How To Heal PTSD

In his book Youth and Identity Erik Erikson states, “… the ‘I’ is all-conscious… we are truly conscious only insofar as we can say I and mean it.” Can you say ‘I’ and mean it??

In order to survive the aftermath of my trauma, ‘I’ was a word that conjured too much fear and confusion for me to say. What slowly emerged as my post-trauma self was a girl who denied everything, beginning with the need or right to speak and extending to everything that might have been good or pleasurable. Joy was denied. And happiness. Religion. Trust. Faith. Medicine. Love. I believed in nothing, not peace or gladness. Neither glory nor pride. Everything became suspect. Everything became a potential trap into which I might fall and the result would be an overwhelming blight of emotion, an empty vortex of disillusionment, a catastrophic event.

Nothing seemed safe, so I never achieved a major step of the healing process: I didn’t “acknowledge the harm … [of] experience and discharge … feelings of grief, anger and despair.” Fear ruled me, and regardless of how often my mother offered to talk (which she did since the day of my hospital release) regardless of how often she suggested I might feel better if I did, I raged in anger at the idea until she, too, fell silent. And so, rather than move through denial and depression and anger toward a new understanding of myself, over the years I sank deeper into a definition against rather than of the new ‘I’. Plus, I sank deeper into an internal silence until finally, there was no voice at all.

I was 13 when my trauma occurred. I was 17 when I first spoke about it. In the intervening 4 years I couldn’t come anywhere near the subject.

And then something broke inside of me and what gushed out one impromptu day was something I don’t even remember. All I remember was that my mother and I were out to lunch and the next thing I knew I was sobbing and she was holding my hand and it was the first time I admitted to myself that I was struggling with the past.

It would be another 20 years before I realized I could be healed; before I made the choice to become healed and do whatever it takes to make that be so.

What I do vividly remember from that day with my mother, as we lunched at a local diner and then drove to New York City for the afternoon, was the huge feeling of release. The feeling that I was no longer carrying around a secret – from myself and everyone else. It would be years before I spoke about it again, but I still remember the tremendous feeling of a weight being lifted. And also, my surprise that it could be lifted just by my attempting to talk.

For the past 3 weeks we’ve been building up to the moment that you share your trauma with someone else. Over the weekend, I posted the voices of other survivors who are finding the words. Now, it’s your turn.

BRIDGE THE GAP EXERCISE:

Your mission this week is to determine one family member, friend, or professional practitioner with whom to share your story. Make a list of the possible candidates in each area.

Carry the list with you; refer to it during the day. If you do not immediately know whom you wish to open up to, let your inner voice guide the way. When you randomly look at the list you will feel a reaction to the names on it. Which name has a positive reaction associated with it?

[Note: If you have already accomplished this step of speaking to family, friend and practitioner, your focus should be on whom you will tell the secrets you still keep. I went through years of therapy without admitting to my therapist what the real driving force was behind my PTSD. I talked about the horror of my illness, but I didn’t mention my continual flashbacks about leaving my body or how those flashbacks were driving the day to day life I was trying to lead. When I finally did tell him this, it brought me to a new level of healing. We cannot fully heal if we keep secrets. Now’s the time for you to get comfortable with the idea of letting out the last bits of information you’ve kept to yourself.]

Some points to think about:

1- The goal is not to go around telling our suffering to unspecified people who may or may not want to hear it. The plan is to reach out appropriately by developing the ability to have a dialogue with a support network: specifically chosen family, friends and practitioners.

2- Anyone to whom we tell the story should be in the position to have chosen to hear it and indicate how much detail he/she desires to know. Be up front about the nature of what you wish to share.

3 - In choosing to whom you will talk, consider the qualities that person possesses. For example, is he/she kind, empathetic, compassionate, respectful, understanding, supportive? You do not need to share with someone who does not have the characteristics to understand the courage it takes to do what you’re doing, and the conscience to know what the right response will be.

4 – Do not feel shy about your right to speak. One of the effects of PTSD is our detachment from the world. This is a major impediment to healing. If we are suffering without support, then telling the story is not a self-indulgence; it is a necessity. Healing cannot occur if we are all alone with our thoughts.

(photo:Elephant Soap)

Three and a half years ago I sat down to write out my trauma. I’m a writer, after all, writing’s what I do. I turned on the computer, I adjusted my seat, I fiddled with the lamp. I opened the window. I sat back down at my seat. I stared at that annoying flashing cursor. I decided I needed a cup of coffee. I went to the kitchen. I scratched Baylee’s belly and waited for the water to boil. I stirred up a great aromatic blend. I went back to my desk. I sat down. I stared at the blank screen. I decided I needed a cookie to go with the coffee. I went back to the kitchen. On the staircase, I passed a new book I’d bought. I sat down to read a few pages.

