Life, Therapy

What trauma feels like (for me, for now)

(This is about trauma and talks about death, with mentions of self harm and suicidality.)

I’ve had lots of upsetting things happen recently — my mom lost all the hearing in one of her ears suddenly, my uncle was dying and then died, my grandmother was in the hospital and then died — those are the main ones, but my great uncle also died, my aunt’s neighbor died, my family has been very chaotic… taken all together, within a month, it’s traumatic.

I’m used to PTSD and the anxiety, nightmares, intrusive thoughts, and flashbacks as a result of that. But with PTSD, it’s post-trauma. I can use opposite action to face fears because I know (at least, rationally) that I am safe now. I can ground myself in the moment with phrases like “this reminds me of something scary, and, in this moment, I am safe.” I can point out the ways that this situation is different from the traumatic one.

Now it’s different. I’m not living in PTSD anymore; I’m living in trauma. It is happening now.

Trauma is something that overwhelms your ability to cope, something that threatens your life or that of someone you love. These events have definitely overwhelmed me: I feel like everything is “too much” very often; I’ve developed new self harm behaviors; I fantasize about dying to escape it all; accomplishing little things, or even getting out of bed and getting meals, are hard. And the lives of people I know and love were threatened and taken.

I know that my subconscious agrees that I’m overwhelmed because my PTSD (from a car accident) has disappeared. I’ve heard that having flashbacks means that your body and brain are ready to process through the trauma that you couldn’t process at the time. Well, clearly my body isn’t well enough to process old trauma anymore. I’ve had one night of traumatic nightmares and intrusive thoughts relating to the accident in the past few weeks. Just one! I suppose I should thank my body for this, for not giving me even more distress that I’m not capable of handling.

On the other hand, I have had nightmares, intrusive thoughts, and lots of strong anxiety, sadness, and other emotions about the current issues.

And when I have startle reactions, like when the phone rings, or someone knocks on my door, or I hear indistinct raised voices, or my mom texts me, those reactions are actually the response that is needed in that situation. It’s not a post-trauma startle reaction. It’s not out of place. It’s serving an essential purpose. It’s getting me awake from my slumber so that I can drive my mom to the hospital. It’s preparing myself for the news that my grandmother died.

This trauma is happening now. It’s awful. Here are some other things I’m experiencing that help show what this trauma feels like.

  • Constantly high anxiety
  • Checking the facts and finding that the intense emotion is justified: people are in danger.
  • Screaming when startled
  • Splitting headache
  • Not knowing what will happen
  • Feeling like my world is collapsing around me
  • Trying to maintain any sense of constancy in my life
  • Things so chaotic that I don’t know when I’ll next eat
  • Expecting my life to be turned upside down and inside out multiple times in the near future
  • Having to always be ready to drop everything for my family at a moment’s notice
  • Waking up to my mom calling me saying she’s in the emergency room
  • And not being fazed by it because it’s become so commonplace — constant danger is the norm
  • Dissociating so much that I can’t read more than a couple of sentences
  • Dissociating the moment I consciously try to stop avoiding emotions
  • Dissociating in order to survive — because if I don’t, my emotions are unbearable, and I get very suicidal, or can’t eat, or can’t get out of bed — so, dissociating is keeping me alive
  • Needing to use my crisis survival skills toolkit many times every day
  • Almost always wanting to die
  • Crying when I didn’t call my mom because I think that if I don’t call her, someone will die — and then having my grandmother die the next day and confirming my worry
  • Not knowing where I am
  • Not being able to participate in a normal, casual conversation because everything reminds me of the awful things going on, and I don’t want to talk about them
  • All of my thoughts leading back to the trauma
  • Saying “HELP” inside my head or writing it on paper or my skin frequently
  • Wanting very badly to be able to escape and not being able to

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Therapy, Uncategorized

My relationship with death

(In case it isn’t obvious already, this is about death, and it’s dark.)

We’re in a close relationship, death and I, but it’s a rocky one.

I saw you, death, for the first time when I was in 5th grade. I had heard about you before. I had heard what you had done to my grandpa, to my friend’s dog, to many others. But I hadn’t been present to see you in the same room.

