What I understand about PTSD

I'd like to tell you a story about myself, for a change. Please bear with me - the relevance will become clear!

The other morning, I woke up having dreamt of my Dad. (He passed away in 1999 after a gruesome battle with cancer.) I told him politely but firmly that I don't want to argue with him again and that I'm not interested in his opinion.

Breathing deeply.

My Dad has always been an avid sportsman - no challenge was too much for him. He could never understand why I wasn't more like the son he would have wanted. My younger sister was much more of a tomboy. She could do all the things kids do long before I even attempted them. (I don't know what made me so shy and scared in the first place, but I just was.)

When my Dad got fed up with me not learning to swim - he resorted to throwing me into the water. I was too young to retain a very detailed memory. What I do know is that I went into a state of shock and nearly drowned. He rescued me, and the whole event won't have lasted longer than a few seconds. But it had a profound influence on my life ever since.

• I try to avoid anything to do with sudden contact with water, whether it is deep or shallow.
• I feel uneasy about heights.
• I loathe the feeling of slipping and losing the ground beneath my feet.
• I hate the idea that I could fall.
• Even just watching other people take risks leaves me anxious that something might happen.

Dreams of endless falling have, thankfully, long subsided. I'm no longer at school where I have to find excuses for not being willing to do what everybody else attempts. But it is still there.

And now it's beginning to change.
I'm not talking about some miracle cure. It has been a long process, and it's not concluded yet. I know, of course, that there are some major differences compared to what some of you have experienced:

• For those of you who have been diagnosed with PTSD or show some of the symptoms, the events which caused it will have been much more recent.
• Most of you will therefore remember much more detail - unless, of course, that memory is suppressed.
• And, it goes without saying, that unlike in my example, few people will be able to relate to what it is you have experienced. But they don't have to understand every little detail. It's a misconception that nobody understands because "they haven't been there".

Much more important are the communalities:

1. It is not your fault!
   Despite all the training and the preparation - you can't control the thunderstorm in your brain. We don't yet know why some people just shake events off and get on with life while others are deeply affected. And though we can speculate on the kinds of events that might lead to post-traumatic stress - we can't predict it. Nor can we prevent it.
2. You need to do something about it - or nothing will change!
   No matter how difficult it is, only you can spark the change. Therapists can help - but you are at the center of it.
   Rather than just focus on the trauma: Try something new; do something that you never thought you could do. Can't think of anything? How many of you have attempted to write a short story? Paint a portrait? Learn a foreign language? Have a go at acting? What's the thing you think you could never do? Then try it. You won't be the next Picasso or Michelangelo overnight - but there is so much satisfaction in achieving even part of something you wouldn't have thought possible.
   Trust me - it will give you confidence. And that confidence will carry on into other areas of your life. You need to find people you can trust, of course: a writers' club where everybody is working on a publication is probably not the best start. But a beginners class in an adult education college will be a very supportive and encouraging setting.
   If you find even such small steps too scary - then you ought to talk to someone about medication, at least temporarily.
3. Therapy - help - doesn't have to involve "going there again"
   There is no "one-size-fits-all", and some of you might be so deeply affected that you need therapy. There are loads of approaches out there, and even for a professional it can be a challenge to navigate through them.
   "Talking about it" seems to be something we would all intuitively recommend - but that's not the only option. Nor it it necessarily always the best. I've done an awful lot of "talking" and it has never changed anything. And if someone were to suggest to "take me back in time" and make me relive what happened, I would finally be able to sprint. Why would I want to re-experience what it feels like to nearly drown???
   If you don't have a GP or receive therapy via some other route, have a chat with the guys at www.ptsdresolution.org.
4. The road to discovery might involve some "trial and error"
   Whether it is a new hobby or therapy - your first attempt might not be successful. This can feel like a major setback, given that it might have cost you considerable effort to make that step in the first place. But, again, it doesn't mean that there's something wrong with you. It might just not have been a good match. A professional in that particular area should unterstand that and should be able to help you find an alternative.
   But don't give up. You can't run away from it anyway!
   Deep down, though maybe hidden away, you have all the skills necessary to get onto the road of recovery! I know that - and I believe in you.
5. You can get your life back on track!
   And you have to. You might have dependants - children, partners. But you also have your whole life still ahead of you. You have a responsibility to do something useful with it. The man (woman) you once were is still inside of you!

Ulitmately, nobody can do it for you.

What it was for me? Well ...

I joined a boot camp class - and, yes, you're allowed to laugh. Me - who doesn't have a record of avid exercise; in fact, I hated it as a child. Now I feel like I'm going crazy when I have to miss a class. I wouldn't dream of getting too dirty as a child - now I end up sweaty, dirty and smelling of wet soil ... and I love the way people look at me on my commute home. I love the way my muscles ache - muscles I didn't even know I had. My friends think I've gone completely barmy. Or, more precise: My civvy friends think I've gone mad; my ex-military friends smile in a slightly condescending way, sometimes mixed in with a "why would anybody do that voluntarily ...?". And, yes, there's the occasional "well done". But none of that is important. It's my journey.

Me being me, of course, it couldn't just be any "military-style fitness class". It had to be the "real thing" - short of joining up, obviously. (That's a whole different story ...) Why? Now this will make you smile as well ... Because I trust them. I trust the man who has worn a uniform. I admire and respect them. I trust them to know what they are doing. I will never get to what they are capable of. But it's an incredibly supportive environment. We all feel part of a team - no matter what our fitness levels. There is so much mutual encouragement. You get praise when it's due - and you're challenged when you don't try hard enough. And they have a genuine interest in people - it never feels as if they were just doing a job.