Do you see where I’m going here? The will and desire to heal are not a straight line. We will be pulled toward healing just as we’re pulled toward not healing. Healing is frightening. Healing asks us to go into the dark believing we’re going to come out into the light. What we must do is have faith that the healing process will bring us to a better place.

Not that faith is an easy thing. Pulling together our thoughts about our trauma and the healing process can bring up new stuff we weren’t (and, thank you, didn’t want to be!) aware of.

I’ll show you what happened when I started writing. I had just moved to Florida from New York City and bought my first house…

A lush tropical garden of weeping French hibiscus, bougainvilla, jasmine, huge red lobster and white birds of paradise surrounds our patio. It is the perfect place for me to stalk the past. While the humidity curls damp tendrils on my neck, I’m slowly beginning to look at events, recount facts, develop a chronology; mine my memories with deliberate consciousness. In the end, there will be something that resembles a plot with characters, conflict, climax and resolution. I will have followed the proper academic protocol for story writing, but will it get me anywhere? Are Charcot and his cronies correct in thinking that telling the story heals trauma? More recently, is Horowitz et. al. correct in assuming that the “repeated replaying of upsetting memories serves the function of modifying the emotions associated with the trauma, and … creates a tolerance for the content of the memories”?When I am through with this very thorough reconstruction of events, will 1981 seem inconsequential? Will I be able to see myself after all? Or is this just another way to honor the trauma because as I get going and get the swing of laying out the facts, telling the story seems pretty damn easy compared to examining, exploring and exposing the deeper meat of it all, aka, Those Things We Don’t Discuss About Trauma.

The acute and sudden sense of overwhelming powerlessness.
My surprise at being so powerless; the seismic shock of that surprise.
The internal and external measures I took (and continue to take) to accept that shock.
How acceptance of shock causes an identity to splinter.
The disorientation splintering brings.
The ways in which disorientation forces the sculpture of an unrecognizable self.
How much that new self is not an entirely comfortable place to be.
How frightened I am that no place will ever be comfortable again.
How I no longer trust myself, anyone else, or anything in the universe at all.
How difficult it is for me to talk about any of this.
How much I want to speak but can’t.
How distressed I am at this unexpected absence of words.
The fact that I am lost. I am overwhelmed. I am afraid.

Doesn’t sound like things are going well, does it? But a wonderful thing happens when we begin telling the story: We start looking beyond the facts and see ourselves and what’s really driving us. We start understanding the why of PTSD instead of just living the what. We begin learning what it will take to heal.

The past 3 weeks of focusing on the I WILL TALK healing resolution has brought you to the point that the words are moving out of the dark of your mind and into the light of the world. This is a terrific accomplishment. This act of bridging the gap between you and the rest of the world will lead to a new level of healing.

Next week we’ll start looking at strategies for choosing the 5Ws of telling our story – the who, what, when, where, why, and how of the right person, place, time and method for bridging the gap between the story controlling us and us controlling the story.

Over the weekend, take some time to 1) finish revising your trauma script, 2) practice reading it aloud to yourself.

Freedom is coming, friends. Let your words lead the way!

(photo: lotusfee)

For many of my undiagnosed PTSD years my brother and I lived together on the Upper West Side of Manhattan. During some of that time I dabbled in playwriting. When my first play went into production I learned pretty quickly that what we put on the page sounds different on the stage.

As I rewrote and reworked the script, I added to the revision process by reading the characters’ lines out loud. This disturbed Bret. He’d come home from work and hear a few different voices speaking in my room, and then, when he stuck his head into say hello there would just be me sitting at my desk, pencil and script in hand, looking up at him as if he’d just interrupted a deeply fascinating conversation.

The first time this happened Bret carefully looked around the room and then back at me.

“Who are you talking to?” he asked cautiously.

He looked worried. I was, although we didn’t know it at the time, deep into PTSD, so he was used to me being a little off and needing some looking after, but having whole conversations with myself was something new.

“There’s no one here,” he said.

“I know.”

“But I heard voices.”

“Yes,” I said, “I’m revising.”

What I had discovered during rehearsals was that two things were happening: actors’ verbal interpretations of my writing gave different inflection and meaning to my words, and also: sometimes the words that sounded so right in my head sounded really awful when put together on the tongue.

