A journal of healing

Archive for the ‘trauma’ Category

Harassment

This idea for this post came from my Doc friend’s blog. She was talking about harassment and where does the line get drawn. She had a patient who was making passes at her staff in jest, but it was still annoying. Of course it was annoying. It was harassment. And as I wrote back to her, harassment is determined by the person who is receiving it, not the person who is inflicting it. It has nothing to do with the intent. It is all about how something is received.

I also went on to say that for someone who has a traumatic childhood, or was a victim of sexual abuse or other violent acts, the response to someone’s intent to be funny has just the opposite effect. It can cause a major trigger that can put someone into a tailspin for days and weeks. They may not even know what they are reacting to. It could be a word or even the tone of the harasser.

Harassment can come in many forms. Often people think they are doing a good thing. But someone who constantly harasses someone from the concept of improving the person is totally misguided. What makes that person think they have that right? What makes them so superior to be able to comment?

As I thought about this all week, it hit me that parents come from a point of improving their child but when does it become harassment? Isn’t improving a child the role of a parent? Is there a point when the parent should stop trying to improve their child?

What about a spouse or your partner? Is it ok to harass them into doing something, especially when it affects your family or home? It probably is not ok, but it is hard not to do. I speak from experience.

My husband’s 28 year old daughter will not learn to drive. This makes me crazy. She is terrified, she says. She finally got her permit and then took one lesson. This took three years to accomplish. She said the lesson went ok. But she has made no attempt to continue.  Instead, she relies on her father to tote her around like Miss Daisy. I think he enjoys her dependency on him. Did I say this drives me nuts?

I am skilled in motivation interviewing. I teach it matter of fact. I know in my heart that I am not going to move either one of them on this topic, so I resort to harassment- truth be told. My intent to get his daughter to drive is based on the best interests for her. I want her to be independent and not have to rely on US for the rest of her life. We won’t be there. She has no other family and she has no friends. Her mother passed away at the age of 52. She instilled this irrational fear to drive in her daughter as the mother never drove.

The real reason the daughter won’t drive is because then she will be expected to do something with her life. That ain’t happening either. I know this probably irks me more than anything. What a waste.

Does harassing them help? Absolutely not. It only escalates my anger and frustration more. Can I walk away from it? NO. It slaps me in the face every time she calls her father for a favor. There was over twelve years when his daughter was out in California with her mother that she never called or spoke to her father. It hurt him to the core. But when the mother died, it was; “Oh, Daddy.” He can’t see it or chooses not to.

The bottom line is it still harassment, even with the good intent. I know in my heart I want her to have a life and not rot away like her mother did. I am sad that she is wasting her life. She has all the capabilities to do whatever she wants, but she chooses the easy way out. I have no right to her life. But boy, it is hard to keep my mouth shut. I am so helpless on this because she is not even my kid.

The bottom line is harassment is a person attempt to control. It is coming at someone from the viewpoint of superiority, or desiring some effect of change. I lived with harassment my whole life. Although it was sometimes masked in humor, it was my family’s way to control and inflict. Years of harassment left me sensitive to being criticized in any manner.

We cannot change people. We can influence them, we can teach, we can support. But it is impossible to change someone who does not want to. But damn, its hard not to do.

 

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4th of July Liberties

 

I was born in America. I have never experienced anything but the freedoms we have here in this country. I do not know any better and so I take it for granted. I am disgusted by piss-poor politicians and can be vocal about my feelings. I am entitled. I take for granted the rights and liberties we have. But I am proud to be an American.

However, I hate the way we celebrate this holiday with fireworks. I personally love the display and the colors. But I hate the noise. It upsets my little Cookie.

Last night we were all sitting in the garden as is our ritual before bed. The dogs take a walk around the yard. We call it the perimeter check. And then we sit for a bit and meditate. There were a few little pops in the distance and Cookie was a bit nervous but still quiet. Then a neighbor set off a huge firework which exploded right over the garden. She panicked.

We ran inside and she took off for the bedroom. I had prepared for this and had the air conditioner and fans going. We crawled into bed and she crawled on top of me and shook. I finally calmed her down and she fell asleep next to me but in my arms. I thought we were ok when another one went off. She again crawled on top of my chest and buried her face in my arms. Finally they stopped and she fell asleep attached to me on my side.

