Part of the PTSD survivor’s journey is dealing with setbacks. Things are running relatively smoothly in one’s life, avoiding self-medication, controlling anger and trust issues, and staying careful about known triggers. Then suddenly there is a PTSD episode. Symptoms flare up, often a relationship gets strained or annihilated, one may return to alcohol, drugs, or porn to offset the memories, to offset the burden of feeling one’s own existence so acutely. At this moment, the PTSD-Identity will encourage you to give up hope, isolate yourself from healthy relationships, take the drugs, and eventually kill yourself. What can we do?
It is almost too easy to just say, “Don’t give in!” or “You’ll get over it.” For those readers who have had PTSD symptoms and for family and friends who have experienced how a loved one seems to fade away into PTSD-Oblivion, we know there is more to it than just cranking out a pithy statement or two (It’s one of the reasons that my PTSD Spirituality essays are so long and tedious, er, I mean informative).
While there is some veracity in those statements, they hold little weight when administered by someone who does not understand how PTSD ravages our soul and tries to program us for despair and self-death. In trying to heal PTSD soul wounds we must think in terms of journey and process. We must consider forgiveness, reconciliation, and moving forward.
Acknowledge It, Name It, Learn and Move Forward
First: Acknowledging I Have PTSD
If I find myself back in the mire of PTSD symptoms and behaviors I need to do something which is fundamentally important: I have to acknowledge that PTSD is active again. This is harder than it sounds.
Some people are unaware they have PTSD. They experience severe changes in personality, behaviors, and relationships, but they lack the knowledge to understand what is happening to them. This will make PTSD worse as we usually self-medicate as we try to figure out what is wrong with us.
They may be aware of the word PTSD and deny they could possibly have it because of the stigma attached to the illness of PTSD’s soul wounds. If they are military they know it can damage a career. We would have fewer soldier suicides if PTSD were acknowledged as a normal risk of military service, that it can be treated, and soldiers need not despair and commits suicide.
The same holds true for survivors of rape, clergy abuse, and other forms of trauma, such as a brutal divorce or adultery case. Yes, we can get PTSD from an abusive spouse.
Regardless of how I got my PTSD, I need to recognize that it will periodically lift its ugly head and spew out fear, despair, anger, abuse of substances, and abuse of relationships. All of these symptoms spread PTSD shrapnel to those we have relationships with and cause hopelessness and despair in us and them.
Just as a doctor needs to understand a broken bone to help heal it, we need to acknowledge PTSD so we can start healing ourselves and others.
We need to acknowledge we have PTSD.
Second: Name It and Understand It
If I am beset with PTSD I must struggle to analyze what is happening to me and why. Having acknowledged that I have PTSD, I will then go on the life long journey of understanding my own set of triggers and the voyage of hope and healing. These PTSD triggers catalyze my PTSD and may make me dysfunctional. The PTSD triggers get things started and then make symptoms more severe if I don’t get myself away from them.
We have triggers that we know about. Some triggers are almost universal. Many people, regardless of how they were traumatized, will have trouble with loud noises, loud voices, fireworks, crowds, and helicopters.
If we know we have these triggers then we can better defend ourselves from them. If I know, before the event, there will be fireworks I am less likely to be traumatized by them. If I know beforehand that there will be a crowd present, then I am less likely to develop symptoms.
We need to take our temperature and see how active our PTSD is. Some days I can be around fireworks, others not. This is where I need to do self-assessment and make my own decisions. If I am having PTSD trouble that day then I should stay away from fireworks. Other days I may be less vulnerable and be able to take part in the company picnic.
In the first ten years of having PTSD I need to learn what my triggers are. What is especially likely to cause a PTSD episode? Not everyone has the same triggers.
In my case, I came close to be killed and eaten by wild dogs when I was in the military. Later, back in the States and as a civilian my memories of large feral dogs plagued me. Presently, I avoid dogs (and really resent when dog owners push their animals at me). If possible, I avoid dogs, I hobble off with my cane or my walker, but I need to be away from dogs most days.
For most PTSD survivors, dogs are a comfort items. For many people, dogs are true friends and companions and show the outpouring of unconditional love that helps beat back the PTSD-Identity. Some even have therapy dogs and benefit immensely from the dog. I am not such a case.
Thus, we need to learn what traumatizes us. From that list we can then self-assess how vulnerable we are on any given day.
I know that large dogs can trigger my PTSD. It is not that I hate dogs; it is more as if I have an allergy to them. We need to figure out what we are allergic to when it comes to PTSD triggers.
