Introspection...Ally or Enemy? It's a question I have been asking myself a lot over the past few days. It seems that every time I have too much time on my hands to sit and think, I get evaluate everything that's going on in my life. I look at my home life, my work life, being a husband, being a dad. I examine every facet of my life, ad nauseum. In some cases, in excruciatingly fine detail.
I have to wonder how healthy this is for a person like me to do. I seem to get less and less out of it the longer I look. While, I know that there is a lot that makes me very happy in my life, there is also a lot that has left a very bitter taste in my mouth. I wonder if I will ever be able to realize my full potential, and sitting on my duff recuperating from a physical health issue doesn't lend itself to feeling positive about what the future holds.
What I have begun to realize is that I desperately need more out of my professional life - and soon. I think about all of the things I could be doing with my time to advocate for changes in behavioral health care, to educate people about PTSD, to work to reduce the stigma associated with PTSD. It makes me sick to my stomach that I am spending my time in customer service in a grocery store. It's depressing and demotivating. I am an accomplished speaker, an even better writer. Yet, here I sit, wondering how I got myself stuck where I am. I constantly think about hunting for work in Veteran Advocacy. I look online all of the time. I think about the good I could be doing and I feel trapped by the need to make a living to support my family, unable to get out from under the thumb of crap wages and a shitty economy.
Yep, that's introspection for you. It allows me to make important realizations - realizations about things I need to change in my life. Yet, when I am in a position where I don't get to choose when the introspection ends, I get caught in the quagmire of depression and catastrophic thinking. I am on pain meds, so I can't drive anywhere, I can't work. I am stuck here at home with one of two options: sleep or think too much.
So I sit here and think. And contemplate the edges of a sword that never get dull from overuse.
This is the danger of isolation for veterans with PTSD. It suffocates our will, douses the flame of hope. Too much introspection is not a good thing. It's like painting yourself into a corner, with no one around to notice you have until the last stroke has already been painted.
Boy was that a depressing trip. I think I need to make sure that I get to CPT group tomorrow, despite my inability to drive myself. I need something to shake the cobwebs loose, something to turn my sight outward. I need to focus on getting a hold on the depression as it sinks its claws ever deeper into my psyche. I need to focus on my wife and my daughter, how much they need me to be here for them. I'll find a way, I always do. I think I just needed to get those poisonous thoughts out of my head. To rattle those insidious doubts from their nesting places in my mind.
I know I can make it until tomorrow, and that's all that truly matters when the going gets rough.
This past Wednesday I was sitting in group and I was pretty angry. I whole lot more angry than I felt I should have been. We were discussing why I felt so strongly about respect and the equal and fair treatment of others. We took a little trip back to high school memories.
Not a place I enjoy going. We discussed how I was bullied in high school because I was an intellectual with independently formed opinions and a strong moral compass that didn't endear me to the acting out that most kids do in high school. I was physically bullied. A lot. When I got to my senior year, I had enough and finally started fighting back. When I wasn't an easy target anymore, the cowards stopped bullying me.
I didn't realize how much of this played affected my response to things I witnessed in Iraq. I was in Diyallah Province for most of my time over there. For the uninitiated, that's where the Shi'ite, Sunni, and Kurdish controlled lands met. Three sects that hated each other in a situation made more volatile by the inherent vacuum of power created by the downfall of the Hussein Regime. The strong in each sect bullied the weak in the others. People were killed in retaliation for 25 year old conflicts between clans and tribes. Kurds killed Arabs suspected of supporting Saddam's regime. Kurds filled with hatred over the Hussein Regime's abuse of their ethnic group took out their pent up anger on Arabic children, hanging them while their parents were forced to watch. In essence, the most extreme and heartless manifestations of bullying imaginable.
And for a year, I was powerless to do anything to prevent it. All I could do was pursue the perpetrators after the fact, if and only if it was in line with the political alliances we had made in the region.
