of your chest.

If you’re not sure what’s happening to you, by all means go to the emergency room; but, if your ticker’s been checked out and is in good shape, and you know that what you’re having is panic attacks, then learning the facts about panic, and using self-talk to remind yourself of this stuff while you’re dealing with a panic attack, becomes an important tool in helping yourself to make them go away faster, happen less often, and eventually, get rid of them.

MCC7

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.

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

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.

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Panic Attacks: Where They Come From, What They Are

Happy New Year, everyone!

I hope your holidays went well. Before you put them behind you, take a quick inventory: what helped you get through the holidays this year, and what didn’t? Taking a few minutes to review this will help you do even better next year.

Now that the holidays are behind us, let’s switch gears, and talk about panic attacks.

There’s a lot to say about panic, so – if at the end of this post you have more questions than answers – hang tight. I’ll cover more in the next post. And the one after that.

If you have PTSD, chances are pretty good that you also have panic attacks. Panic attacks and PTSD are caused by the same reflexhttp://drdee.ca/2013/05/31/ptsd-the-role-of-reflex-part-1-how-reflex-works/. When it senses a threat, your heart rate speeds up, your muscles tense up, you get a shot of adrenalin and you deal with the threat. And then when the threat’s over, if this reflex is working properly, your adrenal glands stop pumping adrenalin into your bloodstream, and you get to feel calm again.

Like PTSD, panic attacks happen when the “off” switch on your threat-response reflex breaks down. Reflex starts to misfire, basically. The triggers for panic attacks aren’t always obvious; often, panic attacks might seem like they’re happening for no reason at all.

A panic attack is one of the most intensely unpleasant things that can happen to you.

I’m going to describe what a panic attack feels like. If you get a lot of panic attacks and they are easily triggered, take a moment now to remind yourself that you’re not in danger; look around the room, take a few slow, deep breaths.

When you’re having a panic attack, you might feel like you can’t breathe; your heart starts pounding like it wants to jump out of your chest; your chest feels like it’s going to explode; you’re shaking, sweating, tingling, numb, hot or cold; you feel dizzy, light-headed or faint; you feel like you’re choking and like you’re going to throw up. It might feel like it’s not real, and you might be (understandably) scared and thinking you’re going to die or go crazy.

Look – I’d love to write a whole book right now, in this blog post, to explain all the biology of how and why they happen, and how you’re going to beat them. That’s going to take a few more posts on my part, and a lot of practice on your part (and hopefully, some real help, because a blog is not a substitute for actual therapy. And if you’re dealing with panic, then I’d really like you to go get some therapy).

What I need you to know for right now, is that panic attacks are not dangerous. Panic can’t make you go crazy, it can’t make you have a heart attack, and it can’t make you die. It is totally, completely awful to deal with. It feels like an eternity, but it usually lasts somewhere between 10-20 minutes for most people. And then it’s over, and you’re exhausted but in no danger.

That’s important information to keep in mind. Because when you have panic attacks, you end up spending a lot of time dreading the next panic attack. So – work on reminding yourself that panic attacks can’t actually hurt you, even if they feel really awful. That’s the first step to taking back your life.

MCC9

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.

**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.

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PTSD Triggers: Crowds

So – while we’re on the topic of triggers, let’s talk about crowds. From what I gather, most of you are not big fans of crowds.

Like I keep saying, PTSD is basically your brain’s threat-alert system, kicked into high gear without an “off” button. So – you’re constantly trying to size up all possible threats.

Say you’re in a room with one door, one window, and one other person. That’s not bad; you can scan window-door-person, to look for possible threats.

Now say you’re in a bigger room, with ten people. Keeping track is much harder, and it’s easier to get overwhelmed.

It goes up to a whole new level if you’re in a grocery store, a mall, or a football stadium. Now, there’s just no way to keep track of it all. Just thinking about it, you might start to feel your heart rate speeding up a bit – that’s your reflex, getting ready to fight or flee.

Take a moment. Breathe. You’re not there right now.

See what just happened there? That feeling started, even though you were just thinking. Thinking is not dangerous – but your survival reflex is so strong, that just thinking about it makes the danger feel SO real.

When we start to feel like that, we interpret that feeling itself as a sign that there’s danger. If we can’t quickly scan our entire environment, we start thinking the danger must be real, only we can’t see it.

Feeling tense/nervous/uneasy does NOT mean that you’re in danger – it just means that your threat-detection system is reminded of danger.

…That little fact right there folks – that is the key to the universe.

When you’re dealing with PTSD, having that feeling that tells you, “Oh no, major danger is coming” does NOT actually mean that anything is coming.

