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Healing, Not Fixing, PTSD

 

Post-Traumatic Stress Disorder (PTSD) is often best approached as a chronic condition that may have “flare-ups.” This is true of many other mental illnesses and mental injuries as well.

It can certainly be the case that someone experiences some symptoms of PTSD one time and never again in their life, but for most of us, what it means is that we are vulnerable to experiencing symptoms again during periods of stress (or in the case of activating events).

We are experiencing healing, which means we are able to improve certain things with support and as we learn to attend to ourselves, but we don’t know how much everything will heal nor how long it may take. This is different than “fixing,” which is when we remove a “broken” part and replace it, and then everything is as though nothing ever happened. You are an organism, not a bicycle.

This does not mean “I have PTSD, so now everything is hopeless forever,” it means that we need to learn how to manage our environments, life situations, and our selves in order to reduce the severity of symptoms and the likelihood of recurrence, rather than to assume “I haven’t had any symptoms in a year, this must mean it’s okay to stop attending to myself!”

It means not subjecting ourselves to unreasonable stressors and life-sucking situations, personally and in our work. It means taking our physical and emotional discomfort seriously instead of blowing it off until it blows up. It means not listening to internalized minimizing messages that say “suck it up” when distressed. It means learning to re-parent ourselves where necessary.

It means treating ourselves with support, care, and dignity, and developing boundaries to ensure that others do, too. It means practicing self-care as a habit, not only when unduly stressed. It means recognizing symptoms as symptoms, rather than as some kind of weakness that deserves self-punishment.

It means learning what events, people, and circumstances make your symptoms worse, and modifying those as best you can. It means learning what activities, people, and circumstances help you feel better, and including those more. It means taking yourself to the doctor or the therapist when you need to go. Sounds simple, but it’s not always easy!

Basically, it means learning to take care of ourselves “as though” our well-being actually mattered instead of as an afterthought. Let me repeat: treat yourself like your well-being matters, because it does. ❤

 

“Treating yourself with kindness is a life skill. It doesn’t matter whether you are ”good at” this skill It only matters that you keep going💛” — Jeffrey Marsh

 

 

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Repression: A Storm Comin’

Twitter user @charlubby (Chuck Mullin) chronicles trauma recovery and other mental health issues in a series of cartoons featuring her alter ego, a relatable pigeon. This page succinctly expresses how repressed trauma can feel when it’s ready to come out and be processed:

 

For more information about @charlubby’s upcoming book, Bird Brain, look here:

 

 

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What Attending Therapy Is About: (AKA We Are Not Just Sitting Here Chatting)

Everyone’s approach to attending therapy sessions is different: people’s needs, symptoms, and circumstances vary incredibly. People want and expect different things in session.

Clearly, there are specific, well-researched interventions that are likely to be effective with most people who experience a certain symptom or pattern of behavior. Some interventions can be practiced in a therapy session, and some interventions are good for a client to take home and practice on their own. I do have plenty of handouts to work on and books to recommend that you read!

But not every intervention is on a list of tips that I’m going to print out and give you outright, or on a sheet in a manual with steps 1, 2, and 3. In fact, nearly all of what we are doing while in session is an intervention, even if I do not formally announce it as such. That is to say, we are not just sitting here chatting, even if sometimes that’s what it appears to be.

When I’m asking about your week, or how you feel, if you’ve gotten over your flu, or how things are going with your family or job, for example, I’m actually assessing your anxiety, depression, hypomania, behavior patterns, physical well-being, environmental influences, sense of hopefulness, and any changes in how you are interacting…for starters.

But I’m not just gathering data. I’m also intentionally getting you to practice certain kinds of conversing, thinking, and interacting during session.

I’m getting you to practice speaking openly about things that may have felt “unspeakable,” uncomfortable, scary, or just awkward. I’m reframing or redirecting your thoughts as you speak them from “shoulds and musts” to “preferences and wants,” so that you can begin to change your internalized messages. I am giving you the chance to practice openly experiencing and expressing feelings in the presence of someone who will not censor or scold you for how “irrational” or “unacceptable” they are. I am often taking the role of defending you from your own inner critic! I am supporting you in developing an attachment that is not based in power and control or other unhealthy dynamics. I’m also simply being a trained witness to your life; checking in with you over time to see how you are changing and making sure you are okay.

Developing different patterns of thought and interaction takes time, and it’s a great deal more powerful if done with another person. That is why sessions are “booster shots” even for those who do a lot of internal work on their own. Humans are social creatures. Everyone, even introverts (like me!) must interact with others in order to process and develop emotionally.

And you know I can tell you’ve been making real progress when you stop yourself from saying “should” in session before I can give you the “shoulds” lecture yet again! ;D

So that is why–even if I didn’t give you a handout to take home or a list of suggested solutions to your situation–you made a LOT of progress in your session today.

Remember, “talk therapy” actually changes brain structure!

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CSA Survivor Support Groups at Samaritan Counseling Center

RISING TOGETHER PARENTS SUPPORT GROUP

This group is for non-offending parents and caregivers of children who have been sexually abused. The group will focus on the impact of child sexual abuse (CSA) on the survivor and the family.

