Book Review: I Always Sit With My Back To The Wall

Rating: 5 out of 5 Stars
Authors: Dr. Harry A. Croft, M.D. and Rev. Dr. Chrys Parker, J.D.

One of my loyal readers sent me this book and asked that I review it.  When I first picked it up and dove in, I was initially annoyed.  The Introduction and sections about the authors, for some reason, sound self-congratulatory to me. I put the book down and waited a few days and reread that section.  What I realized is that what I though was a case of ego stroking was, in actuality, an accounting of why we should listen to what they have to say.  They have worked extensively with veterans and service-members and it shows in their methodology:

They coined it the 'R-E-C-O-V-E-R Approach'.  I caught myself thinking that it was a catchy acronym - but it better be followed up by substance or I would lose interest real quick.  Well, I didn't lose interest.  As a matter of fact, reading their book and learning about their approach has had indelible impact on my ability to cope and the 'whys' of my behavior.

I do not make that claim lightly.  While some aspects of their approach have been written about before, it's the manner in which they organize it all that has a huge impact on the way you, as a reader, will absorb it.  The biggest impact they make with their approach is their focus on the physiological underpinnings that cause the behaviors attributed to PTSD.  Having someone tell you it's the 'battle brain' doesn't tell you anything.  When they explain to you that the basis for PTSD is physiological, when they explain in a way you can understand what is going on inside your body, I guarantee you will feel a great sense of relief.  I know I did.  I now have a reference to help me explain to others that my PTSD is not 'just in my head'.  It will make the reader more aware of the way they respond in varying situations and facilitate recognizing the signs of being triggered much faster.This can also have another major impact on the lives of veterans everywhere:  You now have a resource to give to your family to help them understand how you are different that 'before' and what they can do to support you effectively.


Their approach to writing this book is exceptional.  For every issue or topic they address, they clearly delineate who is presenting his perspective.  At first I didn't think that would work out.  Two people writing about the same issue as separate and distinct voices?  Wouldn't it be better to write collectively?

No. Unequivocally.

Yes, they both have their own unique perspective on the issues.  Yes, their tone and reasoning varies, No, their rationale does not conflict - it complements.  Croft has a tendency to take a more clinical, yet still conversational, tone to his commentary.  Parker, the more spiritual.  The change in voice also helps to keep the subject matter from getting dry.  It provides you a unique opportunity to learn about these issues from all sides.

I don't want you to just take my word for it.  Let me give you the guided tour and you can make the decision to read the book if you find it as beneficial as I do. For those of you not familiar with my review writing style, I break the book into sections and give my account of the 'good', 'bad', and 'unexpected' in each section.  I take this responsibility very seriously and strive for objectivity.  So let's dig in, shall we?

Recognizing when PTSD is in Your Life:
The Good:  In this section, the authors describe the types of behaviors that can be indicators of the presence of PTSD.  They cover all of the bases here and make some very astute and pointed observations about the behaviors attributable to PTSD that made me squirm.  They give anonymous real-world accounts of these behaviors from veterans in all different situations.  They focus on the different ways in which our ability to socialize is compromised in both personal and professional settings and if you don't know whether you have PTSD, reading these depictions will leave you with no doubt.

The Bad:  Depending on your state of mind, the examples they give could lead you to adopting a very stark outlook for the future.  The authors could have done a little more at the end of the chapter to temper this potential reaction by offering encouragement and empathy rather than ending with a three sentence blurb that says 'if this is you, read on'.

The Unexpected:  They depict relationships and how they impact all parties involved.  Their descriptions detail reactions and behaviors of those affected by the veteran with PTSD and allows loved ones reading the description to evaluate more fully, from both sides of the interaction, whether PTSD is in their lives.

Educating Yourself About PTSD:
The Good:  Croft and Parker explain how the things you experience can lead to PTSD.  They explain how experiencing trauma causes the stress that gets us 'stuck in survival mode' and how this causes those affected by PTSD to behave a certain way.  They go over the three major categories of symptoms: Re-experiencing, avoidance, and increased arousal.  They explain how doctors evaluate you and that no two people manifest symptoms in exactly the same way.  They do an amazing job of explaining all of this without getting lost in jargon that would be lost on the average reader.

The Bad: N/A

The Unexpected:  They explain that the basis for PTSD is more than just behavioral.  This is where they first posit that there is a strong physiological aspect of the disorder that is often overlooked.  While this is delved into in depth in the next section, even hinting that PTSD has underlying physiological causes left me feeling a profound sense of relief.

Connecting Biology to Your Psychology:
The Good and Unexpected:  The authors explain how people with PTSD have been done a huge disservice by the behavioral symptoms being discovered and documented before the physiological aspects of the disorder could be ascertained.  They explain how, physiologically, your brain and your hormones play a huge (and I do mean HUGE) role in PTSD.  They explain how the parts of your brain dedicated to survival become overstimulated.  They present it in a way that makes you understand that the underlying physiological effects on your memory, your subconscious, and endocrine system are real - not imagined.  PTSD is not something you can overcome with strength of will.  You didn't make it up and it's not just in your head.  To go into any further depth, I would have to plagiarize.  This section of the book does so much to relieve the stigma we put on ourselves.  If you know anyone who thinks this whole mess is just in your head, kindly shove this book in their face and tell them to shut the hell up and read.

