HTWW 028 – The Impact of PTSD on Families

CouplePorblems David Castillo Dominici FDPThe Impact of PTSD on the Family

In this episode we discuss:

  • Secondary traumatization
  • Ways families respond to stress (and Post-Traumatic Stress)
  • Two key areas of stress for the family
  • Resources for the family

The family’s response to increased stress: (In part based on Kerr & Bowen, 1988)

  1. Grow distant from each other
  2. One will take on the traditional role of another member of the family.
  3. An individual may sacrifice themselves for the sake of “peace”
  4. Conflict
  5. Adapt, bond together and grow

Two significant problem areas the anger outbursts and emotional numbing

Anger outbursts 

  • May be verbal or physical
  • Not necessarily directed at spouse or children
  • Aggression may have been adaptive and appropriate during war
  • Fear and guilt both past and present are foundations of anger
  • May lead to the family members developing maladaptive coping skills
  • See more an anger in “Healing The Wounds of War” episodes: 13, 14, and 15)

Emotional Numbing

  • Isolation for social situations and from family members
  • My become more withdrawn after anger outburst – fear of again losing control
  • Seems unable to experience the good emotions
  • Fears experiencing the “bad” emotions associated with the past
  • May adopt an authoritarian way of dealing with family members

Survivor guilt can make it difficult to connect with family.

Resources for Family Support

  • NAMI.org (National Alliance on Mental Illness: Family-to-Family peer support) This group offers peer support for mental problems of many kinds. They offer a 12 session class at no cost.  It is not necessarily specific to PTSD, but many of the family coping skills needed cross boundaries.  Classes are offered around the country.  Check out their website for more information.
  • MilitaryOnesource.mil (for military members and their families) or you can call 800-342-9647
  • ptsd.va.gov/public/web-resources/web-families.asp (A good place to start for veterans and their family members)

More references

Image courtesy of David Castillo Dominici on freedigitalphoto.net

HTWW – 027 10 Tips for Better Sleep

Sleep Stuart Miles FDPSleep is extremely important for the whole body.  The brain is no exception.  When we are recovering from PTSD we need are brains firing on all cylinders.

PTSD introduces some difficult barriers to sound sleep.  Hyper-vigilance and nightmares are two obstacles that those with PTSD face.

However, a good night’s rest starts with the same foundation for both those with PTSD and the rest of the population.  Once the foundation is in place we are better equipped to deal with specific difficulties.

The foundation

Several sleep improvements list exist.  I link to a few of them below.  Here are the 10 things I have found helpful.

1. Get plenty of light.

What?  I thought dark was necessary for sleep?  Well, it is.  However, getting plenty of intense light in the morning can help set of up for sleep at night.  Daylight intensity triggers our brain to produce serotonin—an important brain chemical, especially during the day, for emotions, thinking and energy.  It is made by the same gland in the brain that produced melatonin—an important brain chemical for nighttime for rest that is produced in the dark.

2. Get plenty of physical activity.

Yes, that beloved topic…exercise! Exercise is excellent for reducing stress and balancing out brain chemicals.  It is usually best to do it early in the day or at least 4 hours before bed.  Your body needs time to cool down and recover.

3. Make sure it is dark.

Just as we need light during the day to help our brains fully function.  We need dark to help the properly function while we sleep (see above).

Experiment with getting rid of as much light as possible.  Sometimes window blinds are not enough.  Curtains over windows (or experiment with putting up a thick blanket.)  Clock radios, cell phones, cordless phones, chargers, and other electronics can also be a source of light that might affect our brain activity.

The experts also say the light from TV or computer screens can interfere with melatonin production.

4. Limit or Eliminate Caffeine

It is a stimulant.  People often report that it does not affect their sleep.  It may not may or may not affect your ability to fall asleep.  But it does affect your ability to get the proper rest your brain needs.

At the very least limit your caffeine intake to 1 or 2 servings a day.  Stop caffeinated beverages around 2 pm (about 8 hours before bed).

