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

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

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

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

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

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

It’s not a competition.

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

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

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

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

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

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

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

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

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

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

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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 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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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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Spouses want to know: PTSD and Sexual Dysfunction

So – guess what we’re talking about today? (Go ahead, check the title again). That’s right.

*Disclaimer: This is a really broad topic, so I won’t be able to cover everything that’s relevant. The question was originally asked by a female spouse of a male veteran. 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.

In person, some of the patients that I work with find this really awkward to discuss.

Well – look on the bright side: this is a blog! You don’t have to ask this stuff in person! All the answers, none of the awkwardness!

The research is pretty clear that there’s a link between PTSD and sexual dysfunction. Most studies show that in veterans with PTSD, about 8 to 9 out of every 10 have some sort of sexual dysfunction. That’s much higher than combat veterans without PTSD, and higher than veterans with other mental health diagnoses. “Sexual dysfunction” can be a whole list of different problems – including having less sexual desire; erectile dysfunction; premature ejaculation, or inability to reach orgasm.

8 to 9 out of every ten. That means that, if you have PTSD and you don’t have some sort of sexual dysfunction – you’re the exception.

If you didn’t know that before, then it’s important that you know this about your body, and what PTSD can do to it. It’s not you, it’s not your fault, it’s not because you’re doing something wrong. It’s not your partner’s fault either. Add it to the long list of things you dislike about PTSD.

But – let’s talk about how and why this happens, and then, most importantly, let’s talk about what to do about it.

First, the “why”: remember that PTSD is survival reflex on overdrive; remember how we talked about reflex making all your big muscle groups tense up? Yeah – apparently, your survival reflex doesn’t consider that part of your body as a big muscle… Go figure.

Basically, reflex thinks that anything that doesn’t help you fight or flee is a waste of energy.

PTSD also makes you feel anxious and hyper-alert pretty much all the time, and that makes it hard to get in the mood and stay in the mood for long enough. Many people who have PTSD also feel disconnected and detached from loved ones, and that can make it hard for both partners to get in the right headspace. Increased anger and irritability can also put a damper on your relationship, and that can make the physical part of your relationship suffer too.

…Sounds pretty bad, huh?

Yeah… I know…

It can get better. Not magically, overnight better, but slowly and with some work – it can get better.

(Yes, pills can help. Talk to your doctor about getting some. But don’t expect pills to be a quick, easy, magic cure-all.)

First – go to therapy, and work on learning to manage your PTSD. When you learn more about how to manage your symptoms, this will make a difference.

Next – consider couples therapy. Especially if you’ve been struggling with this stuff for a long time, chances are there’s a lot of misunderstandings and hurt feelings from both of you that are driving a wedge between you. Couples therapy may help you to reconnect and feel closer, and that might help.

Third – don’t give up. Don’t lose hope. As long as you’re willing to try, things can get better.

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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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Spouses want to know: “Where does the anger come from?”

I have a few more questions from spouses, and this is a really important one.

The answer is pretty straight forward: PTSD is basically the fight/flight/freeze reflex gone into overdrive, and anger is part of  the “fight” part of that reflex. You might remember that we discussed anger in this post.

Well then… that would make for a really short blog post, wouldn’t it?

If you’re reading this, then anger has probably had an impact on your life. I’m going to talk about it in more detail below, and that might be hard to read.

So – don’t go any further if you’re having a bad day and don’t need to be reminded of how anger has made life worse. Save it for another day. Otherwise, find a nice quiet spot where you won’t be disturbed. Set aside time to do a relaxation exercise when you’re done reading this – here‘s one that I’ve posted previously. Here‘s another.

Gee, I’m being a little bossy today, aren’t I?

If you’re just waiting for me to tell you to go pee before you read on, don’t worry. I’ll restrain myself.

Ready?

Okay.

If you’re a spouse, then you need to know where the anger does NOT come from: it doesn’t come from you, or what you said, or because you’re making the wrong thing for dinner. It’s not coming from the kids playing too loudly. It isn’t your fault. It’s easy to lose your confidence and start to blame yourself.

It’s also easy to get frustrated and blame your spouse – the anger is not coming from him/her either.

Look – you didn’t marry an idiot. (Well – if you did, then, this blog can’t help you with that…)

But – if you didn’t marry an idiot, then your spouse didn’t just magically become an angry jackass overnight for the fun of getting under your skin. PTSD makes a person feel like they’re under attack all the time, and anger is part of the reflex of reacting to threat.

PTSD is an injury. Anger is one of the ways that this injury hurts. It hurts anyone who might be on the receiving end of that anger – spouse, kids, random clerk at the grocery store.

It hurts the person with PTSD; they don’t choose to act like this, and a moment after they say something hurtful, scream at someone, or put their fist through the wall – they feel terrible about it.

As the spouse, you feel caught between trying to understand that this is an injury, but also feeling frustrated and angry that they can’t just cut it out.

Understanding is the first tool in making things better: the person with PTSD needs to understand that their anger is coming from their PTSD, and not from anything you did. So the solution is to manage their anger, not manage you. And as the spouse, you also need to know that their anger is coming from their PTSD, and not from them being a jerk. So the solution is to help them manage their anger, and to take care of yourself, because this is a lot for you to deal with too.