I know everyone has the right to celebrate. I wish they would go back to making fireworks illegal in NY. There are enough displays that are set off by the municipalities to enjoy. I am sure tonight and the next night will be even worse for my little dogs. Browny does not seem to get upset by the noise. But he does get upset when Cookie is upset.

I wish I could teach them something I just learned. I am taking a class to become a Certified Trauma Professional. This class has taught me so much about PTSD and trauma. It is taught by Dr. Eric Gentry, who is an internationally recognized leader in the field of disaster and clinical traumatology.

He teaches that people cannot feel the effects of stress or trauma in a relaxed body. Seems so simple. But he explains in length how the human body is always reacting to triggers of some kind. People who have had extended periods of some form of trauma are in a hypervigilant mode all the time. There are chemical reactions in the brain and the parasympathetic and sympathetic systems go into over drive.  In short, our body is in control.

He explains that we need to be aware that this is always on in one degree or another. And we react by constricting our muscles all day. An example is when at the end of the day, you neck and shoulders are way up and hurt and you have no idea why. It is the constriction of the muscles that you held in a clench all day. We clench our muscles everywhere. It is one cause of leg cramps and back pain.

It is common now for people to understand the concept of just take a breath. Dr. Gentry talks about the power of just taking a breath. He talked about other methods for getting control. But the method I think is amazing and it works is called the pelvic floor relaxation. First you have to become aware of the muscles in you hip area. Do a few kegal exercises by squeezing the muscles that can stop you when you pee. Now just completely relax that area completely. Do that several times a day. Concentrate on those muscles being relaxed when something stressful is happening and you will find you won’t be as stressed.

The issue is that the effect only lasts for a very short time. This is something you have to do all the time. It only takes a second and no one knows you are doing it. Another method to use  is called the wet noodle. This is where you go absolutely limp in a chair for ten seconds. It is like a mini vacation. The effect of being in a relaxed body is how people are learning to deal with PTSD and every day stress.

I wish I could teach my little pup this. But for her, the only comfort is a dark quiet room and being held by her Mommer.

Trauma informed

little girl

I have spent a great deal in the past months seeing a variety of doctors for various reasons. At every visit, every time, the patient care-tech brings me back to the visiting room to wait for the doctor. It is their responsibility to weigh, check blood pressure and ask a few questions. One of those questions is the medical community’s answer to being trauma informed. It misses by a huge mark.

Being trauma informed simply means being sensitive to a patient’s history or the possibility of the patient being in a dangerous living situation. We are talking domestic violence, and all forms of abuse: mental, physical and sexual at any age. Being a trauma informed  means everyone on your team from the receptionist to the doctor is sensitive to how they treat a patient. Some may say this is over the top but the concept is very important to the true wellness of all patients.

For example, the patient who keeps coming back with bruises or injuries from falls. Very suspicious if the patient is only forty. Maybe not so for someone who is eighty. But in the case of the eighty year old, she or he may have a care giver who has been frustrated in having to provide care and pushes them to make them move faster, or hits them when they spill things. And the patient is not going to do anything about it because the next step is being forced into a nursing home. They are living in an abusive home and are trapped. They certainly are not going to be forth coming about it.

Patients who have experienced domestic violence of any form will react differently to the way someone approaches their safety bubble. What I mean by this is that everyone has a comfort zone for how close people can get and how comfortable they are being touched. Some people are huggers and touchers and love to get close to anyone, including a stranger. People who have been abused have much larger safety zones and very often do not want to be touched. This not wanting to be touched can range from the patient being able to tolerate it by disassociation or the patient who has a panic attack at the mere thought of having to be touched, which often leads them to not go to the doctor when they really need to.

It an attempt to becoming trauma informed, our local medical center has all providers asking about the safety of their patients? It is a useless attempt to meet a standard. First of all, it is not the doctor who asks this question. It is the care-tech, the gum chewing little twenty-something who is trying to beat a record of some kind by seeing how fast she can get patients in the rooms ready for the doctor. They change regularly and even so, I doubt highly any patient who is in a domestic violence situation is going to open up to that individual as if they are going to be able to do anything. AND… it is none of their business. The lack of sensitivity to the situation of an actual abuse situation is very typical. Unless there has been some form of specific training done with people who are asking that question, simply asking the question almost makes it worse. What are they going to do if a patient says, “no I am not safe. My husband routinely comes home drunk and beats the shit out of me and then rapes me.” The response to that can make or break the patient. The care-tech’s only course of action would be to type ABUSED into the chart. That works!

