Yesterday CPT, Today Individual Therapy

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.

Group CPT:
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.

• Blaming myself for what happened:  Doc took an interesting approach on this one but it was effective.  He asked me if I was a paraplegic in a wheelchair out walking with my two year old and the got loose and ran out into the street, would it be my fault?  NO.  Would you have been able to do anything to prevent it?  NO.  Would you and your wife acknowledge that limitation and modify how you do things until your daughter is old enough not to run out in the street?  YES.  Do you understand that your PTSD is a disability?  YES, but I don't want to accept it.  Do you understand that there is no reason to blame yourself for what happened.  NO.  Think of the paraplegic - would he blame himself or would he change his environment to ensure the incident never repeated?  NO to the first part and YES to the second.  Treat your PTSD the same way.  No one is at fault for what happened.  You just need to change your environment to accommodate for this aspect of your disability and move forward.  Easier said than done doc.  Why?  Because I still blame myself for not thinking it could happen in the first place.  Are you omniscient?  NO.  So why do you think you have the right to anticipate everything before it happens?  I don't but...OK doc, I see your point.
• Deconstructing my script:  Doc and I sat down and looked at the behavior that was resulting from what happened - withdrawal.  Starting there, worked backwards.  He asked me what emotions I felt as a result of what happened.  Horror, guilt.  What thoughts or beliefs did you have that made you feel those emotions?  I don't know doc.  I don't recall thinking much of anything.  Take your time and think about it.  Oh my God.  I hurt my daughter.  I failed her and my wife.  My wife is never going to be able to forgive me.  I'm going to lose my family.  Let's look at those thoughts logically.  On a scale of 0% to 100%, how realistic are those thoughts?  Realistic?  I don't know.  OK, start with the first thought.  How realistic is it to believe that a 270 pound man could have hurt a 35 pound two year old?  100%.  It sure is realistic.  How realistic is the thought that you failed your family?  100%.  Wrong.  Would you, not the PTSD, ever intentionally hurt your daughter?  No.  So what's the reality here?  30%.  It may not have been intentional but it still happened, doc.  Fair enough.  How realistic is it that your wife won't forgive you?  If I would have actually hurt my daughter, 100%.  Did you?  No.  So how realistic is it?  20%, I guess.  How long have you been married?  A little over six years.  Is this the first major issue you two have experienced in that time.  No.  Has she forgiven you for your past behavior?  Yes.  Would she ever take your daughter away from you?  Only if I hurt her intentionally.  That's not what I asked.  You stated that you would never intentionally hurt your daughter so that thought is illogical.  Does it stand to reason that since your wife has stood by you through all the ups and downs for six years that she's not going anywhere and that she's not going to take her away from you?  Yes.  I get what you're saying.  Realistically, doc, 0%.  Max, this is your script you came home from Iraq with.  Every time something happens, you read this script and the end result is withdrawal from your family.  THIS is what we are going to work on changing.  You need to learn to write a script for every situation.

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.

Individual Therapy:
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.