Presentation 3

Of all the research and writing done for this site, this section was the hardest for me. About a year ago a dear friend of ours was deserted by her vet after 13 years together, (her story appears later). As I watched her pick up the shattered pieces of her life; as she struggled with health issues, sold most of her possessions, and moved to her brothers', my heart was breaking; not only for her, but for all the lives I had destroyed.

In the early 70s, I was the first to coin the phrase " Pale Rider Syndrome". (that's right, named after the Clint Eastwood movie). The only " symptom", was easy to spot. The person with this syndrome would ride into town or someone's life, create total disaster, and then ride off into the sunset. That was me for 33 years of my life and 3 marriages.I know how destructive PTSD can be. It's not " just a Vet thing ", it is a family thing. Everyone walks on egg shells, you choose what you say and what you do wisely. You don't want to piss him off. You no longer have a life. Your life is his life.

It is obvious from what I have just written, that I am far from being an authority on family issues, therefor, I will leave it to those who know best; the professionals.But the saga of PTSD can be told through the lives of those who live it and live with it, so my approach to this subject will be through poetry, and personal stories,and links that will get you to where you need to be.The story is told by both sides. That is only fair.

I pray that no significant other; whether if be a wife, child, mother, father, sister, brother, son or daughter, leave this site without having resources to use. PTSD is a family disorder, and requires that everyone receive treatment.

Everyone focuses on the survivor's problem: The family system becomes focused around the survivor's symptoms of PTSD. Feeling good about ourselves depends on how well the survivor is doing. We're brought up to believe that if we are a good enough wife, mother, father, husband, child, our family members will have no problems. (Don't believe it. Everyone has problems). The trauma survivor often will agree. Survivors often have no idea that their behavior is in any way related to the trauma. Yeah, I'm upset because you don't keep the kids quiet. Yeah, I'm having these problems because you're so messy. Yeah, if you kids were good, I'd be fine. Don't believe this either. Nothing we do, no perfection in us, can change what happened to our survivors in the past. There are no time machines.

We tend to think we are fine and the survivor is not, that if the survivor would get better, our lives would be fine. To keep the family system running smoothly, we may develop patterns which are ineffective for dealing with our loved ones, patterns which keep them stuck, like always rescuing them, calming them down, cheering them up, looking for a solution.

I used to do this all the time, trying to fix Bob. I didn't know he had PTSD, but I knew he had problems (not me) so I kept coming up with solutions: read this book, see a shrink, move, new job, read this book. None of them ever worked, partly because I did not know what the problem was (PTSD) but mainly because I didn't know whose problem it was. I thought it was my problem. I thought he was my problem. I saw no egoism in this. I saw myself as a very loving giving person who would do anything to help her husband. I didn't see that I also couldn't tolerate his very natural emotions because I thought trying to cheer him up and keep him from expressing anger was nice. I could not allow him to express anger, sadness, despair-so he was unable to heal. I failed to see the resentment and fear his pain raised in me but it came out in the occasional tearful indignant bout of recrimination or in sweetly self-pitying remarks like "Honey, why aren't you ever nice to me?" followed by helpful hints on how to be nice. I was a bit hard to live with.

Despite my intentions my actions (nagging, instructing, demanding, hovering anxiously over them, being unable to let them feel what they felt) were often quite painful to my family. Everything I did was for a payback (not that I knew this). Bob was supposed to love me and make me feel good about myself. When he couldn't, I could feel better than him, after all I did for him. It was not an effective way to get love.

. Codependency: Not all people become as dysfunctional as I did. On the other hand if you think PTSD hasn't affected you, maybe it has and you can't see it. I couldn't and I'm a magna cum laude college graduate. I spent years trying to control Bob's PTSD symptoms without knowing what PTSD was. I felt I caused them, I could control them if I could just figure out how to be a better wife, and I could cure them if we just found the right self-help book, treatment or whatever. These are the three C's of codependency. I once heard Janet Woititz (author of Adult Children of Alcoholics) say "How do you tell if you're codependent? If you're dying, someone else's life flashes before your eyes." How I laughed! If I had been dying, Bob's life would have flashed before my eyes because I didn't have a life. He was my life!

Some of us also try to control whatever it is the survivor is using to cope with PTSD: drugs, alcohol, food, sex, risk taking. The word codependency, like the diagnosis of PTSD, developed from work with actual people, the wives of alcoholics who did not suddenly become happy when their husbands got sober. I find it a really useful concept. If you don't like the word use another one. For me the essence of codependency is that other-focus. I will be fine when something outside my control is the way I want it to be. For me it was "when Bob gets better." (There's a parallel here to the bargaining stage of grief and I was feeling a lot of grief over my failure as a wife.) As a result of this other-focus, codependents become reactors and lose the capacity to act. They tend to forget themselves while focusing on the someone else, on helping or fixing him or her. Losing track of what you want, what you like, dislike, need, and of what you feel means you don't know how to take care of yourself. A person who is incapable of taking care of herself is not someone I would turn to for advice, yet I expected Bob to follow mine!

