The Shrink’s Links: The Yellow Birds & Fire and Forget

Bringing you the best of mental health every week.

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Today, we have a double shrink’s links. Two links for the price of one. Two great books of fiction I recommend about America’s recent war experience:

The Yellow Birds by Kevin Powers
and
Fire and Forget Edited by Roy Scranton and Matt Gallagher

In both cases, the authors are veterans of the wars in Iraq and Afghanistan. The Yellow Birds is a novel and Fire and Forget a collection of short stories written by a collection of writers. Nearly all the narratives follow a warrior returning home broken and finding he doesn’t fit in, after knowing the horrors of war. I believe they offer a pretty accurate depiction of Post Traumatic Stress Disorder and an incisive exploration of the problems reintegrating veterans into society.

But, I have a question. It seems like no war story can be published today without PTSD being a major theme. I admire these writers for coming home and writing about their experiences. But, I really want to know: are they writing about what they want to say, or what we are prepared to hear?

When did Post Traumatic Stress Disorder dominate over other aspects of war? When I think of other literature from past conflicts, there are other narratives. In The Iliad, warriors are preoccupied with becoming immortal by the renown of their glorious acts. The Red Badge of Courage focuses on, well, courage. Gone with the Wind, the civilian side of war. Joshua, on loyalty to God. War and Peace, All’s Quiet on the Western Front, and A Farewell to Arms gave us realistic depictions of battle, but little about the aftermath. Catch 22, the absurdity of the military. What I remember of The Naked and the Dead is the descent soldiers take into bestiality. In other novels, the authors deal with friendship, confrontation with other cultures, religious conviction, the inexorability of fate, love and longing, disobedience of authority, etc. Any theme that can be presented in literature has been presented in war literature because war pushes everything to the furthest degree.

I think it’s safe to say that some veterans of every war returned traumatized by what they saw and did. There is nothing new about PTSD even though the disorder has only been named and categorized since Vietnam. I’ve been told that in the past, the sufferers of PTSD were marginalized, their bravery questioned, their voices silenced. Clearly, that was wrong and it would be better to fully understand the costs of war before we consider going to another war. But, come on; do we give our veterans a service when we presume that they are going to be messed up, when their madness is highlighted over their courage?

I’ve seen quite a few veterans in my office. They come in for every problem that people can have. In some cases there’s PTSD, but in every case there are other stories to tell. Can they tell all there is to tell? Can we listen to it all?

Grounding

So, you’re anxious. It happens. There are basically two things to do with anxiety. You can face it or avoid it. Avoiding it is often the sensible thing to do if it’s a thing you are not likely to encounter very often; like snakes, for instance. I’m afraid of snakes. If I got a job as a snake charmer, I would have to do something about it; otherwise, I just avoid them.

Now, if I did become a snake charmer, I would have to face my anxiety. I wouldn’t just go and grab the first snake I found and say, go ahead bite me, I dare you. No, that freaks me out just to write about it. A better method would be face my fear systematically, little by little, in circumstances in which I was likely to be successful. And, and this is most important, I would keep myself grounded.

When you are grounded, you are most alert, yet calm and in control. You can get grounded before you step into a difficult situation and it will help you keep your wits about you. If you’re already in a difficult situation, you can ground then, too. If you just left the hard situation and your nerves are still jangled, ground and you will begin to settle down. You can ground anytime, anyplace, anywhere, and no one has to know. Grounding puts healthy distance between you and negative feelings.

No, grounding is not the same as relaxing, being cool, or mellowing out. It’s not a form of meditation. It’s getting a grip on the obvious, that’s all. The general idea is to get out of your head, at least the part of your head that’s like a broken record. It’s a little like breaking a spell.

If you know how to ground, you don’t need that stiff drink, or that pill, or that cigarette, reefer, or that bag of dope. If you know how to ground, you can go anywhere, do anything, and deal with anyone, within reason.

Here’s a few general tips on grounding:

  • If you get a chance, rate your anxiety on a 10 point scale, both before and after you ground.
  • This is not the time to get in touch with your feelings. Keep your eyes open, turn on the lights, and look around you.
  • No blowing off steam or venting. The idea is to step away from negative feelings, not work them up to a lather.
  • Stay neutral. Don’t make judgments, good or bad. If the walls are green, don’t say they’re puke green, just say they’re green. Don’t say that snake is fearsome, it’s just a snake.
  • Practice grounding as often as possible, even when you don’t need it, till it becomes automatic.
  • Start grounding early, before things get really bad, but later is better than never.
  • When a method of grounding works, it works in less than a minute. If the method you try at first doesn’t work that quickly, move on and try another method right away. Continue until it works.

