Understanding Triggers

This is not, despite the title, about guns or a family of a certain ex (or horse, for that matter). Triggers are things that make your system go haywire. They are commonly talked about in relation to depression, anxiety, PTSD, and related conditions. They, in a word, suck.

There are certain things that you expect to be a trigger. If your symptoms are a result of being jumped in an alleyway by a group of people, you can expect dark alleyways and small groups to cause you some problems. Associated triggers might also be dark streets. It grows from there, often logically. One of the first things you learn in dealing with trauma is what your triggers are and how to either avoid them (if they are easily avoidable) or cope with them (if they are not).

Then there are the triggers you never expect. People or situations that seem in no way related to your trauma, but still cause the same reactions. These are the triggers that you have to learn to prepare for if you're going to have any sort of long term recovery. And these are a bitch. They sneak up from nowhere, often disguised innocently enough. Often, they are not what they seem and can take some working to find out what is actually the problem. It's not fun, in fact it can be incredibly painful, but it's necessary in order to move past it.

It's different for every person. For some people, the triggers are closely related to the trauma, but may be extreme. For example, a rape victim might not be able to read about fictional rape without it causing flashbacks. For others, situations that remind the person of the feel of the trauma can be triggers, even if the situation is not similar. If the sufferer struggles with the loss of control from their trauma, any situation in which they feel they have no control can be a trigger, though they might be able to read about their trauma with no effect.

One of the first things that must be understood about PTSD is that it can't be cured. The goal for anyone who has it is to learn how they respond, learn what are appropriate responses, and then be able to move through life with that information. To learn how to recognize when a situation is a trigger, even if it's entirely new, and how to get through or get out of that situation so that it doesn't cause the flashbacks, panic attacks, or violent reactions that can result. The goal is to manage the PTSD so that it doesn't control your life. That means learning to manage your triggers, and hoping the people in your life are understanding.

A Sum of Our Bad Days

We are all familiar with the thin line between explaining something (Sorry I'm late, there was an accident on the 10) and trying to justify bad behavior (Seriously, traffic was awful, omg!). It can be hard to manage as both the receiver and the giver of such information and often comes down to trust in motivations.

I think this can be harder for behavior that is legitimately motivated by something beyond the person's control, but about which they feel guilty. I've seen this among friends and others I know who have various mental health issues, like depression, anxiety, and PTSD, especially if they are considered "high functioning". The person who suffers feel awful for letting it take control of their behavior, for acting in a way that they know is unacceptable, but in the moment they didn't have a lot of control over. This is the side I'm familiar with and can attest to the fact that it's awful. When you try to explain what it was like, you still feel guilty and you feel like you're justifying bad behavior. You end up making a lot of statements like "I know that this action is unacceptable, but let me try to explain what was going on in my head".

A friend said to me today that no one with any empathy can hold that kind of behavior against you if they know what's going on. I like the idea, but I don't know if that's true. All you can do, I guess, is to hope that the offended party is open to listening, and that they will see it for what it truly is. That they will recognize that these kinds of problems are fights that exist in you every day, and that some days are better than others, and some days you lose. For some, losing is hiding under the covers all day and letting the depression take over, hoping that tomorrow will be better, and trying not to feel the crushing guilt of not being productive. For others, losing can have much bigger consequences and effect the people in their lives, even running them out of it. In the end, we have to hope that our next bad day won't be as bad as the last one, and that the people we love learn to forgive, accept, and not see us as a sum of our bad days. Because if other people are anything like me, it can be hard not to see ourselves as that, especially when we don't have someone there to tell us otherwise.

That Thing You Do

There's a lot of psychological theories about why we do what we do. In fact, it's really the entire field. Why do we do X? What motivates us? etc.

We can all point to things we do and say "I do this for that reason." There's the inevitable moment as a grownup when you realize that you're doing things a certain way because your parents did it that way, which always leads to a moment of "I'm becoming my mother/father!" and often a conversation with said (amused) parent. That's always fun. But you get over it and either accept it or change it, depending on where you are in your life and how appropriate that way of doing things is.

Other things are more subtle. The way someone interacts with the opposite sex is usually a combination of active social shaping (often by parents) and personal experience. If a guy has gotten poor responses for holding doors for women, he might be less likely to do so, though if his parents (and/or society) taught him it was the way men do things, it's related more to his identity than to his relationship with women and he's gonna hold that door.