Through guided discussion and shared activities, the participants will explore topics including: trauma response, grief and loss, necessary changes, fostering healthy child/family development, family impact (parents, marriage, siblings), establishing safety and creating a new normal.

The goals for this group include: Sharing information in a supportive environment, Gaining knowledge of trauma response, Imparting universality: You are not alone, and Networking to continue supporting survivors of CSA.

The group will meet twice monthly at Samaritan Counseling Center from 7 to 8:30 pm on the following Mondays: January 28th, February 11th & 25th, March 11th & 25th and April 8th, 2019. Total cost for the 6 session series is $150 for individuals or $250 per couple. Preregistration is required – register online here. Click here for additional information. Contact Lizz Durbin at LDurbin@scclanc.org or 717-560-9969 ext. 254 to register.

SURVIVORS CIRCLE OF HOPE

This series of 6 gatherings for adult survivors of child sexual abuse typically meets twice monthly for 3 months.  Participants experience a safe community and common ground with other survivors as we look at the ways that our lives have been shaped not only by our stories of trauma, but by our own strength, struggle and resilience. By exploring healing truth and hope through conversation and creative expression, we will consider the many ways that the dark or dormant periods in our lives can give way to growth and new life.

The Circle of Hope is co-facilitated by trauma-trained therapist, Lisa Hanna Witmer, MSW, LSW and Deb Helt, Senior Safe Church Facilitator & Congregational Support Specialist. Meetings are held at Samaritan Counseling Center (1803 Oregon Pike, Lancaster, PA) from 7 to 8:30 p.m. on Thursdays and group size is limited to 8 participants. The cost for the series is $125 for all 6 sessions.

The Spring 2019 series runs from February through April 2019. For a printable flyer with additional information about our spring circle, click here. To register online click here.  If you have any questions, please contact Lizz at 717-560-9989  ext. 254 or LDurbin@scclanc.org.

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Believe Survivors, Including Yourself

Today’s Senate Judiciary Committee hearings have been hard for many, but especially those who have a history of sexual abuse or assault. Whether or not you watched the proceedings, it was hard to avoid hearing about them on the news and on every social media outlet.

Some people are only now realizing that some of their own experiences were abuse or assault. Others are experiencing renewed rawness of emotions that they thought were long past. Many are sad, anxious, outraged, depressed.

For many survivors, it’s not only whatever abuse or assault may have occurred. It’s also about the reactions of others, the important others and even loved ones who trivialized, dismissed, or minimized the trauma. Those who told survivors in one way or another,

“Who cares if you were upset then or now. It’s in the past! Get over it! Snap out of it! You’re making a big deal out of nothing. You weren’t actually hurt. This was nothing compared to [someone else’s painful experience]. I’m sure he didn’t mean it that way. He wouldn’t do that to someone so unattractive! He didn’t really do that much. Quit playing the victim! You’re always so dramatic! Be strong! Deep down he’s really a good guy. It was your own fault for being there. For drinking. For wearing that outfit. For trusting someone. For being friendly. For being bitchy. For being vulnerable. For acting tough. For not saying ‘no’ the right way. Why can’t you just be cool about it? You’re lucky he showed you attention. He only does that to girls he likes.”

It can be hard to reject the destructive, victim-blaming messages we may have internalized for years. Seeing someone else go through that process can be very upsetting. But it can also be an opportunity to recognize that while there are those who minimized or disbelieved or just didn’t care, it still wasn’t your fault. Just as you can see that it was not the fault of other survivors, it was also not your fault. It was always the fault of the assailant, no matter how powerful, successful, “nice,” or well-looked-upon.

Teen Vogue has some concrete suggestions for keeping yourself together during social crises that are PTSD triggers. Take care of yourself; you are worthy of care.

 

 

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Trauma Survivors and Assault in the News

If you are a survivor of abuse or assault, it may at times be very difficult dealing with the news cycle on a day-to-day basis. Not only may we hear and read about details of experiences that mirror our own, we also hear a great deal of public discourse around those kinds of traumatic and personal events. In some ways this may be even worse.

Hearing public figures and people in authority expressing doubt, denial, and minimization of survivors’ experiences is often a rerun of the kinds of responses we may have experienced ourselves when we tried to tell parents, friends, family members, or others we hoped would help us. People in our present lives may also be expressing disbelief or minimization about other survivors’ accounts in a way that re-opens our own past wounds and invalidates our experiences.

The lack of support or even belief around assault is in some ways as injurious to survivors as the actual assault was. The underlying message we may internalize is “I’m not important enough to protect or believe.”

You may find you are having trauma symptoms without recognizing them for what they are. It’s common to see increased insomnia, nightmares, flashbacks, depression and anxiety symptoms generally (OCD, GAD, panic, etc.), irritability, difficulty concentrating, hopelessness, and so forth. Always pay attention to an increase in your symptoms–it’s a sign that whatever the reason, you need to make sure you are giving yourself more support, flexibility, and care.

What can I do?