That's the reality of war and 'peacekeeping'. It tore me to pieces knowing I had the ability to put a stop to it but was powerless to use that ability to ensure any kind of true stability. I knew the cultures. I knew the what and how of making it stop and wasn't allowed to act on it because it was out of my purview as a linguist. I could recommend courses of action until I was blue in the face but no one would listen to the word of a sergeant. Not when politics were involved. They all firmly believed that politicking would create the stability they sought. They were wrong and still are.
Because of the civilian on civilian atrocities I witnessed directly or in passing every day in the markets and towns, my soul was destroyed. It was a death of a thousand cuts.
OK, so what does any of this have to do with my ability to cope now that I am home? Whenever my ideas are dismissed out of hand, I have to choke on my anger, my bile. Whenever I see someone abuse a position of power or bully another, I see red. I didn't realize how much empowering myself to stop the bullying in high school would lead to the extreme depths of despair I experienced when I wasn't able to stop it over in Iraq.
Now I do. The only problem I still have is that it doesn't change the way I feel about how people treat one another. It just validates my anger and that's dang
Well, my last CPT session went really well. I was talking about how I had gone into a funk over the holidays and how I was trying to eliminate stressors from my life. It was an interesting conversation. We talked about how my lack of regular schedule at work was keeping me from being able to get into a routine. Routines are important to me. When I have a consistent schedule, I am able to get to the gym and workout. When I am able to work out consistently, I feel better and look better. I expressed how frustrated I was that I couldn't seem to find a way to get myself on a routine. What I realized is that having a job in retail doesn't exactly lend itself to maintaining a low stress lifestyle.
I was all down on myself and one of the guys from group and pointed out to the doc and me how much progress I have made. I thought. What Progress!?! He went on to explain that when I first came to group, I was a hot mess. All of the problems I had been trying to find solutions for were intangibles - worst case scenarios, even though they had little chance of ever occurring. I stressed out about all of the things that were out of my control. What he told me was that I need to keep a proper perspective. What he sees is a guy that is focused on addressing tangible problems that will lead to an improved quality of life.
It goes to show you how incredibly important objective validation can mean to a vet with PTSD. The progress I have made was so gradual that I didn't notice any change in my perspective or any changes in the way that I address problems. I really couldn't see the forest for the trees. My perseverance has paid off, yet I was still the last one to know!
It truly floored me. I sat back and absorbed it for the remainder of group and felt something I hadn't dared feel in a really long time: hope. If I persevere, stay the course, can I really make a more fulfilling and happy life for myself and my family? Maybe I can. Maybe I can.
I couldn't have asked for a better time to have all of the counseling that I have had in the past day and a half. Group CPT ended up being one on one because none of the other members of the group were able to make it. I individual therapy we discussed why the intensity of the anger, nightmares, and hypervigilance have been increasing recently.
When I got there and realized that no one else was coming, I almost left disappointed. I really needed to talk out what transpired over the past week. When the doc expressed a desire to talk with me relieved, I was really relieved. So I went over everything that happened. He grew very serious and we discussed two topics.
Needless to day, it was a productive session. It has helped me to put what happened into proper perspective and helped me identify an underlying issue that causes my PTSD to have such a deleterious effect on my health and life.
My therapist's major concern is the increasing intensity of my nightmares, my inability to fall asleep easily, and my hair-trigger temper at work. She asked me how much physical activity I am getting outside of work. I told her that I don't really get much. She said that I needed to find a way to work exercise into my week. She said that I didn't need to go all out every day of the week. She said to start small - one or two times per week. Her concern is that only talking and thinking about things doesn't help to drain off the energy I build up over the course of a day. When the physical doesn't have an adequate outlet, it can have a very detrimental effect on the mind. So I promised her that I would talk to my wife about making sure that I have the time to exercise at least twice a week without distractions.
So there you have it. I have a few new things to consider and act on. It gives me a sense of direction, of purpose. I don't feel like I am just reacting to my PTSD right now, which is a pleasant change. We'll see how it goes over the coming weeks and months as I work on these new tasks.