.A vicious cycle: If like me, you have been dealing with PTSD for a long time with no (or bad) help, and without taking time out to take care of your own needs, you may be caught in a cycle. We start out full of love and pity (the rescuer) to help the survivor , but if we don't know what the problem is, our solutions don't work. Furthermore, PTSD is not our problem, so we can't solve it. It is the survivor's problem. (This is called a boundary issue.) When our solutions don't work, we get p*ssed (the persecutor) and start saying things like, "If you just did what I suggest, you'd be fine!" or worse, "Why aren't you over that yet?" Then we start bitching to our friends (the victim), "Let me tell you what he/she did to me this week!" After we've been mad for a while, some new solution comes to us and we go through the cycle again. And again. I did.

It never occurs to us that our solutions can't work for our survivors because we are not them. Part of recovery for trauma survivors is regaining control of their lives, so following our directions is not healing. Resistance to codependent suggestions can be a sign of healthy individuality as opposed to unhealthy enmeshment.

.Personalizing: The families of trauma survivors may personalize everything due to our very natural frustration. I feel hurt, therefore he or she meant to hurt me. Feeling Good, by Dr David Burns talks about this kind of cognitive distortion. The book was very helpful to me and Bob. Family members feel the survivor is doing this to me. Angry at me! Depressed because of me! Jumpy because of me! Numb because he doesn't love me anymore! It may have nothing to do with you, but if you are wrapped up in someone else's life the way I was it is almost impossible to conceive of the idea that something not related to the relationship is at the root of the survivor's reactions. And of course being human, survivors will tell you it is your fault, especially if they don't know about PTSD. Yeah, if you kept the kids quiet, I wouldn't be so jumpy. It's not true, but it seems reasonable so we try harder and harder so the survivor won't be upset. It doesn't work. There is also a seductive egotism in personalizing everything-we are so important. This can also lead to the idea that after all I've tried, if I can't fix it, nothing can. Don't believe it.

. Develop survivor thinking: We also may take on the world view of the survivor: become isolated because our friends dump us or we dump them over the survivor. We may live in a state of constant anger based on "Why is this happening to me?" We become mistrustful after the cruel things people say to us about our survivor or because of misdiagnosis and mistreatment by professionals. Makes it hard to trust that getting worse in therapy is going to get them better. (It will.) We become depressed because we keep trying and nothing works. We feel guilty because we can't fix this and that proves we are bad people. We have low self esteem because we know if we were doing this right our loved ones would not be having these problems. When everything is on a downhill spiral we become fearful. We can't act, only react to whatever happens so our lives feel totally out of control. We develop tremendous self-doubt. I used to wonder if it was normal to want hugs. Bob didn't seem to think it was and I couldn't tell anymore. That was why I found ACOA books so helpful in understanding my own life: the first characteristic on the ACOA list was "ACOA's do not know what normal is." Neither do people who live with undiagnosed untreated PTSD. We wind up walking on eggshells, trying to keep from upsetting our survivor. We are numb, because after all we've tried, all the times we've gotten our hopes up, all our effort, we can no longer afford to have feelings. We feel helpless, hopeless and that it is all our fault because we know that if we were good enough wives, partners, parents, children our loved ones would not have problems. We are also exhausted by the multiple roles we may wind up assuming to keep our family together: spouse, friend, confidante, wage earner, sole parent. Children of trauma survivors are often forced into parental roles at an early age, sacrificing their childhood to help hold the family together.

.Denial: Denial that there is a problem rears it's head, and then denial that anything can help because we've tried everything. We wind up blaming each other and trying to be perfect so no one can blame us for anything that goes wrong.

.A stable dysfunctional system: We cycle through this stuff over and over. It's not comfortable or flexible. This kind of family system is not good at dealing with change. New problems are catastrophes to which we can only react. The family gets progressively more dysfunctional. Both survivor and family become more stuck, more ineffective, more unhappy. Behavior that would not have been tolerated at first eventually becomes everyday.

.Perpetuating the problem: Family members do not identify how their behavior can help perpetuate the problem. After all we are only trying to help.

Over the course of time our genuine loving caring can become directing or manipulation. This quite naturally leads to resistance. Even if what we are advising would help, the survivor is not going to do it because he or she needs to keep some feeling of control in his or her life. That is what they lost when traumatized. Traumatized people develop very sensitive control/manipulation detectors because they could not control the trauma. Autonomy is one of the goals of recovery. (Many therapists fail so miserably with trauma survivors because they, too, are codependent. Rather than empowering the survivor to recover, they believe they have the power to fix people if they'll just follow directions.) We also may care so much we lose our ability to tolerate the survivor's pain and start telling them to get over it.

