PTSD FORUM with Dr. Dee Rajska


PTSD ForumPTSD FORUM

This forum is new to us all, and we think that, for the benefit of everyone, we need to keep comments or questions focused on the post itself. Thanks. BONNIE

 

 

 

 

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Dr. Dee Rajska, C. Psych.

Dr. Dee Rajska, C. Psych, Clinical and Rehabilitation Psychologist, focuses on the treatment of trauma in her clinical practice located in St. Catharines, Ontario. She originally received her Ph. D. from Queen’s University in Kingston, Ontario.

Hi again, folks!

Thanks so much for coming back!

(I would promise to make the jokes less corny this week, but I hate making promises I can’t keep)…

As I was saying last week, (I’m repeating myself, but this was my best line so I want to use it again in case you missed it), dealing with PTSD on your own is like trying to fight a war all by yourself, against an enemy you’ve never been trained to fight.

(Good line, right? Aren’t you glad I brought it back for an encore?)

You need to have buddies fighting alongside you, which is why last week I did the used-car-salesman thing about peer support. You also need to KNOW YOUR ENEMY. So, today, I’d like to start giving you the intel you need to kick PTSD’s… ahem, *six*.

According to the DSM-IV TR, the diagnostic criteria for PTSD are as follows:

(What? You thought I was just going to drone on with the same-old, geeked-out explanation you find everywhere else? Seriously? Ha- gotcha! 🙂

(Folks – this is only my second blog post. I’m still trying to impress you, not bore you to tears…)

The problem with the DSM-IV TR diagnostic criteria for PTSD is that they describe how trauma happens in civi’s. With you folks, PTSD is made up of reflex and your military training, both gone into overdrive.

Most of you have probably heard of the fight-or-flight reflex. If you haven’t, a good basic summary of the body’s physical reactions to a real or imagined threat can be found here.

It’s important to understand that fight-or-flight includes an emotional reaction too.

Fear is part of the fight-or-flight reflex.

Reflex is not a choice.

Your training teaches you that if you feel fear, stuff’s about to go down, get ready to deal with it. You learn to use your fear; not eliminate it.

This is a hugely important point to understand: otherwise, you might feel guilt and shame that, at some crucial moment, you felt fear. You might assume that, if you train hard enough, you shouldn’t feel fear.

Fear is a reflex; we can’t eliminate fear any more than we can make our heart stop beating, or stop ourselves from getting goose bumps when we are cold (also reflexes).

Aside from fear, anger and emotional numbness (feeling nothing) are also part of the fight-or-flight reflex.

Think about it: if you’re exhausted, cold/hot, hungry, hurt, worried about random other stuff, and you have to fight for your survival, all of that other “stuff” just gets in the way. Feeling numb works like a big blanket that gets thrown over all the other feelings, so they don’t distract you.

Anger/rage helps, too: if you’re feeling all that stuff I just listed, and you have to fight for your survival, anger drives your focus and gives you the jolt of energy that you need to get the job done.

Understanding that fear, numbness and anger are part of reflex, which is not a choice, is really important: often, you get stuck going over and over stuff in your head, asking yourself,

“How could I have felt NOTHING?”

“Why did I just freeze up and stand there like a coward?”

“Where did all that rage come from? I just went nuts! What’s wrong with me?”

It’s reflex.

You do not have a choice in a reflex reaction.

If it’s not your choice, then it’s not fair to blame yourself for it.

Now, that doesn’t mean we won’t work on helping you to control the anger, numbness, and fear that happen with PTSD – we will. But, it’s important to understand where these feelings come from, and to stop punishing yourself for reflex reactions.

What’s that? Did I just hear you mutter that you don’t believe me, and I’m just saying all that nice fluffy stuff to make you feel better? I know – that’s why last week I told you to get some peer support. Neat how I saw that coming, huh?

Okay folks – I just checked the word count, and it said I should stop rambling for this week.

As always, I welcome your questions and comments.

Next week, we’ll talk about the role of your training in contributing to PTSD.

REFERENCE:

Sylvain Chartrand CD is collecting a Bank of Articles on PTSD. For more information, please see Canadian Veterans Advocacy.
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About Bonnie Toews and John Christiansen

Bonnie's Blog Posts invite our readers and free spirits everywhere to share life's adventures with us. I talk about writing my novels, reading books, chatting with other writers and John's and my journeys around the world. We welcome your anecdotes to our experiences and discussions.
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19 Responses to PTSD FORUM with Dr. Dee Rajska

  1. Randall says:

    My question relates to ones propencity to the onset of PTSD. If you started at a very young age to conquer fear and learn to work through it using aggression as a tool to attain a goal does this increase your chances of PTSD onset. By age 17 I had over 65 bouts in the Boxing Ring and then joined the military straight to Airborne and conquered that fear as well. When is it too much to take or am I out in left field with this thinking? I guess you could say I am lookijg for contributing factors to rationalize my ending up with PTSD. Whats your take on that line of thought?