5. Eliminate Nicotine

It is a stimulant.  

6. Limit Alcohol

Alcohol is a depressant and it can help someone fall asleep.  However, it interferes the deep, restful and restorative stages 3 and 4 of the sleep cycle.  In other word, you may fall asleep more quickly but you will not rest as soundly.

7. Watch what and when you eat.

A big meal may make you sleepy but it won’t typically give you a good night’s rest.  Digesting a heavy or spicy meal has been shown to interfere with a good night sleep.  Try eating a litter earlier in the evening.  Consider making dinner a smaller meal.  Reserve lunch for the spicy or heavy foods.

8. Limit your activity in bed.

Reserve this space for sleep and sex.  From stress to mental stimulation, E-mail, work, electronics each can disrupt our rest.

These last two may be particularly helpful for those with PTSD.

9. Meditation and deep breathing

Practice these techniques during the day.  If necessary apply them as you are trying to get your mind in a restful state around bed time.  Once learned, these can also be useful with we become overstimulated—loud noise, dream, etc.

10. Medication for nightmare reduction instead of a direct sleep aid.

If nightmares are a problem talk with your healthcare provider.  For a long time I use a medication called Prazosin.  It is an older blood pressure medication.  My provider told me that it was about 80% effective in a double blind study at reducing or eliminating nightmares in PTSD patients.

It was affective for me as well.  But be careful.  It can seriously lower your blood pressure—especially as your body adjust to the increasing dose.  So take care when you rise at night, especially to use the bathroom. 

It worked for me.  While I was taking Prazosin I hardly had a nightmare. 

So why did I stop?  I experienced one of the rarer side effect, nocturnal enuresis…aka nighttime urinary incontinence or bed-wetting.

Yet I am glad I took it for a while.  It helped me get better sleep.  The better sleep helped me better deal with the underlying problems.   From time to time I still have PTSD related nightmares, but they are getting less intense and lest frequent.

Question: What has helped you get a healthy, restful and restorative night sleep?

Some Sleep Resources

Image courtacy Stuart Miles, freedigitalphotos.net

025 – Bitter (Not So) Sweet Sugar & PTSD

how-much-sugarWeEat

Sugar Lumps by By Suat Eman at freedigitalphoto.net
*

In this episode we discuss the role of sugar, our brain and recovery… Last week we learn about how running can be a tool for helping us deal with difficult memories.  One of the ways running helps is by increasing a key brain protein, brain-derived neurotrophic factor (BDNF).

The sweet white powder we call sugar is in most processed food products.  It has a powerful effect on our brain in producing a short lived pleasure response.  But it can come at great expense.  Sugar has been linked to obesity, diabetes, cancer and other health problems.  But what does that mean for those dealing with Post-traumatic stress?  It is estimated that Americans consume 22-32 tsp. of sugar each day!  An estimate for the U.S. Department of Agriculture says that we consume an amount equal to 31 five pound bags each year!

It has been shown to influence brain function.  In particular BDNF, a key brain protein involved in memories, is negatively impacted by sugar.  In recovering from PTSD we need all the proper neurotransmitter working as designed. Getting sugar out of your diet is not likely to cure PTSD.  But in combination with all the other tools at our disposal it could help further our progress toward victory.

Some resources for further investigation: A CBS News/60 Minutes Report (See how “addicting” sugar can be)

http://youtu.be/B56Gpf1f5_A

What Eating Too Much Sugar Does to Your Brain http://www.psychologytoday.com/blog/neuronarrative/201204/what-eating-too-much-sugar-does-your-brain

Brain-derived neurotrophic factor: http://en.wikipedia.org/wiki/Brain-derived_neurotrophic_factor

What Sugar Does to Your Brain: http://www.olsonnd.com/what-sugar-does-to-your-brain/

The Effects of Energy-Rich Diets on Discrimination Reversal Learning and on BDNF in the Hippocampus and Prefrontal Cortex of the Rat  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2042136/

Sugar: The Bitter Truth (The SHORT Version)

http://youtu.be/tdMjKEncojQ

Sugar: The Bitter Truth – Dr Robert Lustig, MD, University of California http://youtu.be/dBnniua6-oM

Secrets of Sugar – CBC News

http://youtu.be/xDaYa0AB8TQ

chicklet_itunesrss subscribe Are you drawn to sweets (or other carbs) when you are stress?  I am.

