June has been designated as Post Traumatic Stress Disorder (PTSD) Awareness month, which I suspect you’ve already noticed by now. After years of being considered a consequence of participation in the military, the curtain has been drawn back to reveal just how many people face and live with the lingering effects of traumatic events. According to the latest numbers released by the Department of Veterans Affairs, about 12 million adults in the US have PTSD in any given year, which is about 6% of the US population. We believe for children in the US 3-5% of girls and 1-6% of boys who experience trauma develop PTSD in any given year. Those are staggering numbers.
What those numbers also tell us is that there are far more people walking around each day who are struggling with the effects of a traumatic event in their lives, or maybe even many such events, then we may be casually aware of. If you are one of the millions, this post is for you. If you are someone who wants to be mindful of issues that might not directly impact you, this post is for you too.
My goal today is to help equip you with additional resources to navigate not only the summer months ahead, complete with the BBQs, family gatherings and (potentially) fireworks, but to feel confident enough to use those skills throughout the year.
In order to ensure that my voice is not the only voice you’ll hear, I’ve invited a group of experts who are also experienced in working with clients who encounter these issues frequently. What struck me about their suggestions is how often some tools are mentioned almost universally; meditation, exercise and connecting with others most specifically.
Before we dive too deeply into the nuts and bolts of managing triggers and PTSD related “ripples,” as I often refer to them, let’s cover some standard practices for managing events or situations. Here are the basics:
~ Take things at your pace, not at a pace that seems to fit others. This involves boundary setting and we’ll cover that in a minute.
~ If an invitation or event is feeling uncomfortable to you listen to your instincts and act accordingly; this might mean not staying as long if you opt to go or even not going at all.
~ If having a means of leaving is important to you, make sure you have your own way home or out. Drive your own car or ensure that the people or person you go with know that when you say it’s time to leave, you leave.
~ Do your best to be hydrated, fed and rested and then, here’s the tricky part, stay that way. Getting too hungry or, on the flip side of that, overeating food that leaves you feeling poorly, is never a good idea. Dehydration and lack of sleep are major invitations to allowing PTSD ripples impact you more greatly than they need to.
Diving Into the Science
In learning to manage the physiological changes that occur when your nervous system kicks into overdrive, a common and often debilitating side effect of PTSD, it is helpful to have an idea of what’s going on. Carol Covelli, LCSW, puts it this way, “It’s important to know what is happening in the body (physiologically) when one is triggered: Information (the trigger) is received by the senses and then our brain categorizes it as imminently dangerous and setting off the sympathetic nervous system response. Typically, our logical mind and emotional mind will look to communicate to assess the perceived danger.”
Carol goes on to use this great example: “You’re in a haunted house and someone dressed as a vampire jumps out at you. You initially interpret the vampire as dangerous (amygdala – the emotional part of the brain) and react by jumping or screaming, but then you see it’s actually your neighbor dressed up as a vampire and realize (neocortex – logical part of the brain) there this is not a dangerous situation. This then allows the parasympathetic nervous system (relaxation response) to be initiated. When one has PTSD or a history of trauma, this communication is unable to occur and the emotional part of the brain takes over. This results in the mind continuing to interpret the situation as dangerous and remaining in a sympathetic nervous system response (fight, flight, freeze, fawn).”
If that all sounds like information overload, know that it boils down to something pretty simple; PTSD interrupts the way your brain is suppose to communicate with itself and, as a result, the messages get very confusing. It’s not a lost cause and below are some thoughts on what can help you navigate the weeks ahead.
First up, summer gatherings. These are one of the ways many people choose to welcome the warmer weather and longer days. BBQs, family picnics and outings to places like the beach or concert venues are common. Carol has some great tips for managing the triggers that might be present for those occasions including:
- Knowing what your triggers are (sounds, smells, sights)
- Identify your levels of escalation (use a 0-10 scale). It can all feel like an 8, 9, or 10, but try to see if you can identify what some of the lower numbers are
- Asking a trusted friend or two if they would be willing to receive texts when you’re feeling triggered. Let them know beforehand what kinds of statements help to reassure you. Or, maybe you don’t want a response, and just knowing you can connect with someone else help.
- If you don’t have anyone available, you can do this for yourself. At a time when you are not feeling triggered, write down those statements that help you to feel calmer (you can do it on paper, index card or in the notes app on your phone). Refer to those statements when you’re feeling anxious. Really try to read them.