    • Dr. Dee Rajska says:

      Hi Randall!

      Thanks so much for your comment.

      Unfortunately, there is no quick and easy answer to the question, “why did I get PTSD?”.

      I’d like to address this in some detail in a future blog post – but let me try to give a brief answer here.

      One way in which we become traumatized is when we witness or experience something that shatters our beliefs. So, for instance, perhaps your early background as a (very accomplished!!!) boxer taught you to believe that you can conquer your fear in any situation. Joining the military, as you said “straight to Airborne”, gave you an opportunity to conquer fear again, reinforcing that belief.

      If at some point, you were overwhelmed with fear, and felt unable to conquer this fear with aggression – then this would be a situation that you would experience as traumatic, because it would shatter your belief that you can conquer your fear.

      I don’t know if that’s what happened to you, but that’s one possible example of how PTSD might develop.

      Thanks again for your question, and I hope that answer helps.

    • adamblanch says:

      Hi Randall,

      This s a really good question. Research shows that when young children are exposed to trauma such as family violence, bullying, loss or neglect they are more likely to develop PTSD if exposed to trauma as an adult. An aggression response can be very empowering because it helps the person feel that they were not defeated by their trauma, but there is always something bigger than us (i.e. war) and as Dr Dee has said below, when that response fails to overcome the threat it can leave the person feeling very powerless.

      I congratulate you on once again doing the work to conquer the threat to your well being. Your interest is a pretty good sign that you will get through this and reclaim your life from PTSD.

  2. Nicki Nero says:

    Have you seen and heard this song written for Soldiers and vets, the video is quite touching
    please go to

  3. Wow, Nicki. That is beautiful! This is the first time I have seen it. I think we will have to make it part of the introduction to Homecoming Vets because it illustrates that message so well and becomes visible to every visitor to this website. Thank you again for sharing this with us.

    Bonnie

  4. Randall says:

    Hey Dr. Dee! I am going to give you an A+ in narrowing the gap here. Yes I have experienced mulitiple causualties and infact been injured with an OSI. However having many multiple years and hindsight on my side I attribute my PTSD more to a feeling of helplessness and or hopelessness at the time of these incidents. The fact is I did my job even when injured and what I cant get over, what haunts me today is just how ineffectual I was at the time. The crazy part is we do it over and over again and we learn to hate the machine. The higher ups the retards that send us back to the same place expecting a different result and act surprized when their plans end up FUBARED. We the Grunts learn to rely on each other and infact become our brothers keeper because truthfully we believe nobody gives a DAM! It is eye opening, akin to an epithany to KNOW you are expendable and yet you have a job to do and you dam well do it because you are who you are, A Soldier First and Always!!!!! This is not regret or bitching, this is the Soldiers cross to bear and we do it willingly enough, We know the score and we chose to stay and in a lot of cases gone back because “SOMEONE” has to protect his brothers! Where it gets dicey is when you end up on medical and you are out faster than lickity split and I mean BAM your a civi and a non-entity over night and people look at you as if you failed! Thats where the world turns to shit and the mental mind F@#$ begins. Who, where, why, and how mean nothing all you are left with is “WHAT FOR?” What was it all about and was it worth the price of admission? My answer is “YES” I would do it all over again and I believe that is the general concensus of most that have seen more than they care to so here’s the question. What is the underlying signifigance to that statement? Are me and my brothers Purposed, Driven, Motivated, and Nobel or Honourable as we would call it. Or are we simply looney tunes and should head for the nearest Psyc Office. I have left reintegration into civillian life out of this equation cause that is a whole other can of worms. Suffice it to say it took many years to find purposeful living as a civillian and the struggle continues. Be Proud Stay Airborne!

    • Dr. Dee Rajska says:

      Hi again, Randall!

      Thank you so much for the A+ 🙂

      You’re quite right to say “narrowing the gap” – I realize that I haven’t fully answered your question, because that would take several more blog posts, lots more information about how our threat-response system learns, blah, blah, blah.

      I’ll do my best to keep narrowing the gap in future posts, and I appreciate you letting me know what you’d find useful for me to talk about. It makes me feel a little less like a fool talking to an empty room 🙂

      You’ve touched on a lot of important issues in sharing your story. I wonder if, in your early boxing career, one of the beliefs you developed is that you have what it takes to overpower your opponent when you conquer your fear and harness your aggression. It sounds like part of your military experience was “we are helpless, all we have is each other, the higher-ups don’t understand and don’t care”. That’s a pretty direct threat to your belief, not to mention, an experience of helplessness and danger. That’s exactly the kind of traumatic event that may result in PTSD.

      I hope that helps to narrow the gap a little bit more.

      Thanks so much Randall, for sharing your story to contribute to the discussion here.