In 5th grade, I saw you come and take my grandmother away. I saw her heart rate fall, fall, fall, until it got to levels at which she was surely unconscious, and we took the monitor off her finger.

I understood that it was her time. I loved her, but it was a peaceful way to go.

Then, the summer between 9th and 10th grade, you noticed me. Before, we were just strangers in the same room. Now you introduced yourself to me. You showed me my life. I saw it flash before my eyes. It was a good life, one I was proud of. You told me it was enough. You told me to come with you. You showed me peace and beauty, the calm in the eye of the storm. You took my breath away. I said okay. I didn’t have a choice, but I said okay anyway.

But you decided not to take me then. I don’t know why. Maybe it was fate. Maybe it was God, if he exists, thinking I deserved to live longer, that there was some plan for me. Maybe it was physics, just the way things moved in that moment, and my luck of being where I was. Maybe it was that I was wearing a seatbelt. Maybe it was that I wasn’t too tall. I’ll never know why.

You turned away from me and looked at my dad. He was too tall for the car. The physics did not work in his favor. I saw and heard horrible things. For maybe five minutes, I thought you had taken him. I imagined the rest of my life without him. I regretted not loving him more. I hated you, death. You caused pain, misery, and sadness.

And yet you didn’t take him away from me, either. It was an amazing gift, one that I struggle to be thankful for today, but it really was.

Time passed. You stayed in my mind. The image of peace stayed in my mind. The horrors stayed in my mind. For better or worse, you and I were linked together.

Later, when things were too much to bear, you knocked on my door. I invited you in. At some point, we must have started dating. I thought about you often. I fantasized about you, “Death + Me” written in a heart. I wanted to be with you, but at the same time you repulsed me. I hadn’t forgotten the accident. I hadn’t forgiven you for that. But the peace was so tempting.

I kept our relationship hidden. I didn’t tell friends, family, teachers, even my therapist, what you meant to me.

We’d break up. I’d swear we were never getting back together. I’d write lists of why I wanted to stay living. I’d plan things to look forward to. I’d make checklists to follow during the times when you tempted me, so that I wouldn’t give in.

I’d go without seeing you for a while. I would try to forget. But somehow you still called to me, especially in my dark moments, especially in flashbacks, especially when I was alone.

At some point I started becoming more open about our relationship. I wrote about it in my journal. I alluded to it with my friends. I confessed to my therapist when she asked me point blank. A few months later, my therapist and I told my parents about my relationship with you. They didn’t really understand. But they loved me and wanted to support me. They wanted to help me move beyond you. At the time, I wanted to be done with you, too.

You were my guilty pleasure, death, a secret kept hidden, but also a monster haunting me. You keep proposing. You keep wanting to run away together and get married. I keep saying no. But I’ve gotten so close to saying yes.

You always ask in my weakest moments. When I’m feeling better, I hate how close I came to giving in to you.

Death, I know you will take me eventually. Subconsciously, I expect that it will be soon, but I think that’s just because the horrors you left me with make me expect to die. You’ve never left me completely. You still feel close.

In the times I’m feeling well, I don’t want to be with you. You offer peace, but it’s mixed with pain for others. You offer peace, but it’s too soon. I have plans. I have dreams. I have relationships besides the one with you. I can find peace in ways other than what you offer.

I wish I could break up with you permanently. I wish that when you finally do come, it will be many, many years from now, after a full, satisfying, joyful, loving life. I hope when you do come, I’ll be sad to leave.

For now, I am working on healing from my relationship with you.

Therapy, Uncategorized

Memories of being in the hospital

This morning in bed I read through a blog about being in a mental hospital. It reminded me somewhat of being in the day treatment program at the mental hospital this summer, but it actually reminded me more of a traumatic time in a hospital, being treated for physical reasons…

I am aware that writing about this could trigger me and give me flashbacks or dissociation, and I’m also aware that I haven’t been this open on this blog before, or in person, for that matter… I normally avoid talking about trauma things, even in therapy. Although that will hopefully change soon. But I think these thoughts all the time, and I want to put them in the world, and I’m finally feeling like maybe I’m able to do that without getting super triggered…

(And also, be aware of yourself while reading this and mindful of if it’s the best thing for you at the moment. It’s not very graphic, but it is about injuries, hospitals, being away from home, doctors, a dangerous city, etc.)

