016 – Six Things YOU can do to help someone dealing with PTSD

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You can make a difference!  You do not have to be a doctor, psychologist, clergy or other professional to make a difference in the life of someone with PTSD.

We are not helpless when it come to helping ourselves of helping others dealing with Post-Traumatic Stress Disorder.  We do not have to face our own PTSD alone and we do not have to face the PTSD of our loved one alone.

Below is a brief list of things that I have found helpful in dealing with PTSD in my own life and helping others in my role as a Chaplain, Pastor and a friend.

1. Educate yourself

Useful Books:    (share what books have help you in our comments section)

  • On Combat: The Psychology and Physiology of Deadly Conflict in War and in Peace, Lt. Col. Dave Grossman, Loren W. Christenson
  • Achilles in Vietnam: Combat Trauma and the Undoing of Character, Jonathan Shay
  • War and the Soul, Edward Tick
  • After the Trauma the Battle Begins, Nigel W.D. Mumford

A few web resources:

2. Accept this reality
3. Have reasonable expectation of both them and yourself
4. Establish boundaries (physical abuse is always over the line)
5. Be willing and prepared to listen. (Know your limits: boundaries and expectations)
6. Be willing and prepared to join them in their journey. 

Some Other Lists:

 Question of the Week: What books/resources have you found helpful?

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HTWW 014 – 3 Practical Steps to Gaining Control Over Anger

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Last week in “Anger!!! What Lies Beneath” we discussed the fuel underneath anger.  It seems to be largely connected to fear and its friends: shame, guilt, etc.  This week we continue on our path toward growth and victory.

Out of control anger does not only affect our relationship; but it also physically affects our hearts—and a lot more of our bodies.  So how do we START to deal with problematic anger?

1. The R and E of RESTORE

Recognize and Evaluate:

But there is more to it R and E.  We can learn to detect the sings in our bodies as we start to escalate.  We can learn to identify the thinking patterns that start to lead us down the road toward rage.

(See Episodes 002 RESTORE and 003 Recognize)

2. Physically Prepare: Sleep, Eat and Exercise

Sleep:

What happens when you do not get enough sleep?  For starters: increased depression and moodiness.  Your brain goes through a rest process when you sleep.  While sleeping the electrical and chemical makeup of the brain changes.  This is apparently necessary for proper function while you are awake.  Without proper sleep we are also likely to gain weight, have trouble learning, focusing and remembering.

[CDC Sleep Report; Effects of the Lack of Sleep; Anger and Heart Disease]

A few things about PTSD that can add extra complication to the sleeping problem. 

Hypervigilance (always on guard) can make it difficult to fall asleep.  For some, they are easily awoken by sounds.

Nightmares: These can interfere with sleep on many levels: (a) wake you out of sleep; (b) keep you from falling back to sleep; (c) interfere with the quality of sleep.  Even if it does not wake you out of sleep the thrashing screaming and sweating can interfere with the quality of sleep.

What can I do to get a better night sleep?

  • Exercise – 5 to 6 hours before attempting to sleep.  20 min of intensive activity (Talk with your Doctor before starting an exercise plan) [Exercise and Sleep]
  • Get rid of the electronics/TV watch from the bedroom
  • Exposure to outdoor (bright) light in the morning

Eat:  Ok, we constantly being told how we need to eat a balance and healthy diet.  Well, it is true.  But there is too much to really get into this topic here – although I mention a couple of things that you may find useful in the show.

“But caffeine doesn’t keep me awake.”  I hear this a lot!  Studies show that it does interfere with the quality of sleep.  In other words, even when you sleep it decreases the quality of sleep.  Suggestion: don’t drink caffeine after lunch and only a couple cups of caffeinated coffee or tea in the morning.

[Effects of caffeine on sleep]

3. Practice Tactical Breathing

Say what?  Yes, you can significantly change your body and mind by learning and practicing a breathing technique known as “Tactical Breathing”.

When the body is in the fight-flight response the blood flow decreases to the reasoning center of the brain and increases to the mid-brain focused on preserving your life.  Researchers have developed a breathing technique that has proven useful to people in tactical situations to help them lower their heart rate and help reestablish more control.

It is not difficult but it takes practice.  Like with most skills used during a crisis mode we need to first practice them when we are not in a crisis mode.

Question: What helps you deal with anger?

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How can we successfully deal with angry people?

