I have been asked by a reader to “explain the interaction between grief and PTSD”. Her brief question also made reference to “"PTSD symptoms" of flashbacks, nightmares, and intrusive thoughts” whose content relates to her “death trauma”. There is a lot to respond to in this query.
As with many common words, most of us don’t much pause when we encounter the word “grief”. It has, however, received a detailed and careful consideration in psychology, and I have written in detail about some aspects of this elsewhere. In summary, grief is a variety of a feeling called distress, which is the brain’s automatic response to loss. It lies on the high end of a continuum that runs from minor loss (say, of your car keys) to extreme loss (such as of a child), which can be called “anguish”. Put into words, that continuum might look like this: distress → sadness → sorrow → grief → anguish. In summary, grief is involuntary, fairly serious, and can become very serious.
Trauma! A PTSD Blog
In my previous post, I looked at the question of whether or not your therapist was doing "the correct thing" in treating your PTSD. I suggested that this is an ambiguous question, for what is correct from her or his point of view is usually related to the treatment model they are using, while for YOU it is not about that at all. So, we really have two questions to look at.
I suggested previously that assessing whether or not your therapist was doing the correct thing was basically beyond the capability of most psychotherapy clients, with the probable exception of a client who was themselves a psychotherapist, and who uses the same treatment model. Finally, I suggested that it was actually quite sufficient for you, as the client, to deal simply with YOUR part of this question. That question, as I have thought of it, forms the title of this post: Is your PTSD therapy giving you the results you want?
So many times I've heard civilians say, "You mean, major trauma that leads to PTSD happens outside of the military?" The answer, of course, is a big, resounding, YES! The problem is that we don't have enough sources demystifying trauma and PTSD so that it's easy to see where it comes from and how it happens (Finding Meaning in Trauma and PTSD).
One of the biggest problems in my PTSD experience and my recovery from PTSD was how fragmented I was and felt. Do you know what I mean?
It seemed like I had slivers of memories, a shattered sense of self and random sprinkles of what it meant to live a healthy, 'normal' life.
Healing PTSD, to me, became finding a way to pull everything back together. It meant re-integrating who I had been with who I had become, with who I wanted to be. (PTSD and Integration: The Path To Healing) Whew, that was a big job! And back then, I didn't have the benefit of Dr. Daniel Siegel's input - but you can!
The beginning of my PTSD recovery looked like this:
Force me to go to therapy for one hour, once a week.
I show up and expect the therapist to do all of the work.
For the rest of the week, I pretend there’s nothing else to do and just try to limp through the days coping with symptoms of PTSD.
Why did I pretend there was nothing else to do? Because if you’ve ever, for a second, struggled with the effects of trauma or PTSD, you know what it feels like to be sleep-deprived, depressed, emotionally volatile, powerless, hopeless and sometimes, just downright utterly despondent. In that state of mind, I often believed there was no way to save me. I was crazy and would remain so forever.
A reader recently asked me a very important question. Speaking of her therapist, she asks "How do I know that what he is doing therapeutically is the correct thing?" This is a surprisingly complex question. I will point out the major issues to address in coming up with an answer, then describe my own preferred way of dealing with this question.
However, there are two aspects to consider here - your therapist's viewpoint, and yours. It is quite possible for your therapist to do the "correct" thing, but not to get the results you want. Because each of these considerations deserve careful thought, I will address my reader's question in two posts. This first one will consider how to think about your therapist. We must begin by asking: What determines "correct" for your therapist?
Previously, I proposed that thankfulness can be an antidote to the anxiety (fear) that results from living with trauma memory (In the Midst of Trauma, Why Thankfulness Matters). Whereas anxiety, when examined, is a response to an anticipated loss (of safety, of something of value, or opportunity, etc.), thankfulness is a response to the realization of gain. It is, indeed, a perfect antidote. Remarkably, few people think of it that way. You now have a way to become an exceptional person, to stand out from the crowd: realize the value of gratitude, and act to bring it into your mind. Read on for a list of ways you can bring thankfulness and gratitude into your life.
A friend of mine forwards articles she finds as she researches for a major paper. Recently, she sent a copy of an article about posttraumatic growth and life-threatening physical illness. The article, by Kate Hefferon, Madeleine Greal and Nanette Mutrie, cites this quote:
It is through this process of struggling with adversity that changes may arise that propel the individual to a higher level of functioning than which existed prior to the event.
In my previous video about walking meditation, I spoke a little about meditation in general, pointing out that not all meditation is done while sitting. One can also meditate while walking, and even perform a water walking meditation (not what you may think). In some ways, this is quite possibly the best way to meditate. Walking meditation can be seen as a kind of bridge between classic sit-still meditation and the ordinary activities of our lives.
Active trauma memory - a memory that gets triggered, is intrusive, and is invariably painful - will disturb your state of mind, your focus, your ability to be productive, and any sense of hope for the future you may still possess. Put simply, it alters your present perspective on life, and never for the better. Pushing back against such an assault well may seem impossible, but that does not have to be the case. One management tactic of proven value that almost anyone can use is the practice of cultivating a sense of gratitude.