It was an amazing and fulfilling experience this past Wednesday at group. We had known ahead of time that one of the guys in group was going to share his experiences in full. And boy did he. For the sake of privacy, let's just say it was pretty emotional and very heartfelt on his part.
What really touched me in a way that I didn't expect: How honored I felt that he trusted me and the other guys in group with his story. It takes a lot of courage for someone to come forward like that and lay it all out, raw and unfiltered in a group setting. So I wanted to congratulate him on taking the leap. For the other guys who still haven't shared their trauma, I think this was an encouraging moment. A watershed moment.
The other thing that our doc talked about was the fact that so many current conflict veterans seem to have a cavalier attitude about death - an ambivalence about their own survival. It's something that has been seen in veterans of other conflicts, just not in numbers of this magnitude. Doc thinks it may partially contribute to the high suicide rate and wonders how energy drinks (available by the case when I was over there) could affect the way that emotional and psychological trauma is received by the brain. Interesting thoughts, but I disagree. I think that it is a generational thing. It's not that a lot of veterans are cavalier about it. I think it's because they are desperate to appear as normal as possible. The faking disregard for suicide ideation comes across as disingenuos, cavalier. I would love to hear others thoughts on this.
Well, this was an interesting session. I had just gotten out of individual treatment just a little bit before I headed out for CPT group. When I got to group, I was agitated and emotionally raw, the anger oozing out of every pore. It was obvious to everyone in group.
I talked with them all about my anger coming out a lot more since I have begun confronting the PTSD and they all understood. The anger coming back out to the forefront is apparently part of the healing process. Wish I would have known that in advance. So is it any wonder that as my anger becomes less and less easy to control that my anxiety has ratcheted up proportionately? Uh.....No?
The doc explained that phenomenon to all of us in group. When the anger isn't tightly controlled, we become unsure of what is going to happen next - but whatever is going to happen next, it won't be good...
What also came out is that anger manifests more strongly as I feel less in control at work. Thus my cycle of quitting jobs every 6 to 8 months. Well, it appears that cycle has taken longer to come to a head with my current employer, but I am there. It's frustrating knowing that the cycle had continued over the past three years. So what is my biggest priority right now?
Breaking the Cycle
I will not walk away from stability and employment, despite how draining my workdays can be. I gotta break the cycle. If I want to ensure stability and safety for my family, I can't give in to the urges to walk away from what distresses me.
Let's see how things go...
It's been a longer week than it should have been and way too long since I used this blog to get my thoughts out. I wanted to write about one aspect of Cognitive Processing Therapy that has been really good for me and difficult as all hell - both at the same time. The doc says accepting what happened is a major step in the therapy process that presents the biggest challenge for most guys. Doc continually talked to us about acceptance and it started to annoy me how much he talked about it. I knew in my heart of hearts that I would never be able to accept what had happened.
I have been thinking about this constantly for the past few weeks and I finally had a breakthrough two weeks ago that I never got to write about - I was unwilling to accept the wrong thing. I finally made the connection that acceptance isn't about accepting the horrific things that I saw. It's about accepting that there was nothing I could have done to change the outcome. It was completely out of my control. THAT was what the doc talked about when he talked about acceptance.
I was so relieved when I made that connection. I felt like I had reached a guidepost on my journey. And then, as the world always does, my world did everything in its power to challenge this new found clarity. While I won't go into specifics, work threw down the gauntlet and I lost my temper. I got very angry at work and caused a lot of people a lot of worry. I ended up going home that day just so that I could regain control of my emotions.
I recognized what was happening and felt powerless to stop it. It the past, this type of stumble would have sent me into a tailspin for weeks, if not months. That didn't happen this time. I was angry and agitated for the rest of the day but somehow found it within me to let go of the anger. What had happened at work to trigger my PTSD was outside of my control.
Then, I simply accepted that it had happened and felt all of the angst and raw jumble of emotions dissipate. I went to bed exhausted but relieved and woke up the next day feeling much better. So, the concept of acceptance has taken hold and helped me to rein in volatile emotions.