Trying to be helpful can become shameless having to be right. Bob used to tell me I would die before I would admit I was wrong. I remember thinking it was too bad he was such a sore loser, because if I had been wrong, I would have admitted it. It just so happened that in the course of the first 25 years of our marriage, I was never wrong. Today I'm often wrong. I no longer mind making mistakes. I tell myself I'm working on my perfectionism.

Finally, our victim attitude (look what you did to me/ made me do) leads to healthy resistance in the survivor or to feelings of shame and hoplessness if they believe you. The fact is we have problems, too. Every one does. Healthy survivors resist our view that everything is their fault and we have no faults.

We develop these characteristics because we are human, want to help, but don't really know what would be helpful.

PTSD can affect even functioning families in many ways. In one study of families of Vietnam veterans with PTSD, all of whom were successful enough to have private insurance, Linda Reinberg, PhD, a psychologist in private practice, found that the mothers were just as or more depressed than the veterans. The kids were depressed too. The families felt different from other families and felt grief over that fact. The dads were overprotective and emotionally distant. The kids thought they and their mothers had to take care of dad. The kids had a cluster of symptoms: aggressiveness, underachieving at school, feeling they had to take care of their parents, numbness, problems with concentrating, an impaired feeling of belonging, and a tendency to self medicate with alcohol and drugs.

Other family effects of PTSD: Childhood abuse survivors may pass the abuse on because they are often so numb they cannot tell how much it hurts. "It didn't hurt me to be whipped," they say, trained to think of abuse as discipline. "My dad messed with me and I'm ok. Why is she whining so much?" a numb incest survivor says.

PTSD can lead to violence and terror in the home. People in flashbacks or rages are terrifying. So is the sound of someone screaming in a nightmare. Survivors hit out in their sleep, and if you get hit, it's traumatic. Rage attacks can wind up in beatings. The traumatized families of trauma survivors have PTSD of their own. Remember a traumatic stressor is worse when the cause is human neglect or human cruelty. Think how much worse the effect is when the neglect or cruelty is from your beloved partner or parent.

Dual survivor families are pretty common. Sometimes the very thing that attracts two people is their perhaps unconscious recognition that someone else has been through the fire and can understand. It turns out not to be so easy to live with, however.

Denial and numbness affect families profoundly. Secrecy becomes a family pattern: Don't talk, don't trust, and don't think or feel. This causes major problems because you not only keep what is going on at home secret from others, you keep it secret from yourself and you cannot take care of yourself.

Numbness hurts family members. We don't feel loved. Numbness discounts us. We feel we don't matter. We become defensive. 'So what's your problem?' comes up a lot in numb households. Denying the affects of trauma makes it hard to be accepting or helpful to the everyday problems of others. Kids especially get discounted.

The survivor's numbness teaches family members not to feel either. We can't take care of ourselves because feelings are what tell us how to do that. Numbness teaches us that we are not important and we become people who will do anything for love, like the generation who went off to Vietnam to earn America's love or became hippies to get free love.

The PTSD family may produce kids who have to look good so the parents can feel good about something (family heroes); or who have to be bad (scapegoat) so the parents can focus on the problem child and try to straighten him or her out instead of facing their personal PTSD and relationship problems. If you have a perfect child and a bad child, you might want to look at this.

Spouses and children from undiagnosed, untreated survivor families are often afraid to hope, afraid of what will happen next. We try to control everything which makes us bone weary and desperate. We, too, need help.

Today there is more information available on PTSD and more help. People do not have to reach this level of dysfunction if they are willing to educate themselves about PTSD and then to work together as a family to get the help they need to recover.

©1998 by Patience H. C. Mason. All rights reserved, except that permission is hereby granted to freely reproduce and distribute this document, provided the text is reproduced unaltered and entire (including this notice)
and is distributed free of charge. www.patiencepress.com

Don't be fooled by me. Don't be fooled by the face I wear. I wear a thousand masks, masks that I'm afraid to take off, and none of them are me. I give the impression that I am secure, that all is sunny and unruffled within as well as without; that confidence is my name and coolness is my game.; that the water's calm and I need no one. But, don't believe me! PLEASE! My surface may seem smooth, but my surface is a mask. Beneath dwells the real me: confusion; fear; lonely. But I hide this. I panic at the thought of my weakness and frantically create a mask to hide behind, to shield me from the glance that knows. Yet such a glance is precisely my salvation. I know it! If it's followed by acceptance and by love, it is the only thing that will assure myself that I am worth something! But I don't tell you this. I don't dare, I am afraid to! So I play my game, my desperate game with a facade of assurance without, and a trembling child within. So begins the parade of masks, and my life becomes a front.! I idly chatter to you...surface and top-of-the-head talk, saying nothing of what's crying within me. Please listen carefully and try to hear what I am not saying, what I'd like to be able to say, what for survival I need to say, but what I cannot say! I don't like hiding, honestly. I want to genuine, spontaneous, and me...but I need help! Please hold out your hand, even when it seems that it's the last thing I want. Each time you are kind, gentle, and encouraging, each time you try to understand me because you care, my heart soars with small and feeble wings, but they're wings. Your sensitivity, sympathy, and your power of understanding breathes life in me. Your help gives me the help I need to be the creator of the person that is me. You can help me break down the walls and strip away the mask and my shadow world of panic, uncertainty, and loneliness. Don't give up on me. I may fight against the very help I need, but I really want your gentle hands of love and caring...firm, but gentle hands.