I would love to know how asking this question, “do you feel safe in your living environment” is the proper opening for a patient to disclose something so humiliating and degrading as being abused. And how many providers are even trained to handle the situation past the physical? Do they know who in the community is providing help for domestic violence? But the bottom line, most patients will not jeopardize themselves by spilling the beans about their crappy home life in a brief visit to a doctor, especially if there is not a relationship built over time with that doctor.

But being trauma informed goes beyond asking that inane question. It is things like how the patient is treated by everyone; from the rushed handling of the care-tech to the actual doctor. Patients who are victims of abuse will react from the way they are placed in a room and then left abruptly to wait for an extended period for the doctor. Letting the patients know if the doctor is running late, or checking in on the patient to see if they are ok would go much further to calm a nervous person. Having the doctor explain what and why they are going to do something BEFORE doing it will help also. Even the simple act of having them listen to the heart can be traumatic. Some doctors will do it over clothes, some doctors reach right in without warning for skin contact. Sometimes there may be a need to hold the patients head while examining their throat for example. This simple act can terrify someone who has had their head restrained in an abusive act such as forced oral sex. Lying down on an examining table makes anyone vulnerable, but for an abused patient, it is excruciating.

For some patients, the act of disrobing will send them back to a place of past abuse. These patients need a sense of safety which throwing them into a sterile, brightly lit room and demanding they disrobe behind a flimsy curtain does not provide. Then they have to sit in anticipation of being probed on a ridiculous scary examining table sitting in the middle of the room as if they were a piece of meat shivering in a paper gown. Would it be so absolutely terrible to provide a soft blanket to comfort and to also help with limiting the exposure while being examined? Something that simple is being trauma informed.

The patient is brought back to the exam room and sat down after being weighed. For some, being weighed is very traumatic. I know that doctors need the vitals but unless you are suspicious of your patients and do not trust them, can you not simply ask them what they weigh? Or make it part of the exam in private and not in a hallway where everyone is walking by. The scale calculates and the care-tech yells out the reading like everyone needs to know….and you still have your boots on. I skip it and refuse. Unless I am there for weight related issues, I know what I weigh and I will tell the doctor if they ask.

Health care workers are highly trained. But in the area of trauma informed, there is much to learn. This study goes hand in hand with a comprehension of the ACE study, which identified the link of abuse to chronic illnesses. I have asked all the doctors who I see if they are aware of the ACE study, and none of them are. I am going to leave a couple of articles for them to read. (see below) We need to work on this information being disseminated and so if you found this helpful, read and print these out and give them to your doctors.

Ace study: http://www.ajpmonline.org/article/S0749-3797%2898%2900017-8/fulltext

PDF of journal article: http://www.ajpmonline.org/article/S0749-3797(98)00017-8/pdf

https://acestoohigh.com/2017/01/05/dear-doctor-a-letter-from-a-survivor-of-sexual-trauma-to-all-medical-professionals/

https://acestoohigh.com/2016/08/10/childhood-trauma-leads-to-lifelong-chronic-illness-so-why-isnt-the-medical-community-helping-patients/

 

 

 

Midsummer Dreams

Nightview 2015

The light has shifted ever so slightly in the garden at night. I have been doing an epic battle to keep everything hydrated. But even so, things are crisp or wilted. My glorious ferns are gone and the grass is brown and crunchy. The trees in their deprived state are dropping leaves early. I fear for how brown our fall will be this year.

I am not good with the heat. The other night, the little air conditioner in our bedroom could not overcome the heat and it was still 80 in the room. I find myself longing for a storm or two. I realize I could never live somewhere that was sunny perpetually.

I spend my last hours of the day in the garden readying from my Kindle. It’s so dry that the bugs and mosquitos are less and so the light does not attract them. I finished a non-fiction book intended to reflect on what it is like to live with PTSD. It was a story of woman who was raped by her boyfriend over a period of times when she was 16. She lived with his threats and never told anyone. The book revolves around her growing up and dealing with the ramifications. She is splinter from her family, her own choice, and ends up as a disenfranchised woman living in a hovel.