I felt so much better until I saw how worried and stressed my wife was. She was so afraid that I was going to regress. She was scared to death that I was losing the battle with PTSD, that the PTSD was winning and she was losing her husband to it again. I saw the fear in her eyes and I felt horrible, guilty, and responsible for her distress.
So over the past week I have worked diligently to impress upon her that I am not slipping back into the horrible funk I was in last year - that I am OK. I explained to how much my ability to cope had improved since I started CPT. While she understood what I was saying, it didn't lessen the fear for her.
And that's when it came out.
Because of turmoil and instability my PTSD can cause in our lives, she never feels safe and our life never feels stable. It was at this moment that I recognized how much my therapy could help her and other caregivers as well. I sat down and talked to her about my CPT and the concept of acceptance. While I was talking to her I remembered something that her mother used to always tell her. I reminded her of it and am going to leave it with you now, for there is much truth in the following words.
God grant me the serenity
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.
Living one day at a time;
enjoying one moment at a time;
accepting hardships as the pathway to peace
It was another very thought provoking session of CPT this past Wednesday. We had a special guest: An 82 year old Korean War Veteran who was looking for help from the VA for the first time. This is a guy who has lived most of his adult life with PTSD and successfully raised a family - without any help or treatment. He made some choices he wasn't proud of and he has always had a short temper. He made it through it all, working for over 40 years with the same company, raising three kids, etc. He said there was one thought that got him through it all. Well, more of a philosophy or approach to each day:
Two things in life are free. Your love and your time. He always made sure that he gave enough of both to his family.
Can it really be that simple? I thought about what he said for quite a while. The conclusion I came to was that his philosophy offset the inherently self-centric/selfish nature of PTSD. Or at least, that's the only thing that makes sense to me. I find it hard not to emotionally withdraw from my family after a long day at work. It's not fair to them or to me and I need to figure out a way to make it stop. Sooner rather than later would be nice. So what harm does it do to try out his philosophy? Time will tell.
I had an interesting day on Wednesday. When I was getting ready to go to CPT my daughter jokingly closed the door to the bathroom. The lights were off and the central air was on. In that moment, I was in a state of perfect relaxation. It felt amazing.
After this amazingly relaxing episode of cool, dark, quiet, I headed out to the local VAOPC for group. This session was a little different. Doc said every now and then it was good to pause and see what kinds of issues or questions bubble to the surface. So I asked why I felt so at peace in the cool, dark, and quiet. Doc had a really interesting observation: I wasn't unsure of what was going to happen next. I also wasn't sure that whatever happened next was going to bad. Hence, the absence of anxiety.
So this begs the question - how do I recreate this feeling of blissful emptiness in daily life? How do I use this to alleviate or reduce daily anxiety? This got a chuckle from the other guys in the room. I even got a smile and a joking roll of the eyes.
The doctor came back to the topic of acceptance but in a little bit different context than last time. It was two parts:
I accept that what happened in the past can't be changed and that worrying about the past doesn't help me change the present or the future.
I accept that others will never understand what I have experienced.
Hmm. Time to think on those too. It may seems simple on the surface but many times the simplest ideas are the hardest to accept. Don't ask me why, I haven't the foggiest. I will follow up in later posts this week once I have had more time to absorb this information. I can say this for sure: CPT is making a difference for me.
This is getting ridiculous. I can't seem to break out of the funk I am in. Maybe when I talk to the guys tomorrow in CPT group I will have a breakthrough. I want so badly to be present for my family and I have been more successful today than I have been over the course of the past week, but I shouldn't have to work this hard just to show my love and affection.
Maybe I am putting too much pressure on myself. God knows, that wouldn't be the first time I have done that. Maybe I should try putting this into a little bit different perspective. Last year, my life fell apart after the anniversary. Eight months later, I was out on short-term disability - my physical and psychological health were in shambles. This year, things are starting to return (albeit slowly) to normal already after just a week.
Huh. How about that. Talk about a silver lining.
As I continue my life with PTSD, I will share my challenges and discoveries on this blog.