PTSD Class October 20

Ray and I welcome you to the OLLI (Osher Life Long Learning) online adventure in cyber connected learning. We are teaching this class via zoom – a deep dive into technological PTSD for us.

We are laughing and learning along with all of you! We have heard that learning new skills is great for aging brains. We figure we have shaved a few years off our brains this month.

I saw this flower in my garden last week and sat with it in awe. Like you, it is unfolding in the light of life. I thought about how the flower does not worry about tomorrow or about one day having its petals grace the ground. The flower lives the moment fully. That is a good lesson,yes?
Our first class, a few technological glitches aside, began the look at PTSD. Over the next four sessions we will be exploring in more depth the impacts of PTSD and how to manage them effectively.

A PRE SURVEY OF WHAT WE KNOW I shared the story of Jamie, a woman in her 60s who was diagnosed with PTSD a number of years ago. She has struggled with managing her emotions and reactions this last year. She feels like her life these days is as an ongoing series of new traumas.
She sent this to me one day. I laughed, but honestly could relate. Jamie said she was gaining weight and couldn’t control her sweet tooth. Stress=munchies. Ray and I could fall into that trap!

Jamie told me that the last four years have been especially hard. She watches TV every day and has yelled and gritted her teeth at the news many times.

At one point she began to see all people of the “other” party in an increasingly negative light.

Covid shocked all of us, including Jamie. She has been terrified of getting covid and deeply sad that people are dying. She watches the death count and worries she will die alone.

She said she is mad at the government for not doing more and mad at herself for not preparing more. At times she has felt guilty that she didn’t better teach her grown children about budgeting and health and politics when they were young.

Before the Oregon mask mandate, Jamie found herself wanting to swear at people not wearing masks.She was also a little afraid of them. Would they spit on her or have a gun? She started hiding away. If she went to the store she was anxious and fearful of people. She still is. The rates are rising and some people are still not wearing masks right.

When George Floyd was killed Jamie watched the protests and worried and worried and worried. Some days she watched the protests on TV for hours, not caring about cleaning the house.

And then the fires! Fire season seems to be the new fifth season in Oregon, Jamie commented to me that first week. She packed her go-bags, just in case. She felt like everything, everywhere, was on fire, though her home was far from the closest fire.

I can understand some of her anxiety. I backed up my computer backup drive on another backup drive. Ray teases me.

Fires, covid, smoke, protests . . . Jamie sometimes feels she has a super sized,2020 version of cabin fever. Jamie hates the isolation, the restrictions and the feeling she has to stay home and has to not travel and “has to, has to, has to.”

She has started using danger and trauma words again . . . horrible, awful, terrible . . . and sometimes sees the world as all unsafe.

Jamie told me a few weeks ago that she sometimes forgets what day it is. Many of us have had that lapse. However, Jamie said she can lose track of hours. She spaces out and feels like she is in a fog. It is a surreal and uncomfortable feeling.

Knowing she is growing older isn’t helping Jamie. Ray and I understand. We don’t like being told by young doctors that “as you age,” as if aches and pains are to be expected. What surprises Jamie is the increased body tension and nerve pain she has been having this last year.

She has caught herself thinking over and over about “what if I can’t take care of myself” or “what if I can’t go up the stairs” and more.

Jamie has wondered if she is crazy. To her it seems everyone is doing better than she is doing. She has thought about how unfair it is she experienced trauma in the past and how it messed up her life for years.

When others remind her that they too have the same thoughts and feelings, she often says “Yeah, but you handle it( or have more money or more friends) and I am stuck.”

Jamie had been in therapy for a few months several years ago and could list, after a few pauses, some of the things that made it harder to manage her reactions and feelings. “I know I should sleep more and eat better and look at my thinking errors. I forget to do those things.”
“I bet I would freak out a support dog,” she said one time.”I know all my friends are sick of me complaining.”

TO PONDER: Class members shared some of their reflections about Jamie’s challenges.We will list them later. For now, what do YOU think is impairing Jamie’s ability to live well? What thinking errors, behaviors or perceptions are getting in her way?
So just what is PTSD? How does it affect Jamie and the millions of men and women, young and old who are dealing with PTSD? ? What can she, can we, do to effectively manage PTSD?

Ray gave us a beginning tour of the history of PTSD. That is not to say trauma is a new thing. While humans continue to develop newer and sometimes more insidious ways to traumatize each other, stress and trauma are inherent in living.
Throughout the history of humans, trauma has been a part of the world. What has change is how we define the impact of trauma on people.

TO PONDER: The old beliefs may still linger under the surface. Do some people still partly believe “Weak people can’t manage trauma and brave, strong people can?”