How to Ground- Mental Methods

  • Describe your environment in detail using neutral words. “The walls are blue, there are five red chairs, there’s fifteen photos on the wall….” Note objects, sounds, textures, colors, smells, shapes, numbers, and temperature.
  • Play a categories game with yourself. Name all the vegetables you can think of, breeds of dogs, states that begin with the letter N, baseball teams, rock anthems, presidents, impressionist artists, etc.
  • Describe an everyday activity in detail, like a dish you cook, your bedtime routine, how to run a bath, etc.
  • Imagine skating away from your suffering, changing the channel to a better show, picking a new book off the shelf, building a fence between you and pain.
  • Declare yourself. “My name is ____. The date is ____, it is not ____. I am located ____, not at ____, etc.
  • Read something, saying every word to yourself. Read each word backwards, letter by letter.
  • Count to ten. Say the alphabet forwards or backwards. Start at 100, subtract by 7, and continue.
  • Repeat a favorite saying
  • Pray.
  • If a thought is giving you pain, repeat it over and over as fast as you can. For example: “I’m a terrible mother,” will become,”imaterriblemotherimaterriblemotherimaterriblemotherimaterriblemotherimaterriblemotherimaterriblemotherimaterriblemother…” Notice how the meaning disappears and only the sound is left? Try saying the sentence very slowly, like half speed. Create a song out of the sentence. Say it in a Donald Duck voice.
  • Think of the pain as something external. If it were an animal, what would it be? What color, what sound would it make?
  • Instead of having the thought, “I’m a terrible mother,” for example, change it to, “I’m having a thought that I’m a terrible mother.”

How to Ground- Physical Grounding

  • Fill a bowl or pitcher with ice water and stick your hand in until it hurts.
  • Clench your fists as tightly as you can and then release.
  • Touch objects around you and notice their temperature, texture, and weight.
  • Grind your heels into the floor, literally grounding them.
  • Jump up and down; do pushups.
  • Keep a grounding object in your pocket, a rock, a key fob, a special coin, and feel it.
  • Keep a rubber band on your wrist and snap it. Pinch yourself.
  • Notice something that you sense that you haven’t noticed. The sound of traffic outside, the feel of your toes in your socks, the feel of your elbows on the chair arms, etc.
  • Stretch
  • Walk half as fast as you usually do, noticing every footstep.
  • Eat just a spoonful of something noticing the smell, the texture, the flavor.
  • Focus on your breathing, notice every inhale and exhale. Repeat a meaningful word (Peace, Love, etc) or short prayer with every exhale.
  • Sometimes all you need to do is get up and go to a different room.

How to Ground- Self Soothing

  • Say something nice to yourself. “You can do this. You are good. You’ll get through it.”
  • Think of your favorite things.
  • Sing
  • Picture people you care about.
  • Remember a safe place. Describe a place that is very soothing to you. (A path in the woods, a mountain, a beach, a room.) Describe everything about that place.
  • Say affirmations. “Every day in every way, I can get better and better.”
  • Plan a small treat for yourself: a dinner, a bath, a piece of candy.
  • Plan something to look forward to.
  • Hug yourself

Notice what works for you, create new methods. If you have any to share, please add them in the comments section.

New Class: Madness 101- Trauma

13RB_PROD_Teacher_KeithWilsonOn Tuesday, March 26th at 6:30-8:30 pm I will be teaching a class at the new Rochester Brainery, Madness 101.

I hope this to be a series, starting with, The Trauma Drama – Post Traumatic Stress Disorder. But you only have to sign up for one class at a time.

Participants will learn how the past will overstay its welcome, what happens when it does, and how to make it go away.

This class will be a mixture of instruction and discussion. There will be no white coats or straightjackets! Nor will you be obliged to share.

The Brainery is located at Village Gate Mall, 274 N. Goodman St, Rochester.

The cost is $16. Click here to go to the Brainery website and sign up.

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Understanding the Trauma Drama, part 2: Hot Stove

Let’s start with instincts. We don’t have the same kind of instincts that animals have. We have some we are born with, like sucking for milk and preferring to look at  human faces; but, for the most part, we learn our instincts. Rather, we learn things and then they become as if they are instinctual. By instinctual I mean automatic, unconscious, and beyond the reach of reason, almost beyond the reach of change. Walking is this way. You don’t have to think about how to put one foot in front of another, you do it without thinking. It wasn’t always this easy. At one time you had to do it very deliberately, but, as soon as you learned, you didn’t have to think about it.

