My PTSD (part 2)

Several people emailed and messaged me following my last post on PTSD. They thanked me for articulating their feelings. I am humbled by the number of people still unable to give voice to the dysfunction and depression in their lives caused by trauma and I respect and honor that they are not ready to go public with their pain. I promise that this will be the last of my laundry list style posts, but I will visit my own struggle, past and present, in posts to come. I will shed light on the “lost years” via stories about the people who helped and those who capitalized on my weakness. Thank you for writing. And please continue to write to me. Please comment. It is part and parcel of my recovery.

Anais Nin said, “People living deeply have no fear of death.” It’s true that most of us who backpack one or two standard deviations farther out toward the horizon have little time to ruminate about death. We were too busy living it…

Wounded writers, artists, athletes, explorers, abuse victims and warriors have one thing in common: We don’t fear tumbling into the abyss again as much as we are terrified of returning to routine and normalcy after trauma has dilated our senses. As the old joke goes: It is not the fall that will kill you, it’s the sudden stop. The body, no longer protected by endorphins, neurosteroids and adrenaline screaming into every cell, is suddenly left without properly functioning emotional or physical battlement to help protect against the worst memories of our descent and of the collision: these are sights, smells and sounds that throw the body into full defensive mode and at the most inappropriate of times.

Part of the issue can be explained by classical conditioning. Pavlov’s Dogs salivated every time a tone, that had been paired with food many times, sounded. The same can happen with trauma. Everything nearby can trigger a chemical memonic. And you cannot simply will, meditate or exercise away this kind of anxiety.

One unethical experiment from years past demonstrates the negative biological power of adversity. Humans are hardwired to be afraid of two things: heights and loud noises. Knowing this, experimenters presented an infant with a very huggable looking rabbit. But, each time the child reached for the animal the behavioral scientists would crash a large cymbal behind him.He would fall forward in sobs and tears and in no time at all the child panicked at the sight of anything resembling a rabbit. His system had been trained to react. No talk therapy was going to convince a traumatized baby that rabbits were anything but terrifying. It is no different in sexual abuse, domestic violence, accidents or combat. Those things in and around the stress become associated with it. The generalizations can be specific and narrow or disturbingly broad and can emotionally charge other things seemingly unrelated to the original event: sights, sounds, colors, time of day….. And these episodes can become so debilitating, they will destroy your trust that anything or a anywhere can be safe and you are left believing that it might be better to take your own life than to be visited by more anxiety or depression. Our willingness to face adversity in the first place is not always equal to our ability to handle its consequences. And because it is biological in nature it should not reflect poorly on the victim’s character or strength. Take for example the admission by Medal of Honor recipient Dakota Myer this week. He was so debilitated by his experiences that he attempted suicide. He is a hero again for talking about the price he paid for his bravery.

A couple of weeks ago I was the first car behind a particularly grisly accident. An open top jeep had flipped, rolled and then ploughed its way from the interstate into a forest preserve boundary fence. The driver, a young man in his twenties, was in shock and thankfully couldn’t feel the multiple compound fractures, bones protruding through his skin. I called 911, rendered simple aid and kept him warm and reassured. It wasn’t until after the ambulance left that I noticed how fast my heart beat of how shallow my own breathing had become. And I wept as much to release the scene, mourn my own past traumas and because I was incredibly sad for a man whose life was altered much too soon. It is my nature to run toward adversity and danger, but only if there is little tome between the event and my intervention. Any delay, and stress will debilitate me.

My anxiety has spread to things I once loved and to tasks that I once performed with ease. On my trip to Detroit I made a trip to Canada to test my passport. I had laundered it in a commercial washer and since it looked a bit worse for the wear, I did not know if it would pass border inspections. It did, but caused me irrational tension during the discovery. I told a friend when I returned how nervous the experience had made me and she replied that she understood because most of us are a little jolted by immigration inspections. Yes, but it is a matter of degrees. My resting heart rate is now 95-110. A few short years ago it was 46-48. To hit the gas and spur a corporeal engine already running all-out is nothing short of terrifying.

Since the 90s I have daily experienced most of these symptoms:

–Insomnia. It is hard to get to sleep and hard to stay asleep.

–Night Terrors. At least 2-3 times a week I wake almost numb with fear though cannot remember what I was dreaming about. I sit up in bed in the midst of dreams and for minutes at a time before I wake do not know where I am. This can be pretty upsetting for anyone spending the night.

–Reactivity to loud noises. I go to the theater often, but at hours when few people are there so they won’t be bothered when I leave to recover from the THX or Dolby blarings of a Hollywood movie. When my chest hurts so badly I think I might be having a heart attack, I head for the lobby. Theater staff know me by name now and are kind beyond measure. Car horns, intense arguments, and alarms can bring me to the brink of panic.