So, you are not a hot head.  But you have to deal with one or two or three.  Below are some ideas to consider when dealing with outwardly angry people—note: we will have to talk about the quiet angry types in another post.

[Most important: your safety!  If the angry person becomes abusive (or you believe it is heading in that direction) you should remove yourself from the situation and seek appropriate help.  What we are discussing here is anger that does not result in abuse.]

Anger usually comes from some insecurity, fear, guilt, sense of inadequacy, etc.:

Understanding this can help us to NOT internalize the other person’s expression of anger.  When we internalize someone else’s anger we tend to get defensive—at least this is true for me.  When we get defensive we can get side tracked from the real issues at hand.

Expectations: Do you have unrealistic expectations about the reasonableness of the angry person?

It is unreasonable to expect a person in the passion of anger to be completely reasonable.  The biology of anger does not support it.  The more angry the individual the less the reasoning center of the brain can operate.  The blood flow actually decreases to the reasoning center (pre-frontal cortex—the part behind your forehead).  Instead the body/brain puts its resources in to the fight/flight response.

Anger, fear, anxiety and alike all have a similar physiological response.  It is important that this balance be restored before attempting to engage in a reasonable discussion.  Justifying our actions—even if we are in the right—accomplishes nothing in the heat of the moment.

Post-traumatic stress responses can involve anger outbursts.  PTSD is not a means for excusing inappropriate actions.  However, it can be helpful to keep in mind that the stress and anxiety that accompany PTSD can help contribute to a shorter fuse.

Diffuse before Engaging:                 

In the heat of anger (our own or that of another) our goal should be to diffuse the situation before attempting to solve the problem(s) surrounding the event.  Time is an important ingredient in this mix.  People’s bodies need time to work out the rush of hormones that accompanies anger and the fight/flight response.

It may not be helpful to declare an official “time-out”.  However, some kind of separation in time and space should be considered.

It is important that the individuals involved reengage the issues when all have had an opportunity to cool down.  If we are not careful time and space can lead to avoidance and the underlying problems will never get resolved.

Get someone else involved:

I don’t mean that you should drag someone else into the middle of the argument.  Rather, when a relative calm has set in, invite someone to help mediate the discussion.  This person should be perceived by all involved as being relatively neutral.

Addressing their anger issue:

Yelling back, “You have anger issues!” In the middle of their outburst is not likely to be helpful. (I know, I have tried it.)  When all is calm it may be possible to discuss your concern for how they are handling anger.

However, in order to be able to successfully deliver this message, it helps if you actually care.  I have not found many people ready to accept a “critical” message from someone who does not care.  If that is the case, then try and find someone who does care to deliver the message of concern.

This is by no means a complete list of things to help deal with angry people.  What ideas or strategies have helped you deal with angry people? (Please share your thoughts in the comments section.)

Check out the first part of our podcast series on anger: “Anger!!! What Lies Beneath

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013 – Anger!! What Lies Beneath

Anger affects more than just people with Post-Traumatic Stress Disorder (PTSD).  Some people just seem to be wired to be more volatile.  All of our life circumstances and experiences help us cope with the “stuff” that we encounter.  We can learn new ways of dealing with whatever we experience or feel.

People dealing with PTSD are often also dealing with deep anger.  Learning to “manage” anger is extremely important.  Part of that process is gaining insight to what lies beneath the anger.

In today’s episode:

  • Is anger “bad”?
  • Quiet vs. Loud Anger
  • Physical Impact of Anger (+ stress and fear)
  • Can anger be managed?
  • Analogies of anger: Diet Coke; lighter
  • The Fuel of Anger
  • PTSD and Anger
  • Taking responsibility

Some quotes on anger:

“Anger is an acid that can do more harm to the vessel in which it is stored than to anything on which it is poured.” Mark Twain

“Holding on to anger is like grasping a hot coal with the intent of throwing it at someone else; you are the one who gets burned.” Buddha

From —   http://www.brainyquote.com/quotes/topics/topic_anger.html

Yoda on fear and anger … 

“Fear leads to anger, anger leads to hate, hate … to suffering” Star Wars Episode 1

http://youtu.be/kFnFr-DOPf8

Is anger “bad”?