How’re ya doing? I warned you – it got a little heavy. If you feel a bit like this post punched you in the gut today, please take a minute to look after yourself. You don’t even have to scroll back up to find the hyperlinks to the relaxation exercises – here‘s the woods. Here‘s the water.

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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 Murray Chappell, 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 and Relaxation: When and Why

So – have you noticed that lately, I’m talking a lot about relaxation…?

Well – today I’d like to talk to you a bit why relaxation is important, and how to use it to manage your symptoms.

If  you’re like most of the patients that I work with, you might think of relaxation as something you do when you’re feeling really wound up to bring yourself back down.

If you use relaxation this way, that’s a great start. The next step is to get into a routine of doing some sort of relaxation every day, even when you aren’t feeling really wound up and you don’t think that you need it.

Think of doing relaxation the same way as you think of brushing your teeth: you don’t wait until you have a toothache to brush your teeth. You do it regularly because it helps to prevent a toothache. Same with relaxation: try an exercise like this every day. If you prefer to relax by imagining a hike in the woods, you can do this instead.

Here’s why: when you have PTSD,  even at your most calm, you are probably still pretty wound up and vulnerable to stress as compared to a person without PTSD. That increased vulnerability can be pretty stressful in itself – you might spend much of your time worrying about how you cope with unexpected stress, or feeling embarrassed about how you react to stressful events.

Put simply, doing relaxation exercises regularly can help to rebuild your resilience. It can help you feel calmer and more centred, so that you can handle stressful events with more confidence. It’s not a miracle; it’s a skill, and just like any other skill, it takes time and practice to get better at it. But it’s worth it – over time and with practice, relaxation can make a difference.

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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 welcome to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is the copyrighted property of Larry M. Jaipaul; please do not copy images without permission.

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Finding Solid Ground When You’re Triggered

Hi!

Today, I want to tell you about grounding skills – the kind that you use when you’re being triggered, and you’re starting to feel sucked into an ugly old memory. Those of you who are getting help probably have a few of these already; for everyone else, these are your life jacket when you feel that you’re drowning. Learning to use these is an important investment in your well-being.

The key in this type of a situation is to use whatever tricks or strategies you can, in order to remind yourself that you are here in the present and the danger is over.

Some ideas for doing that include:

– look around the room; notice and name some of the things that you see. Becoming more aware of where you are now helps you fight off being sucked back into the past.

– rub the palms of your hands together. Pay attention to the sensation of warmth that this creates in your hands. Usually, our hands get cold and clammy when we’re nervous – so this little trick makes you feel calmer by changing how your hands feel.

– listen to music. You can pick either soothing, calming music to relax you, or you can pick something loud that you can sing along to, something that reminds you of a pleasant memory. (Singing out loud also makes you breathe deeper – and since we often hyperventilate when we’re triggered, this helps too).

– do any kind of physical activity that your pain and/or physical ability allows. Focus on how it makes your body feel. Your muscle tension will go down as you do this, and that will make you feel calmer.

– if you have a pet – touch your pet’s fur, talk to your pet, and/or hug your pet.

– carry something meaningful in your pocket, something that reminds you that you are here now, and that the danger is over. Touch it to re-orient yourself. If you didn’t have your current car or home when the trauma happened, your car or house keys will do: touch them to remind yourself that you are here now, and that event was in the past.

– remind yourself of today’s date. If you carry a cell phone, looking at your phone can be a good trick for this – look at today’s date, remind yourself of the date when the bad memory happened, and then firmly tell yourself, This is now, that was then; I am here now. Feeling scared is not the same as being in danger;  I may be reminded of back then, but I am here now and the danger is over.

(Of course, if the anniversary of the trauma is what’s triggering you – looking at the date is NOT the way to calm yourself. Here‘s some tips on how to get through it).

These are skills – so the more you practice, the better you get at using them…

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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 welcome to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is copyrighted. The photo gracing today’s post was taken by Wojtek Rajski, and I’d like to thank him for generously allowing me to use his work. Please do not copy photographs from Coming Back Home without permission.

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PTSD: The Role of Reflex, Part 3: Reflex has values

Hi again!

In a nutshell, here’s what we’ve discussed so far: reflex learns as a result of your experiences; but reflex isn’t very smart, so what it learns as “predictors of danger” is a mixed bag of good predictors and random stuff that was going on at the time that the danger happened.

Today we’ll discuss why reflex doesn’t bother filtering good from bad predictors of danger before learning them: because reflex values speed over accuracy.

To illustrate, let’s revisit our old friend, Dave the zebra.

Dave and his zebra friends are out enjoying some delicious pasture.

(I know – last we saw Dave, he was avoiding pasture, because of what happened to George. But he got help for that, and now he’s doing much better. He says thanks for asking.)

Dave catches sight of something out of the corner of his eye that might be a furry tail, like the lion’s. But he only got a glimpse, and he’s not sure.

What should he do – raise the alarm, or try to get a better look?