Sugar Lumps by By Suat Eman at freedigitalphoto.net

024 – Running Through, Not Away From, Memories

RunningTowardTarget by Master isolated images FDP
by Master isolated image on Freedigitalphoto.com

Hay, I found an instant, quick fix to post-traumatic stress… Not really.  But there are many tools we can use to grow and work toward—and achieve—success over PTSD.

One of the coping mechanisms in PTS is to avoid memories.  At times this may be necessary.  But at some point we will need to deal with our past.  We can equip ourselves with tools to help with this process.

This week we take a look at the role running can play in the recovery process. 

We will discuss:

  • The brain and body in stress (and post-traumatic stress): hormones, steroids and the body/brain connection (see Episode 001 – Post Traumatic Stress: It’s not just in your head).
  • The brain and body while running
  • How much running?  According to Dr. Otto, blood levels of brain-derived neurotrophic factor (BDNF), increase after about 30-40 min of running.  But this is not the only benefit!
  • Prolonged Exposure Therapy
  • Other benefits – besides the physical and psychological: goal achievement, causes, comradery.
  • What about those that cannot run?  Perhaps it is best if we not focus on what we can do and consider whatever we can do right now.  I share my own struggle with not being able to run or do other intense physical activity because of my lungs.

 Resources:

Article, “Running Back From Hell”, http://www.runnersworld.com/runners-stories/running-back-from-hell?page=sing

Team Red, White, and Blue – helps service members transition http://teamrwb.org/

STRONG STAR (South Texas Research Organizational Network Guiding Studies on Trauma and Resilience) http://delta.uthscsa.edu/strongstar/

Question:  Have you found exercise to be beneficial?  Please join the discussion.  Your experience can help or encourage others.

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022 – Should we drop the “D” from PTSD?

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Does the “Disorder” word/idea get in the way of service members seeking help?  How do potential employers see service members when they are labeled with a disorder?  Does the stigma of being labeled with a “disorder” really impacted those dealing with Post-Traumatic Stress?

 In today’s episode we will discuss:

  •                David’s health update
  •                Dropping the D from PTSD

 Why the delay since the last show?

The last few weeks, with the heart attack in mind, I have been diligently working on my health.  Listen to learn how diabetes is being defeated!

Change to the to:

  •                Post-Traumatic Stress
  •                Post-Traumatic Stress Injury

Why consider the name change?

  • Unlike other mental health conditions it requires on outside force to create the problem
  • “Disorder” carries a stigma
  • “Disorder” implies life long programs
  • Soldiers, especially young Soldiers, believed reluctant to seek help for a mental “disorder”.
  • Consider Dr. Dave Grossman and his view on PTS/D from his gook “On Combat”.
  • Concern over employers not hieing veterans with a mental health disorder.

Some concerns of why NOT to drop the D:

  • Compensation concerns
  • Insurance coverage concerns

Articles for further exploration of the topic:

 Your thoughts!  What to you think about the possibility of droping the “D” from PTSD?

021 – Anatomy of Forgiveness

David Castillo Dominici freedigitalphotos.com
by David Castillo Dominici, freedigitalphotos.com

“Darkness cannot drive out darkness; only light can do that. Hate cannot drive out hate; only love can do that.”  Martin Luther King, Jr.*

“The weak can never forgive. Forgiveness is the attribute of the strong.” Mahatma Gandhi**

Many offences in life can and should be easily dismissed.  Today, however, we are talking about the deep hurts.  The deep wounds that significantly alter our lives.  Some wounds even threaten to crush us from the inside out.  It is these situations that call for a deliberate forgiveness process.