Although the book explained about triggers it was not a good representation of what it is like to live PTSD. The woman in the story goes to a psychiatrist and is “healed” by simple breathing methods and other mindful exercises. She meets a man and life goes on off into the sunset. Although the authors attempt to help bring awareness, I think she misrepresents the truth.

People do not ever heal from PTDS. They learn to cope. And while some are better than others, it still can rear its ugly head at any moment. Triggers come from everywhere. I was reading where a female soldier (nurse) who had PTSD after being in Nam was fine for years. Then she moved to a new area to work at a hospital. She started having horrible flashbacks and attacks. She could not figure it out when on a very still night she heard the sound of a chopper flying to the landing pad at the hospital. It was not the first flight since she moved there. Normally it was noisy with other ambient sounds and this was so subtle she never paid attention. But her ears did. They heard and she would start to have panic attacks.

The shift in light for me is a trigger. I am so sensitive to it that I am aware before it really gets to the point where it bothers me. Something about the afternoon light before sunset in the fall and winter makes my chest tighten and other sensations. It has to do with sunset around 5 pm. This was the cocktail hour when my parents would barricade themselves away from us and start drinking. Yes, this still affects me forty years later. I am aware of it and can normally deal with it. But I still get a stomach ache and my mood shifts.

This morning, as many Sunday mornings, I sleep an hour or two longer than normal. It is very common for me to have nasty dreams but there is a prevalence of one reoccurring situation and it often plays out in these stolen moments of extra sleep. I have no idea why and I cannot control my dreams. Even after being divorced for over 13 years, I still have horrible dreams about the way I was treated. I am not going to dwell by explaining this as I need to let the dream I had this morning go. But my point is PTSD does not just end.

I know what I have to do and will tend to it. The summer ending is always hard for me. We are off to the River for our long extended stay in a couple of weeks. That will help me to focus and ground. There needs to be more awareness of PTSD, and not just for Vets. It affects many people in many ways.

 

In the throes of PTSD

Bunnies 2

There are times in my life when I think why? Why do we as humans struggle so much just living. Was it like this since the beginning of time? Is there anyone out there who truly has no stress, no difficulties and breezes through live without conflict? Or is this what human nature means?

Being diagnosed with PTSD was the biggest ah-ha moment of my life. So much finally made sense in my world. Diagnosis means being aware and of all the medications and treatments, being aware the one thing that matters. Because I believe there is no cure. There is only living with it.

I have done as much mindfulness and meditation as humanely possible. I have sought treatments from cognitive behavior therapy to AAT and other forms of energy work. I am not saying they do not “work” but they do not cure. There is no cure. There is acceptance and awareness.

Last week, something tripped me over the weekend. I have no clue what. That is one of the tricky parts of having PTSD. You do not need to know what trips you off, it just happens. By Tuesday, I was in a full blown attack. During the day, I am anxious about stupid things like driving and loud noises. I jump at the slightest provocation. I am bit short in patience. But the telling sign for me is I gain a few pounds that won’t come off. And I have not changed what I am eating. My body pain level is extremely high and I have sharp pain in certain spots like my neck and shoulders which were tight as a trampoline. I cannot take a deep breath even when I doing breathing exercise. But the most telling is I do not sleep. Tuesday night I had about two hours of sleep. The rest of the week my sleep was fitful and full of nightmares that stay with me during the day.

On Wednesday, I was asked to do a presentation for the whole management group on a project I am leading. I then have to drive 40 miles one way to deliver the same presentation to another group. Just as I seemed to becoming down a bit, or maybe just calmer because of lack of sleep, this set me off to an even higher level of anxiety. Just writing this made me catch my breath. It is not that I am nervous about presenting. I just hate presenting to this group. Hate it! It is like they are sitting there with bared teeth waiting for you to make a mistake or in total judgment (which they are). Driving is another big time stressor. By the end of the day on Wednesday, I was a mess. The rest of the week I was a walking nerve fretting about it.

