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Posttraumatic Stress Disorder (PTSD) Awareness

TRAUMA

 

As PTSD Awareness month comes to a close I wanted to take the time to write a little bit about this disorder and the individuals who might suffer from it. Let me start by saying that traumatic responses are normal responses to abnormal situations. Similarly, not everyone who experiences a trauma will suffer from PTSD.

Let us examine for instance, an individual who may have almost lost his or her life in the military. It would be a normal response for that person to experience symptoms of traumatic stress (e.g., intrusive memories, nightmares, etc.). That person over the course of the following several weeks may notice that those symptoms get better and not end up suffering from PTSD. However, another person may experience the same exact situation in the military and instead of symptoms getting better over time; the symptoms may continue or worsen more than a month later. This person may be suffering from PTSD at this point. There are many reasons why different people may experience the same trauma but have different responses, including but not limited to: biological differences, thought pattern differences, perception of the trauma, and differences in environment and support system.

In the example above, we examined the difference that an individual may have after experiencing a military trauma. It is important to note that PTSD affects individuals who may have never been in the military. I can recall numerous sessions in which an individual was describing symptoms of PTSD and when I bring to her or his attention that I would like to assess for PTSD he or she says “I thought that was something that only people in the military might get…” It seemingly continues to be a misperception of the public that PTSD is isolated to a certain population.

The reality is that any person exposed to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, in the following way(s): direct exposure, witnessing the trauma, learning that a relative or close friend was exposed to a trauma, or indirect exposure to aversive details of the trauma may be at risk of suffering from PTSD. As you can see, trauma that puts an individual at risk of experiencing PTSD stems beyond any certain environment or population.

It is my hope as counselor that the public will become aware of how trauma can affect a person, whether or not that person suffers from PTSD and that we as a nation will able to identify when a person needs professional help for symptoms that may have reached the level of PTSD. Once PTSD is identified, early intervention can make a big difference for those who suffer from it.

 

References:

1) American Psychiatric Association. (2013) Diagnostic and statistical manual of mental disorders, (5th ed.). Washington, DC: Author.

2) Image from https://www.khanacademy.org/science/health-and-medicine/mental-health/anxiety/a/post-traumatic-stress-disorder-article

Grief and the Holidays: 5 Ways to Cope

As the holidays approach, the reminder that loved one(s) we have lost are not physically here to enjoy them with us can sting like a slap in the face. Their absence can alter our perception of the holidays and what they mean to us. Our minds may be flooded with memories of holidays past that we have enjoyed with our loved ones and the cold fact that we no longer have the opportunity to relive these type of memories with them can seem unbearable. Below are some things that can assist people as they grieve during the holidays:

  • Support: Having support during the holidays can be critical. Though it may be tempting to isolate, keeping contact with friends, family members, seeking help from a professional, or joining a support group can make the grieving process during the holidays much easier. Other people can assist you with processing the loss or help you see things from a different perspective.
  • Write a Letter: Try writing a letter to your loved one to highlight the memories that you are thankful for. Attempt to write the letter in a way that celebrates the good memories that you have of them. If you are able to work with a support group, counselor, or have someone you feel safe with in your life; try reading the letter aloud to someone else.
  • Symbolism: Some people find it helpful to symbolically incorporate their loved one(s) that have passed into their holiday celebrations. For instance, they may set a place at the table for them, light a candle for them, use items for decoration that remind them of their loved one, or dedicate time during the holiday celebration to discuss the life that they had together.
  • Quiet Time: Though the natural response may be to suppress or hide feelings of grief, it is okay to grieve during the holidays. You may need some quiet time in order to express your feelings in your own way. If you are not comfortable expressing these feelings in front of others, this may be a process that you need to go through on your own. Pray or meditate about how you are feeling.
  • Reflect on What Your Loved One(s) Would Want: Reflect or journal about what your lost loved one(s) would want for you if they were still here on Earth. Reflect on questions such as: “How would my loved one want me to remember them? What would my loved one want for me during the holidays?”

These are just some ideas for things that could help people as they go through the holidays without loved one(s) that they have lost. There are many other things that people can try to assist them as they go through the holidays without their loved one(s). The loss of a loved one is a life-altering experience and it can take an entire lifetime, one step at a time, to determine what might help for you specifically with the difficult feelings that accompany grief.

