A Provocation?
From today's NY times:
“I feel that ‘healthy’ infantile omnipotence is the most important asset for dealing with life’s stresses and potential trauma,” Dr. Krystal wrote in a chapter he contributed to “Living With Terror, Working With Trauma: A Clinician’s Handbook,” edited by Danielle Knafo and published in 2004. “It is the emotional mainspring ( Read more... )
“I feel that ‘healthy’ infantile omnipotence is the most important asset for dealing with life’s stresses and potential trauma,” Dr. Krystal wrote in a chapter he contributed to “Living With Terror, Working With Trauma: A Clinician’s Handbook,” edited by Danielle Knafo and published in 2004. “It is the emotional mainspring ( Read more... )
I do think you're absolutely right about the need for some sense of resilience, some visceral inner confidence, in the face of trauma and its lasting impacts. I guess at some level my reaction to the Krystal quote was really, "yes, that's almost certainly right, why do I resist it so much?" (and is that resistance itself part of the process of perpetuating the damage?)
I'm really impressed by your successful resolution of PTSD issues and, though I don't want to pry into areas you may not want to share, I'd be very interested to know what sort of therapeutic approach you found effective. In my one experience with therapy we focused on PTSD as a model of childhood emotional and physical abuse, and I thought the diagnosis was compelling, but my therapist leaned toward the hypnosis/recovered-memory approach to treatment and I just found it difficult to buy into that. I've read a bit of Martin Seligman's learned helplessness/cognitive therapy approach and that seems compelling, but I've never gone further into it in a therapeutic setting.
I did a little follow-up browsing on "My Twentieth Century" and I didn't realize how hopelessly obscure it was, so please forgive me for sounding like some sort of caricature of a film snob :). It's a Hungarian film from the early 90's that got a rave review back in the day by Vincent Canby at the NYT and was available in my video store years ago and just made a big impression on me. It's sort of a mildly erotic and feminist fairy-tale that in part is about how random fortunes and misfortunes determine a person's fate, not just directly, but through the mediation of the way they form or deform a person's ongoing approach to life.
Though I suspect that is a very personal and eccentric interpretation based on my own issues! The film has a couple of "animal story" interludes on the same theme, but really it also reminds me of friends whose wildness and recklessness could easily have gotten them killed (or in jail) in their 20s, but whose sense of invulnerability, maybe reinforced precisely by "getting away" with things, probably helped them evolve into much stronger people in the long run. It feels like I secret I misunderstood or resisted at a time but that might have done me some good if I had been open to it. :)
It's true that mention of the Holocaust always makes people modestly (and decently) disclaim any comparison; I thought of doing the same in my first post, but trauma is trauma, damage is damage, and I really think no one should apologize for drawing lessons and insight from whatever source is available.
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I'd be happy to share that, though of course with the caveat that what works for one person doesn't work for all!
The therapist who initially diagnosed me was a big proponent of EMDR, but I never actually tried it; I think I was too scared. After that I bounced from therapist to therapist for years, doing various styles of talk therapy, some of which helped in certain areas, but didn't budge the core problems. I think I felt at the time that I was "getting better", but what was really happening was that I was getting more adept at organizing my life around PTSD.
It was actually by chance that I happened to start up with a therapist who is trained in Cognitive Processing Therapy. I was drawn to CPT right away because of the clear structure and goals, and the fact that it used a skill I'm good at (writing). I see that the Wikipedia article gives a good overview of the program, so I won't repeat everything there, but the two major factors that made it work for me were these:
- Identifying thoughts and beliefs (not events) as the cause of feelings. We know this-two people can feel differently about the same event because of how they think about it-but CPT provides specific tools for recognizing unrealistic, distorted thoughts and challenging them before they spiral out of control.
- A written account of the trauma is not required for CPT, but the version I did used it, and it worked very well for me. Repeatedly writing and reading aloud increasingly detailed accounts of what happened to me not only provided opportunities to identify where those distorted beliefs came from, but also gradually wore down my horrific feelings about the trauma by sheer exposure and repetition. It was a good day when I realized that I had read a particular account so many times that I was actually bored reading about my own trauma.
Over the past few years awareness of PTSD has grown a lot, but I think what we need now is more awareness of treatments. It's a tough illness to beat, and I still have to work to stay well, but improvement is possible. I will say that it puts arguments over trigger warnings in a very different light for me, knowing that avoidance of triggers is what kept me so sick for so long. Not that I am suggesting people's triggers should be stomped on-grappling with them should surely be done in a professional setting. But sometimes there seems to be an implication that the ill person is going to hide from their triggers forever, and in my experience, that doesn't help and it's no way to live.
it also reminds me of friends whose wildness and recklessness could easily have gotten them killed (or in jail) in their 20s, but whose sense of invulnerability, maybe reinforced precisely by "getting away" with things, probably helped them evolve into much stronger people in the long run.
It's a tricky paradox, isn't it? I think it's normal to have some big swings in your awareness of mortality throughout the course of your life. Young children struggle to understand death, and might go through a phase of being very scared of dying or their parents dying. Then that seems to get put away in the adolescent years and a feeling of invincibility sets in. I'm in my 30s, and this seems to be the age when my peers are starting to notice aging, and to take on the role of the adult, the parent, and realize again that one day we will die. Yet we also have to get up every morning and get the kids off to school, get some work done... People have to cope somehow, and a bit of healthy fantasy, optimistically assuming that death will come sometime in a vague future that's not worth thinking about yet, can prevent fear from taking over. Coping with mortality is something that's worked differently for me because I had PTSD from a young age, so it can be a strange comparison to other people who also have to figure these things out. There are parallels but also stark differences.
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