Guidelines for Listening to War Veterans

by Al Siebert, Ph.D., Director of The Resiliency Center
author of The Survivor Personality

Dear Friend,
     Even though its not been long enough, I've come to visit you once again. I live to see you suffer mentally, physically, emotionally, socially and spiritually. My visit will again make you anxious and irritable so everything and everybody will cause you to feel uncomfortable and disoriented. I want you to be confused and depressed so that you can't think clearly and you'll hate everybody, especially yourself. I want you to feel guilty and remorseful for the things in the past. I want to keep you angry and hateful towards the world and the way you are now. I want you to blame everyone but me for the predicament. I want you to stay fearful and paranoid for no reason at all. I want to live inside your dreams so you can wake up sweating and unable to go back to sleep. I thank you for the countless jobs you gave up for me, and for the fine friends that you ignored because we became so close. Most grateful for the family you sacrificed so you and I could be together. I am happy that you were able to pass me on to your wife and children when they tried to stand by you. Thanks for devoting your life to me. But do not despair!, because I will never desert you as the others have. I will become an even greater part of your life. You can depend on me to keep you living in eternal Hell. I will be your only friend.
                                 Forever with affection,
                                                PTSD

A couple of years ago someone asked me if I still thought about Vietnam. I nearly laughed in their face. How do you stop thinking about it? Every day for the last twenty-four years, I wake up with it, and go to bed with it. But this is what I said. "Yea, I think about it. I can't quit thinking about it. I never will. But, I've also learned to live with it. I'm comfortable with the memories. I've learned to stop trying to forget and learned instead to embrace it. It just doesn't scare me anymore."

A psychologist once told me that NOT being affected by the experience over there would be abnormal. When he told me that, it was like he'd just given me a pardon. It was as if he said, "Go ahead and feel something about the place, Bob. It ain't going nowhere. You're gonna wear it for the rest of your life. Might as well get to know it."

A lot of my "brothers" haven't been so lucky. For them the memories are too painful, their sense of loss too great. My sister told me of a friend she has whose husband was in the Nam. She asks this guy when he was there. Here's what he said, "Just last night." It took my sister a while to figure out what he was talking about. JUST LAST NIGHT. Yeah I was in the Nam. When? JUST LAST NIGHT. During sex with my wife. And on my way to work this morning. Over my lunch hour. Yeah, I was there.

My sister says I'm not the same brother that went to Vietnam. My wife says I won't let people get close to me, not even her. They're probably both right.

Ask a vet about making friends in Nam. It was risky. Why? Because we were in the business of death, and death was with us all the time. It wasn't the death of, "If I die before I wake." This was the real thing. The kind where boys scream for their mothers. The kind that lingers in your mind and becomes more real each time you cheat it. You don't want ot make a lot of friends when the possibility of dying is that real, that close. When you do, friends become a liability.

A guy named Bob Flanigan was my friend. Bob Flanigan is dead. I put him in a body bag one sunny day, April 29, 1969. We'd been talking, only a few minutes before he was shot, about what we were going to do when we got back in the world. Now, this was a guy who had come in country the same time as myself. A guy who was loveable and generous. He had blue eyes and sandy blond hair.

When he talked, it was with a soft drawl. Flanigan was a hick and he knew it. That was part of his charm. He didn't care. Man, I loved this guy like the brother I never had. But, I screwed up.I got too close to him. Maybe I didn't know any better. But I broke one of the unwritten rules of war.

You hear vets use the term "buddy" when they refer to a guy they spent the war with. "Me an this buddy a mine . . ."

"Friend" sounds too intimate, doesn't it. "Friend" calls up images of being close. If he's a friend, then you are going to be hurt if he dies, and war hurts enough without adding to the pain. Get close; get hurt. It's as simple as that.

In war you learn to keep people at that distance my wife talks about. You become so good at it, that twenty years after the war is over, you still do it without thinking. You won't allow yourself to be vulnerable again.

My wife knows two people who can get into the soft spots inside me. My daughters. I know it probably bothers her that they can do this. It's not that I don't love my wife, I do. She's put up with a lot from me. She'll tell you that when she signed on for better or worse she had no idea there was going to be so much of the latter. But with my daughters it's different.

My girls are mine. They'll always be my kids. Not marriage, not distance, not even death can change that. They are something on this earth that can never be taken away from me. I belong to them. Nothing can change that.

I can have an ex-wife; but my girls can never have an ex-father. There's the difference.