I am not the Magellan of revision – for centuries poets, playwrights and other writers and orators have been revising their work by reading it out loud. For us writing our trauma scripts there are some great advantages to reading it aloud before we speak it to anyone else:

[For those of you who are already speaking with great ease, you are not exempt from today’s exercise! We all hold back. We all keep some details, images, or instances secret for ourselves. Sometimes it’s because we just can’t bear relating them, other times it’s because we don’t know how. Now is the time to figure out how to say what still haunts you.]

1 – You get used to hearing the story yourself. We can’t help it, we get emotional at the thought – much less the act – of relating what happened to us. If we don’t practice what it sounds like before we speak to someone else then we’re hearing it all for the first time at the same time we have an audience. This is not necessarily a recipe for success. We’re dealing with our own emotions about the past at the same time we’re feeling very emotional and vulnerable in the present. Not the best way to go.

2 – You get to hear how the words sound. When we’re writing, we can tend to overdo it a bit. Big fancy words and long explanations sound wonderful when we’re speaking to ourselves, but you’ll lose your audience this way. Likewise, if the phrasing is ambiguous and lacking detail the audience won’t get the whole picture which, in this case, is extremely important. By rehearsing out loud you can decide if there are better words to express what you mean, more succinct ways of telling it or more facts that should be conveyed.

3 – You get to practice the feeling of speaking and remembering at the same time.
We deal with enough unwanted flood of emotion without bringing it on ourselves. Let’s not take the positive step of beginning to tell the story and sabotage it by not being prepared for how it feels to hear it and feel it at the same time.

4 – You get used to how it sounds when the ideas, memories and emotions exit your head and enter the world. In our heads memories can loom so much larger than life we can’t imagine shrinking them down to world-sized pieces. But we can. When we put them on the page they shrink a little. When we speak them out loud we get to see that they are only memories, after all. They are not happening in the moment and, though we may be a little psychologically skewed, we are still strong enough to pull it all together and share the burden with someone else.

I could go on; this is just a starter list for the benefits of speaking. These items only relate to where you are in the process today of writing it out and getting it ready for public consumption, which is a topic we’ll tackle next week.

For today, to continue the BRIDGE THE GAP healing workshop your goal is to begin reading out loud the script you wrote a few days ago. Find a quiet place where you are isolated and alone. Block out at least 30 minutes when you can read your script out loud, revise it, and read it through again.

Look for phrases you stumble over, words that just don’t fit, ideas that don’t really get the point across when you hear them out loud, and gaps in the narrative that need to be fleshed out.

Trust your instincts. When something doesn’t sound right you’ll know. Stop, revise, start over again from the beginning. The goal is to be able to read through the entire script without feeling the need to revise anything.

Final tips:

Play with your voice. Experiment with how high or low, strong or weak, full or thin it is. Find a register that feels comfortable. Don’t fake it. Be real.

Control your breath. Read slowly. Do not be in a rush to get out the story. Take your time. Breathe. Speak slowly and clearly. This will help your audience take in and understand what you’re saying, and it will also help ground you. The breath is an extremely strong source of calm to the body. Use it to your advantage.

(photo: EmazingEm)

An interesting study was released this weekend (conveniently in time for the biggest collective kissing day of the year) that indicates cortisol levels are reduced by locking lips. This is a tough nut to crack for PTSD application. I mean, here we are dealing with symptoms of emotional numbing, anger and the detachment of dissociation – and scientists are proving that if we did just the opposite, if we passionately smooched for a while – it would actually be very healing for us. A conundrum, yes?

Just like the rest of the PTSD riddle what we need to do to bridge the gap from PTSD to healing is a bit of a big jump. But I still think this info is good to know, so that when we’re having a bad day we can stop ourselves mid-stride, say to our partner, “Come over here and kiss me!” and feel a little better afterward. Sort of a new twist on cognitive behavior methodology. And not a bad one to get us thinking that maybe the isolation in which we cocoon ourselves is not the best way to go. Let me know what you think about this.

Getting back to the idea that TALKING is part of the healing process, today’s the day to look over what you wrote last week and get it into the shape of a script. That’s right, today you’re a playwright putting the finishing touches on a climactic monologue.

Using a highlighter, read back over the story you wrote out. Pull out the sentences and paragraphs that you feel tell the story in the best possible way. Rewrite the piece so that your favorites lines, explanations and descriptions are all in one place in one stream of information. Good. Now you’ve taken the burden of telling the story in the moment right off your shoulders.

If you’re anything the way I was, I could not tell the story. I could get out jagged bits of info in completely unrelated sentences one at a time. I could not look at the person to whom I was telling the story. I could not think straight while I was telling the story. And I usually couldn’t get out enough of the details for the other person to get the whole idea behind the story. Usually, I’d abruptly say, ‘That’s all’. By the time I was finished trying to formulate the throughline I’d be a black emotional mess and my thoughts were all over the place. I think the main reason for this was that bringing up the memories in the moment and sifting through them was too much of an emotional overload.

