PTSD FORUM with Dr. Dee Rajska


PTSD ForumPTSD FORUM

Dr. Dee Rajska is back to continue with her contributions to this forum about PTSD. Please remember that, for the benefit of everyone, we need to keep comments or questions focused on the post itself. Thanks. BONNIE 

 

 

_____________

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!

I know, I know… My last blog entry said I’d be back “next week” – and that was a month ago. Yikes…

Rest assured, I’m not going to sit here and tell you that the dog ate my homework.

Nope – I’m going to blame my husband instead. And my sinuses. 

He brought home a bad cold; I caught it and kicked it up a notch, to a full-blown sinus infection …

 Didya miss me? 😉

Last time, I was saying that: 

PTSD = survival reflex + military training, both gone into overdrive.

You vaguely remember me droning on about some of that stuff, right? 

How we’re all hard-wired with a reflex, called fight-or-flight, that kicks in when we need to respond to potential threats? 

Still doesn’t ring a bell? 

It’s okay, go ahead and cheat to refresh your memory right here. 

The fight-or-flight reflex is an innate response to a threat; your military training adds on to this, to make you more effective at responding to threats. 

Here’s some examples of how: 

–          Being aware of your surroundings at all times, and to react immediately to sudden changes in your environment.  

–          Maintaining control of your weapon and your gear at all times, so you’re not running around looking for stuff in an emergency.  

–          Mastering emotional control – the military doesn’t exactly encourage getting in touch with your feelings… Your emotions are limited to:

  • Fear – fear is a reflex; no amount of training will eliminate fear. Training teaches you to use fear: when you feel it, you immediately scan your environment, identify the threat, and respond appropriately.
  • Anger/rage provides a jolt of energy and a focus on neutralizing the enemy;
  • Numbness drowns out all other emotions. In a combat situation, all other feelings may be a liability that leaves you or your buddies vulnerable.

Okay – we agree that these skills come in pretty handy in a combat zone?

(If not – we’re up for a really interesting discussion this week…)

 Now, here’s the problem: your skills don’t come with an “off” switch.

 So, when you get home:

 –          You may feel a need to monitor your environment at all times. This is what makes it difficult to cope with crowds, like at a concert or a shopping mall. You may also have a hard time keeping your attention on any one thing for a length of time: the way it works is you can either scan everything, or you can sustain focus on just one thing.  

–          Keeping track of where you put all your stuff is a combat skill. At home, you might overreact if someone moves your things from where you left them.

–          Emotional control may lead loved ones to comment that you’re cold, aloof, and distant. You may feel disconnected from others, misunderstood, and lonely.

–          In a combat zone, fear is a signal of danger. Back home, fear may be triggered by reminders of danger, or just by a passing thought of “what if?” going through your head. When you can’t identify a clear threat, your training doesn’t give you a protocol for how to respond – it’s like your brain thinks that there must be a threat because the fear signal says so, and if you can’t spot it, then you feel vulnerable and defenseless, unable to consider the possibility that you might actually be safe.

My point is to illustrate that you’re not “crazy”; you’re not “messed up”; you’re not weak, you’re not a failure, you’re not a loser. (Hey – of the stuff I’ve heard some of you guys call yourself, these are the less colourful terms that I can actually put in print…)

What you are is a warrior out of context.

A lot of these “symptoms” are actually your warrior skills – skills that probably saved your bacon, and that of your buddies, time and time again when you were “over there.” They just don’t come with an “off” switch.

As if it wasn’t bad enough that these skills don’t come with an “off” switch – because of your training, they actually come with a switch that kicks them into high gear.   

Military culture values personal accountability – you are accountable for doing your job to a very high standard. You expect yourself to have it together; your buddies, your superiors, and your subordinates expect the same.

In a combat zone, there’s no room for error – there’s no do-overs, no, “sorry guys, I was daydreaming, can we try that again?”. Um, *no*. If a mission is 53% accomplished, you don’t get a cute animal sticker and a chance to improve your grade on a make-up test next week.

So – you may have difficulty accepting anything less than perfection of yourself.