On Friday, I sat down to finish the PowerPoint and having accomplished that helped to calm me. Later at home that night when I was somewhat at peace, I went into my work email. Big mistake. We have a Coach from the med center who is overseeing the program I am presenting on. I am supposed to be learning from her because when she leaves in a couple of months, I am supposed to fill in. She never likes anything anyone is doing. We have had people actually go to our CEO and complain about her. She always has something to correct me on. I think she is a terrible coach. Sure enough, she hated the PowerPoint and said that she thought that only three of the fourteen slides had value. I just burst into tears and sobbed for a while. I was exhausted from the week and then this.

I did something I usually do not do. I fought back. I forwarded the email to my boss who is aware of the situation with the coach. I also sent an email back to the coach and said that it seems I never seem to get things right with her and this was making me very anxious. My boss wrote me back and said the PowerPoint was exactly what the administrators wanted and she liked it. I have not heard anything from the coach. But I felt I stood up for myself and that in itself is powerful. Shame is often a big part of having PTSD and so to stand up for myself was a big deal.

My thoughts for this week included feeling trapped. That is a sensation I have lived with forever and it is not because of any one situation. It is from years of emotional and mental abuse. I felt feel trapped in a job that is frustrating and limiting and often does not bring much satisfaction to me. It does not make me feel like I am contributing to the world. I am trapped as I need to work and the thought of switching jobs is worse than living with it….which is why I stayed in a shitty marriage for 27 years. Fear.

I hate the thought of presenting to this group because of their critical judgment. This is all management including the ones who are clawing their way up the chain and would do whatever they could to push someone out of their way.  This group also has staff that have been there a while and like the way it was always done…. Change agents are not welcome.  Fortunately, there are less of them now. There is a woman who will be in the audience who looks and act so much like my mother and I have had a terrible time with her. Her reputation is that she looks for the holes or mistakes in presentations and will pounce on any weakness. She constantly interrupts to ask for “clarification” and asks a million questions. Everyone knows this about her and it is a big joke, but it is also terrifying when she is grilling you. It does not help me that I have her position which she held for 12 years and she feels I am inadequate because I am not a nurse. When I first started, she had a posy of peers who felt the same way and made my work life difficult. A few of them have left or retired but she perseveres on.

The thing is… I know this is only fifteen minutes max of my life. I know this will pass. I know I will be fine driving 80 miles as it is not snowing and I take back roads.  I know that by Wednesday night, all this will be over. I know all this. I fight to be in the present moment and not worry about the future. I know perseverating on this only adds and does not help. I am writing as another act of trying to cope. I am employing techniques that have I learned to calm. I am trying to think before I react, which is another sign of being in the throes of PTSD. My reactions are over the top and visceral. I am using all the techniques and skills I have been taught to cope. They are helping some.

But sadly the truth is I just have to wait for it to pass. I can only hope that nothing else triggers me and I can deregulate down to a more homeostatic level. I know I will emerge once again out of the rabbit hole.

Bunny and Dove

 

 

 

 

Living brave

Waiting for Santa Paws

I am doing a class from Brene Brown in her Courage Works Classes called Living Brave. I thought it would be a good distraction this winter. I love her work and have read her books and followed her blogs for a while. My intent is to get back to the spiritual and self-compassion work I had let go of. I also thought it would help because I usually am depressed in winter and this year has been very bad for me.

I also have been so overwhelmed at work that I am miserable, cranky and in general, very unhappy. My hope is that this class might help me figure out why. It seems so simple at first glance but the layers and complexity is deep and involved. The bottom line is being vulnerable. My biggest issue in my life all stems from one intense feeling for me and that is feeling unsafe.

Children who grow up in chaos and abuse learn to create a way to get through life. The toll on the body appears later in life in chronic health issues, mental illness and addiction. This has been proven with the ACE Study. I believe that this occurs because the body never deregulates in to a calm and natural state. There is always a sense of fight, flight or freeze going on with the individual that never really goes away.

I do not think I can even put into words the way this feels. It is not like a phobia that only occurs when faced with what-ever action created the phobia. This is more like a low level current that just feels like bad food sitting in your gut. It never goes away. It can be more prevalent at times, especially if something happens to put me in an even more vulnerable spot. I wake up in the morning with it and often will wake in the middle of the night to perseverate on something to the point of become nauseous.