Okay, so I’m going to try to write this, and I will do it mindfully and stop and take a break when I notice myself getting worse, and I will do grounding skills. 🙂

Okay, here goes!!

So, it reminded me of being in the hospital and getting kicked out before I was ready to leave. I was in a bad state… with a broken bone knocked two inches out of place (i.e. no chance of it healing properly on its own), with a concussion that doctors refused to acknowledge or treat, barely able to walk…

In a country where I didn’t speak the language, in a part of town where you could get shot if you walked around right outside the hospital – my family members were staying at a bed and breakfast two blocks away from the hospital, and people advised us to take a taxi there because it was too dangerous to walk.

As I write this, I notice that I am getting a bit of a headache, feeling nauseous, and my thinking is getting a bit foggy. I’m gonna take a quick break…

I’m back! I ran up and down the hall and jumped around. I also got some more water to drink. It is TWENTY EIGHTEEN, I am at home, I am in college, I am on fall break, I am studying engineering, I have new friends, my watch is blue, I am thinking about a distressing memory, but it is not happening now. Memories are painful but not the present reality. It is safe to write about. Whew. Deep breath. Okay.

Yeah. So I did not feel ready to leave the hospital. I also didn’t have my belongings. I was in a foreign country. I was a bajillion miles from home. For a good amount of time, I didn’t have shoes, and had to walk around the hospital barefoot until I pleaded enough that someone gave me giant navy crocs.

One day, they had me move to a new bed in a different wing of the hospital because someone needed the bed I was in. This happened suddenly, in the middle of the day. My family was not around, and I had no way of contacting them. I owned a cell phone at the time, but it was at home across the ocean. I hadn’t brought it on the trip because I didn’t use it much at the time (I was kinda young), and I knew it wouldn’t work anyway because I didn’t have an international data plan. But anyway, I had no way of telling my family where I was. I thought they would just show up to my old room, looking for me, and not know where I had gone or have any way of knowing. I ended up telling a relative of someone I shared the room with exactly where I was going. I think that helped. I don’t actually remember how it turned out, but my mom definitely found me eventually.

I know that this is kinda disjointed. Apparently that is how trauma memories are: not in order, random snippets. These aren’t even the super traumatic parts. Sighhhhh

There’s a lot more I could write about being in the hospital, but I think this is enough for now, so I’ll say one more thing to end on a good note.

In the room I was in, there was an older woman being treated for some sort of heart problem. Her family was with her. Her granddaughter was in her 20s and studying to be a doctor, I think. The granddaughter was really sweet. When I was super nauseous, she went to the drugstore in the hospital and bought me cinnamon gum to chew. Apparently chewing gum and experiencing strong smells or tastes helps with nausea. I didn’t actually chew the gum at the time, but I have chewed gum more recently to help with nausea.

One time, she took me on a walk. She let me lean on her arm for support (because I wasn’t walking well and was also very dizzy and nauseous). We walked through this peaceful spiritual garden thing in the hospital. It was only about 20 minutes, but it was my first time walking since I’d gotten to the hospital, and my first time away from my bed in a while. It was so nice. I felt so taken care of. She was so kind to me.

Therapy, Uncategorized

Packing for trips

I made a joke in a group chat with my friends recently…

Me when I’m packing: I should bring at least three books in case I’m not in the mood to read the other two, might as well bring this flashlight, nail polish is always good to have

Me when I arrive: looks like I forgot underwear, socks, pajamas, and my toothbrush

😂 this is literally what happened ughhh

It’s funny, and I was laughing, but it also annoys me how I’m like this. I have such a strong urge to bring everything I could possibly need with me. I think it’s part of my PTSD/OCD.