Limit your exposure to triggering material: we certainly want to be informed about the world around us, but it’s easy to get sucked into obsessively monitoring the radio, social media, or TV for news that goes over and over the same points. If you need to, give yourself a specific window of time to take in the material. But make it short, and recognize that you may need to account for how it may affect your functioning afterwards. If others insist on discussing it, it is okay to say you need to not hear about it for a while.

Be around supportive others: if you have friends or family who are especially minimizing, it will be harmful for you to be around them all the time with no validating voices to neutralize them. Spend some time in person, on the phone, or even online with people you know are supportive and trustworthy. Maybe friends, your therapist, a relative, or your clergy. (If no one you know is available when you really need to talk, you can call the National Sexual Assault Hotline [800-656-4673].) For those lucky folks who have a pet, hug an animal companion. They are often our most ardent and nonjudgmental supporters!

Take care of yourself. If you tend to dissociate from your symptoms, you may not even realize how stressed you are feeling. Re-visit how to do self-care if you have allowed it to slide a bit. If you have worked on your recovery before, now is a good time to re-visit interventions that have worked for you before. If you have not worked on your recovery, now is the time to start!

For a general overview of how PTSD affects survivors of sexual assault, here is a short article.

 

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You Are Not “Lazy”

“I’m not getting enough done, I’m so lazy.” “I ended up hardly doing anything Sunday and I felt so lazy.” “I need to get this one task done, but I keep being lazy about it.” “After work I’m just too lazy to work out.” “I’m too lazy to keep track of things.”

In fact, I have never met a lazy person.

I’ve met people who are: overworked, exhausted, sleep-deprived, in chronic pain, ill, mired in depressive episodes, struggling with anxiety, stuck in intolerable situations, and having attention difficulties, but I’ve never met a lazy person.

“Lazy” doesn’t really mean anything clinically. It’s a “folk” term, and it is primarily used as a pejorative towards self or others. One patient summed it up as “not doing what you think you ‘should‘,” and I think that’s a good all-around summation.

Calling yourself “lazy” is usually an internalized message from caregivers in your formative years. It could have been directed towards you or towards others. The message is “You are unacceptable unless you do what I want, regardless of your ability, wishes, or how you are feeling.”

If you are injured, walk it off! If you are tired, too bad! If you are sick, it can’t be that bad since you’re not actually in an ambulance on the way to the hospital! Just because you don’t want to do something is no reason not to do it! You’re just “lazy”! In other words, how you feel and what you want do not matter. Ignore your own feelings and your wishes.

“Lazy” has also been used (and still is) as a way to demean racial minorities, those with disabilities, the poor, and women. Please be especially careful not to re-enact racism, ableism, classism, and sexism on yourself by calling yourself lazy!

The implication is that if you would just “will” yourself to do whatever it is, then you would be acceptable and worthy. If not, then you must just be a bad, unworthy person and you must deserve bad treatment.

The fact is, you are already acceptable and worthy, without doing anything to “earn” that worth. Now, you might feel better or happier if you were doing certain things, and they are certainly worth trying, to see if that is the case. But telling yourself you are “lazy” is not helpful.

Feeling awful about yourself is not a good motivator for anyone. And it is in no way helpful in mitigating situational factors, such as poverty or prejudice. In fact, it is likely to worsen your exhaustion, depression, anxiety, insomnia, and concentration, which will make it even harder to do whatever it is you would like to be doing.

Instead of calling yourself lazy when you did not do something you intended to, try paying attention to your feelings. Are you tired? Has it been weeks since you had a good night’s sleep? Have you been working 60 hours at three different jobs? Do you have an infant or a toddler? Are you taking care of others’ needs? Are you sick? Are you getting sick? Are you going through an exhausting life transition? Are you grieving? Are you experiencing chronic pain or illness? Are you in a depressive episode? Are you experiencing anxiety/phobia about certain tasks? Do you have PTSD? Are there systemic barriers to your tasks that make them much harder than they are for others? Have you been paying attention to self-care?

It may be that you have internalized some unrealistic expectations for what you “should” be able to do. It may be that some others can do the thing you want to do. It may be that on “good” days you have been able to do twenty times as much as you are doing today. But where are you, just you, today, right here, right now? Maybe you’re doing the best you can with what you have at your disposal right now. Maybe that is enough.

Another day, you may be able to do something more or something different. But accepting yourself right now is even more important than doing the thing. And that does not make anyone “lazy.”

 

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Compassionate Acceptance of Mental Illness

While there are many aspects of mental illness or injury that we can usefully learn to manage and to cope with, we may still have feelings, reactions, thoughts, and behaviors we would rather not have.  We may have internalized harsh or destructive judgments about those symptoms.

It is useful to cultivate an attitude of compassionate acceptance not only for the struggles of others, but also for our own struggles. When we first realize just how many aspects of life have been affected by mental illness, it can be overwhelming. It is also a chance to forgive ourselves and remember that we do not have to do everything “right” to have value as a human being.

This very useful post describes some of the unexpected ways mental illness may show up in everyday life, in things that we often criticize in ourselves or others:

 

http://anxiety-depression-recovery.tumblr.com/post/117465657230/the-inspired-lesbian-if-you-dont-live-with