No.  Anger is a normal human emotion.  It is what we do when we are angry that brings most of the problems.  It can have bad physical results on our health when it dominates our emotions.  Consider these words of wisdom, “And “don’t sin by letting anger control you. Don’t let the sun go down while you are still angry,” Ephesians 4:26a (Holy Bible, New Living Translation).  Mahatma Gandhi made a similar observation, “Man should forget his anger before he lies down to sleep.”    It is what we do as a result of anger that gets us in the most trouble.  The Buddha on anger: “A man conquered by anger is in a mass of darkness.” Kodhana Sutta: An Angry Person

Loud vs. Quiet Anger (Aggressive vs. Passive)

Not everyone screams and shouts when they are angry.  Sometimes passive aggressive behavior is rooted in anger.  Also some people will hold it in and withdraw from relationships.  It can show up in giving someone a cold shoulder or a fake smile.  Anger may also be behind some self-destructive behaviors.  Some may quietly literally feed their anger with food.

The Biological Reality of Anger (+ stress and fear) 

Anger is a biological process…

Hormones and Steroids flood the body causing, among other things, a rise in blood pressure, decrease blood flow to the reasoning center of the brain (pre-frontal cortex).  All this is part of the Fight or Flight response—very much like stress and fear.

Can anger be managed?

Yes! (Don’t miss next weeks episode when we discuss strategies we can do before during and after we are angry.

Analogies of anger: Diet Coke + Mentos(TM) (thank you Mythbusters); a lighter

 Diet_Coke_Mentos_CC

Courtesy of Zan  FreeDigitalPhotos.net
Courtesy of Zan FreeDigitalPhotos.net

The Fuel of Anger – What lie beneath?

Anger does not just happen.  It is tied to deeper emotions.  Most of us may rather admit we are angry than afraid.

PTSD and Anger

A great book on PTSD by Dr. Shay: “Achilles in Vietnam”
PTSD anger complicated by “What’s right” being violated.  Trust is lost …

Taking responsibility

People may push our buttons; but they are our buttons.

 Sometimes when I’m angry I have the right to be angry, but that doesn’t give me the right to be cruel.  – Author Unknown

Check out some other resources:

How Anger Words  http://science.howstuffworks.com/life/inside-the-mind/emotions/anger2.htm

Understanding Your Emotions  http://www.wire.wisc.edu/yourself/Emotions/Understanding_emotions.aspx

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012 – The Power of Music

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Throughout the world and throughout time music has been part of celebrations, calls to battle (action) and dealing with loss.  Even when the style, instruments and language are unfamiliar there is something recognizable about the message being conveyed in music.  It aids us in expressing our joys and pleasures.  It can pull tears even out of hard hearts.  But can it help bring lasting transformation to those dealing with PTSD?

In this episode we will discuss the different roles music plays in our lives and possibly as part of our recovery.

Therapeutic role of music 3,000 years ago (David)

Music affects our bodies, our minds and our soul.  Music can:

  • make you laugh: “Weird Al” Yankovic,  (for those who enjoy this kind of song…)

  • be part of celebrations
  • stir people to action.
  • bring us to tears.

The Brain and Music

 Music Therapy

 PTSD and Music

Group therapy utilizing different objects (need not be a musician)

A UK study of PTSD and music therapy (non-veteran) in the journal Psychology and Psychotherapy: http://onlinelibrary.wiley.com/doi/10.1111/j.2044-8341.2011.02026.x/full

 A VA (U.S.) study by Health Service Research & Development Service: Guitars for Vests: Evaluating psychological outcome of novel music therapy: http://www.hsrd.research.va.gov/research/abstracts.cfm?Project_ID=2141700403#.UuEs8hDTlhF and http://www.va.gov/health/NewsFeatures/20110805a.asp

 Live music played during a group session

Dr. Mary Rorro (the violin doctor):  http://www.wnyc.org/story/93503-music-helps-vets-control-symptoms-ptsd/

 Individuals and groups participating in the creative process

If you are interested in Guitars4Vets: http://www.guitars4vets.org/

 LifeQuest Music camp:  http://www.washingtonpost.com/lifestyle/style/military-veterans-seek-support-and-release-through-music-at-lifequest-arts-camp/2012/01/23/gIQAeRcMQQ_story.html

 LifeQuest Music camp video:

 Healing Veterans through the Creative Artshttp://warriorsongs.org/

 Some of the music created by veterans via Warrior Songhttp://warriorsongs.org/music/

 Jason Moon’s song, “Trying to Find My Way Home”:

Buy this song on Itunes: “Trying to Find My Way Home”

Music Theropy and the Military (a Huffington Post article):  http://www.huffingtonpost.com/ronna-kaplan-ma/veterans-music-therapy_b_2361076.html

 Listening to Music

We each have different tastes in music, art and comedy.  Take a chance and listen to something that falls outside of the norm for your tastes.  People for all backgrounds communicate their stories through song. 