I write about this not because I want people to feel sorry for me. I write this because I am facing my own vulnerabilities. I am not sure if this is a help.  I am not alone in this though. I was surprised in reading through the multiple threads in the class that the issue of being “unsafe” is something that so many people face. When I realized how common the lack of security or trust is with my classmates, it made me think what are we doing to ourselves? There are hundreds of people from all over the world taking this class and so many all feel some degree of being vulnerable to a point massive insecurity. That is what unsafe is.

Just being aware that I am not alone has been helpful. I think many people do not want to face fear and it does take being Brave to do so. I am not sure yet what steps to do or if there is steps, or even if there is a fix for this. I am starting with some self-compassion which is very hard for me to do. And it goes back to feeling worthy, which is a whole other issue unto itself.

This weekend I made time to do things I enjoy like reading. I am dealing with the guilt that came from not attending to the things around the house that need to be done. My usual approach is I do the work and then heap on being more miserable because I did not want to do it in the first place. It is like I still hear some voice saying “clean your room” and I feel like I am going to get into trouble for not doing the work. But no one is going to yell at me. I literally had to talk myself into a place of feeling ok with not spending the weekend busting my ass. I admit, I am really enjoying the escape into my book and it helped to not think about the negative stuff for a while. The outcome was a few hours of peace and pleasure and well worth the grace it gave me. Who cares if my Christmas tree is still up? I love my tree and I would leave it up all year.

I am a work in progress….

 

The Beast Returns

IMG_2172

People who are diagnosed with PTSD will relate to this post. I am of the belief that there really is no cure for it and that it is an easy beast to get captured by and eaten. All the therapy in the world will never truly vanquish the beast. But therapy may help to armor up and fight.

I am ensnared at work in a most ridiculous, piss-poor and totally out of control project. It involves almost every aspect of the agency. The two captains should have been removed months ago. Meanwhile, we all are being sucked down this path of disaster unable to stop the slide. And of course, there is a ton of money involved so just pulling the plug is not possible. But it really was the answer four months ago. Now, we are headed right for the launch at the end of this month.

We were about to roll it out in September when none of really knew what was going on. The night before the first training session, the team of six of us practiced how the training would go and discovered huge issues, so we stopped the roll out. Since then, the team was to resolve these issues so that things would work. But the reality is that they will never work. The system is faulty and does not meet our needs.

I am responsible for training all the staff on this system. There are two factions. One group was launched this week, and I do not foresee any issues with their piece. It is the training that commences with the 250 aides in the middle of the month that is a challenge. Even of the training goes through without a hitch, the after effect, the tsunami, will be awful.

I know that training will be blamed, even though everyone knows we cannot train to the level to thwart this disaster. It is inevitable as the users apply this product. The issue is that the product is not what we should be using. They needed a different system. But the Captain signed the contract and pushed it forward without testing. He continues to fabricate reports to the admin team about how wonderful this product will be. It could not be farther from the truth.

I am not sleeping. I had a cold at Christmas which seemed to get better and then last week it returned. I actually think this was the flu. I had chills Monday night so bad that I crawled into bed and covered myself with blankets and two comforters. But I had to muster on and go to work because there is no one to cover what I do. I have not been this sick in years. And everyone is feeling ill. That is what stress will do to folks.

Because of my PTSD, I have reverted to old reactions that I thought I had worked to subside. I need control in my life. When I do not feel safe, I am reactionary. I fire off in fear and anxiety. I feel trapped in a place I cannot get out and for me, that is the worse. I become a trapped animal. I wake in the middle of the night and perseverate on all the things that are happening and even if I work out a resolution, I will fret and worry for hours until sleep overtakes me again. I wake feeling exhausted and I have the shakes. I cannot meditate because I am so exhausted I fall asleep or I start a cycle of worry. I have tried to use my breathing exercises but have only successfully set off a series of hacking coughs.

In a month, it will be done for me. I will survive. It helps that I know what is physically happening to me. I can control some of the anxiety at times. I am aware when I am flying off and reacting in fear. But the hard thing is to control it before I lose it and it takes over. That is usually in the middle of the night when the demon seems so massive. I am aware again of that endless deep abyss that seems to be right below me and that my grip is weak. It really gives perspective to being on the edge for me.