–Crowds. I will avoid large gatherings. I have turned down over 100 speaking opportunities in recent years. Where I was a keynote presenter in years past it is rare for me to even be a panelist. And if I do participate I have to work so hard to stay calm that I am exhausted by the end of a presentation. The response cost is terribly high. I become disoriented and confused in traffic and busy malls. It is best for me to avoid them. China is a bit problematic as it is always crowded, everywhere.

–Sudden contact from someone I do not know. I am not proud of the fact that I have wrist locked, hip tossed or otherwise subdued several people over the last few years after being surprised or assaulted. I am not proud of the fact that I have put people on the ground from Tiananmen Square to Stockholm, Sweden. Well, except for that thief at the Summer Palace …But, I digress. Even were I not a Hapkido Master, my extreme fight or flight reactions would make me a dangerous adversary.

–Heights. I used to love rappelling backwards off a helicopter skid. Now, I cannot cross a pedestrian bridge without a crippling rush of adrenaline. I visited the Dunhuang Buddhist Grottoes on the Silk Road this year and had incredible trouble navigating simple scaffolding only 1-2 floors above the ground. I am humiliated when I have to chart a course down the center of an overpass and run across to keep from being stranded in the middle by fear.

–Creativity. I stopped writing poetry the same year I won a National Endowment for the Arts Fellowship in Literature. The medication I had to take robbed me of ambition and original thought. The struggle is whether to be stress free, but with a chemical lobotomy and the artificial anger that it creates, or to fight anxiety ocean with a sword. The latter seems a bit more heroic.

–Coffee, Epinephrine… More than a single cup of coffee may well render me too stressed to drive and conversation comes to a halt because I am trying to keep my body from accelerating into a panic attack. I don’t like shots and won’t ingest anything that might hype me up.

–Memory. I once had a nearly eidetic memory for certain things. Years after they graduated I could tell students where they sat in my class and could remember names and details about their lives even if we were not close. These days I have trouble with recall and it is not unusual for me to forget the simplest things, much less long term data (CRS)…This is likely due to the side effects of the Klonopin doctors put me on years ago and because parts of the brain are actually destroyed when under constant pressure. The desk clerks where I live have spare keys at the ready and have retrieved dozens of things I have left behind. They now assume that any lights left on in the parking lot are mine. They kindly say that all is not right in the universe if I have remembered everything. I have a number of task lists, but they do little good when you can’t locate the list 😉

–Egress. I study a room to make sure I can exit and can defend myself if a problem occurs. I do not need my back against the wall, but I need a clear field of vision. I have noticed at the VA that new hospital staff will often walk directly behind some of the vets. The docs will look puzzled when the patient stops and glares as he lets them pass. Nobody likes to be “snuck up on” but PTSD sufferers like me are especially hypervigilant and much easier to threaten.

–Hypervigilant. I love the Psychic Detective show on TV as I am pretty similar to the protagonist. People watching has always been my hobby, and clinically I am a great diagnostician. These days, it is a survival response. I scan everyone in unfamiliar places. It is a threat assessment. That is why I frequent the same restaurants, gas stations and coffee shops day in and day out and get to know the people there. It is less tiring than being overly alert.

–Social Interaction. I am either too talkative or not talkative enough until I get to know you. I was a champion speaker and professional communicator. These days I’m just happy to survive a conversation. It is why I am anxious to get a service dog: A buffer and grounding tool when things are too much to handle. Too, I avoid conflict now. It has led to disastrous ends in some situations. In China unethical folks took great advantage of my detours around confrontation and I was cheated by a number of folks and always took the financial and reputational hits for the consequences of my avoidance. For the record: I own the failures and am still working to make amends where they are due. There are a handful of folks that should be aware that they are not yet off the hook for their transgressions.

–Confidence. Nothing will erode your confidence like this. To go from successfully competitive to incapacitated is a journey I pray you never take. And people will be sympathetic to those with physical difficulties, but suspicious and unforgiving with those struggling with mental health struggles.

My world view has changed because of this. I think the public and business worlds are basically bad, with a few good people in them. I am thankful to many of those few good and trustworthy people in my camp. It may sound devastating. And there are days that it is unbearable. The good news: I continue to learn how to accommodate for my issues while not expecting it from others. I will survive this as best I can. I am still competitive and determined, most days, that PTSD won’t deter me from finding a way through this while helping others in the process. It truly is about the journey and I intend to enjoy every bit of it I can.

Where self will comes in is this: It would be easy to give up and spend my days holed up like I was years ago afraid to go outside. But, to desensitize you must have experiences that train your body to let go of fear and let stimuli that once were your enemies assume neutral or helpful roles. Eleanor Roosevelt said that you gain strength, courage, and confidence by every experience in which you really stop to look fear in the face. You must do the thing which you think you cannot do. I gave up Tae Kwon Do, Writing, Speaking, Teaching. Everything I have accomplished these years has been in spite of this goddamn disease.  More to come…




Today’s call to action:

Follow Patriot Paws, a service dog training organization that provides help to people with emotional and physical disability. They do charitable double duty by training prisoners how to train dogs. Their students have a 0% recidivism rate.

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