What songs have impacted your life?  Share with the community the music that has impacted your life?

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Trying to Find My Way Home…through music

Music can make us laugh, calm us down, rile us to action and move us to tears.  It can be a powerful tool in helping us deal with and overcome different aspects of PTSD.

Jason Moon, a Veteran and song writer, captures a small part of the struggle that many face when returning home.  In this case it is coupled with the visual arts in the video.

Question: What do you think of the song?

(On January 24, 2014 we will be releasing an episode of the podcast exploring how the role of music in our recovery process.)

Music, Art and Recovery…

Music and art—including movies, poetry, pictures and paintings—can move us emotionally.  We each of may have different tastes and we may be move by one thing or another; but there is something that will affect each of us.

Can music help in the coping with or healing of PTSD?  In our next podcast episode we will consider some of the scientific research into this topic.  We will also look at the more personal side of what each of us experience when we listen to music.

Until then, here is link to one bloggers take on Music, Art, and Poetry that I find interesting: http://www.ptsdspirituality.com/2012/01/29/ptsd-spirituality-engaging-music-art-poetry-helps-to-heal-ptsd/

Question: How has music be beneficial in your life?

011 – START A New Direction in 2014!

What desires do you want to achieve in 2014?  Growth in getting a handle on PTSD?  Healing a relationship?  Starting a business?  Overcoming a fear that has been holding you back?  Dealing with a difficult work or home relationship?  Whatever it is, there is a set of goals and tools that can help you achieve your desires–one goal at a time.

2013 had some great moments.  It also had some challenging moments.  In 2104 we can START to turn our desires into tangible goals?

 In this episode we will:

  •  Explain why we have not had a show for the last three weeks.
  • Discuss: What We See Vs. What is Going On Inside
  •  Explore how to begin to turn our dreams into reality using the START process – A New Direction in 2014!

 Why was there no show for three weeks?

A few days after our last December show I had a heart attack.  It was a mild heart attack, as far as those things go.  I was blessed to be out of the hospital on Christmas eve.  It is good to be back!

START A New Direction In 2014!

A summery of START:

  • Set goals: discussed below
  • Tools: people, training, books, resources, equipment, techniques
  • Action Plan: who, what when, where and how
  • Run: Just do it!
  • Test: Ask the question: Am I achieving my goals?  Am I getting closer to achieving my objectives/desires?  If not, what needs to change?

 Set Goals:

  • Outcome and/or Performance
  • Specific
  • Measurable,
  • Time Sensitive,
  • Written and Shared

See the blog posts s on Change: part 1part 2part 3 for more information on the start process.

Our “issues” do not have to get the best of us in 2014.  There is hope and help.  We can take action and set goals in the Physical, Psychological and Spiritual aspects of our lives.  Let me know if you would like assistance turning your desires into goals.  Contact me: David@HealingTheWoundsOfWar.com

Question: Do you have a goal you would like to share with the community? 

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010 – Cannabis: Curse or Cure for PTSD?

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In this episode we will discuss:

  1. A report on 21 days of my gratitude exercise from episode 007 – Can Gratitude Save Your Life?
  2. Cannabis: Curse or Cure (or something in between) for PTSD

21 Days of Gratitude

  • Consistency was difficult
  • Helpful or not?

Medical Cannabis (Marijuana) Curse of Cure?

(List of topics and terms.  There are hours of research linked below.  I would love to hear your thoughts and credible resources you may find.  Please share them in the comments section.  Some of the journal articles only link to an abstract.  When that is the case, the full article is only available at a library that subscribes to the journal or for a fee.  Links to news reports about many of the articles is also provided.)