I can still see the faces, though they all seem to have the same eyes. When I think of us I always see a line of "dirty grunts" sitting on a paddy dike. We're caught in that first gray silver between darkness and light. That first moment when we know we've survived another night, and the business of staying alive for one more day is about to begin. There was so much hope in that brief space of time. It's what we used to pray for. "One more day, God. One more day."

And I can hear our conversations as if they'd only just been spoken. I still hear the way we sounded, the hard cynical jokes, our morbid senses of humor. We were scared to death of dying, and trying our best not to show it.

I recall the smells, too. Like the way cordite hangs on the air after a fire-fight. Or the pungent odor of rice paddy mud. So different from the black dirt of Iowa. The mud of Nam smells ancient, somehow. Like it's always been there. And I'll never forget the way blood smells, stick and drying on my hands. I spent a long night that way once. That memory isn't going anywhere.

I remember how the night jungle appears almost dream like as the pilot of a Cessna buzzes overhead, dropping parachute flares until morning. That artificial sun would flicker and make shadows run through the jungle. It was worse than not being able to see what was out there sometimes. I remember once looking at the man next to me as a flare floated overhead. The shadows around his eyes were so deep that it looked like his eyes were gone. I reached over and touched him on the arm; without looking at me he touched my hand. "I know man. I know." That's what he said. It was a human moment. Two guys a long way from home and scared sh*tless.

God I loved those guys. I hurt every time one of them died. We all did. Despite our posturing. Despite our desire to stay disconnected, we couldn't help ourselves. I know why Tim O'Brien writes his stories. I know what gives Bruce Weigle the words to create poems so honest I cry at their horrible beauty. It's love. Love for those guys we shared the experience with.

We did our jobs like good soldiers, and we tried our best not to become as hard as our surroundings. We touched each other and said, "I know." Like a mother holding a child in the middle of a nightmare, "It's going to be all right." We tried not to lose touch with our humanity. We tried to walk that line.To be the good boys our parents had raised and not to give into that unnamed thing we knew was inside us all.

You want to know what frightening is? It's a nineteen-year-old-boy who's had a sip of that power over life and death that war gives you. It's a boy who, despite all the things he's been taught, knows that he likes it. It's a nineteen-year-old who's just lost a friend, and is angry and scared and, determined that, "Some *@#*s gonna pay." To this day, the thought of that boy can wake me from a sound sleep and leave me staring at the ceiling.

As I write this, I have a picture in front of me. It's of two young men. On their laps are tablets. One is smoking a cigarette. Both stare without expression at the camera. They're writing letters. Staying in touch with places they would rather be. Places and people they hope to see again.

The picture shares space in a frame with one of my wife. She doesn't mind. She knows she's been included in special company. She knows I'll always love those guys who shared that part of my life, a part she never can. And she understands how I feel about the ones I know are out there yet. The ones who still answer the question, "When were you in Vietnam?"

It is normal to be affected by trauma. That is the most important message in this newsletter. Recovery is healing your life. You'll have a scar. You'll also know what to do if the pain comes up again. Trauma never stops affecting most trauma survivors. Those who forget or deny how much pain they were (or are) in can't help others, can barely help themselves. They hurt others with remarks like "I was in a real war," or "Put it behind you!"

PTSD symptoms, numbing, hypervigilance and reexperiencing, are hints to get help! They helped you survive, but they do not go away by themselves. People have to warp their lives to control them. They can become both ineffective and a source of constant pain. When that happens, it is possible to change.

If you are in pain because of the way your life is today, you can change your life. It will be a slow process. Pain will come from the memories of what you survived and from frustration at new stresses and slow progress. It is okay to be in pain. That is the first principle of recovery. Your experiences were painful. You survived the pain of the actual trauma, and you can survive the memories. To recover you need to know at least a part of what you survived, to reconnect your feelings to those events, and mourn your losses.

Treat yourself with respect. Respect your experiences and your problems. Your symptoms are circumstantial evidence that you have been through a lot. PTSD is normal when you have been traumatized. You are not weak, weird, or unusual. If we could live through something without it affecting us, it wouldn't be trauma and we wouldn't be human. Admitting we're human and we have problems is respectful of ourselves. Many trauma survivors minimize the effects of what they've been through (It didn't affect me!) and then wind up resenting people for not respecting their pain. This is human but not very effective.

There is no rush in recovery. Recovery is based on acceptance. I have been traumatized. It did affect me. Why wouldn't it? I have skills that kept me alive which are now causing me trouble. I'm closed off from my feelings and from others. This makes my life lonely and difficult. I am in pain from my memories because what I went through was painful. I need help.

Help is available from therapists who are well trained in the field of trauma. Ask about training and experience and pick someone you are comfortable with.

