ANZAC Day, lets think about PTSD and trauma

In Australia, we are celebrating all the people who have fought in wars, protected our borders and done service for the country. There is a big march in the city, they had a dawn service and veterans from far and wide take part in this coming together, this appreciation, the memories....

So as I reflect on the members of my own family who fought in the war (like my grandfather) or became a nurse in the war (like my grandmother), I often think about the mental scars these men and women are left to face in the aftermath. The nightmares they have seen, the lives they have taken, the friends and comrades they have lost, the casualties, the fear and the survival. No-one can ever truly imagine what these people have gone through, what people are continuing to go through in the likes of Afghanistan, South Korea, Iraq, Somalia, Syria etc.

It was also thanks to soldiers and military men passed that we are able to understand something called PTSD (Post Traumatic Stress Disorder). It was only after so many men were coming back from war and started to develop common symptoms, that the governments and the world of mental health started to accept that there are links between what had occurred at war and these symptoms. As you can imagine, this was no easy journey, to admit that PTSD was a real side effect of war would be for governments to accept liability, to be responsible for changes and treatment. We can also thank these soldiers and their trauma for the developments in psychotherapy and psychology that move beyond psycho-analysis and the days of Freud and his long - term therapy which had been the dominant means of treatment for mental health issues. When these soldiers started to return home after the likes of WWII and Vietnam, long - term psychoanalysis, which entails delving into childhood and working through deep set issues, was no longer viable. Something was needed to treat the mass of soldiers and military men for what was now emerging as PTSD, something which was now being acknowledged as a response to trauma (not embedded in childhood). As the likes of Carl Rogers and his Person Centred Therapy started to gain popularity, so too did our growing understanding of the human condition. Questions were being asked, theories were being challenged and when you look at all the different modalities and frameworks employed today, we have to give thanks to these men and women who suffered to make this possible for us all. I say us all because psychotherapy and psychological fields are now available to masses of people with a variety of presenting problems, it is good to acknowledge that it was not always this way.

PTSD can effect everybody, not just soldiers in the war. This disorder is due to the residual effects of a past trauma or trauma's. It is thanks to these soldiers that a very comprehensive list of symptoms has now been developed and associated with PTSD. Some of these symptoms include nightmares and sleep disturbances, hyper-vigilance (being extremely alert), racing heart, anxiety, depressive symptoms, inability to do certain activities that were otherwise easy for you, anger, confusion, panic attacks etc. There are many symptoms and changes that occur when people suffer PTSD and it is often overlooked or misdiagnosed through lack of awareness or due to a very late onset. It is not unusual for people to develop PTSD after a substantial period of time has lapsed since the trauma, sometimes even years. This makes it difficult for people and practitioners to often make the link between symptoms and PTSD.

Trauma does not always have to be about war, death, terrible accidents or personal injury. People can get traumatised by someone else's trauma or potential trauma. This is called 'vicarious trauma'. For instance witnessing an accident, almost being in an accident and wondering what could have been or having something happen to someone close to you. We are beautiful creatures, human beings, most of us equipped with a very special tool called empathy. Unfortunately by being able to empathise with others, imagine yourself in their shoes so to speak, we are also vulnerable to imagining people's pain, fear and panic. Thus it is important to be mindful of how you are being affected, to be kind to others and yourselves and to be aware of what PTSD is all about. It is also important to spare a thought for all those brave men and women who have had to live with trauma and put their lives on the line for the safety and protection of their country and it's people.

Thank you to all the ANZAC's!
Paula

Stress! How do you get a handle on it?

Stress is such a society friendly word isn't it? I mean, there is no shame in saying it, whatever age you are and whatever sex you are, we all seem to get 'stressed'. So why is it so very hard to just 'stress-less?'

Let me start by chatting a bit about stress a bit. We tend to use it when we are feeling things such as 'overwhelmed, frustrated, panicked, pressured, annoyed, and confused'. We may also start using it when we start getting illnesses or pain that cannot be explained away by tests and doctors, such as upset tummies, back ache, headaches, skin irritations and rashes, insomnia or sleep disturbances and changes in diet or appetite.

Stress is used to tell someone to calm down and don't worry "Don't stress, we can make another plan" or "No worries, thanks anyway". It is used to highlight a point "I would like to stress the importance of xyz". It is used in such a variety of ways and by such a wide amount of people that it is no wonder we often feel bogged down by stress and silently suffer symptoms that may be worse than the society friendly label suggests. So am I asking you to become stressed about your stress, absolutely not. I want to open the doors to a deeper understanding of how you cope with stress, how you experience it and I will offer a few of my own stress busting strategies at the end.