Third: Move Forward
If I have a setback then I need to take special care of myself and eventually move onward.
PTSD wants me to give up at this point. It wants me to say that every day will be a rotten PTSD, self-medicating, massive symptoms day. If I stop and think about it, I realize it does not have to be this way.
The PTSD-Identity is always angling for us to despair. It wants to set the hook firmly and then reel us in. It wants us to give up hope.
Managing to a Level of PTSD Normal
Between my physical disabilities and PTSD I will never be “Normal” the way most folks think of it. I know there will be good days and bad days, and I have to be careful that I don’t program my future based on only bad days.
We have to be careful about controlling our expectations. This applies to both extremes. If I have been doing well for a while I must be careful not to make plans and commitments based on that level of ability. If I have a week where I am effective for four hours a day, I am careful not to program all of my future commitments to reflect a four hour window of ability.
I Need to Be Realistic About My PTSD
I know what most of my triggers are. I need to be realistic about my triggers and how many effective hours I have in a day. I must be careful to not take on too much activity. I definitely should have some activity, no matter what. I need to keep somewhat socialized or the PTSD wins.
If I over commit beyond my abilities, then I end up disappointing others and myself. This can lead to my withdrawing into negative behaviors and despair. If I cannot sustain a four hour day, then I need to cut back, but not quit altogether.
If I feel like I let people down. If people tell me I let them down. Then, I am more likely to be coaxed into despair and quit altogether. People need to be realistic about my abilities. And, so do I.
PTSD sets us up. It wants us to over (or under) commit and then fail. It wants us to cope with our failures by going back to negative behaviors – drugs, alcohol, porn, violence.
This keeps us in the downward spiral as those behaviors will reinforce the feelings of worthlessness and shame that go with the PTSD soul wound. They will help to sever relationships and isolates us.
We need to figure out what is reasonable. I know what my worst days are like and what my best days are like. I need to program my expectations so that I can achieve what I set out to do. This means I don’t create my expectations based on extremes. If I do, then I will fail. If I fail, I may go down in a PTSD spiral.
Constant Need to Reassess
Once we have survived PTSD for a few years we need to keep reassessing our abilities and our expectations. If I am healing my triggers may not zap me as often or as much. Sometimes I discover new triggers. They may show up even ten or more years after the initial trauma.
If a trigger does not bother me as much as it used to, then I can perhaps do more with my time.
The PTSD Journey
If you have PTSD, regardless of how you got it, then you have been thrust onto a lifelong journey (Welcome Aboard!!). PTSD wants us to fail, give up hope, aggravate others, and then die. Don’t give it the satisfaction.
Just as someone who has lost an arm or a leg must be more aware of their environment and abilities, so must we. We have a compound fracture in our soul. We must plan and act with the knowledge that we are soul-wounded.
There is much we can do. Some of us me may be disabled from the job market and that will certainly be a challenge. But we are not disqualified from life. We get to still live, find joy where we can, nurture healthy relationships.
We will have good days and rotten days. But we do not have to give up hope. Through constant self-assessment we can do the steps:
- 1. Acknowledge PTSD
- 2. Name Our Triggers
- 3. Learn and Move Forward
Last week I had a rotten PTSD day, several days to tell the truth. But it did not mean I had to give up forever.
Don’t be surprised if you have done well and then have a setback.
Whatever the setback is, you can recover from it.
You may have to ask for forgiveness if you harmed a relationship, but that is part of maturity regardless of your PTSD status. People who say never apologize are trapped in their ego and insecurity (Some morons even wrote books called “No Apology”.) To apologize, at its root, means “to explain.” I may get real forgiveness if my apology includes an explanation of my PTSD and what it can do to me. It takes maturity to apologize and it takes maturity to forgive.
If you have a PTSD setback then take good care of yourself and strive not to fuel a downward spiral through self-medication. Then ask what the triggers were that started the spiral. Then get back up and keep going.
- Don’t quit.
- Figure out what happened and why.
- Then set reasonable goals and keep going.
I have been at this for a couple decades. I know I will have an uptick in symptoms at times. But that is not a call to surrender. Rather, it is a call for hope. It is really, really, really, (Yes, Really!) tough to get back up after a PTSD setback. But you can do it. I have seen many people, including myself, have a PTSD setback, then reassess, and then get going again. You can too.
You have value. And, that is why, even after a sudden setback, you can keep going, keep healing, and experience authentic love and relationships.
Semper Pax, Dr. Z