For years 12 step programs were the only help available to survivors who self-medicated with alcohol or drugs. Thousands of veterans, incest and domestic violence survivors and others have dealt with PTSD by going to Alcoholics Anonymous, Al-Anon, Overeaters Anonymous and other 12 step programs. I started going to one to get help with my problems in living with a guy with PTSD, but since I knew about PTSD, I saw it everywhere. It was clear to me that the people who get diagnosed and get help from the psychiatric community are the tip of the iceberg. Many 12 steppers mistrusted everyone and everything except the 12 step fellowship they were in for good reason. Their traumatic experiences had been ignored and discounted and their self-medication called willful misconduct or self indulgence. They had been insulted, misdiagnosed, drugged and told it was all in their head.

There were people who thought they were stupid because they couldn't concentrate in school but thought being battered hadn't affected them because they always had a job and could take a beating from anyone, people who had stayed drunk for 20 years, married a series of alcoholics, or weighed 300 pounds and never connected it to their traumas. Trauma was invisible to the survivors who thought it shouldn't bother them. Yet, using the steps they were slowly recovering; some simply through working the steps of the program. Others needed and became able to seek outside help.

It takes time to get better. Getting better is the reward for taking the time to recover. Getting better is a slow process. The physiological arousal which many trauma survivors live in makes it difficult for survivors to take in the kind of information needed to heal. This is part of the brain chemistry of survivors. It is not resistance. People can talk about changing but all survivors see is their lips moving. The words and concepts make no sense. This is because they are taking in survival information: who's in the room, where are they sitting, where is the door, how are they reacting to me? In twelve step meetings we have a saying which describes this process: "came, came to, came to believe," meaning we got ourselves to meetings (or therapy), eventually we started to be able to hear what was being said, and finally we came to believe it could work for us too.

Safety first. Survivors won't feel safe with a therapist or group until they have, over time, experienced safety. Why should they? When they have been treated with respect, not discounted, not pushed to hurry up and recover (which are secondary wounding experiences and make PTSD worse), they will feel safe and know it because they will be able to hear and understand what the therapist or group is saying in a new way. A good therapist or 12 step group will let you take your time and treat your traumas with respect. Badly trained therapists often exhibit what I like to call "a profound and pervasive narcissistic sense of entitlement," which manifests itself as "I'm a therapist. You should trust me. I can fix you." An honest therapist will say he or she may be able to help you work on this problem..

When they can hear, survivors can begin to work on safety issues, understanding and protecting themselves from triggers, learning to handle anger and fear. Survivors can develop the capacity to respond rather than react, like having a pause button instead of an on-off switch. Sobriety is necessary if you've been using alcohol, drugs, food or some behavior to numb your feelings. You can't heal what you can't feel.

Once safety has been established, trauma work may begin. Rushing through trauma work is to be avoided. When you feel safe enough, you will remember. Some people use hypnosis to speed this up. Experienced therapists now prefer to let memories surface when they will.

Today in many communities, after a crisis all the rescue workers are debriefed. They get to talk about what happened, what they saw, smelled, heard, felt, what they wanted to have happen and how it all turned out. Debriefing is what trauma work is about. You don't have to know every detail or relive every moment of trauma. As you talk about what happened to you and feel the feelings you had to suppress to live, you will relearn the broad variety of human feelings, because they have all been suppressed along with the painful ones. Recovery will help you understand yourself and be understood. This is a very healing experience for people who have felt like no one could ever understand what they have been through.

Groups are particularly helpful in recovering from trauma. You are not alone. Others have been through similar pain. It helps to see others progress, to learn ways to grow yourself, and to help those who come after you.

Searching for the right help is important. You need to be comfortable enough with the therapist or group. On the other hand searching for the perfect group or a therapist who will never make a mistake can put off recovery for life. The therapist or group is not going to fix you. They (therapist, other group members) provide you with information and a variety of skills, and you do the work.

A word on drugs: There is no drug for PTSD. If you choose a well trained therapist, short term drug therapy may help with physiological arousal and enable you to benefit more from therapy in the beginning.

It is okay to hurt. As a survivor, you need to go through the process of mourning which takes about two years if your mother dies of old age in her bed at home and you were expecting it. Traumatic losses take longer.

Recovery takes persistence and patience. "Progress not perfection" is a good motto. Recovery is not a smooth swift rise out of the depths of pain or numbness. It is a rough climb with many slips and lots of hanging on at new rough places in the climb.

"We recycle" is a slogan that will help you laugh when you slip. Acceptance of the slowness of the process is hard but it's reality. Since PTSD symptoms can come back with new stress, knowing that it is normal to recycle can help you continue to recover.

It takes what it takes and it takes as long as it takes. Human beings hardly ever change quickly except under extreme stress, so be easy on yourself. In response to the idea, I should be over this, remember this slogan (made up by yours truly) "Everything after the word should is bullsh*t."