Now think of what happens when perfectionism collides with PTSD:

  • You’re having symptoms that you can’t control;
  • Because of these symptoms, you’re not able to perform to your usual standards;
  • And – you expect yourself to be perfect.

Folks, that combination isn’t pretty: you end up feeling ashamed and guilty, feeling like a failure, telling yourself to man up and get it together.

Basically, you’re yelling at yourself to solve a problem that you don’t know how to solve. You feel helpless and angry, like you want to throw in the towel. Except – here comes your training again – giving up isn’t exactly encouraged in the military either.

You get stuck in what seems like a no-win situation.

Which is why you’re here. 

The more you understand how your symptoms work and where they come from, the less they freak you out when they happen, and the less you blame yourself for symptoms that are based on reflex, and not a failure on your part.

Letting go of blaming yourself for things over which you have no direct control is really, really important – and I will discuss this again in the future.

Notice that I learned my lesson and said “future” rather than “next week” – because my husband is going on a business trip, and you never know, he may bring home the bubonic plague or something… You think I should tell him to skip the souvenir shop this time? 😉

As always, I look forward to your questions and comments.

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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24 Responses to PTSD FORUM with Dr. Dee Rajska

    • Dr. Dee Rajska says:

      Thansk so much Robert – and thank you for keeping the discussion going while I was out of commission! 🙂

  1. Margaret Ballance says:

    I suffer from extreme PTSD. No I was not in the war, but I lived a war since I was 5 in my own country. Since 2006, I have a believed a service dog would protect me during episodes. During these episodes I have been robbed, raped, and beaten more than once. My family does not know anything about these life changing episodes. I have been in a comma a result of the people that preyed on the weak (me). I am sad learn that my recommendation for a dog has gone on death ears because I am not with the military. I sent an email Rome Leblanc if others could expect support if they experience PTSD years after the initial trauma. Thanks to Mr. Leblanc, Veterans Affairs have put a five year limit. My grandfather was a veteran from world war I and my father a veteran from world war II, I have been attempted suicide so many times I have lost count. I am surprised I am still alive. I supported you. I need your collective help to ensure one day my daughter will talk to me again because she doesn’t understand how someone once so professional successful could fall so far.

    • Dr. Dee Rajska says:

      Thank you so much for your comment Margaret, and welcome to the Forum.

      It sounds like you have really been through a terrible time.

      Service dogs can make a tremendous difference to many people with PTSD. Unfortunately, the benefits of service dogs are only slowly beginning to be recognized. Currently, even if you had been with the military, it is my understanding that VAC does not provide funding for service dogs. We are hoping that it will become recognized as an important form of treatment that helps many individuals function more independently.

      I hope you are able to follow up with Bonnie to see what we can do to assist you.

  2. Margaret, we can’t promise you anything because your situation is not directly related to veterans’ services, but we will look into any possibilities where a service dog could be provided under your special circumstances. It would help to know in what part of Canada you live – no specific address, just general areas such as “near Calgary” or “southern British Columbia” or “near Toronto.” If anyone reading Margaret’s comments has suggestions, please email me at bonnie.toews@yahoo.ca.

    Bonnie

  3. Murray Scott says:

    It is always interesting to read an informative article which breaks the recovery process into small easily digested pieces. This bite size glimpse into recovery is so necessary if one is to have any hope what-so-ever. With all do respect I am wondering if the recovery process would follow the same continuum if a person with PTSD also suffered from Addison’s disease. Would the monster go back in the box if the Addison’s was successful controlled. Great work thank-you…..All the best Murray Scott

    • Dr. Dee Rajska says:

      HI Murray!

      Thanks so much for your kind words, and your question.

      To be honest – as Addison’s is a physical disorder treated by medication and not psychotherapy, I wasn’t familiar with it, and had to look it up.

      According to Wikipedia, “The most common symptoms are fatigue, lightheadedness upon standing or while upright, muscle weakness, fever, weight loss, difficulty in standing up, anxiety, nausea, vomiting, diarrhea, headache, sweating, changes in mood and personality, and joint and muscle pains. ”

      I can certainly see how in terms of symptoms, there would be some overlap – it looks like anxiety, digestive upset, sweating, changes in mood would be common symptoms of both Addison’s and PTSD.