  • Post-Traumatic Stress Disorder involves a complex body/brain response – anxiety, intrusive memories (flashback, nightmares, anger, fear and other emotions
  • Full disclosure: I am not a medical doctor and none of this should be construed as medical advice.  Consult with your licensed healthcare provider for all your medical needs and guidance in making medical decisions.  Also, I never used cannabis.
  • Antidotal Reports: Billy Bob’s Smoke Blog – non-scientific, credibility questions, no check and balance to the facts or outcomes.
  • Scientific Evidence: more “objective” controlled, peer reviewed studies
  • Effects of Long-term/high use of cannabis = Study shows direct relation to decrease in memory, metal processing and intellectual markers even when sober.  There appears to be a direct link to duration and intensity to low performance on cognitive test for long-term and heavy users.  (Full JAMA article)
  • Brain chemistry and function (senses, emotion, memory, reasoning)
  • Developing Brain – The reasoning center does not complete until about the age 25!  Don’t mess with it!
  •  Medication for depression (SSRI) or other mental illnesses – Are they helpful for PTSD?
  • Cannabinoid Receptors (emotions, memory, appetite) CB1 and CB2
  • Endocannabinoids (cannabinoids produced by our bodies)
  • PET-image of brainPositron Emission Tomography (PET) scans of PTSD brains
  • Brains with PTSD show greater number of CB1 receptors in certain parts of the brain and a decreased anandamide concentration compared with subjects not diagnosed with PTSD  (Brain-Image Study at NYU)
  • Anandamide (an endocannabinoid produced by our bodies)
  • Researching ways to increase anadamide w/o causing damage and minimal side-effects
KDS-4103/URB597
KDS-4103/URB597

Other news articles and references:

Question: Do you think that the government should allow more research into the use of cannabis and its components in the treatment of PTSD and other disorders?  Why/Why not?

009 – Substance Use Vs. Abuse: 3 Warning Signs

In this episode we will discuss:

  • Substance Use/abuse and PTSD.
  • 3 Signs Substance Use has become Substance Abuse
  • 3 Strategies for dealing with Substance Use/Abuse

Substance Use/Abuse and PTSD

  • Both civilian and military suffers of PTSD are more likely to also deal with Substance Use Disorder (SUD), according the U.S. VA
  • Self-medication
  • Why?  Deal with intrusive memories (forget for a while), sleep problems, covering feelings of: anger, numbness, depression, etc.
  • http://www.ptsd.va.gov/public/pages/ptsd_substance_abuse_veterans.asp

The following is not an exclusive list.  Add your own thoughts to the comments.

Also, this is not intended to diagnose any mental or physical disorder.  This is based on the host’s experience with family members who suffered from substance use/abuse, his experience as a pastor/chaplain dealing with many individuals and families and his reading of the literature in the area of addiction.  Please consult a qualified healthcare provider for your specific needs.

Prefrontal cortex is the blue shaded area on the left of the diagram of the brain
Prefrontal cortex includes the blue shaded area on the left of the diagram of the brain.

[Special Note:  The adolescent brain is still in development until about the age of 25.  The region to last develop is the reasoning center of the Prefrontal Cortex.  Don’t mess with it!  Why is this so important for our discussion?  Some sufferers of PTSD are below the age of 25.  Much research show that illicit drug use at younger ages run significant additional potential psychological and neurological problems.  For more info: http://science.howstuffworks.com/life/teenage-brain1.htm]

3 Signs Substance Use has become Substance Abuse

  1.      Used to escape, avoid or “deal” with problems
  2.      Lying about or hiding use
  3.      Defensive about use

What can I do if I think substance use has become abuse in my life?

3 Strategies for Dealing with Substance Use/Abuse 

What can I do if I think substances use has become abuse in the life of a loved one, friend, or coworker?

  •  Individually (or with another) Confront:  Do this only when all are sober and there it is a safe environment with no risk of violence or abuse.  Also, be prepared for resistance, denial, defensiveness, other manipulative tactics and/or hostility.  A first discussion about substance abuse rarely result in the abuser willingly surrendering for the necessary help.  Be patient.
  • Set boundaries:  Let them know what is acceptable and unacceptable behavior in your presence, work or home.  They may deny the problem that does not mean that the problem does not exist.  It is important to let them know that how they are handling things in their life is affecting your life as well.  There are consequence for their choices.  Do not hesitate to get counsel on what would be healthy and reasonable boundaries for your specific situation.
  •  Intervention:  At some point you may determine that an intervention is necessary.  It may take a group of people who care for the individual to get through to them—especially if the first actions have not been successful.  Be prepared.  Make sure the group is on the same page.  It is extremely helpful to have someone experienced present at the intervention.  Make sure you have resources lined up to deal with the needs if the individual is ready to accept help.  For further help with an intervention read the following link from the Mayo Clinic http://www.mayoclinic.com/health/intervention/MH00127

Question: How has reaching out to help other assisted you in your journey?

[For a discussion of the medical distinction of use vs. abuse see: http://methoide.fcm.arizona.edu/infocenter/index.cfm?stid=201]

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