June 30, 2o11

Someone asked what I find helpful when someone triggers my post-traumatic emotions and behavior.  “Your ideas might help someonePTSD is a normal reaction to an abnormal event, not a sickness else who got triggered today,” she said.

The ideal trigger plan would enable me to stop the cascade of post-traumatic feelings before I lose my temper, start rapid-cycling, become suicidal, run to the whiskey bottle or medicine cabinet, or fire off an e-mail I’ll regret when the mood passes.

I’m getting better at slowing the reaction down long enough to put a plan in place before I go haywire, but sometimes reaction is instantaneous. It leaves no time to put any plan in place. And sometimes, the instant reaction is inappropriate, embarrassing, or harmful.

My worst-case reactions are a sudden explosion of temper, or rapid cycling between rage and suicidal depression.  I’ve never attempted suicide because I’ve learned this reaction will burn itself out eventually if I just keep postponing the suicide attempt until the impulses go away.

I have wellness tools that help me get through these suicidal, rapid-cycling sieges, without attempting suicide or going to the emergency room: reaching out for support, watching old movies on cable, taking a PRN, listening to music or making my own, prayer, riding with the moods, not trying to stop or reverse them, and reminding myself that this is not a disease.  It’s my normal reaction to an abnormal event, or particular kind of trauma trigger.  So I don’t get scared of my own mind.

Getting scared of your own mind makes everything worse, and it can put you in the hospital or worse.

The temper is the only part of me I hate because it affects other people.  It is never dangerous or violent, but very scary to witness. And if someone has never seen me that way, they don’t know it’s never violent or dangerous.  It’s like a huge bang of thunder that rattles the windows, walls, people, and pets, then disappears as quickly as it came, or a thunderstorm that lasts a short time and passes by. With me, there is only thunder, no lightning. Thunder is not dangerous, lightning sometimes is.

These worst-case reactions only happen when I’m tired, already feeling bad about myself, and am taken completely by surprise, blind-sided by someone I thought I could trust.

So what has helped me slow down my reaction time?

A sustained relationship with a support group — people who have been through it, know how it feels, and what helps them — is often the best kind of help, many trauma survivors say.  It’s usually free.  You can usually call a member of the group for support between meetings when you’re having a hard time.

In recent years, I’ve gotten tremendous help from an individual therapist who is very good at treating trauma. Many therapists in public mental health centers lack experience or training for it, and insurance often limits the amount of one-on-one sessions one can have in the private sector. I have Medicare, and a “medicomp” policy that pays all Medicare co-pays. That policy costs some money, but it takes a lot of office visits to learn to control PTSD, so my policy pays for itself.

With my therapist, I’ve catalogued the kinds of traumas that cause me the worst reactions, and given them names:  betrayal, rejection, exclusion, discrimination, being marginalized, abuse and neglect by a spouse, family member or caregiver, humiliation, job stress, getting yelled at, self-doubt and self-hatred, and feeling overwhelmed or helpless.

In Latin, “to define” means to fence in.  An angry tiger is far less scary and dangerous fenced in than running around loose.

With my therapist, I’ve gone back to the source of these traumas, often in childhood, adolescence, or my twenties.  Very often, an acute reaction to a trigger – or over-reaction to a small trigger– is really all the feelings connected with all the old traumas coming back as if they are happening now.  You’re often unaware this is happening.  You just know you’re having an intense reaction to something in the present.

But if you have a name for what you’re reacting to, and know you’re reacting to more than just the current trigger, you can say to yourself, “I know what this is and where it comes from.  This is my normal reaction to this kind of abnormal event.  What has helped me get through these reactions in the past, and what will help me this time?”  That little process, which can take just a few seconds when you get good at it, can shorten and blunt the reaction, or give you time to put a plan in place.

Looking back for origins does not mean placing blame, or becoming a permanent victim.  When horrible things happen to you, it’s not your fault, but it’s your choice what you do next.  The blame and victim games are seductive choices because the people and things that hurt you really happened and were really horrible.  But choosing blame and victimization stops you from moving ahead with your life, and learning to live in the present and future.

At 50, I decided to stop playing those games, that hurt nobody but me.  I chose instead to understand why I made the decisions that became traumatic. Then I was able to forgive myself for those choices, and forgive many of the horrible people who hurt me. (Some were too horrible, and hurt me too much, to forgive.) Suddenly, I was able to put the old events in the past, where they belonged, instead of carrying them with me all the time, wherever I went.  It made me a happier person, far less angry and depressed than I had been my whole adult life.  It cleared the way for me to understand my reactions to horrible things in the present, and learn skills to deal with them.

There is nothing less “your fault” or “your choice” than rape, and the feelings do stay with you.  There are people out there who want to help you by saying you’ll never get over it.  Other people who want to help say, “It’s been years; get over it.”