On the one hand, he didn’t get a good look, it could be nothing, and those other zebras can be pretty snooty if he gets it wrong.

On the other hand, taking a closer look wastes precious seconds that could be better spent getting everyone to safety.

Folks – from the viewpoint of your survival reflex, the only thing that matters is survival. Your survival reflex assumes that it’s better to make a fool of yourself by overreacting, than to hesitate and waste a second.

So – reflex learns by the principle of “better safe than sorry”, and reacts by that same principle.

This will lead to a lot of situations where your survival reflex will be convinced that you’re in life-threatening danger, even though you’re not. It’s reacting to a reminder, even if that reminder doesn’t make any sense to your “thinking” brain.

We’ve discussed how you can have a reaction to a trigger even when you understand that there’s no real danger; we’ve covered how important it is to NOT beat yourself up over this, because it’s an injury and not a personal failing or character flaw.

What you can do instead is use this knowledge to help yourself regain a sense of calm: when you’re triggered, the reaction can make it feel like the danger is very real. So it becomes really important to understand that being triggered does not mean being in danger: you can be triggered when there’s no danger.

It helps to understand that your survival reflex sometimes acts like a kid pulling the fire alarm at school when there’s no fire, but because he doesn’t want to write the math test.

Use this knowledge: when you’re triggered, remind yourself of where you are, and what you’re doing. Remind yourself that you’re safe, and it’s just your survival reflex going off, pulling the fire alarm at a faint reminder of danger. Reminding yourself of where you are and that you’re safe is a way of grounding yourself – and knowing how to ground yourself is an important coping skill.

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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 welcome to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is the copyrighted property of Larry M. Jaipaul; please do not copy images without permission.

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PTSD Triggers: Coping with Thunderstorms

Hi there!

How’s everyone doing? Didya make it through the fireworks okay?

Now that the fireworks are over, a lot of people’s first instinct is to forget about it until next year. If you have a really tough time with fireworks, I can certainly respect that…

But – before you do that, please take a few minutes, and make a mental summary of what strategies worked for you this year and what didn’t. Then, use that information to plan what you’ll do the same way next time, and what you might try differently. Learning to live with this beast called PTSD is sometimes a process of trial and error, and you can get better at managing it by adapting your strategy to do more of what works, and less of what doesn’t.

And while we’re on the topic of coping with sudden loud noises that make you jump, let’s discuss thunderstorms. Chances are, thunderstorms are no longer your favourite thing. Particularly the kinds where a giant clap of thunder right outside your window makes you end up under the bed at 3 am.

Not fun.

Okay – here’s what we’re going to do about it:

– Make a habit of reading the weather forecast. If you know a thunderstorm is coming, then it can’t catch you by surprise. If the weather forecast calls for overnight thunderstorms, your plan is to go to bed reminding yourself, “I’m home. I’m safe. They’re calling for thunderstorms – so I may wake up to the sound of thunder, but I’m not in danger”. Having this little conversation with yourself won’t stop you from reacting, but it will make it easier to re-orient yourself more quickly.

– Invest in a nightlight. Get a couple of pictures of a favourite place, somewhere you go to relax. Put the pictures somewhere you’re likely to see them when you first wake up, like your nightstand. If they’re calling for thunderstorms, turn on the nightlight before you go to bed. Being able to see around the room quickly when you wake up, and seeing an image of a familiar and relaxing place, will help you to orient yourself quickly to the fact that you are home and you are safe.

– Shut the window. I know – it’s nice to sleep with some fresh air. But shutting the window will help you block out some of the noise. If you miss having a breeze in your room, get a fan – as an added bonus, the sound of the fan can help to muffle the noise of the thunderstorm.

These ideas will help you re-orient and calm yourself if you react to the sound of thunder.  However – these tips are not enough to help you stop reacting to the sound of thunder. The best way to do that is a strategy called prolonged exposure.

Disclaimer: If you’re getting treatment, I’d like you to talk to your therapist and get them to help you with this. If you’re not in treatment, and you’re really struggling, I’d like you to get some help from an actual therapist, aside from just reading this blog.

If you’re mostly doing okay, but thunderstorms get to you, then this might be an exercise you can try on your own.

– sit comfortably; stretch; relax.

– set the volume on your computer to where you can barely, barely hear it.

– cue up a clip of thunderstorms on YouTube. Here’s one that I use.

– remind yourself that you are home and you are safe, and this is a sound clip on the computer. Keep doing this through the next step.

– hit play. Keep reminding yourself that you’re safe and this is a clip playing from your computer.

(If it terrifies you, and a minute into listening to the clip at the lowest volume you are still not feeling any calmer, STOP. Get a professional to help you with this.)

– if it’s only mildly unpleasant, keep doing this until it feels boring and pointless, and you’re not reacting to it. The next day, turn up the volume slightly, and repeat again until you are no longer reacting. If you keep doing this, slowly and gently, you will retrain your fear reflex that the sound of a thunderstorm is not dangerous.

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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 welcome to share the link, but do not copy and paste content. Unless otherwise noted, all original photography on Coming Back Home is the copyrighted property of Larry M. Jaipaul; please do not copy images without permission.

 

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