      So – to address your question “Would the monster go back in the box if the Addison’s was successfully controlled” – I would imagine that the part of the symnptoms that was due to the Addison’s would decrease, but I don’t believe that symptoms of PTSD brought on by psychological trauma would completely go away by controlling the Addison’s. I’m guesstimating here, because I can’t say that I’ve ever treated a patient with Addison’s – bu that would be my guess.

      I hope that helps.

  4. Randall says:

    Ok Dr. Dee, I just finished reading this post for the first time. You have struck a cord for sure and I plan to let it simmer some, go back and read it again and apply what you have said to my perceptions when thinking, feeling. and acting. I can tell you right off that for me its 2 speeds. Wide open and Stopped! When I am on a roll there is no tasking that cannot be completed despite mounting obstacles. That being said when I am feeling overwhelmed I cant seem to hit the gas. I know I have shit to do but i just “DONT DO IT”! This state can take days of my life. Immobilized in my own head. This used to occur for weeks on end so there has been improvement but I would be lieing if I said it no longer happens. IT DOES! I reveal this in order to face this major obstacle to my recovery as it has caused me “MAJOR” heartache, financial issues and a number of relationships. I see the writting on the wall but am unable to act, correct it, speak out. I can only watch it all fall apart and do nothing. Obviously I am not there today but the scary thing is yesterday I could not dial the phone despite my knowing that there is, correction was no immediate threat in doing so. So once again I applaud your efforts and would have you know we are listening. For every one of us that responds I can gaurentee that 25 are observing! Speak out brothers and sisters this shit will help square ya away! Keep writting Doc!

    • Dr. Dee Rajska says:

      Hi Randall!

      Thanks so much for your kind words. I will certainly keep writing – how could I even consider stopping, after that sort of encouragement? 🙂

      I know this was a long post, and I covered a lot of ground so it wasn’t exactly a bite-sized piece of information – so it’s not a bad idea to read through it, let it sink in, read through it some more, and absorb a bit more…

      You raise some important points; fear can become so overpowering that it can interfere with the most seemingly simple tasks. This is partly due to triggers, and partly due to just the fact that, when we don’t understand how our body is reacting, we basically get freaked out by the fact that we feel freaked out, so the fear goes into a vicious cycle, and gets bigger and bigger. This is how panic works – we haven’t had a chance to discuss panic just yet, but thanks for giving me an idea for something to discuss in a future post 🙂

      Randall, I’d also like to thank you for encouraging others to feel free to jump into the discussion – I hope more and more people feel comfortable enough to do that.

      Take care, and let me know if any more questions crop up after you’ve had a chance to read through it again.

  5. Hi again, everyone!

    I just wanted to add a general comment.

    First, let me start off by saying, Bonnie’s never had a recurring guest-blogger-psychologist on board, and I’ve never blogged in my entire life (well, that part you could tell, right? That I have no idea how to actually “write a blog”, and I’m basically pretending you’re just sitting in front of me and this is a conversation?). Yeah…

    But what that means is, we’re flying this operation by the seat of our knickers, learning as we go along. We’re open to your suggestions on how to improve it, and I will make sincere efforts to improve as we go.

    Folks, we’re three blog posts in, and I think I’m ready to new-and-improve this experience a little.

    To make things run more smoothly, we’re going to have some guidelines for comments. To be clear – I’d like to encourage comments, because that helps me get to know my audience and gear the blog to what you’re looking for. But, to make this as pleasant an experience as possible for everyone, I think a couple of guidelines are important at this point.

    ***NO “war porn”***.

    By that I mean, no comments that describe the gory details of horrible things that happened to you. Bear in mind that your trauma accounts could trigger someone else who is reading your comment, and we are working on building a supportive community here. Traumatizing each other is not support. So – if you post gory details, I will ask Bonnie to remove your comment, pronto. This is not because I don’t want you to participate – it’s because I don’t want you to harm each other by participating. Speak, by all means, but please be gentle with each other. I hope everyone can understand this and abide by it.