There are some distinct advantages to not having to think about something. Every hitting coach in baseball has told their players to stop thinking about hitting the ball. If you had to think about it, you never would be able to do it. Accordingly, our instincts are much better at things like motor control and making split second decisions than our conscious thought ever can be. Research tells us that instincts are better guides at making complex decisions, as well; the kind that have to do with multiple complicated factors, like deciding who to marry and what job to take. That’s why therapists ask their clients to consider what their gut is telling them. The gut can often make a better decision than days or weeks of careful deliberation.

Unfortunately, not everything that we learn should be made automatic. Bad habits are so hard to break precisely because they have become instinctual. Then there are plenty of behaviors that we learn because they make sense at the time, but, become maladaptive when conditions change. Instincts are valuable in that they simplify and quicken our responses, but they come at the cost of flexibility.

I went for tennis lessons once. The coach wanted to watch me serve. I showed her. She shook her head and said we had a lot of work to do. I was tossing the ball too far back, holding my racket wrong, not reaching high enough, and on and on and on. I was doing all these things automatically. She wanted me to focus on them, correct them, and practice the right way ten thousand times. Once I did that, I will have formed a new, better instinct. She may be right about the ten thousand times. It takes lots of repetitions to create a new habit, to form an instinct. I practiced about twenty times, then I got tired and quit.

There are some behaviors, though, that don’t require so many repetitions. Touch a hot stove once and you will instinctively pull back if you come near one again. Searing pain facilitates learning. Here’s the thing, though. You’d be careful near the hot stove, but it wouldn’t keep you up at night. That’s because most hot stoves just sit there and don’t hurt you until you touch them. What if a hot stove jumped out at you and beat you black and blue, or crept into your bedroom at night when you were sleeping and raped you, or shot lead at you from a mile away? You’d be a lot more scared of them then. You’d always be watching out for them. You’d be imagining them when they weren’t there. You’d be replaying in your head all your encounters with stoves. You’d stick to Sushi and raw vegetables.

Imagine that you went for a walk down the street one day and a hot stove chased you. You ran and got away with your life, although it gave you a good swipe and burned your ass. You might not want to go down that street again. If you did, your heart would be pounding. You might even stay out of the kitchen. You’d walk out of the room if someone put on the cooking channel. You’d dream of stoves. Every night one would chase you down that street. You’d wake up just as you felt its glowing red grill your back. Every little sizzle you hear would set you on edge and make you jumpy. You wouldn’t be able to see a spatula without thinking of stoves. It’s instinctual. You have PTSD, otherwise known as Post Traumatic Stove Disorder.

It’s really called Post Traumatic Stress Disorder, and it can drive you barking mad. But, by itself, it’s a perfectly normal reaction to extreme circumstances. If you had a fire in your house, you’d be a lot more mindful of fire in the future. You’d put a smoke alarm in every room. You’d keep the batteries fresh. The trouble is, they’d go off every time you cook dinner, and every time they’d go off you’d be reminded again of the fire you once had. People with PTSD have their alarm system set really, really high. They figure it keeps them safe. It does do that, but at a cost. It drives them crazy.

It’s not good to be on edge all the time. It causes high blood pressure, strokes, heart problems, ulcers, and a hundred other physical ailments that take some time to develop but will earn you an early death. In an effort to control this chronic stress, people who have been traumatized often turn to things to control it. They may get drunk a lot, take up drugs, smoke cigarettes, eat too much; all in an attempt to calm down. To distract themselves, they may pick fights, drive fast, have promiscuous sex, run risks; just to change the subject and think about something else.

Because they are so mindful of dangers around them, they may believe that they will not live long and plan, or fail to plan, accordingly. They will not bother to develop healthy habits or be prudent about long term risks. They’ll burn the candle on both ends. They’ll live on the edge. Because of these assumptions and the choices that come from them, they’ll be likely to be re-traumatized. They will go to places where bad things happen and do things that have bad outcomes. Evil will happen to them again and again and again.

The problem is that they are only doing what comes naturally. To recover, we have to do what is unnatural, and hard. It’s like this. When you walk in the woods, you walk on a path, right? A path is created by others who have walked there before, starting with rodents, perhaps, then moving up to deer and larger creatures. Maybe you walked there before and contributed to the path yourself. Anyway, no one crashes through the underbrush or hacks their way through a thicket when there’s a perfectly good path to walk on. They’ll take the easy way.

Our instincts are like this path through the woods. Most of the time it makes sense to use them, but some of the time they go the wrong way. Recovering from trauma involves acknowledging that something happened to you that influences you still, being mindful of the unhealthy things you do in response, and bushwacking a new trail, ten thousand times.

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