PTSD because it’s part of the trauma belief that traveling is dangerous, and I could get into a serious accident, and you never know what will happen so you have to be as prepared as possible at all times because who knows when you’re going to need everything you could possibly need.

OCD because I have the obsession (intrusive thought, worry, fear) that I will be in danger on this trip and maybe not come back home, and I appease that obsession with the compulsion of bringing lots and lots of stuff with me. At least, this is OCD as I understand it. I haven’t been “officially” diagnosed with OCD, but a therapist once implied that I probably had it but that she didn’t want to bother to separate out what is PTSD and what is OCD because the treatment for both is the same: exposure.

Anyway. I do feel like I have OCD, and I feel like I have all these rules I have to follow, just in case. It’s less scary and more frustrating at this point because I have to put up with myself. I have to appease my emotion mind within, or else I won’t feel safe. This happens with germs, too. I’m not particularly afraid of getting sick, but I just have rules, like anything that falls on the ground is dirty and must be sanitized or washed with soap and water before I touch it, and anything that touches anything dirty is now dirty.

I think I’ve gotten better at not always following these rules though, through, you guessed it, more exposures. The rules aren’t as strict anymore. But it’s just annoying. It’s like something extra I’m carrying around and paying attention to, an extra monster inside of me I have to care for and appease. I should maybe bring this up in therapy, but I feel like we’re addressing the more important issues (suicidal and self harm urges, trauma) now, and this is a lower priority. Plus, my old therapist was right: if I do the trauma work, these OCD-like thoughts and behaviors will probably diminish.

For now, I suppose I can radically accept (DBT skill) that this is the way I am now. I bring lots of stuff with me on trips. That is the way it is at this time. AND (there’s that DBT dialectic), it doesn’t mean it can’t change in the future. I can do more exposures. I can take small steps. I can be patient and slowly make progress.

Anyone else have issues like this?

(This was an interesting article about the link between PTSD and OCD.)

Positives, Therapy, Uncategorized

I’m doing better

For the first time in a while, I am feeling solidly okay.

  • Sirens aren’t a trigger for me anymore. I go to school in the city, and this was a huge problem for me last year. I would get caught in flashback-y/dissociative states for a few hours as a result of hearing the unremitting sirens just outside my window.
  • Brains aren’t a trigger for me anymore. We look at lots of pictures of brains in my psychology class, and I am not alarmed and do not associate them with traumatic memories anymore (at least not unless I consciously prompt myself to think of the connection, like now).
  • I’ve been having fewer nightmares. I haven’t had a really bad nightmare, one where I wake up in a panic attack, in a while. The few nightmares that I have had haven’t been that bad.
  • I don’t feel as dependent on my therapist(s); I don’t feel as much of a need for a therapist. I think this is because I have formed other close relationships in my life where I feel comfortable talking about things similar to those that I talk about in therapy. What I want most from therapy right now is to do the trauma work (which keeps getting put off, because I didn’t have enough time left at the program I did over the summer to do the trauma work then, and then when I got a new therapist I had to get used to her, and I was overwhelmed at the start of the school year and thought I couldn’t handle anything extra until school settled down). As kind, sensitive, caring, and wonderful as my friends are, I know they don’t have the knowledge or experience (or time) to help me work through my trauma. So I still need therapy for that.
  • I haven’t self harmed in a while… maybe a month? I think the past few times I have self harmed have each been about a month apart. I’d say that’s pretty good! I used to self harm a lot, maybe a few times a week, although I didn’t think of it as self harm at the time.
  • I’m getting better at asking for things!
  • I’m being more vulnerable with friends, gradually, slowly.
  • My college feels like a real home now. Last year, my home home (place where I grew up and my family still lives) felt like my real home, and I missed it a lot. It was a better place than college. In contrast, this year, my college home is better than my family’s home. My suite there is my home, and my suitemates are my family. When I go back to my family’s home, I miss my suitemates. My suite is a much more supportive environment than my family’s home, and I feel more comfortable being vulnerable and being myself there. And my friends are there. And we’re at similar places in our lives and studying similar things, so it’s much easier to relate and get along. If I squint, I almost feel like I’ve lived here my whole life. In my suite, we have a kitchen and lots of people who love to cook. Sometimes my suitemates make food and share it because they have extra, so I sometimes wake up and am offered freshly made crepes, or come home from a long day and someone says I can have the caramel apples in their fridge. It’s really lovely.
  • I declared my major! This has a lot of benefits. a) It enabled me to drop a hard, stressful class that I don’t need for this major. b) I can stop worrying about what to major in, which I had been worrying about a fair amount for at least half a year. c) I can plan out what classes to take in the rest of my time at college. d) I can see a future for myself that looks at least a little enjoyable. I am more hopeful. 🙂
  • I’m doing my homework regularly.
  • I ask questions more in class and am developing relationships with professors.
  • I’m getting better at knowing what I need. Sometimes I need to express myself, sometimes I need validation, sometimes I need someone to know something, sometimes I need a hug, sometimes I need distraction, sometimes I need help grounding or need help checking the facts, sometimes I need a broader perspective. I am still working on this but have gotten a lot better at identifying what would help in a situation and taking steps to get it.
Therapy, Uncategorized

