Addressing PTSD

Posted by Dr. Dan Gottlieb in Life After Paralysis on March 27, 2019 # Health

A survey in the American Psychological Association Journal showed that nearly 25% of people with spinal cord injury get PTSD!

So, what is PTSD? The symptoms are many. They include agitation, hostility, isolation, or self-destructive behavior like using alcohol or other drugs to excess. But they also include flashbacks, severe anxiety or mistrust. Some get unwanted thoughts, nightmares or become hypervigilant to danger.

But think back to that statistic, one in four of us has PTSD. So, what about the other three? Why do we get it and they don’t? The ones at most risk are people with previous trauma or depression or limited supportive relationships.

I have one of the risk factors which partly explains why I have PTSD. When I was 12 years old I was sexually abused by my teacher. I didn’t understand what really happened and I didn’t tell anyone because of my shame. Even though I was popular and had many friends, I still felt different because of my secret shame. That feeling lasted for well over two decades. And here’s why…

20 years later, I was driving on the Pennsylvania Turnpike and an 18-wheel truck lost its entire wheel. That wheel crushed my car and severed my cervical spinal cord. I certainly have PTSD. After nearly 40 years, my baseline anxiety can sometimes cause a great deal of stress on my body and mind. Ever since my accident, the threshold for my startle response was low as it would take much to get me startled. But now if a fork falls on my hardwood floor, I jump. It had gotten so bad that I had to give up driving.

So, I scheduled some sessions with someone who practiced EMDR (eye-movement desensitization and reprocessing). This is a treatment in which we visualize what we are most afraid of. While we are doing that, the therapist moves her hand slowly left and right. While we are concentrating on the hand, the image of the event crosses from left hemisphere to right. That’s where the integration takes place. The image may remain the same, but the fear diminishes. I found these sessions to be pretty helpful.

And now there is a whole new body of research indicating that the most effective treatments for PTSD may be bodily focused as ell as the brain. Trauma gets stored in the brain, but it is the body that gets frozen or agitated, as in hypervigilance or chronic fear. Traditional and well-researched therapies include cognitive behavioral and exposure therapies. The bodily focused therapies tend to address what happens to the body in fight/fight or freeze mode. These therapies involve learning how to deactivate the body quickly.

But with all of these techniques, well researched, as they may be, please remember that nothing changes without safety. Unless you feel safe in that room with your therapist, the techniques won’t work. And if you don’t feel safe because you feel the therapist has their own agenda, it’s time to find a new therapist.

But many of us experience Posttraumatic Growth. That’s when our lives actually improve as a result of our injury. My growth began one night while I was still in my halo best in ICU. My deepest wish was to close my eyes and never wake up again. But a nurse came up to me and asked if she could talk with me. She told me her tale of loss upon loss and her great suffering. When she left, I thought my life might have some value after all.

I’ve treated many parents of autistic or disabled children. And of course, they talk about the stress and fear, but most of them say that they are better people and more loving because of their experience with their child.

So what happened to that feeling of being different? Like most people with disabilities, I felt very different from everyone, including my family. The more I tried to explain what it was like, the more isolated. I felt. At one point, I just gave up. I knew that no one would understand what it’s like to live with quadriplegia. And then I began to talk about my inner life of helplessness and fear of the future, my desperate wish to have what I had yesterday. I talked about the depression and feeling judged. And then everyone understood what it was like to be me. All humans have those feelings and the ones I spoke to felt great compassion for me. Since that time, my heart has been open, and I talk about what’s in there.

So, I have both posttraumatic stress and posttraumatic growth. So how can we further develop posttraumatic growth?

Probably the best way is to keep a gratitude journal. Keep a daily record of three things you feel grateful for. It could be anything from love to feeling grateful for your caregiver or your wheelchair. But when you are aware that you are grateful, allow yourself to feel gratitude. Do that three times a day and you might find your mood changing.

-Dr. Dan

You can find me on Reeve Connect talking about and answering questions about well-being.