 Forgiveness is possible!  (See last week’s show: Forgiving the Unforgivable.)  It takes great strengths and courage to enter into a forgiveness process for deep wounds. 

Before we begin:

  • Forgetting is not forgiveness.
  • Remembering is not unforgiveness.
  • Forgiveness is a process.

At the Hope and Restoration Team (HART) we use an acronym to help facilitate the forgiveness healing process.  R.A.F.T.

  • Recognize
  • Accept
  • Forego
  • Trust

Recognize:

We can start with recognizing the wrong that has been done AND the impact it is having on our life.  What has been the result of the hurt, violation, betrayal, etc.?  How have you changed as a result of those events?

Why?  Because we need to be able to deal with the REALITY of what happened to us in order to REALLY forgive.

Example: I was having a post traumatic response when interacting with a particular person.  Fight and flight was kicking in even though there was not perceivable danger.  After some reflection I realized that this person exhibited the same incompetents as someone who nearly got me killed.  After recognizing this I was able to deal with that event constructively.

Accept:

It is one thing to recognize what has happened and how it has impacted and changed our lives.  It is yet a deeper thing to accept this as our reality.  These tragedies are part of how we are right now.  They do not define the totality of who we are; but they are part of who we are and who we are becoming.

Due to the wrong actions of others my lungs were severely damaged.  I live with this reality every day.  Even after dealing with forgiving those involved in bringing this devastation into my life I have to live with these physical problems.

Forego:

Once we know and accept what needs to be forgiven we then forgoing payback, vengeance, and retaliation is part of the forgiving process.  This does not meant that justice will not take place.  It does mean that we let go of being the executor of that justice.

In this step we let go of any demand for payment or payback for the wrong suffered.  It does not mean we will let the offender continue to hurt or damage us.

Consider the idea of a monetary debt.  Someone borrows $20 dollars and promises to pay you back next week.  But instead the next week they come back and borrow $20 more.  This goes on for a few weeks and before you know it they have racked up a considerable sum.

At some point you decide to forgo demanding repayment for past debt.  But that does not mean you allow them to accrue more debt.  You say, “Your debt is forgiven.  But in order for trust to be restored true change (in your life) must take place.”

Forgiving the debt is not forgetting what caused the debt.  It is, however, not demanding payment for that past debt.  Trust needs to be established over time with evidence to demonstrate change (repentance).

Trust:

By trust we are not here talking about trusting the one (group) that has wronged us.  This should be a goal and our desire.  However, for reconciliation to take place and trust to be restored repentance and transformation must take place.

For me the trust aspect is about trusting God to take care of me.  It is about entrusting the process to the One who is greater than I.  Trust in a God how is just, merciful and loving in ways I can only begin to comprehend.  Trust in God that no matter what the other may choose to do or not do that God will provide, care for and supply all my needs.

http://www.brainyquote.com/quotes/quotes/m/martinluth101472.html#8Ke6Q2VSXC4gyPk0.99

** http://www.brainyquote.com/quotes/quotes/m/mahatmagan121411.html#PhXxeQWq7lUWqJom.99

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020 – Forgiving the Unforgivable

Photo, "Silhouette Of A Man" by Markuso on freedigitalphoto.net
Photo, “Silhouette Of A Man” by Markuso on freedigitalphoto.net

The concept of forgiveness runs deep at the core of any society.  If we cannot find a way to forgive then vengeance is all that will be left in the end.  But is it always possible to forgive?  Are some actions unforgivable?  What does forgiveness look like?

Today we remember the genocide in Rwanda that took place in April 1994.  This was 100 days of slaughter.  10,000 people killed per day.  In total, over 1,000,000 dead—1/8th the country’s population.  Either such destruction will lead to more destruction or forgiveness can lead to healing.

We will hear from some of those involved in the healing and reconciliation process.  The topics come from excerpts for the PBS show, “Religion and Ethics Newsweekly” from April 2005.  As you listen to today’s podcast and look over the note please feel free to enter the dialoge via the comments section.