It just means that your threat-response system was reminded of danger.

Remember Dave the Zebra, and his red flowers? Well – crowds are sort of like your red flowers.

So – how do you cope?

Remind yourself that, as soon as you start to think about crowds, your PTSD will start to act up. This is not because thinking is dangerous, or because crowds are dangerous; it’s because PTSD reacts to reminders of danger.

Heading into a crowd, you’re going to feel anxious/tense/wound up. You may even start imagining all kinds of horrible things that could go wrong, and all those things might feel very, very real. Feeling and thinking this way does not mean that you’re in danger, or that awful things will happen. This is a normal part of PTSD; it is to be expected. This is unpleasant, but not dangerous.

Repeat this information to yourself frequently; with consistent practice, it will get easier. (You’ll probably still not like being in crowds, but it will get easier to cope with it.)

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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.

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

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PTSD Triggers: Trauma Anniversaries

As far as triggers go, few are as powerful as the anniversary of your trauma.

You probably start to tense up a bit just thinking about it. As the date gets closer, you might get this sinking feeling, like you’re a sitting duck and there’s no escape.

To cope with that feeling, you have to realize that even though you can’t stop the calendar, there are things you can do to cope.

Whether you feel uneasy, tense, nervous, anxious… You’re feeling that way because an anniversary is a reminder. Realize that your feelings are unpleasant but not dangerous.

Use your grounding skills to ground yourself in the here-and-now:

What year did that stuff happen? What year is it now? How long has it been since this happened? Asking these three questions is an important part of reminding yourself that the memory is “back then”, and you are in the “right now”, and there is lots of time separating you from that memory. The memory is a painful one, but it can’t hurt you. Your memory is back then. You are here now. It’s over, and you are no longer in danger.

– Where are you now, as compared to where you were back then? What’s different in your life now, as compared to back then? These are different ways of making the point in your head: That was back then. I am here now; now is different from then; and I am no longer in danger.

It helps to do things to keep busy, especially things that are different from what you were doing on the day when it happened. When the memory starts to creep up, remind yourself: “Right now, I’m home, the year is [now], and I am [doing whatever you’re doing right now]. That happened back in [whatever year], and I was [wherever], and I was [doing whatever]. Right now is different from back then. That’s a memory. I dislike remembering it, but it can’t hurt me anymore. It’s in the past. It’s over.”

Sometimes, your trauma anniversary is not just about something awful that happened to you – it may also involve the loss of someone you care about. If that’s the case, then you may also be overwhelmed with feelings of loss and grief for the person or people you lost on that day. You may think about all the good things that have happened since that they missed out on.

It’s healthy and natural to have feelings of grief. Too often, we think that acknowledging a loss is the same as depression, so we try to avoid healthy, appropriate grief.

So give yourself permission to grieve. Realize that the day will be hard on you; take it easy on yourself. Plan ahead of time to do things that ground you and give you comfort.

When it’s over, take an inventory: what did you do that helped, and what will you do differently next year? That way, hopefully coping might get a little easier from one year to the next.

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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.

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

This post is shared to mark my own trauma anniversary, and dedicated to the memory of my cousin Pete. We miss you buddy.

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PTSD: Dissociative Symptoms

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 (this is called, WTF just happened to me?).

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?

Lookit – I’m not gonna try and tell you that getting out of that hot mess is easy, quick, or painless. It’s none of those. If your PTSD includes this stuff, research suggests that, as far as PTSD goes, you won the bleeping jackpot.

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. 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 none of you ever 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 and trying to fix it on your own, it’s a bit like trying to perform open heart surgery on yourself. I’m just sayin’ – there’s help out there. Go get some.

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~ Dr. Dee Rajska, C. Psych.

I’d love to have you share your thoughts, comments, and questions – but before you post, can you take a quick peek at the guidelines? Thanks…

If you’d like to get more updates from me, you can find me on Twitter and on Facebook.

Fine print: Reading this blog is a good start, but if you’re having a hard time, it’s no substitute for getting actual help (like, therapy). It takes a different kind of courage to admit to yourself that you’re struggling, and to seek help. Getting help 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.

Really fine print: Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by Larry Jaipaul, 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.

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PTSD: Reflex and The “Freeze” Response

…You know I’m all about feedback, right? You know this is YOUR blog, and I’ll write about whatever you need?

Well – my stats tracker thingy tells me somebody ended up on Coming Back Home by Googling “PTSD + Freeze response”.

And I thought, Huh – I don’t really have a good article on that. I mean, if I was Random Google Person, I’d be a little disappointed.

So – good suggestion, Random Google Person! This post is for you!