Lets take a closer look at you and your life.
How do you cope with the challenges life seems to throw your way?
How many of you have found that your stress comes and goes, some days you feel better equipped to deal with stress than others?
How many of you have started to feel stressed for 'no reason'?
How many of you tend to be alerted to your stress when you put your neck out or you start to get nausea and stomach troubles?
How many times do we start blaming things or people around us because we 'just don't need this right now!'?

We all experience our stress in different ways, unique to our own way of life and coping style. Stress can often be misleading and perhaps what you have been experiencing may very well be anxiety. But without throwing labels around and self diagnosing yourself (not a good idea), ask yourself what area's are the most challenging for you. Do you have trouble with thoughts that seem to endlessly go around and around in your head? Do you find you are always worrying about something? Have you been really hard on yourself lately? Check in with your body, does anything stand out, any pain, discomfort, tightness, etc? How have you been sleeping lately? When was the last time you did something enjoyable? How have you made it through when you have been struggling? If you are aware of your stress, lets break that down, what is it that makes you aware of your own stress? What was it that alerted you?
We tend to say that we are stressed without really thinking about it. Perhaps being overworked, lacking patience and having deadlines is simply a neon light of stress warnings for you, but it is more than that. Think about it.....
For me, I tend to have a very short fuse and get annoyed very easily. I seem to worry about so many things that are completely out of my control. I am often very emotional and can cry at the drop of a hat (sad adverts, a moving song, a TV show etc). I get horrible back pain and neck pain and my hands flair up with eczema. I can usually fall asleep but find I wake up a lot during the night and toss and turn in the early hours of the morning. I get really fatigued and run down and when it gets bad, I get stomach troubles. As life needs to go on, I often forget to notice all these symptoms until I feel completely overwhelmed by them and by this stage I feel quite helpless and get really annoyed and angry with the whole situation. Any of this sound familiar? I urge you to think about your own paragraph here :)

Once you start having more of a handle on your own symptoms of stress, of your problem areas and of your coping style (because yes, you have actually been coping, even if it doesn't feel like it), you are able to realise that you have a particular way of dealing with stress and it is up to you whether it is working for you or not, or if some of it is working but there are areas you would like to change or improve. The body is a very clever creation and believe it or not, is acting in a protective way towards you. When we do not listen to our own inner needs, when we don't slow down and take care of our selves, our bodies seem to start forcing us to do that. We get ill, feel pain, get fatigued, throw up etc, and the common element here is that with all these symptoms, you are forced to pay attention. In many cases you are forced to physically slow down and rest. How many of us, however, pop some pills and push on anyway (I myself am guilty of this)?

Lets get pro-active instead of becoming inactive!

Stress and anxiety is not unlike fear in many ways. Both fear and stress accelerate your heart rate in a response to adrenalin or the fight or flight response many of you will have heard of. As your heart rate increases, your body goes into survival mode and starts to react in ways that inherently are built to protect you. The big trick here sounds so very simplistic but it is to slow that heart rate right down and relax the nervous system.
HOW you may ask? When you are in the midst of your stress, at work, looking after the kids, running errands, cleaning the house, being a friend, cooking dinner, planning for the future, struggling financially, job hunting....you name it, we have a lot to be stressful about in this fast paced, rather difficult world we live in. It is not always realistic to go on a spa retreat, take a tropical holiday or get a full body massage!
My strategy is to work with your breath. When you hear the old tip of taking ten deep breathes, it is not all a bunch of rubbish. There is huge merit in this technique. There are many different ways to work with your breath and it is about finding the method that works for you. The basic principle is mindfulness. Getting your head out of your worrying, rumination of thoughts and fears and into the present. Finding that relationship with your body and taking steps to slow down that heart rate and calm that nervous system.

This can be as simple as doing a small meditation where you sit or lie comfortably, close your eyes if you want to and take some deep, long breathes where you imagine the air coming into your body and as you release your breath, you imagine a releasing of stress and emotion. I like to imagine sending breath to different areas of my body, such as my back or neck when it is sore, or my tummy when it is upset. Yoga is a great way of working with your breath as well as incorporating stretches that open up your chest, groin, back etc and strengthen your core.

Listen to Bob Marley! perhaps my favourite strategy to suggest because it is just so do-able! The beat of this reggae is similar to the beat of a slow, calm heart. Pop some Bob on in the car or on your phone to have easy access and focus on the music for a while. Let the music get that heart beat of yours to slow down :)

Exercise. This releases endorphins, gets you in the moment, works with your breath and gets that blood flowing. Hard to worry about things when you are playing sport, working up a sweat or trying to breathe! There is more and more research being done on the benefits of exercise, particularly with depression and anxiety! It's not all about looking good at the beach!

Do something that makes you happy, at the very least once a week!