To help yourself, say something like this: This will always be with me. Sometimes it will hurt, and I’ll deal with it.  But I won’t let my perpetrator own the rest of my life.  I was a victim once; I choose to become a survivor. He killed my ability to trust, and my belief that the world is a safe place I have some control over. But I will rebuild as best I can. I will choose my own present and future, despite what happened to me, and I’ll deal with the feelings about what happened when they come up.  If I start having “symptoms,” I’ll remind myself that a lasting reaction to rape is not a disease.  It’s a normal reaction to a horrible, abnormal event.  My perpetrator is the sick one, not me.

The same thinking applies to all horrible, traumatic experiences that rob you of your ability to trust and feel that the world is a safe place you can control to some extent.

Other Plans and Wellness Tools

Another way to shorten, blunt, or delay a strong reaction is to call a friend, but not just any friend.  This must be someone who knows you well enough to realize, and remind you, that you’re having your normal reaction to this kind of abnormal event.  Then, you can brainstorm together about what has helped in the past with similar events, and decide on a plan.

A third way is to do whatever helps you take your mind off your mind.  Talk to a friend  –  any friend — about something that has nothing to do with your trigger.  You might say, “I’ve been triggered. Can we talk a few minutes while I calm down?  What’s going on with you and the kids?  How was your trip to the beach?” At some point, your friend will probably ask what happened.  You can either tell it, or say, “I’m not ready yet. It just happened.”  Don’t tell if it will escalate and upset you, or cause you pain.

Make a list of diversionary activities and wellness tools that help you take your mind off your mind, and help you get back on track when things get wobbly.  (If you have a WRAP Plan,[1] this list is probably in it already.)  Walking, crafts, doing a chore, exercise, prayer and meditation, listening to music or making it yourself, cooking – anything you enjoy that distracts you from what’s upsetting you.

Reading and writing help me most, but I’m usually too upset to do that when I’ve been triggered.  Often, I turn on a movie on cable TV.  Because this is such a useful tool for me, I make sure I always have a couple on hand, different kinds so I can choose according to my mood.  I pay extra for a couple of cable movie channels, I program the TV to record things I might like.  If this tool were not so helpful to me so often, I doubt I would spend money on it.

I can distract myself taking a walk, singing, listening to music, talking to friends, and by making a whole lot of food in a slow cooker (crock pot): chili, oriental dishes, soups, stews, beef, lamb, or pork roasts. These take just a few diverting minutes, an hour at most, of chopping and assembling, then leaving it alone for several hours.  I freeze individual portions, so I always have a hot, healthy meal ready in just a few microwave minutes.  These frozen portions save me money when I bring them to work for lunch, or for supper when I’m too tired to make something, and don’t want to pay restaurant prices.

Everyone experiences trauma in their lives, but Post-Traumatic Stress Disorder (PTSD) is relatively rare — except in the public mental health system, where researchers since 1985 have agreed that about 65 percent (2 out of 3) of the adults have it, and 80-plus percent (more than 4 out of 5) of adult women.  It’s 100% if you believe, as I do, that emotional difficulties bad enough to put you into a mental health center or hospital are traumatic by definition.

Trauma becomes chronic adversity when it takes over the part of the brain that controls involuntary functions:  heart rate, respiration, immune system, and the fight-or-flight response.  Evolution and/or God gave this instinctive response to all higher animals to protect them from danger.  It quickens the pulse and breathing rate to pump oxygen to the brain.  It makes them hyper-alert, and they start pumping adrenalin, which makes them stronger, faster, and ready to run or fight in an instant, until the danger is past.  Then, it takes a little while to recover from the extra adrenaline in their systems, to get the breathing and heart rates back to normal.

For someone with lasting trauma issues, that natural response becomes a negative.  It takes over too easily, and at inappropriate times, when something happens that is not really dangerous.  To the person, it feels like a serious personal threat because he is experiencing something beyond the current trigger.  All the feelings connected with all previous traumas come back as if they’re happening now, and the fight-or-flight response takes over.  He’s not making it up.  He really feels threatened enough to send the right side of his brain into overdrive.

What other people see is an inexplicable, often unacceptable, over-the-top reaction to a minimal trigger. It’s embarrassing and painful.

Thinking “I should get over it,” or being told that by somebody else, is not helpful, because it’s usually impossible.  The hurts have penetrated too deep, and now control involuntary functions. But it is possible to learn to live with this old baggage and control reactions to it almost all the time.

 

 


[1] The Wellness and Recovery Action Plan (WRAP), created by Mary Ellen Copeland Ph.D. with others, is a self-help program for people dealing with emotional difficulty or a mental health diagnosis.  It does not prescribe what to do.  It shows you how to make your own individual recovery plan to keep yourself on track, and get back on track when things get wobbly. WRAP was just designated an “Evidence-Based Practice” by the Substance Abuse and Mental Health Services Administration (SAMHSA) of the U.S. Dept. of Health and Human Services.

 

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