    I may get some criticism for this next bit, and I really don’t like being bossy, but I’m going to really put my foot down and have a major “princess moment” on this one.

    *****No selling stuff*****

    Absolutely no selling stuff.

    Not even a tiny bit of selling stuff.

    Folks, if someone asks a question, even if I have to research the answer and it takes me a half hour to type something up, I’m never going to respond with, “Come by my office, and give me your K number, so I can bill VAC for this”. I’m here pro bono because I believe that you guys deserve an online community of peer support and some good information on PTSD – this is a place to learn, ask questions, and support one another. If I can show up without expecting to get rich off of this, then I really must require the same of everyone else. If you show up just so you can sell something, I will gently remind you that none of us are here to make money off each other. Please contribute comments and questions, but no links to buy your book, gadget, gizmo, thingamajig, miracle cure-all doohickey, you get the picture. This is a forum, on online support group if you will; it is not a bazaar.

    If you have a book or thingamabob that you’re absolutely dying to share, you can click on my name to go to my LinkedIn profile. Contact me privately. If you’re really serious about this, send me a copy of your whichimacallit. I will read your book or try your gadget out on myself, and if I think it’s something that will benefit this community, heck I’ll write a whole blog post singing the praises of your gizmo. Promise.

    Whadda y’all think of this new-and-improved arrangement – does it sound awright?

    If you can think of any more improvements, feel free to suggest them. I’m happy to have your input (so long as you’re not selling stuff or triggering the living daylights out of each other).

    Thank you; the “princess moment” has now concluded, and I’m stepping off the soapbox…

  6. RIGHT ON, DR. DEE! I have already deleted comments that have not adhered to these two essential rules for our forum and be forewarned, folks. I will continue to delete comments that do not comply with the guidelines Dr. Dee has laid down here. Our aim is to help each other find ways that have a positive outcome in our lives through discussing what works to help us heal, and Dr. Dee, you are doing a tremendous job guiding us through the many possibilities both affecting PTSD episodes and working them out. A big thank you for volunteering your time and a HUG from all of us to go along with it!!

  7. Walt Moore says:

    Dr. Dee,
    Wow young Lady, you’ve done it again. This is a great Blog, and it is well written in such a language that even I can understand it. 🙂
    For those of you reading this, my name is Walt Moore, and I am in Salt Lake City, Utah, USA. I am a Army Vet, a Certified Peer Support Specialist (CPSS), and Chairman of the Veterans Advisory Council (VAC) at the VA here in Utah.
    I am not a Doc or anywhere close, but I have had a great deal of training to be able to help our Vets, here in the States, (or elsewhere) with Mental Health issues. (And in the six years of doing this, I have never received a dime. I Volunteer because of the passion I have to help any, and all Vets. I am not a “white-coat”.)
    I have joined many a Canadian Group, have connected with a few Canadian Vets that are great people, and have connected with a couple of wonderful Doc’s that can really understand us, (Dr. Dee) even when they haven’t been in the Service.
    Myself, I have PTSD, Anti-Social, Homicidal, Depression, and all sorts of good things that I take Meds for three times a day, and see my Shrink once a month. But…I haven’t had to be Hospitalized for the past six years or so, and I hope to stay in my Recovery for as long as I am able. And I do so by helping my fellow Vets as much as I am able to.
    I tell you this because there is always hope for Recovery, I am proof of this, and I will tell this to all that will listen. I hope that those of you reading this don’t mind a “foreigner” telling his story. 🙂
    To all, I thank you for your Service to your Country, and may God Bless all of you.
    Have a great day, and go in Peace, Walt CPSS.

    Again Miss Dee, I thank you for all that you are doing for our Vets, and best wishes to you in all of your endeavors. Your friend, Walt.

    • Hi Walt!