 

Autumn park

The Masks We Wear

The streets are speckled with people dressed in costumes, some of them wearing masks, on this evening because it is Halloween. As I see theses physical masks I cannot help but think about the internal masks people wear on a daily basis. If you are human, you have most likely worn an internal mask in your life. Let us examine some of the masks that people often wear:

  • The Emotional Mask: This is the mask people wear when they are hiding their true feelings. Anger often masks internal pain and hurt. Sometimes people stuff their emotions down, pretending that they have no emotion at all, until their true feelings bubble to the surface because they have pushed down too many emotions for too long. I often use an exercise with youth and children in which we draw on one side of a paper how they truly feel and on the other side we draw what people see; this is often an eye-opening experience for them.
  • The Dating Mask: This is the mask that people wear when they are just starting to date someone that they are trying to impress. Often times in the beginning of relationships people act like the person they think a future partner “wants” them to be. Their hygiene may be better than usual and their house meticulously clean; they may even go to the extreme of attempting to be the paradigm of perfection.
  • The Professional/Political Mask: This is the mask that some people wear when they are attempting to get ahead in the professional world. They adapt to their surroundings and the people that they are working with. Like a chameleon, they respond to others in a way that they believe will help them fit in, perhaps telling people what they want to hear rather than being honest about what they truly think and feel about different topics.
  • The Social Mask: This is the mask that people may wear in social settings. Some people want to play a particular role with the groups that they socialize it. They may talk and act differently to get the kind of attention that they are seeking (or to keep the attention away from them).

Does it even matter that we wear masks? Quite simply, yes, it does. When we wear masks we are often putting on a façade that is not congruent with who we truly are and what we are feeling and thinking. This can lead to increased stress and mental discomfort. Leon Festinger, a social psychologist, coined the term cognitive dissonance which is the mental stress that we experience when we hold beliefs that are contradictory to our behavior. When we fake a smile when inside we are actually hurting or upset by a situation, we are creating a dissonance within ourselves that can make us even more distraught.

So, on this Halloween I would like to pose a challenge to anyone reading this: Try taking the mask off for a day or if you are extra courageous, a week. If you laugh at jokes that aren’t funny to you or find yourself smiling out of habit rather than true happiness, try making your facial expressions congruent with how you really feel. You just may find that you have a lot less stress at the end of this experiment because you have lessened your internal dissonance. Happy Halloween!

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When the Music Returns

Bereavement is a normal response to losing a loved one. There is not a “right way” to grieve and there is not a particular timeline or expected length of time in which one will no longer grieve. After the loss of a loved one, it is common for grieving individuals to lose the desire to do things that they perhaps once enjoyed (especially if these activities trigger painful memories).

After I lost my mother in May of this year, I lost the desire to make music as well as the desire to listen to much of the music that we enjoyed together when she was alive. I can still vividly remember the day she came home when I was in the fourth grade from a parent meeting about the new music program at school. I had been not so patiently waiting for her to return with the news of whether or not I would be getting to play a musical instrument. I could feel her excitement fill the living room as she prepared to give me the news that there would indeed be a musical program and I would be playing a stringed instrument.

For years my mother had been sharing the beauty of classical music with me. She had already taught me so much about different symphony pieces and composers. When I found out that I would be playing the violin or viola (or as they say here in Texas either way, “the fiddle”), I was overjoyed. I pranced around the living room humming Cannon in D by Pachelbel…one of our favorites.

It was then, in the fourth grade, that my love for music further blossomed and my journey as a viola player began. The beginnings of my studies in music lead to many accomplishments in the orchestra world. In high school I was sent to state competitions and continued to play in college. I would often pull out the viola and play holiday music at my mother’s request and play “fiddle music.”

For the past four years, I have been blessed with the opportunity to play with our church’s orchestra monthly as the only violist. As my mother battled for her life against metastasized cancer, I continued to play when I could and would play recordings for her because she could no longer come to my concerts. As she moved closer to fading away from this world I let our music director know that I would no longer be able to play in orchestra until further notice.