H.O.W.? Honesty, openness, and willingness are characteristics that will help anyone recover. These things did happen and do affect us (honest). We can find help if we look (open). We try suggestions from others who have recovered or have worked with others who have recovered (willing). This is not to say that every idea or suggestion will work for you. Some won't. Some will be very uncomfortable, but will have a healing effect on your life, like getting sober

Yet. If those ideas scare you, the most healing word in the English language is yet, as in I can't do that yet... Someday you will when you are ready.

Willing to vs Wanting to: There is also a great deal of difference between the words "want" and "willing." Spelled differently. Mean different things. Willingness may mean I do things I don't want to do! If I wait till I want to do the things that will help me recover, I may never recover.

We heal by degrees. You don't have to heal perfectly or on someone else's schedule. People do this work in stages and have to take breaks from it.

Feelings are facts: you feel what you feel. It doesn't have to be reasonable, justified, or what other people feel. Feelings do not have brains. They are not logical! Part of recovery is learning what you do feel so you can take care of yourself. Trying to take care of yourself without knowing what you feel is like trying to budget without knowing your income.

Feelings are not facts: Emotional reasoning is a distorted way of thinking common in our society: I feel it therefore it is true. I feel hurt therefore he/ she meant to hurt me. I feel guilty therefore I am guilty. Many of us tend to feel hurt by or guilty about everything. It comes with our culture, but we don't have to believe it.

Respect your emotions but don't necessarily believe them and don't act on them in old ways. People can change by acting in new ways until new feelings come. Waiting till they feel like changing is a dead end for most people!

When trauma survivors begin to get better it is very scary for family members. Underlying this is the fear that if you change you may not love them any more. You may wonder why they have problems since they weren't traumatized. Next month I'll talk more about the effects of living with PTSD, of seeing someone hurting and doing all you can to help and having it all be useless.

Don't compare: Compassion is something that develops in recovery. You will see that what each person has lived through is the worst thing he or she has been through. Remembering how you felt after the first firefight, the first beating, the first time someone in your neighborhood was gunned down, before you got so numb, will give you empathy for others.

Recovery leads to autonomy, the feeling of being whole, the ability to change when necessary and the ability to regulate yourself. These are important concepts to people who may feel they have lost great parts of themselves. You may not get all of yourself back, but you can get some of it back. For people who have been stuck in survivor skills, being able to change is freedom, and for people who could be blowing up one minute and numb as a stump the next, the ability to regulate these reactions is pure joy.

Recovery will bring back joy into your life. It will be mixed with pain because this is real life, but learning to feel the pain lets it pass and the periods between the pain will get longer and longer and better and better.

One final word, no matter what you did to survive, you do deserve to recover. Many survivors feel guilty for surviving or for not doing enough or for overreacting. During the recovery process, your feelings about this may change. If you find that some of your guilt has a realistic basis, you can make amends for your actions.

Copywrite 1998 by Patience H. C. Mason. All rights reserved, except that permission is hereby granted to freely reproduce and distribute this document, provided the text is reproduced unaltered and entire (including this notice) and is distributed free of charge. www.patiencepress.com/

"PTSD and Me"

("Patience's husband Bob was a helicopter pilot in Vietnam in '65-'66 and wrote a bestselling memoir about his tour, Chickenhawk, and Chickenhawk: Back in the World. and has written numerous other books. (see the Reading Room) visit Bob's Site at:http://www.robertcmason.com/

We lived with PTSD for 14 years without knowing its name, because it didn't have one until 1980. I felt tremendous guilt, became very controlling, and started an other-centered quest for the thing that would fix my life: when I got Bob straightened out. I had no idea what was wrong but I was sure it was my fault.

I thought he didn't love me because of his emotional numbing, his attempts to isolate himself, and his lack of interest in things we had done together. I concluded I was unlovable. I saw his substance abuse not as self-medication to maintain numbness in the face of unbearable thoughts, feelings, and memories, but as deliberate naughtiness. Wild rides on his Honda 750 looked to me like stupid immaturity (except when I joined in) instead of a sense of a foreshortened future. The fact that he couldn't sleep became a joke. Rage attacks meant he was a jerk. When he couldn't remember something I'd told him, I got mad because I had never heard of the inability to concentrate, another symptom of PTSD.

My whole life became centered on fixing Bob. My upbringing told me that I could make other people happy. He wasn't happy. I wasn't happy. I figured I just wasn't trying hard enough. I knew you can do whatever you put your mind to. It never occurred to me to try another way. Even after I found out what PTSD was, my quest was still what we should do to fix Bob. I had no idea that I had problems and that my actions and reactions were making it impossible for Bob to get better. We were stuck in a series of ineffective patterns.

Finally a very caring Vietnam veteran nurse said to me, "And who is taking care of Patience?"; I realized no one was taking care of Patience. I had no idea how to do this and I was afraid to try in case I did it wrong. I felt if I made a mistake I was a mistake. I also felt like after all I'd been through and done for others they should take care of me. I resented that they didn't. I also thought I didn't deserve care or I'd be getting it. At that time I was writing Recovering From the War and first discovered Adult Children of Alcoholics literature. I really identified with the list of symptoms. Finally, I started going to an ACOA meeting (after I tried for a year to recover by just reading the books).