Society and professionals during and after WWI were sometimes unintentionally cruel to returning veterans. Veterans were stigmatized and even shunted aside.WWI soldiers, unprepared for trench warfare, came back with severe facial and limb disfigurements and multiple emotional problems. Some were diagnosed with shell shock as if the reverberations of bombs and guns damaged their thinking and reactions. Others were required to wear masks to cover their disfigured faces that shocked civilians.
This article offers more information about WWI masks for veterans.

WWII veterans with trauma impacts fared little better. While severe facial damage was not as widespread, other damage was. The “be a man” and “get over it” messages persisted.

Even on the battle field where combat fatigue was acknowledge by some, treatment was often about getting over it and getting back to the front. When veterans came home again they too were expected to get over it and get to work.

TO PONDER: How did the messages of “be a man” and “get over it” influence how WWII veterans treated Vietnam Veterans?

Thanks to Vietnam veterans and the Women’s Movement, academia was forced to change their diagnosis and treatment of trauma. PTSD became an officially diagnosis and not just for veterans. Female and male civilians, the young and the old, people of diverse cultures were seen as being impacted by trauma.

Over time, the diagnosis became both more refined AND more inclusive of the ways people could develop and exhibit PTSD.

People were frequently diagnosed with a range of mental illnesses before the diagnosis of PTSD was widely accepted.

TO PONDER How did these misdiagnoses impact people and their families?

The recognition of PTSD began to change the negative view of traumatized people. It has been slow and has not fully erased norms and beliefs. Some people with PTSD still find it difficult to give themselves the grace and kindness of personal compassion.

We are all teachers and learners. One of Ray’s clients shared with him this profound description of PTSD:

PTSD is about being deeply hurt and profoundly confused as a result of that hurt.

TO PONDER: How might that definition change how you see and interact with a person who has PTSD? How might that change how you see yourself if you have experinced trauma?

The current PTSD diagnostic criteria acknowledges the varied ways someone could be impacted by trauma. They may develop PTSD through directly experiencing trauma, witnessing trauma in person, learning a close friend or family member experienced trauma and/or repeated exposure to adverse details about trauma.

Previously, social workers, lawyers, counselors, Red Cross volunteers and others who helped after a trauma were often seen as having compassion fatigue or burn out or vicarious trauma. Under the DSM-5 definition, they may now be included in the PTSD diagnosis if they meet other criteria.

TO PONDER: How might that expanded definition of PTSD impact those in the helping fields?

People with PTSD do not look alike or act alike and sometimes never share the pain they carry.

More than one person has said to Ray and me “you should never walk alone in my mind. It is a dark and scary place.” They usually say it with a laugh. Ray and I have joked with each other about the weird world of our own minds.

It is not just about rollercoaster emotions. People with PTSD may look fine but their thinking, perceptions, decisions and assumptions about the world may be profoundly impacted.
Another word for confusion is shattered assumptions.

The reason why Cognitive Behavioral Therapy is the gold standard for treating PTSD is that it has been proven through meta-analytic studies to effectively address shattered assumptions.

People wonder why some people seem to be more vulnerable to PTSD. Research is ongoing as to predictive factors, but a few are emerging as increasingly likely. They include:
being imaginative
being empathetic
lacking ongoing support and acceptance
having experienced previous or repeated trauma and/or losses
carrying intergenerational and/or cultural trauma

TO PONDER Why might those factors make a person more vulnerable to developing trauma?

NOTE: If you would like to read the full DSM-5 criteria for PTSD this site has the full version. PTSD

NEXT WEEK’s CLASS: We thought about doing a Fun With Flags for Sheldon, but flags may be too controversial right now. So instead we are going to cover in greater detail Dissociation, Flashbacks, Anniversary Reactions and Emotional Reasoning – what they are and how to effectively manage them.

In the meantime, we hope you will open your eyes with wonder on each new day.

Several years ago Ray and I were traveling through Montana. We came across a funky little roadside cafe tucked way up north in the forest. We heard this song by Alan Lane, a one armed guitar player.

Ray and I spent the rest of the trip learning it. We would singing it at night in the hotel and as we drove. To us it was an anthem, a talisman, a reminder that a new day will come with the rising of the sun.

For both of us on that trip, it was essential we deliberately opened our sights to a new day. Six months before one of my sons, Robin, was killed in a random act of violence. Ray and I both knew that Robin would have wanted us to live well every day in his honor. He was that kind of dear soul.

At the end of the trip I made the song into a video with some of the photos we took on that healing trip. I share this with you. Robin would want you to live life well.

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