Next, in looking at the US, July 4th is often a holiday filled with fireworks and scared pets who bolt away from their owners. It is also a time that can feel like torture if the snap, crackle, boom and smell of the pyrotechnic display reminds you of those events that were wounding.
Robyn Sheiniuk, LCSW from the Restorative Counseling Center suggests using a grounding technique to help you navigate the bright lights. “Will you be with someone you trust and feel safe with? If so, let them know that fireworks are hard for you, and can they help you stay present by holding your hand. Focus on their hand, and what it feels like to hold it in yours. Look at it and notice what their hand looks like. How does your hand feel in theirs?” You can, she suggests, use this with an object such as the shirt you’re wearing or a sight you can see, even something as common as a rock you can observe beneath your feet.
A skill that is useful year round is what you might want to think about as the Art of Setting Boundaries. Kimberly Goodrich, LCSW, LCADC has a great way of thinking about them, “Often, I find that people feel triggered and/or overwhelmed when their boundaries aren’t being respected in some way. This is very common when it comes to holiday celebrations and time spent with loved ones.
This, of course, means that boundaries need to be clearly communicated in the first place. This poses the biggest issue for many people. Commonly, they feel overwhelmed with uncomfortability or guilt by the idea of setting boundaries. The quote that I often use with clients is “The only people who will have an issue with you setting boundaries are those who benefitted by you NOT having boundaries”. This quote has a great way of shifting perspective and sheds light on those relationships. Rather than ‘this person did this thing to me and it made me so upset’, it becomes ‘this person can’t seem to make space for my needs and so I have to reevaluate whether I want this in my life or not’. It gives back control. It gives back a sense of self-respect. In the end, this replaces those intense feelings of overwhelm with more peace and authenticity.”
You’ve set the boundaries, learned about triggers in general and for yourself specifically, started to do some grounding exercises and figured out that your brain, as wonderful as it is, is not always giving you accurate feedback. And still the question remains, ‘Is this it? Will this get any better?” Yes, it will.
Healing the wounds of PTSD is a little bit like taking care of your dental health; it requires a bit of work on a daily basis, sometimes a bit more work like that time when perhaps the wonderful corn on the cob at the BBQ gets a bit too stuck in your teeth (where’s that floss when you need it?!) With practice some of the skills become much more familiar and, ultimately, helpful. The boundaries, trigger regulation and strategies will be enhanced with the three common threads I mentioned earlier; meditation, exercise and the connection with others. And, if you like yoga, you might consider that to be a combo package of meditation and exercise built into one.
Much has been said and written about the practice of meditation so for now I’ll keep this deceptively simple; taking 5 or 10 minutes out of your day to sit quietly and follow through breath can be life-changing. No joke, no hype. There is a reason it is offered and taught in nearly every treatment facility for PTSD and why so many therapists not only practice it themselves but urge you to as well; it works. Not quickly but, like brushing your teeth, over time it does amazing things for the brain and one’s perceptions of one’s thoughts.
That brings us to exercise. Perhaps not the first thought you’d have for the daily maintenance and management of PTSD ripples but one that also works wonders with a minimal amount of effort. Diane Schoeder, MA, EFO puts it this way, “It doesn’t take much to work up a sweat or get your body moving whether that’s going to a yoga class or taking a long walk in the woods. In the end, it’s really about grounding yourself in your own skin and feeling comfortable there.”
To finish the analogy of taking care of your PTSD as you would take care of your teeth, you might want to consider connecting with others the same way you’d think of smiling. A lovely, broad smile, with that shine to your eyes comes from a place within you. Connecting with people who support you, allow you to both laugh and cry (or, use language you’d not use with too many others) is the key to staying linked to yourself and the person you’re seeking to heal into. Going it alone is not required.
In a country with over 12 million adults living with the ripples of trauma there is no need to believe you’re alone or that the summer (or any season for that matter) has to be filled with BBQ to BBQ stressors. Taking the steps before you find yourself overwhelmed is no more difficult than living in the pain you are currently experiencing. There is, as you can see, any number of professionals who are more than willing to offer support. If you’re a current or former first responder or you are seeking relief in your life from PTSD, I’m here to help. Schedule a consult with me so that we can discuss our course of action.
Wishing you well for the season ahead.