The culmination of this experience so far was a trip to an "obstacle course". OMG. There was an awful lot I didn't attempt and for a while I felt like quitting - but I didn't. I still remember the adrenalin rush which accompanied what I did master. It worked, because I knew there were two Marines I could rely on. I knew I would be in safe hands. I wasn't pressured. And I wasn't petrified either, I even enjoyed it - continuing to run in soaking wet clothes to try and keep warm (having waded through a small river), shoes that suddenly feel so much heavier, the mud splashing up and always at the verge of slipping. And, yes, I do want to do it again and see if I can push myself a little bit further.

I will never be the one to jump off a cliff into the sea. But I would like to have a go at abseiling within the next 5 to 10 years.


What's your challenge?

It doesn't matter what it is,
as long as it takes you out of
your comfort zone!

Make one tiny step today - and keep going!



If you want to share your story but don't want to create a Gmail account - email me: sabine.pitcher@mail.com - and I'll add it.

Don't employ a veteran - he could suffer from PTSD

Why is it that, at the moment, whenever our troops are mentioned, it is in the context of PTSD - even in a recent BBC special about Northern Ireland.

Don't get me wrong - PTSD exists. It's real. Research might even have been able to link it so specific patterns in brain activity that are out of balance. We send our troops to some pretty nasty places and, despite the best of preparation, sometimes situations occur with which some of them can't cope. The same goes for our police force, ambulance staff, firefighters. Most of the time, our troops are not in combat - and life in the barracks can actually be pretty boring.

Yes, they deserve our respect and our understanding. It is hard to believe that there are still veterans who, after decades of suffering, have not been given a diagnosis. And those who have are quite often prescribed a whole cocktail of medication which is disabling in itself. But there is a dangerous downside to the current media coverage: it adds to a negative stereotype. First they were just uneducated, violent and potential addicts; now they are ill and need looking after. What they are not is normal human beings, like you and I.

Statistically, one in four troops returning from combat zones will develop symptoms of PTSD.
Also statistically, one in four in the general population will develop mental health symptoms at some stage in their lives.

I have seen the stage play "The Two Worlds of Charlie F.". And I have also just seen the film adaptation of "Sunshine over Leath".  The first was mesmerizing, extraordinarily well acted. (By that I mean that it was what I expected after all the many conversations I have had with people who had come extremely close to similar events. Obviously, I have never seen anything like it myself.) The latter was actually much more useful - two young soldiers who had just left the Army. They were struggling with life - but a lot of that was actually independent of their time in the Army.

They are among us. And most of them are actually pretty normal. Yes, they sometimes struggle - but for different reasons. They might not understand the hidden rules in civilian organisations. They might expect actions to be carried out. They will be irritated if after three meetings it is still not clear what ought to be achieved. But they can adjust. Having been made redundant might actually prove a much bigger trauma than a few months in a "hostile environment".

What they struggle with the most is our stereotypes and prejudices! Headlines like "Homecoming Horrors" in today's Shortlist certainly don't help.

Post Traumatic Stress Disorder

I have just filled in a survey about the attitude to Combat Stress - another word for PTSD, or C-PTSD or shell shock or ....

As a psychologist, I know a thing or two about post-traumatic stress disorder - how it can come about and what potential treatment options there are. But does anybody really understand it? We can't explain why a group of soldiers will go through the same battle, see the same horrible scenes, but one or two of them will struggle later. It can catch up on them when they least expect it. You don't necessarily see it. And most of them won't talk about it.

I have met Northern Ireland veterans who are still on medication, all these years later. Who sometimes don't want to go to sleep because they know they will wake up in the night, sweating, feeling as if it had only just happened.

In the wake of the war in Afghanistan, PTSD is now a recognised condition, but many still doubt it exists. They still believe that all it requires is to "pull yourself together".

One of the questions in the survey was whether I believe there is a cure ... My honest answer: I don't know. Each case is different. Some will get over it if they can talk about it. Some will take medication and will otherwise lead a perfectly normal life. Others will continue to struggle.

There still is a stigma attached to PTSD / Combat Stress, which makes it difficult to talk about it for those who are affected. But I think there is also a growing awareness that there might be no cure. To some extent, no matter what treatment, people might still have to live with the consequences. So why talk about it? Why talk about it and risk a reaction that only shows a total lack of understanding?

I don't know the answers. But I would still urge those affected to talk - by NOT talking,

• we will never know the full scope of the problem - we will continue to speculate:
• you miss the chance to find out that there are others out there in the same situation (realising this can help!)
• you won't realise that there are, indeed many people out there who would like to support and, at least, try to understand.

My favourite knock-out argument is: "You can't understand, you haven't been there, you haven't seen what I have seen." Though this is undoubtedly true, it would mean that I can talk about hardly anything, because there is so much I haven't experienced - hunger; neglegt; domestic violence; abortion; delinquency; prison - I have been lucky and have probably led a rather sheltered life. That doesn't mean I can't empathize; it doesn't mean I can't understand.

The biggest fear of those who don't talk might not be the fear of being misunderstood - it's the fear of living through it again. And who could blame them? Who could blame them for trying to lock it away?

If you have read until here, you will by now have guessed that the topic isn't new to me. I have friends who have been diagnosed with PTSD. Some have been medically discharged. Some have recovered.

When you are ready - I'm willing to listen. And there are others out there trained to listen and trained to help you make the next step.