Facing reality/the truth:

We were hut specifically, we must forgive specifically.  At some point, when we are ready, we have to come to terms with what has happened and the impact it is having in our lives.

“The wounds and the healing is a process that we continue to engage deliberately.”

“To tell people they just can’t cover it up.  We need to be able to unearth it and deal with it head on.”

Benefits of forgiveness:

“Forgiving not only benefits the criminal, it benefits me.”

When we forgive we are set free.  We also open up an opportunity for the offender to find freedom.

It is a process:

Repentance – Counseling – Forgiveness – Reconciliation.  This did not spontaneously happen.  And in order for reconciliation to take place the offenders had to “repent”.  In this they took responsibility for their actions and committed to living life in a new direction.

Sometime reconciliation is not possible.  They offender may not be willing to repent.  They may be dead.  We may not know who assaulted/hurt us.

As a result we may take it out on the group or kind of people involved in our PTSD.  Even if we cannot reconcile with the individual(s) we can reconcile with the gender, ethnicity, or group they represent.

The power of three words:

“You killed my wife and my child.   I will not do wrong to you…I forgive you.”

There is such power in saying and hearing the word, “I forgive you.”  This man captures the heart of forgiveness when he declares, “I will not do wrong to you.”  Forgiveness is not devoid of justices.  Rather it is giving up our right to vengeance or us exacting whatever we consider justice.

Bitter:

First bitter, then…remember Christ’s words on the cross.

“He did not wait for the paint to subside.   He cried to the Father, ‘forgive them for they know not what they do.’”  “The fact that Jesus called from within the pain is a guide and a teaching for us to forgive.”

Willing to repent:

Some offenders may never have a conscience concerning their evil actions.  While others seek transformation.  Especially during war wrongs are due by otherwise decent people.  These “moral injuries” can cause deep pain.  This can lead to repentance and transformation.  Seeing the offenders ad humans can help us do our part in the forgiveness process.

Many who have done wrong to others suffer from fear, nightmares, guilt, and self-loather.  One part of us may say, “Good for them.  They deserve it.”  Forgiveness would lead such people toward repentance.

It is not magic:

We have to continue to work the process until completion.

Forgiveness and your journey:

Next Week:

We will consider specific steps toward forgiving the deepest of wounds.

Where are you in this process?  Do you feel stuck?  Are you ready to consider moving forward?  If so and you want someone to walk along side you on this difficult part of the journey contact me, david (at) HealingTheWoundsOfWar (dot) com

Full video of Religion and Ethics Newsweekly story on Rwanda Reconciliation

Questions:

Why is forgiveness so hard?

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019 – 3 Barriers to Healing & Tips to Knock Them Down!

It may be important to understand barriers; but we do not need to focus on them.  Instead, we can focus on positive actions we can take to overcome the barrios.

Stuart Miles FreeDigitalPhotos.net
Stuart Miles FreeDigitalPhotos.netIt may be important to understand barriers; but we do not need to focus on them.  Instead, we can focus on positive actions we can take to overcome the barrios.

In this episode we will discuss: (Note: topics are not necessarily in this order.)

  • Barriers to healing
  • Tips to overcome these barriers
  • My 7 Day Green Juice Fast
  • Principals learned from dealing with diabetes that can also help me deal with PTSD

7 Day Green Juice Fast: Cucumbers, celery, kale and all their friends.

  • Why?
  • Diagnosed with diabetes about 6 years ago
  • Not obese
  • I tried to control with diet and oral medication; but nothing seemed to work well enough.
  • Started experiencing diabetic complication (eyes, feet and heart attack)
  • Started using insulin a couple of months ago

Expectations

Our mindset is important.  Do we see PTSD as something that can be dealt with?  Do we see it as something that can and will bet better?