Using a safety behavior is like cheating on a test

I had an interesting dream last night that made me realize some things.

In the dream, my little sister was caught cheating on a test. Before taking the test, she had to fill out a form with her name, education level, employment, etc. (remember this was a dream, so it was a little weird). She made up a person, Avery Perkins, MD–an older, more educated woman–in order to seem smarter and get a better grade.

She took the test under this persona and got a B+. She had been hoping for an A+, but it was still better than the B- she got last time.

Now, her teacher had looked up this Dr. Avery Perkins my sister claimed to be and found that no doctor existed with that name. She knew that my sister had made up a fake person.

The teacher (who reminded me of my therapist) came over to my sister and told her that Dr. Avery Perkins doesn’t exist. She told my sister she was cheating. She looked at my sister with a serious, sad expression, and asked, “Do you understand why we don’t want you doing this?”

My sister said no, and the teacher continued, “If you cheat on a test or impersonate someone else and get a good grade, you assume that the good grade came because you cheated. You think that in order to get a good grade, you must pretend you are someone else. Getting a good grade when you cheat positively reinforces cheating. So you cheat more.

“The problem with this is that you never learn what happens when you don’t cheat. You don’t learn that you would have gotten the same grade if you had written your own name on the test. You don’t learn that you can take a test and be successful without anyone’s help. You don’t learn that you can do it.

“Cheating is a safety behavior. You use it as a crutch to get through the test. You rely on it. What are you avoiding? What are you afraid of?”

My sister said she didn’t know.

The teacher offered, “Are you afraid of failing? Are you afraid of disappointing your parents? Are you afraid of not being as good as you thought you were?”

My sister again said she didn’t know.

The teacher said, in a manner much like my therapist, “Well, I don’t have all day. I have other students to take care of. I want you to think about this and what cheating is doing for you.

“You’ll only learn that you can do it without cheating when you try it and see what happens. Maybe some things you thought would happen aren’t very likely to happen, or, when other things do happen, they’re not as bad as you thought.”

And she walked away and left me with my sister.

I like this dream because, as good dreams do, my subconscious uses metaphors to explain things to my consciousness. If I only try to face scary situations as Dr. Avery Perkins, using my safety behaviors, how will I ever know that I can face them?

My therapist has been talking to me a lot about exposure to the things I am afraid of and avoid. I’ve been noticing what my safety behaviors are when I do things that scare me.

A safety behavior is something that distances you from something you think would be too scary to face without it. Safety behaviors include avoiding something entirely (e.g. not going to a party out of fear of judgement), escaping from it when you’re confronted with it (e.g. leaving a party early), and avoiding in subtler ways (e.g. attending the party but not talking to anyone because you’re on your phone all the time).

I have a lot of safety behaviors. I carry around survival gear with me. I use google maps even when I know where I’m going. When I’m in the car, I physically brace myself for impact. I announce, “bump,” out loud before we drive over a bump. (I was in a bad car accident.) These are just a few. More obvious behaviors are that I never learned to drive on the highway, and I avoid going on trips with my family (I try to say no or get out of them).