When my mother died, the music stopped. I couldn’t bear to look at my viola without remembering that she would never again see me play. It was placed purposefully in a dark corner where I didn’t have to see it every day. I couldn’t bear listening to certain music without remembering that she would never again hum or sing along with me again. Even as I write this, there are tears in my eyes because I know that these are still the painful facts.

After about four months, the music slowly began to return. I was able to slowly listen to different pieces of music that I hadn’t previously been able to without breaking down. I knew logically that my mother would want me to remember our musical history with joy, not pain. One morning, on a day that I knew that orchestra was playing, I woke up and knew it was time. I was called to play again and without any warning to the music director or anyone else I rushed to orchestra practice. Amazingly, my instrument was still tuned and ready to go and the orchestra accepted me back with open arms.

The music returned. I was able to play again and feel good about it. As mentioned earlier, the length of time that it takes to begin to heal from loss is different for everyone. The music returned for me on that day, but this is not to say that the music will not skip or pause again. Even when we believe we have fully “healed” from a loss, the void of the life we have lost is still present, leaving a scar that won’t ever go away. My goal for myself as well as my wish for others is that we all can find that place in life after loss in which we are living the lives that our loved one(s) would have wanted for us…a life with the music turned on.

 

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Grieving in Unity

It may seem odd that I would choose to enter my first blog entry on a significantly upsetting day and on such a difficult topic. I have made this choice based on my experiences with grief these past couple of years.

15 years ago today the United States lost the twin towers to terroristic attacks. There were 2,977 victim fatalities and over 6,000 wounded due to this. This event still impacts many lives every year and always will. On this day, as a nation we are able to unite as we grieve the loss of these lives. I’m sure as you are reading this you may recall exactly where you were and what you were doing when the attacks were taking place.

The date of September 11th has an even deeper meaning for my family and I as it has also been identified as Grandparents day this year and we lost my husband’s father, James “Tootie” Edward Kennedy exactly one year ago today. Tootie was a man that brought joy to our lives. We would spend hours being entertained by discussions with him; therefore, the sting of his loss on such a momentous day is quite challenging.

For me personally, the emotions that color my entire being seem to be more intense as these losses trigger memories of the recent loss of my mother, Margaret Rose Hopp on May 7th of this year; 49 minutes before Mother’s Day. My mother was one of the people I would talk to on a difficult day like today. Her absence has added pieces to what I would call my quilt of life but it is especially on days like today that the stitches that added the patches of her loss are magnified. This brings me to a quote that quite vividly demonstrates how I feel about loss in general: “Your absence has gone through me like thread through the eye of a needle. Everything I do is stitched with its color.” -M. S. Merwin

There have been many ideas and hypotheses on how to deal with grief, the stages that we as humans go through as we grieve, etc. However, my experience has been that when it comes down to it, we will all grieve in our own way in our own time. Just like a deep cut on the arm, we will stitch it together and then heal at our own pace. Healing has a lot to do with how we tend to the wound; how often we cleanse it and nourish it. Even after it has healed to a “manageable” point, we will have a scar. The scar will never feel good when we look at it or touch it. In other words, we will never be the same. Our quilts of life are forever changed by our loss.

We have briefly reviewed grief, but what about the unity part that I mentioned in the title of this post? Obviously, there will be times when grief is complicated and the assistance of a mental health professional is needed. Complicated grief is especially important when the individual who is grieving is lacking a support system. However, as a counselor, I have noticed a pattern when working with people who are grieving in general: people often feel alone in the midst of their pain. People who have a support system may feel abandoned by those who care about them. There is a time immediately after a loss where a grieving individual may wish to be alone but grief is a process and at some point the person most likely will benefit from having support. I noticed this pattern of distancing again when my husband and I both lost parents this past year. People expressed brief condolences immediately after the loss but generally it felt as though people distanced themselves. This is most likely because many people simply don’t know how to “handle” people who are grieving. I think the very fact that we often look at people who are grieving as someone to “handle” may be part of the problem. Instead, if we could practice empathy and simply be with a person as they are grieving and perhaps even grieve with them, in unity, the healing process may be much different for someone.

On this September 11th, I would like to invite everyone as we grieve the loss of thousands of people 15 years ago in unity, to reflect on how we support others around us who are grieving in general. How can we best impact each others’ quilts of life by practicing grief in unity?

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