  5. Randall, I am not jumping in here in place of Dr. Dee — I am jumping in as an extension of your experience. In 1994, when I went to Rwanda to report on the humanitarian relief effort, I interviewed every peacekeeper/air crew that lived through that horror and saw some of the results myself. I understand the sense of helplessness you are talking about — I became just as angry and frustrated with the UN’s position — together with the treatment of our peacekeepers through this mission. I came home enraged with our government, the military brass and the unsympathetic, ignorant public and then ultimately with my media bosses because they weren’t interested in any truth that doesn’t sell papers. Every peacekeeper/crew member I talked to never said that, if they knew before they left what would happen, they would not have gone. Instead, every single one repeated what you just said: “YES, I would do it all over again.” I met some of the Airborne’s finest there, so you have my admiration. You have in fact made a difference to someone, if only one at a time. It is my sense that it is the additional feeling of abandonment and betrayal that further bonds your sense of brotherhood. I felt a part of that brotherhood in Rwanda, and I’ve never felt so vital or so close as I did while on that assignment.

    So I’m wondering, Dr. Dee, if the self-anger — indeed the terrible FRUSTRATION that seizes us because of the hopelessness of what we are a part of becomes another link in an emotional chain reaction that sets off PTSD?

    Bonnie

    • Dr. Dee Rajska says:

      Bonnie,

      I don’t know that I would describe it exactly that way – when we feel that our safety or the safety of others is threatened, we feel helpless to do anything about it, that can be traumatizing. It is not quite an emotional chain reaction – but perhaps I can discuss this in more detail in the future.

  6. sean maher says:

    I would like to talk about the per training

    • Dr. Dee Rajska says:

      Hi Sean!

      Thanks so much for joining the discussion, and for offering a topic suggestion. I think that’s a great idea. So far, this week’s commentary is overflowing with great ideas – at this rate, you guys are going to keep me in business for a while with topic ideas for future posts!

      I’m going to share the wealth, and reach out to an expert who is more qualified to speak on that particular topic than myself – I hope that this is a topic that perhaps Robert Simpson can address in his series, A Veteran’s Point of View?

  7. Having read this weeks blog or column if you will.I’d like to say Thank You Dr Dee. Now there’s a question which is…. Per Training? Well what is our training? Think back to your Basic Training: Pt ( lots and lots) Military drill and law, weapons, working as a unit. As you go on to more advanced training the unit is enforced, that you are part of a unit. For those who joined Special Forces, we are given the training to work as one person if need be, but mainly as a unit. When we suffer from the wound PTSD we feel alone, cut off from the unit. However we all have been trained to mask fear and to move on with our tasking’s. Support groups revert to the unit, we come together with the common goal of dealing with the effects of our wound. It effects each person differently, BUT it effects us all the same. With the group you are back with the unit so to speak, in that we come together. However unlike being back at your unit, this time everyone is saying I’m hurt, I got this problem, I need help, and I need the safety of the unit. While you are afraid of what the others might think all you know is that if you are part of a unit with a common goal, then you are safe. Our training enforces the concept of the unit. We need that as we suffer with the wound PTSD. I believe this give a quick answer to ” Per Training” So I say to all Think of your training, look for a group, Veterans Affairs know of such groups Canadian or USA. Also there’s media. I try to get Radio and Newspapers locally to let people know we are meeting. As always I say “Let’s Talk” You can always private message me if you want to talk more.

    • Randall says:

      Robert,
      All I can say to this point of view is awesome! I belong to and am a participant with an O.S.I. Group here in Sudbury and we meet monthly as well as most members are also members of U.N. NATO Military Group that meets weekly. The concept of UNIT seems so simple that I am embarresed to say I haven’t articulated it. We have explained it by sort of skirting around the concept but not quite so succintly as you just layed out. As we used to say back in the day T.F.E. my friend. I totally get it, ding ding, the light is on. I am very happy I found this web site it has helped improve my recovery and quaility of life exponentialy. Cheers to you and an even bigger cheers to Bonnie, ya gotta love her!

      Getting Better,

      Randall

  8. Randall says:

    Of course Cheers to Dr. Dee as well!!!!!!

  9. Randall, helping you all help yourselves find ways to deal with PTSD and get your lives back is what we at the PTSD FORUM have been hoping we could help you do, so thanks for the cheers from all of us.

    Bonnie

  10. Randle that’s good to hear. Thank you for you kind words. I’ve been fighting this beast since Oct of 1978. The London OSI Clinic has helped me and they say I’ve helped them. If we work together there’s nothing we can’t do as a group. Yes there’ll always be that dream at 3am oh too real, but having the knowledge that you are not alone in suffering this wound. Helps and member of the Group here in Wallaceburg call each other for help. Just to be able to chew on that ear is a big plus when dealing with a bad day . Remember the group is now the unit. As we 8CH use to say OSONS We Dare.

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