As I analyzed the patterns I grew up with and had developed since my marriage, I noticed that I had been affected by PTSD. My father was a surgeon in Europe during World War II. Once his hospital became part of the front line during the Battle of the Bulge. Something about the way he told me that made me realize he was talking about an experience that had really affected him. I was about eleven. He said he didn't like to talk about the war. We never did again.

Our family was organized around the principle don't bother Dad. He was brilliant, always on call, worked tirelessly, never took vacations, invented operations, had a few drinks every night to unwind. We thought this workaholics(ism) was normal. So did everyone else in America. My mother, like many other wives of WW II veterans, was left a desperately lonely woman, emotionally deprived, angry, lost. She tried to have a perfect family which entailed a lot of correcting of us kids. I grew up feeling there was something intrinsically wrong with me, that no one could love me just for myself, but maybe if I were good enough I could earn love. I consider this feeling, which is very common, a direct legacy of trauma. We had things, but we didn't have emotions or permission to be imperfect, human.

I've worked on myself since then, learning to change patterns of behavior in myself that are not the way I want to be. I can only change one day at a time, (much more slowly than I'd like), but that gives me compassion when I see how hard it is for others to change. This has let Bob recover in his own way: His symptoms are much less distressing to him and to me than they were. Five years ago, I wrote in Recovering that Bob absolutely could not say when he was having a bad day. Today he can. That is a miracle.

I don't know what your situation is. Whether you grew up with PTSD or your partner has recently been traumatized, whether you see a family member as the problem and the rest of you as fine, or you know that no one will be unaffected by a trauma even if it only strikes one of you, read and educate yourself about trauma and work at recovery for all family members. A lot of books reviewed in this issue can help.

What affects one member will affect others. In "Bridging Normative and Catastrophic Family Stress", in Stress and The Family, Vol 1. McCubbin and Figley, eds., 1983, Charles Figley describes the ways functional and dysfunctional families cope with trauma. Functional families acknow-ledge and accept that there has been a trauma. The problem belongs to the family and they look for solutions and are willing to change rather than seeing it as the survivor's problem and blaming him or her for it. They seek outside help and are flexible about family roles. It is pretty humbling to go through such a list and see yourself in the dysfunctional column every time, but today I can forgive myself for that. I was doing the best I could do at the time, following patterns I grew up with or developed out of ignorance. If you are in that situation and you've picked up this Gazette, please read on and find the help that works for you. There was nothing available like the PTG or the books I am reviewing in this issue when my Mother was struggling with my Dad's unavailability. Nothing was available to me either when Bob got back from Vietnam. Years later I wrote the book I wish I had had, Recovering From The War. Today there is lots of help, lots of books are available for all types of trauma, PTSD has a name, and there is treatment available. I am grateful that today no one has to get as dysfunctional as I did.

As I said before, families are systems and what affects one family member affects the rest of the family. To expect a trauma survivor to do all the recovering is to place an unfair burden on him or her. It is also unrealistic to expect to be unaffected by the problems of your nearest and dearest.

If someone you love has recently been traumatized or has recently disclosed something traumatic to you, self examination is in order. Do I expect miracles (just put it behind you)? Am I willing to see that I may have been attracted to this person because he or she was numb, hypervigilant, needy, etc? Am I willing to face this possibly long and painful journey as I would if my partner had cancer, or am I going to bail out? No one can answer this for you, but remember that all people have problems. This one is treatable. If you work together the prognosis is good. If the survivor isn't willing to work, you can still have a good life if you work on your own recovery. And your recovery will rub off on your family.

Even if you are new at this and have not become as focused in on fixing the survivor as I was, it is going to be difficult to watch someone else go through the pain of recovering from trauma. What are you going to do when your survivor is upset or crying and you suddenly want to "cheer" him or her up? It is the wrong thing to do. How do you find the strength to let the survivor feel what he or she feels? You need your own support system whether it is friends who understand, a professional, or a group of people who have been through something similar. You need to know that it is okay to take care of yourself. Listen when you can and when you can't, be honest about it. Get help for yourself. Trauma is disaster, but it doesn't have to stay disaster. It can be an opportunity to grow. I'm not glad that Bob saw so much blood and death in Vietnam, but I am grateful that coping with the aftermath gave me the chance to grow, change, and do something that has been of value to others.

One of the reasons I've focused so much on the long term affects of living with PTSD is because there are so many families struggling with undiagnosed PTSD out there.

Guidelines for Listening to War Veterans

by Al Siebert, Ph.D., Director of The Resiliency Center author of The Survivor Personality

"PTSD and Me"

by Al Siebert, Ph.D., Director of The Resiliency Center
author of The Survivor Personality