      Thanks so much for joining us here! It’s good to “see” you 🙂

      Thank you also for your kind words, and for sharing your story here; your story is a great example of the importance of peer support, not just for helping others, but for feeling good about helping others, taking pride and satisfaction in making a difference, and helping yourself heal by doing so. Thank you Walt, for all that you do to help out your fellow vets! 🙂

  8. WALTER...MITCH...MITCHELL USN.RET says:

    This lady is amazing…Her vast mind is comparable only with her caring friendly generous giving kind loving heart…IF…WE VETERANS HAD MORE JUST LIKE HER HELPING US….WE WOULD BE MUCH BETTER OFF…AMEN

  9. james says:

    Hi, I never went overseas and I find that I have the same issues after going through the Canadian medical system for 7 years I found that my head responds to the nerve damage in my back resulting in what I call uncontrollable violent outbursts. But I never went overseas. Anyways my new doctor has recommended ptsd testing and I’m finding that… Well I’m not going into more detail I’m sure you understand why.

    James

    • Hi James!

      Thanks so much for joining us!

      While my focus on this blog is to discuss service-related trauma, you’re quite right to point out that being deployed to a combat zone is only one type of trauma that can result in symptoms of PTSD. Any set of circumstances where there is a threat to either your safety or the safety of others, and you feel helpless about it, can potentially lead to developing similar types of symptoms.

      Aside from military service, some examples include: law enforcement; first responders; or civilians who survive/witness serious accidents or abuse. An illness where you feel you have little or no control over what is happening to you would be another example of a potentially traumatic situation.

      Whenever possible, I will try to make my blog posts general enough that so anyone dealing with PTSD would be able to read it and identify with what I’m talking about. I also do realize that there are veterans out there whose PTSD is not combat-related at all, but has to do with other types of trauma.

      This is why questions and comments from you guys are so important – a blog is rather different than talking to a live audience, in that you can’t see who you’re talking to until they leave a comment (and you just hope you’re not talking to yourself and that someone out there is actually on the other end…) So, I thank you for your feedback, and I will certainly do my best to learn as I go along, and gear what I write about to what you guys tell me you need.

      • waltsgm says:

        Dr. Dee, if I may comment on the statement by James, please.
        In my years of dealing with PTSD, I have spoken to many a Vet that never saw one day of Combat, or never Served in a war zone, MYSELF included.
        Everyone was being pulled out of Nam when I enlisted, so I guess, I can be thankful for that.
        But with PTSD, it can appear under all sorts of circumstances.
        How about the Service members that just walked the DMZ in Korea, and never pulled their weapon once. They had that fear, tension, and the hard part, just anticipating, and waiting for something to happen, that never did.
        The Service members that pushed buttons that deployed missiles, that they knew would kill hundreds of people, a thousand miles away, yet they never saw Combat itself.
        Or our Navy Vets out in the middle of a ocean, that fired their cannons, and killed who knows how many, yet they never pulled their own Weapon once.
        And the one thing that hits me close to home…how about the Vets that, for whatever reason, lost someone they loved back home, and could not be there for them.
        My story…my sister was murdered, thirteen years old, while I was elsewhere, and couldn’t be there. To this day that affects me, and although I’ve learned to deal with it, it’ll probably hurt the rest of my life when I think of it. You think PTSD applies to that issue?
        So PTSD is such a wide ranging MH issue, that I believe, affects more people, Military or Civilian, then we are really aware of. And along with PTSD,
        Depression, Anger, and other MH issues can arise to hurt us, and our loved ones also.
        At the VA here in Salt Lake City, Utah, we have a PTSD Intake every Thursday, that any Vet that even thinks they have PTSD can come in and be evaluated, and a determination will be made on just how severe their symptoms are. After that they are referred to the correct Clinician, who can best deal with their MH issue.
        My being a Certified Peer Support Specialist, (CPSS) I work as a Volunteer who is willing, and capable, of helping ANY individual, Military or Civilian, that seeks help, and needs answers.
        The main thing to this story I guess, is to seek help if you are even thinking about any of these issues. You owe it to yourself, and your loved ones, to do so. The worst thing you can possibly do is to ignore these symptoms, think they will go away, and that all you need to do is to “man-up”.
        So my long-winded story comes to a end, I’m sorry to say. (^_^)
        Take of this what you will, and throw away the rest, your decision my friends.
        Have a great day, and go in Peace, Walt.