Start a journal or start sketching/drawing/painting. Try this as free association, working with whatever comes to mind in the moment. You may surprise yourself with what crops up and it is a great way to learn about your inner self as well as to release some pent up stress! You don't need to be an artist or an author, this is just for you!

Talk about it! Lets support each other and ask for support ourselves. So many people battle with stress and anxiety, it is not something that needs to be kept in the dark. Lets share our methods, tools, experiences and help each other to feel less overwhelmed and more hopeful!

Eat for health! Give your body lots of fuel to cope with the day! Make super foods your friend and start getting creative with food! My favourite new additions at the moment are ginger and ground up linseed! Taking care of the basics, the physiological needs, is vital for good mental health!

And lastly, if you find you are not coping, nothing is working and you need some help, be proactive in this area too. There are many great therapies and treatments out there to help you. It is always helpful to ask yourself what type of help you are needing when choosing a form of therapy. I am happy to give some examples and options if anyone would like to send me a message or comment (here or on my Facebook page www.facebook.com/counsellingcounsel).

Hope this helps
Paula

Is my Grief 'Normal'?

YES!

There is NO strict set of rules, set time frame or particularly approved way of being when it comes to grief. In other words, there is no 'normal' way to grieve in my opinion. It is important to be mindful of your own process. If you have been battling to function for an extended period of time, it may be useful to see a counsellor or join a group to help you learn how to cope with your grief and regain some control over your functioning. I always recommend seeing your GP if you are not sure what to do or how to get some help.

Every person will deal with loss in their own unique way. The person, pet or even non-living thing or aspect of self that has been lost will be significant to the bereaved in different and personal ways. Our relationships are complex and cannot be given a formula or a one-size fits all mentality, so too is our grief. Think of the last movie you saw. Many other people will have seen the same movie too. Some people will enjoy it and others won't. Most people will have a view of the movie based on their unique outlook coupled with past experience, how they relate to characters, what effects moved them etc. You get my point. Grief is the same. There will always be commonalities between people who are grieving and theories are formulated based on these commonalities. We can establish that there are similarities in how people of different age groups grieve, of how men and women grieve and in how various cultures grieve. The circumstances of the loss will also affect the way people grieve. These similarities are important because they can make us feel less alone, less afraid and perhaps less judgemental of ourselves.

Comparing our grief to others can also be harmful. Many people have a stereotypical view of grief and loss. Some examples I have come across are that people are tearful and cry all the time; people are unable to enjoy themselves and mope around wearing black; that people do not want to talk about the deceased or that people are 'strong' because they are not crying. There are many more and I am sure each culture, family or social group will hold varying stereotypes. The reason I call this harmful is because people have very little control over how they react to loss. Literature shows that grief is all encompassing and can effect us on almost every level (physical, emotional, spiritual, social etc). Many people find they feel a lot of guilt and/or regret whilst grieving. By setting these stereotypes of grief, society has found a way to add to this guilt by creating judgement towards people who are not grieving in a way that is deemed 'appropriate'.

My message today is to attempt to move away from these stereotypes and to share what I feel is the most important lesson I have learn't in regards to grief: There is no right or wrong way to grieve and there is no clear definition of 'normal'. If you are unable to cry, that's alright. If you cry all the time, that's alright. If you need to be around things that remind you of your loved one, that's alright. If you need a complete change and to create distance from your memories, that's alright. If you want to talk, that's alright. If you can't talk, or don't want to, that's alright. If you feel angry, that's alright. If you feel happy despite your loss, that's alright. Whatever and however you are reacting is how you as an individual are coping. You are doing what you need to do to get through this loss.

As I said above, grief can effect us on all levels and some people will have more trouble than others in certain areas. Some common features of grief are loss of appetite and inability to sleep or stay asleep. Many people become very run down and pick up illnesses at this time due to a reduced immune system.There are biological reasons for this, I won't get into this here but I urge people to read further on this topic if there is an interest. Taking care of yourself may not seem important when you are bereaved but if these symptoms persist perhaps it would be helpful to see your GP and talk about options to help you, particularly with the physical symptoms. Lack of food and sleep can impair our reasoning and can make things feel a lot worse.

If you have any thoughts of suicide or self harm please know that there are people there to help and numbers you can call. Don't suffer in silence. Listen to your body and be kind to yourself. Things will never be the same but you CAN learn to find ways of living with your loss. Time will give you perspective and there is support out there. Try to find someone in your life who can listen to you and allow you to work through your pain in your own unique way. Remember too that some people in your life may not be able to help you and that does not mean that you are doing anything wrong or that you do not deserve help; it means that some people are unable to help you due to their own unique circumstances or abilities.

Hang in there!
Paula