I’ve been trying out mini exposures recently. I wiped up some blood (which was a big deal for me!), but I noticed that when I did it, I was sure to have lots of napkin in between me and the blood, and I washed my hands right away. So, to continue the exposure, next time I would try to do it without those safety behaviors.

I also told a couple friends that I was in a bad car accident, something I definitely avoid talking about. My safety behavior in that situation was that I laughed through the whole thing. I couldn’t keep a straight face, even though I was talking about something serious. I wasn’t fully experiencing the emotions that talking about it brought up. I was also very jumpy and tried to end the conversation as soon as I started it. I’m not sure how much control I have over the laughter, but maybe next time I’ll be more serious.

I’ve also been doing exposures to vulnerability with my parents. I try to share something vulnerable that I would normally avoid, like how I’m really doing. My biggest safety behavior there is avoiding eye contact at all costs. I also avoid eye contact when I’m telling my therapist something I’m uncomfortable with, and she has to remind me, “I’m over here, look over here at me,” and “If you don’t see my face, you won’t know that I’m not judging you or thinking you’re weird.”

My dream made me realize more deeply what I already knew logically, that I have to try the things I’m scared of without my safety behaviors, just as I am and no one else, in order to learn that they are safe and I can do it on my own.

Coping Skills, Uncategorized

Nightmare Plan (and ice dives)

I have a lot of nightmares and have a hard time getting out of the fear and/or dissociation when I wake up. It is hard to either fall back asleep or to get up and get on with my day. So, this is the plan I came up with after some suggestions from my therapist.

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Nightmare Plan: Ice dive, Drink water, Play catch, STUN wave (Sensations, Thoughts, Urges, Name the emotion), Listen to music, Paced breathing (in-2-3-4, hold-2-3-4, out-2-3-4, hold-2-3-4), Go for a walk (go to the bathroom, go outside, pace in room, stretch/yoga/ballet), Self-validation, Ground in present (5-4-3-2-1 senses, colors of the rainbow). Self-validation: “All emotions are valid.” “It makes sense that I am feeling this way, given my life experiences.” “It’s okay to feel strong emotions.” “Something scary happened to me, and it makes sense that being reminded of that would be scary, too.” “I am feeling ___.” (scared, sad, angry, happy, loving, shameful, guilty, envious, jealous, disgusted) “I had a nightmare.” “It was intense and very scary.” “And, in this moment, I am safe.”

My plan has suggestions of things to try that will probably actually help me. It also has pictures of me doing them, so that it’s easier to figure out how to do them when my brain is slow.

I tried this last night, and the ice dive followed by paced breathing and listening to music or calming sounds seemed to help. Identifying that I was feeling fear also helped.

An ice dive, if you haven’t heard of it, is a way of getting your heart rate to slow down (and therefore making your anxiety to come down a bit) pretty quickly by making your face very cold. It’s a way of hacking your evolutionary reflexes. Your body thinks you just fell into an icy river, so it brings down your heart rate.

You can simulate diving into an icy river by sticking your face in a bowl of ice water for 10-20 seconds a few times. Making a bowl of ice water is too much effort and thinking for me when I’m coming out of a nightmare, so I do the ice dive differently.

I keep instant ice packs near my bed and just crack one and hold it over my eyes while lying in bed. It calms me down fairly quickly. A slowed heart rate also helps me to fall asleep! I also keep ice packs with me during the day and try to use them when I am having a flashback, anxiety attack, or am just feeling intense fear and having a hard time calming down.

Ice dives are a part of the “Temperature” component of the TIPP DBT skill. TIPP stands for Temperature, Intense Exercise, Paced breathing, and Progressive muscle relaxation. It’s a Distress Tolerance skill and is intended to change your body chemistry when you are super overwhelmed. I think it’s really cool how well it works. 🙂

More info about ice dives! description of ice divesdescription of TIPP skills, including ice dives

This Nightmare Plan is taped to my wall near my pillow so that I can see it while lying in bed.

Yay for things that work!