If you recall from previous discussions, PTSD is basically a survival reflex stuck in a loop with no off switch. This reflex has three parts, depending on what kind of threat you’re up against:

fight is where you respond to a threat by beating up on it. Military training works to strengthen this part of your survival reflex.

flight is where you run for the hills to get away from the threat.

freeze is what you do when neither of the above is an option.

In this post, we’re going to discuss the freeze response, the way it happens in the face of an actual threat. Next post, we’ll talk about dissociation, which is what happens when the “freeze” reaction gets stuck, like in PTSD or dissociative disorder.

It’s like this: imagine a goldfish.

It’s in a fishbowl. The cat just jumped on the table and stuck his paw into the bowl. What’s the fishy gonna do?

He’s can’t fight off the cat, and he can’t run away, because he’s in a fishbowl. Poor little fishy. The cat is about to enjoy some fresh sushi.

So – what does the fish do? He freezes; freezing helps him feel less pain, both physically and emotionally.

Freezing might feel like time has slowed down; like what’s happening isn’t real; or like he isn’t really there. The goldfish might feel like he’s floating above his body, watching the cat enjoy his sushi.

Feeling this way is a normal reaction to a situation of extreme, life-threatening danger, where you can’t fight and can’t get away.

If you’re a goldfish who’s about to get eaten by a cat, feeling like you’re floating above your body and the whole thing is not really happening is less terrifying, which is why our reflex is built this way.

But – suppose just as the cat is scooping up the goldfish, someone comes along and screams, startling the cat. Poor little fishy lives, but is scarred by this near-death experience: he might get stuck in this “freeze” reaction. He might end up with severe PTSD, and symptoms that we call dissociation. We’ll talk a bit more about that in the next post.

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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.

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

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Your Deployment, Your Family, and… THEIR Trauma

Since we’re already on the topic of all the different kinds of trauma that can result in PTSD, I was thinking… let’s talk about families.

As we were discussing in the last post – a “traumatic event” is any situation where you’re exposed to actual or threatened harm.

As we discussed, “actual or threatened” means that even if it doesn’t end up happening, being genuinely scared that it would happen can still impact you.

It doesn’t have to happen to you; it can be something that happens to someone else, while you’re 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.

So – let’s take a minute to put this together:

Say you’re deployed. Your family stays behind. They spend months on end being bombarded with media reports about the horrible events happening in the place where you went.

You face dangers every day; they’re too far away to be able to do anything other than feel helpless and hope that you come home in one piece.

…what’s happening to your family here – that’s trauma. It’s not the sexy kind of trauma that makes for a great story, but it’s still trauma.

Now, that does NOT mean that your family will automatically get PTSD just because you were deployed – but, it’s trauma, so it certainly might impact them.

Your family might feel pressured to outwardly say nothing other than how proud they are of your service. They might face a barrage of well-meaning friends and strangers offering all sorts of comments – everything from, “You must be so proud!”, to, “That’s crazy! Don’t you watch the news? They get blown up all the time over there!” (This was actually said to the spouse of someone I know…)

To you, deployment is part of your job; to them, it’s hard not to take personally. Privately, your loved ones might feel rejected and abandoned. They might feel angry and resentful that you would leave them behind, to go to some far-away place and risk getting hurt or killed, and leave them worried about your safety for months on end. They might also feel guilt if you made it home safe and other families weren’t so lucky.

So – on top of the emotions that you might bring home – your family members may have some concerns of their own to throw into the mix.

All that can make for a challenging adjustment to family life.

So – how do you get through it?

You try to be understanding of each other. You went through a lot; so did they. It’s not a competition. You’re a team;  adjusting to life after deployment is teamwork. Communication is important; try to talk about your feelings. Try to listen to family members talking about their feelings, without getting angry or defensive.

Most importantly, recognize when you need help adjusting, and reach out for it – whether you need individual therapy, family or couples therapy, or a bit of each.

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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.

**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 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.

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Sexual Dysfunction and Relationships, Part I

*Disclaimer: This is a really broad topic, and I’m not a sex therapy expert, so unfortunately, I won’t be able to cover everything that’s relevant. Most of my patients are male and heterosexual, so I’m addressing the topic from that perspective. I don’t mean to leave anyone else out, I just try to stick to writing about what I know.  

So… Judging by the number of pageviews on the last post, it looks like some of you find it less awkward to discuss sexual dysfunction on the blog than in person.

Good – you need to have access to this information, even if you feel too embarrassed to ask about it face-to-face.

You know, I briefly considered writing the last post about Dave the Zebra. I thought, maybe that would be less awkward for people?