 “While some people do suffer from full-blown PTSD, most cases are mild. What often occurs is that a doctor tells a patient that his symptoms look like PTSD, and that diagnosis impacts that person right between the eyes as if he were told he had cancer. Well, it is not like cancer; it is more look like PTSD, and that diagnosis impacts that person right between the eyes as if he were told he had cancer. Well, it is not like cancer; it is more like being overweight. If you weigh 30 pounds more than you should, those extra pounds, while tiring to lug around, are probably not life threatening.”

Grossman, Dave; Christensen, Loren W. On Combat: The Psychology and Physiology of Deadly Conflict in War and Peace (Kindle Locations 6690-6693). Human Factor Research Group, Inc..

“It is important that you bring the issue into perspective and think of it more along the lines of being overweight than being stricken with cancer and all that that means. Put it in perspective and make peace with the memory.”

Grossman, Dave; Christensen, Loren W. On Combat: The Psychology and Physiology of Deadly Conflict in War and Peace (Kindle Locations 6697-6699). Human Factor Research Group, Inc..

If we do not expect to succeed, or get better, we are not likely to even try.

Knocking down the negative expiration barrier:

  • Listing to others.  What worked for them may not work for us…but it might.
  • Stepping out in faith-even if we do not see the improvement at the moment.  Allow time for small things to add up to bigger changes.
  • Changing our mindset.  Philippians 4:8

Desire

Asking ourselves some difficult questions:

  • Do we really what to get better?
  • What does it cost to get better?  I am not specifically referring to money.
  • What are you willing to pay?
  • What are you willing to do to get better?
  • What are you willing to do to get 1% better?

Fear

What if I try and do not get better.  Other people have gotten better.  What does that say about me if I try and do not get better?  In fact, some people fear getting partially better and losing their disability check.

Knocking down the fear barrier:

  • Listing to the stories of how other people have overcome adversity.
  • Beginning to trust.
  • Stepping out in faith.

Discussion Questions:

What do you think about Dr. Grossman comparing comparison for dealing with PTSD?  Is it more like losing weight or having cancer?

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018 – Healing PTSD: The Role of Grace, Mercy and Forgiveness

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There are many parts and paths involved in any healing process.  Post-Traumatic Stress is no different.  We have to address physical, psychological and spiritual need.  Some aspects of these needs we all share in common.  Other aspects may be unique each of us.

The ideas of grace, mercy, repentance, reconciliation and forgiveness are part of the PTSD healing process.  To one extent or another these concepts impart our lives and our recovery process.

In this episode we will,

  • Go beyond the dictionary definition to practical application in a spiritual and healing context. (Dictionary referenced: www.merrian-webster.com)
  • Discuss the relationship between repentance, reconciliation and forgiveness.
  • Forgiveness: what it is not

Question: Is it ever right to not forgive someone?

Request: If you have been blessed by any of our programs.  Please drop us a line and let us know.  Leave a comment, a voice message via Speak Pipe or send an e-mail to david(at)HealingTheWoundsOfWar(dot)com

(Scriptures referenced: Romans 5:8; Matthew 18:21-35)

Beyond the limits! Jason’s story…

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Doctors, professional books, and even those close to us will sometimes unintentionally place a limit on our potential.  They may be well intended.  Sometimes they are correct.   There are things that we may need to accept.

But …  That is not for others to determine on their own!  Consider Jason’s story.  The VA was willing to sustain him in an institution.  When he decided to go home with his parents their books determined that he was as recovered as he could be and cut off the rehab resources.

Jason, however, was still progressing.  So his family continues to pay for rehab services out of pocket.  The VA was willing to spend huge amounts on institutionalizing him but not to pay a much less amount for continued rehab services.

We understand that some people stop progressing in their rehabilitation and there needs to be checks and balances.  But a formula should not be the determining factor.  We are all unique and have unique situations.

Are you facing a physical injury, Post-Traumatic Stress, relationship issues, work problems or you are being told that it cannot be done?  Don’t accept that on face value.  Don’t blindly rely on the formula.

Be wise and listen to the counsel of others.  There are some limits we may have to accept; but not without a fight.  Not without first thinking outside the box!

Watch Jason’s story as captured by the Wounded Warrior Project