The Bad: N/A

Organizing a Comprehensive Care Plan for PTSD:
The Good:  Croft and Parker do an excellent job of explaining the different types of treatment available to help manage your PTSD.  They talk about therapy, group and individual, and the most common modalities used to treat PTSD.  They talk about medication.  They talk about alternative treatments including massage, yoga, acupuncture, and meditation.  They even talk about naturopathic alternatives.  Most importantly, they explain that this is a plan - one that you control and direct.  If something's not working, try something else.  In essence, be your own advocate.  Learn what you need to learn about the treatments available to you and make educated decisions.  Don't let doctors throw medication and therapy at you and hope that something sticks.

The Bad: N/A

The Unexpected:  In this chapter, they explain how some treatments need to be approached with caution.  Some forms of therapy require that you need to be ready to actively engage in them.  They also explain that certain medications can inhibit the positive effects of some forms of therapy.  If I would have known these things previously, I would have demanded a change in my medication.  This is powerful knowledge that will help every veteran with PTSD better direct their own treatment.  In fact, some prescribing doctors and practicing therapists should be reminded of these 'minor' details.
  
Viewing Your Issues in a New Light:
The Good:  In this section, the authors discuss how looking at your PTSD from a different perspective can be life-changing.  They ask you to consider how it affects your spouse, your family, and the importance of protecting your children from trauma, emotional or physical.  From my experience, PTSD is inherently ego-centric.  You are in your own head all of the time.  In this chapter, the authors forcefully suggest you take a look at how your behavior impacts those you love and what you can do to manage that aspect of the disorder.  They also discuss how you can learn to view your environmental triggers as manageable.  They even offer up an approach that was developed by one of the authors, Chrys Parker.  It is called the 'I Am Able Method' (Copyright 2010, Chrysanthe L. Parker, All rights reserved).  It is a quick and functional way of helping you manage your triggers and associated behavior.  What astounded me is that it took until 2010 for someone to come up with this approach.  Lastly, they talk about high risk behavior and substance abuse.  While I am not an adrenalin junky or a substance abuser and these portions of the chapter did not pertain to me, I could see how they could be helpful to a veteran who is at risk.

The Bad:  N/A

The Unexpected: N/A

Empowering Yourself Through Strong Systems of Support:
The Good:  Croft and Parker explain the necessity of having strong systems of support.  They detail how disparate the effects of PTSD are on people that have created strong support networks and those that haven't.  The talk about family support, support from friends, getting support by giving support, and spiritual support.  I have mentioned how lucky I am to have a strong support network.  My family is loving, compassionate, and supportive.  While my PTSD has caused me to alienate many of my friends over the past ten years, I am finally learning how to make new ones.  For two years, I have been offering insight and support through my website and blog.  Just one small problem.  My life has no spiritual component.  None.  Zip.  Nada.

The Bad: N/A

The Unexpected:  I didn't know why blogging and giving to others always made me feel better, more stable.  Now I know.  The authors explain in physiological terms why showing compassion for others and giving of yourself is so rewarding.  When I finished reading that section of the chapter, I felt vindicated and motivated.  It was a wonderful feeling and one that has persisted.  Additionally, the authors forced me to evaluate my spiritual health.  The verdict - on life support.  I have said on more than one occasion that what I experienced shattered my soul.  While I have attended to healing and gaining support in the other three areas, I have conscientiously avoided confronting the spiritual pain and loss I have felt.  It was an unpleasant but necessary revelation and one I plan on addressing as soon as I can figure out who to talk to about it.

Redefining the Meaning of Your Life: Posttraumatic Growth:
The Good:  In this final section of the book, the authors talk about how to 'keep the faith' long term.  They talk about dispositional optimism, the importance of maintaining your support networks and social ties.  They emphasize the insidious nature of self-doubt.  They also talk about the importance of holding onto your core value system -  the system of morality and beliefs that define you,  Those who tenaciously hold on to this core of their identity are better equipped to manage their PTSD.

The Bad:  After all of the insight I gained in the other sections of the book, this section seemed slightly anti-climactic.  While I understand their intent to leave the course of your recover open, it felt like it was rushed.

The Unexpected: N/A

Conclusion:
Croft and Parker have done something amazing in this book.  They have tied together all of the pieces of the puzzle - and have done it in a way that speaks to the experience they have working with veterans. Their R-E-C-O-V-E-R Approach is comprehensive, simple, and approachable by all, regardless of their progress on their personal road to recovery.  The most important aspect of this book is the emphasis that they place on the physiological nature of PTSD.  It has given me much clearer insight and understanding into my behavior.  I highly recommend that veterans and their loved ones read this book.  You can't understand what you don't have knowledge of.  Take the time - you won't regret it.