Just like when we realize we're becoming our parents, there are moments when you make a connection between a part of your personality or behavior and something that influenced it. One of the therapy process for PTSD uses CBT - Cognitive Behavioral Therapy. It is a pretty standard cognitive/behavioral process that has to do with actively recognizing your actions, determining the reason for you actions, determining if that is an appropriate response, and making active, conscious decisions to change inappropriate responses. The more extreme the reaction, the harder it can be, but it's shown to be very effective. It's a list of questions that, after awhile, become second nature. "Why am I doing this? Is this an appropriate response? What is a better response?" I run through these questions all day, everyday. It's mentally exhausting, but it allows me to better function in society. I still jump a mile when someone drops a book on the floor in class, but I no longer assess them as a target and take an alert position. Better!

Once the major behavioral issues are dealt with and the patient has the tools to manage themselves, smaller, more subtle things come to light. Tonight, I had a moment in the shower (where a great deal of introspection seems to happen) where I realized that while a lot of my "hardness" - the enjoyment of guns, the casual nature of violent and aggressive speak - is simply residual from the Army and it's environment (and is not behavior that needs active correcting since I recognize socially acceptable situations and abide accordingly), a portion of it, maybe even a lot of it, is laying down warnings. It's "Do not mess with me or I will destroy you" behavior. In a physical situation, I am simply outgunned when facing someone bigger and stronger (which is less people than perhaps it should be for my size, but is still a significant portion of the population). I make up for it with a very clear attitude of "if I have to kill you, I will. Please stay over there, where I don't have to kill you." 

In my Psychology of Violence class, we discussed what it takes to kill someone in the context of the military and how it trains. My professor asked us if we could. And I knew, without a hesitation, that I could. With that knowledge comes no value judgement on myself. There were people in class who felt like they could if they were protecting someone (and every mother said she could to protect her children) but they didn't like it about themselves. It doesn't bother me. Could be desensitization to the concept. It could be that I have thought about it a lot more than others. But either way, the knowledge is very clear to me. I don't want to kill anyone (no murders in the making, promise). I don't want to hurt anyone. But I know that the situation could arise where I would. 

Confessions of a Gleek

I am now officially caught up on Glee thanks to Kyle's Hulu Plus account. I know the show has lost its magic for some people, but it still speaks to me. The Santana/Brittney relationship continues to be beautiful to watch, especially seeing Santana deal with the very real reaction from her grandmother. But the story line that speaks to me the most is Emma's struggle with OCD. The show has done a really good job of addressing the struggles, stigmas and real challenges of mental illness though Emma's story, just as they have addressed other issues on the show. One of the things I like so much is that they didn't fix Emma with a pill and say it was fine. In the most recent episode, she refers to having good days and bad days, that it will always be that way and that it's simply part of her.

Emma is the character I relate to the most on Glee, and not just because of her red hair and Kate-Spade-meets-J-Crew fashion sense. While I don't have OCD, I do have PTSD and the battle with mental health is similar. There's the stigma not only with people in general but with yourself. Accepting that the diagnosis is part of who you are is a challenge that threatens your identity and can shake your security of who you are. Even once you come to terms with it, there are times when it feels like it controls your life, which generally only exacerbates the symptoms, leading to a spiral that can be hard to break. The moments of watching Emma really struggle with it, like the brief clip of her trying to stop herself from cleaning the coffee pot in "Yes/No" are the ones that resonate for me.

I think the show does a great job of balancing the humor of Emma's excessive cleaning (which is, in fact, funny) with the seriousness of what is behind it. It's made it easier to laugh at some of my own rather funny habits that are a manifestation of something more serious. They always say that being able to laugh at yourself is healthy and I've found that when I can do that, it's easier to have a good day.

Also, she has a killer wardrobe that I want very badly and would consider homicide as a matter of acquisition.

As a side note, I was preparing to post this and looked through my labels for the appropriate ones. I noticed that I had labels for fibromyalgia and medical, but not PTSD. I then realized that, despite my openness about my physical ailments, I've never talked about this. So, to be clear...I'm Jenn and I have PTSD. And now, I have a blog label for it too.