Treating PTSD
PTSD is notoriously difficult to treat. There are so many trauma theories!
The thing about treating trauma and PTSD is that it's ALL theory. Every last treatment out there is just a theory: the psychiatric treatments, the psychotherapy treatments, the spiritual treatments, the bodywork treatments, the drug treatments. Each and every one of these methods is based on a theory. I think it's really important to acknowledge that. Just because the shrinks can say they have a peer reviewed study which provides statistics that science finds acceptable doesn't mean the other, lesser known treatments are not going to work for us. Nor does it mean that we'll be one of the lucky x% for whom a big University study had positive outcomes.
There is a pattern that I notice in either the study or practice of each treatment that claims, "this really works! This is proven to work! This has worked for my 1,000 followers! This is life-changing!" And that is the absolute insistence that this way is the right way and everybody else is a charlatan. Hmmm. This presents the sufferer with yet another conundrum. How far down this path to a so-called cure do I travel before I give up and try something else? How long do I give this cure to work? There are without doubt, sufferers who have tried everything for twenty years to overcome the condition, and still suffer the symptoms.
There are shrinks and gurus who are applauded for the PTSD treatment method they invented.
And of course, there is a never-ending supply of judgemental, ignorant people who believe we are choosing to stay stuck. Wallowing in self-pity instead of pulling ourselves together and getting over it. In other words: stigma.
For me, that judgement is akin to judging a paraplegic for choosing to stay stuck in a wheelchair. Or a person who never learnt to swim choosing to drown.
Judging Ourselves
But for many of us, the worst judgements can come from ourselves of ourselves. The second arrow. After many years of soul searching, personal responsibility, tackling head on the brutal realities of living with the condition - losing friends and family who just want us to 'be our old easy-going selves'. We can struggle with the resulting practical issues of homelessness, unemployment, chronic pain, and possibly addiction. Sufferers have a disregulated nervous system, and we label the thoughts and uncomfortable emotions arising out of this as 'mental illness'. Sufferers can try one cure after another and still find themselves sliding up and down from feeling normal to feeling suicidal.
And they can find it difficult to forgive themselves for still suffering when they've put in so much effort and so many people haven't been ignorant and judgemental but kind and understanding.
How Mindfulness-Based Counselling Can Help
This is when we stop talking about it to our friends and switch to counselling. With mindfulness-based counselling, we can learn to turn our compassion and forgiveness back towards ourselves in safety and solitude, pretend that everything is okay and put on our public mask in order to get through each day without more external pressure to be other than we are.
We take ourselves in our own loving embrace, speak tenderly to ourselves, hush the harsh inner critic, and get back to the business of healing. Still. We let go of other-and-self-appointed deadlines for, "I/you should be over this by now". We pick ourselves up, dust ourselves off and continue living, even when we can't see any reason to go on.
We return to our gratitude inventory. We look around and seek to see the value of what we still have in the sea of loss that surrounds us. We grasp for dear life to every bit of flotsam and jetsom we can find still floating in our sea of despair. We practice letting go again. Holding on less tightly to the things we hold dear despite having lost so much of that already (home, friends, family, work, purpose, direction, joy, identity). As much as we feel completely nuts, our basic sanity has never left us. This is where counselling can help us get back in touch with our own authentic selves, our own deepest values, and move towards a life driven by meaning and purpose.
This is where counselling (especially ACT) can help us get back in touch with our own authentic selves, our own deepest values, and move towards a life driven by meaning and purpose.
PTSD Changes People
The experience of PTSD has made us braver and wiser and kinder. And that post-traumatic growth is something worth valuing - even as we hold onto it less tightly! Because the holding on just feeds our ego. And the more ego, the more suffering. By now, we can see this bare truth in the people around us. Because by now, we are well and truly awake.
By now, we understand that the more we cling to things and people, the more we suffer when we lose them. We understand that the loss of our dreams, our home and our place in society is far greater than the loss we suffer when we already lead simple lives. We understand that we and our society are addicted to growth. That resting in a place of simplicity, with few possessions, few greater responsibilities than our own wellbeing, and a few really high quality friends brings us much closer to joy from time to time than when we were still on the treadmill of 'success'.
With mindfulness practices we rediscover hope. By now, we are beginning to understand that each day of managing our symptoms is perhaps what cure is about. That the likelihood of waking up one morning to find that we have finally 'got over it' is at least a possibility. We understand that this game of snakes and ladders is not only ours to play, but everyone's. We have an extreme case of the human condition. That what we are facing is life, a lifetime, a rebirth, a different outlook, a cataclysmic change to the way we were before.
What this journey is going to take is enormous courage and infinite self-compassion. Without praise, without glory, but rather with blame and scorn (stigma) should we choose to put our heads too far above the parapet.
Keep Trying Everything
We pick ourselves up, dust ourselves off, and try a treatment that we've not yet tried. If we never tried the drug-based approach, then we go after that for a while. If we never tried inner-child work, then we go down that path. If three - hour guided visualisations on YouTube haven't looked too appealing in the past, we give them a go. If we aimed for openness and authenticity and it's wounded us more deeply, then we have a stab at faking it - avoiding anything that might trigger us and wearing a mask whenever we are outside our homes. We just go on putting one foot in front of the other, remembering that this is truly what most of our fellow humans are doing too. The more we resist the symptoms and consequences of the condition, the more we suffer. The more we accept that this is the life we have, even though it's not the life we want, the less our suffering. The less we compare ourselves with our former vibrant lives or our former successful friends still on their blind treadmills, the better we feel.
We never signed up for PTSD. But that's what we got. And now we have a quest. A purpose so big that we keep losing sight of it. We are bigger than the social treadmill or avoiding our experience with drugs or other distractions. We are called upon to reframe the entire landscape of our own lives and heal. We are called upon to undertake a courageous and solitary inward journey until such time as we are able to find remission from PTSD and extend a helping hand to others.
Why Not Try ACT?
Acceptance and Commitment Therapy is an evidence-based, mindfulness-based intervention. It is about training the mind. This training is not a quick fix, but a number of dedicated practices for bringing about powerful and lasting change over time. This 'third wave' of Cognitive Behaviour Therapy is gaining recognition as a treatment for PTSD. Ask me about it.
© Nicki Paull
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