However – Dave the Zebra is actually named after Dave the Dude. I value my friendship with Dave the Dude. Somehow, he didn’t like the idea of putting his name in the same sentence as sexual dysfunction, in a blog read by thousands of people. Go figure, eh?

Well – let’s talk about it. (Dave the Dude, you can relax. I’m keeping you totally out of this…)

In the last post, we talked about how and why PTSD can mess up your sex life.

Today, we’re going to discuss how the mess in your sex life can have a ripple effect on the rest of your life.

Sexual dysfunction messes up your relationships, starting with the relationship that you have with yourself.

(Hey – can we try to focus please? I’m talking about the emotional relationship with yourself – not the five-knuckle-shuffle relationship with yourself! …Not that there’s anything wrong with that…)

Look – who you are in bed is part of your identity. You don’t need to go through life being Mr. Don Juan – even if you’re a relatively vanilla kind of dude, you have a sense of how your plumbing works and what you enjoy doing with it.

When that changes, it can have a big impact on how you feel about yourself. We live in a culture where, as a guy, you’re supposed to be obsessed with sex, or so the media would have you believe. So a lot of guys end up feeling like they’re somehow less of a man when stuff like this happens. You might feel angry and ashamed, and try not to think about it.

If you’re a single dude, this might really have an impact on your confidence about getting into a new relationship. You might question whether a woman would want to be with you, if things don’t quite work the way they used to.

(Answer: yes, the right woman would still want to be with you. The right woman would love you for your sense of humour, your smile, and whatever else it is that makes you awesome in her eyes. And you can sweep her off her feet with flowers and chocolates and kisses and dancing and backrubs and… Well, when it actually comes to sex, most women like all that stuff that most guys rush through to get to the main course. So, serve up a really good appetizer, and she won’t really miss the main course, you catch my drift?)

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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.

**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 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.

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“I know I’m safe, so why am I still freaking out???”

This question is important, and it comes up a lot.

Okay – for me to explain this, you’ll have to imagine that your brain is a grapefruit.

(Hey – it’s either that, or this becomes a hard-core neurobiology lesson where I start throwing around Latin words that are harder to pronounce than my last name…)

…So – we’ll go with the grapefruit then?

The peel of the grapefruit is the “gray matter”, or cortex. It’s got all your smarts – this is where you analyze, make decisions, set priorities, and so on. You’re conscious only of the stuff that the gray matter does: the other parts of your brain do their thing behind the scenes, like an autopilot.

The fruit part of the grapefruit is the “white matter”. It’s a messenger – it sends ideas back and forth and makes your brain work quickly to translate a thought into an action.

The grapefruit’s got a few seeds in it. One of these seeds is a little thing called the amygdala. (This will be the only Latin word I’m throwing out there today, promise.) The amygdala sets off your fight/flight/freeze reaction, in response to anything that reminds it of a threat. It’s a reflex, so it doesn’t ask your permission before it goes off.

So – how is it that you can realize that everything’s okay, but still find your body reacting like you’re in danger?

Simple – the realizing that there’s no threat is coming from the peel of your grapefruit. But, at the same time, one of the seeds (your amygdala) is reminded of a threat, so it’s reacting as if you were in danger. Two different parts of your brain are doing two different things, at the same time.

It’s really important to know that this is how your brain works. If you don’t know, you might end up doing one of two things:

1. Telling yourself, “I should just suck it up and stop being so (bleep)ing scared, and what the (bleep) is wrong with me?”.

Yeah… Cause that’ll help, right? Fear is part of a reflex; beating up on yourself for it is sort of like blaming yourself for letting your toenails grow; you didn’t have a choice, so quit blaming yourself, it’s not your fault. Plus – talking to yourself this way just makes you feel shame and guilt, which feeds your depression. Do yourself a favour, and remind yourself that you are not to blame for your reflex.

2. The other option is that you start thinking, “I’m feeling so nervous that there must be something to be scared of and I’m just not seeing it”.

…If you want a quick, easy recipe for freaking yourself right out, then telling yourself that there are invisible dangers that you cannot sense is a good way to do it…

However, if you want to help yourself relax instead – then remind yourself that you’re feeling nervous because a very primitive part of your brain is being triggered to think of a threat; it’s not very smart, so it can’t tell the difference between real and imagined threats.

So, how do you try to stop it? You tell yourself that it’s just your threat reflex sounding a false alarm; then use your relaxation skills to help yourself to relax. (Yes, this is exactly why I keep droning on about how important it is to practice relaxation regularly…)

It’s simple – but simple and easy are two very different things. You’ll need a lot of practice to make it a habit to think this way, but once you’re successful, it will be a helpful tool.

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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.

**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 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.

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