      • Dr. Dee Rajska says:

        Walt,

        Thanks so much for your input, as always – thank you for making this discussion come alive! 🙂

        You’ve done a great job of illustrating a variety of circumstances, other than direct exposure to combat, that can have a real impact. Great points, each one of them.

        Whether you were ever in a combat zone or not, there are lots of experiences that have the potential to be traumatic. In many cases, having never been in a combat situation makes it even harder to reach out for help – you might feel ashamed or weak for feeling this way, and discount your trauma as not being “real”, comparing it to what someone else went through.

        Walt makes a great point – it’s not important where, exactly, your trauma comes from. If you don’t feel good, reach out, get some help.

  10. chasity penny says:

    my husband is a veteran that is sitting in our county jail, in chesterfield sc back the solicitor doesn’t know what to do with him. my husbands mother died in our house almost 2 years ago and afterwards something happened to my husband and he started acting strange. i had a pick-up order for him with our local mental health office but I nor the deputy’s with the sheriff’s department couldn’t find him. for two weeks we looked and then on Dec. 20th 2012 he came and took two of our kids and left, police was called because they knew of the pick-up order and now he’s in jail, just sitting. My husband doesn’t think anything is wrong with himself but me, family and now the jail and solicitor see that somethings wrong but don’t know what to do next. He’s been in jail for over 120 days, i feel like the longer he sits their without getting any kind’a help is just making it worse. i’m asking anyone for help.

    • Dr. Dee Rajska says:

      Hi Chasity Penny,

      Thanks so much for jumping in and joining the discussion.

      So far, my focus in the blog posts has been on the veteran themselves – but, you bring up the very important point that there is a larger impact, affecting family members and loved ones.

      I can imagine this is very difficult for you and your family.

      I wish I was in a position to give specific advice on what to do – you mentioned that you are in South Carolina; I’m based in Canada and I know the system here is quite different to what you’re dealing with.

      Have you tried contacting your local VA, to ask them what could be done? Unfortunately – I’m sure they have dealt with circumstances like this before. Your local Legion, or a local veterans’ advocacy group may also be a good place to turn to for advice and help.

      I’m sorry I can’t be of more direct assistance – I wish you all the best and I hope that things work out for your husband…

    • Chastity, you can also contact Lily Casura, well-known advocate for American veterans through her Facebook page — https://www.facebook.com/lilygc

    • waltsgm says:

      Chasity,
      Here at the VA in SLC, Utah, we have personnel who are strictly trained for legal issues. They visit the jails, courtrooms, or wherever is needed, to help the Vet with their legal issues, ONLY.
      We also have a Veterans Court, where a Judge considers the Vets problems, and possibly, their MH issues, unlike a Civilian Court.
      If you’d like further info, please don’t hesitate to contact me. I will tell you what I know, or I can go to our Regional Office, or I will ask our Veterans Justice Outreach Coordinator, if needed.
      Best of luck to you, and go in Peace, Walt CPSS.

      Sorry to butt in Dr. Dee. I’m just a busy-body I guess. You have a good day, and stay out of trouble. Your friend, Walt. (^_^)

      • Dr. Dee Rajska says:

        Walt,

        Thanks SO MUCH for contributing – you’re not “butting in” at all, if anything you’re recognizing that I’m way out of my league here and contributing your expertise, and I thank you for that! (In fact, I was kinda hoping you might know how to help out on this one) 🙂

        That goes for everyone else as well – feel free to jump in and share your knowledge, I’m not the queen of this blog – if you have something to contribute, this space becomes all the richer for your contributions.

        Chasity, I hope Walt’s advice is helpful. I did a quick search on VA services offered in SC and came up with the following:

        http://www2.va.gov/directory/guide/state.asp?STATE=SC

        Please check it out. Please do come back and let us know how it worked out. Please know that you are not alone.

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