Having a script helps us lessen and get over these issues. With a prewritten script we no longer have to rely on our own clearheadedness to get the point across. We can memorize the script and then go on autopilot. We have a guide; we don’t have to do the guiding of the story. We know what to say without dipping into the past in the moment of the present to get there. Now that’s my kind of healing!

Today, sit down with your recollection. Think about it like a big lump of clay. You’re going to take that blob and transform it into a piece of art. You’re crafting the story. You’re choosing the words. You’re hand-picking the memories. You’re rising up just a little at a time to take back your power and control. You’re the artist of your healing journey. Create. Create. Create.

(photo: wacky_tom)

It’s great to organize all of the troubling thoughts and memories in our heads. That’s the whole point of the work we’ve been doing with PTSD Healing Resolution No. 2. Gaining control over the things that swirl is the first step toward freedom. But that’s only the beginning.

Next, we need to pin down the memories on the mat. To conquer the past we must prove ourselves stronger that it is. And we are stronger – even if it doesn’t feel like it! We are in the present. The past only continues to affect us because … Well, the truth? Because we let it, subconsciously or otherwise. Creating your future means consciously choosing to move beyond trauma and build a new life. Learning to speak about the past is a major step toward that action.

Once you have a general idea and ability to conjure and organize the memories, it’s time to get them out of your head (that’s the ultimate goal anyway, right?). Step #2 in our I WILL TALK resolution is to begin putting it all down on paper. When people want to communicate clearly and effectively they don’t just ramble off the top of their heads; they write speeches so that in the moment their thoughts are focused and follow an explicit order. Today, that’s your task, too: begin getting the words out and down.

The key here is to solely focus on retelling the story of your trauma itself. Take some time today to sit down and write it out. Use details. Set the scene and then in plain language explain what happened. Utilize the flowing structure of the writing we’ve done in the past and just begin to write. Don’t worry about grammar, spelling or syntax. Begin writing and let the words flow and don’t edit yourself – we’ll do that later. Don’t set a timer for this exercise, but do give yourself a boundary. Say, 60 minutes. Know that you will have a completed draft by then and force yourself to stick within the limit. (Of course, if you get going and need to go beyond the time limit, keep it up! But know that within 60 minutes you must have put something of the whole story on the page. If your trauma lasted over a series of days or years you may need more than one writing session to get the whole overview done. Working in 60 minute intervals will control the amount of time you spend in the past.)

Plan ahead: When you’re finished writing, give yourself a reward. Go to the movies. Meet a friend. Call a buddy. Listen to your favorite music. Watch television. Read a book. As you would cool down your body from exercise, do this for your mind, too. Get close to the memories, and then put something between you and them. Writing out the story is not an easy task, but it is the beginning of regaining your power. Word by word you can take back yourself, your life and your future. Do it gently and pamper yourself.

If this exercise seems too difficult, trust me – you can do it. Sit down. Try it. If you can’t follow through the first time. Walk away. Think about it. Go back the next day and try again.

When I’m in pilates class the teacher always shows us the most difficult position, and then offers a modification of it. So, here’s a modification if you’re not ready for the advanced position yet:

Don’t write in the first person; write in the third person instead. Remove yourself from the event and it will be easier to look at and write about. Instead of saying, “I walked down the street,” say, “The young girl walked down the street.”

Changing to a distant pronoun is a way to ease into taking an objective look at yourself and your circumstances. My entire graduate school thesis – a book of poems dealing with my original trauma and PTSD – was originally written in the third person, about a man because I just simply could not get that close to myself. That’s okay. These things take time. Eventually, you’ll be able to write out the whole story.

Need an example to get started? Here’s an excerpt from my own:

The hospital staff remained woefully behind predicting or salving this rare illness’ progression. Ultimately, my parents became the primary managers of my care. They were the ones who ceaselessly researched and predicted; who turned my quarantined room into a burn unit through sheer instinct and will.

I lay in my standard issue hospital bed thinking these little blisters and this big headache were as bad as things would be. And then things happened that made me understand otherwise.

See? Not so tough in the end. Focus on the details and let them guide your way. You’re a detective, remember? Writing about a scene. Just the facts, ma’am, just the facts. Just you, the facts, and a pen and paper. Nothing so scary about that. You are in a safe place. You are creating your future by exorcising the past. Think about that, and then get to work!

(Photo: CrotchSplay)