Some of you House fans might recognize this as the title of the twelfth episode of season 3. I don't think it's really a spoiler just to say that House has a clinic patient who was raped. A lot of the episode consists of philosophical discussion about religion and abortion. I've already talked about my views on abortion here and here. What was more interesting to me from this episode was when the patient (who insisted on House as her doctor) and House talk about the "why?" of the event and the "why?" of the universe: why the Event happened to her, why things happen.
It made me think about my own situation and if I ever came to terms with why it happened-- or if I even cared. I don't know, truthfully. My parents, being some corrupt version of Buddhist, decided it was fate. They said they were told by a monk or a fortuneteller-like person that something bad was going to happen to me (because of something I did in a past life), and that this was it and they were glad it wasn't worse. That went in one ear and out the other; once I stopped living with them, I stopped having to put up with their version of religion. I would rather believe that bad things happen at random or because of my own bad choices than accept that my "past lives" dictate much of what I experience this time around.
After rejecting the "Buddhism" I grew up with, I don't think I ever came up with my own belief system, though. I still don't know if I'm atheistic or agnostic. I don't know if I believe in Fate. After the Event happened, it didn't occur to me to ask about why it happened when I was more worried about how I was going to get through the day or if there was anything worth getting through the day for.
If I hadn't seen this episode of House, maybe I never would have really thought about this at all. It's not a question that really bothers me. It happened. It wasn't the first time, but hopefully it will be the last. Why did all of it happen? *shrug* Therapy says the easier, or better, question to ask is if anything good came out of it. I suppose so. The event my senior year pushed me to get therapy for it and all the other previous events that I never talked about. The gravity and reality of mental illness finally touched my parents' consciousness, penetrated the Great [Asian] Wall of Denial and Disbelief, and they let me see a therapist and take medication. After the event happened, I turned into someone who lived day-by-day, which gave me a better appreciation of the little things in life once I could start to appreciate anything at all. I found purpose. I found an issue I really cared about, and I became an activist for women's rights and an advocate for survivors of sexual and domestic violence. When therapy helped me see that I didn't have to let being raped affect my whole life in order to validate my experience, I decided to become a veterinarian instead of a human-doctor because I finally saw how much animals meant to me, how much they helped me, and how much I wanted to help them. A lot of things happened because of what happened in the early, early hours of March 26, 2008. Some of them were even good. Does this mean the Event happened for a reason? Can I actually answer the question of why it happened to me? *sigh* Even after my rambling, I'm still left where I began. Uncertain about the answer, and unsure I even care.
It was part of the Cognitive Behavioral Therapy program D* and I did at the VA Hospital. The last unit wanted me to make meaning of the trauma. I guess when I was still deeply entrenched in the aftermath, I did spend some particularly bad times asking "why me?" out of bitterness and pain and despair. I didn't expect an answer then, nor do I think an answer would have helped. Come to think of it, maybe it was a rhetorical question for me, just an outlet for pain and self-pity.
I've always had some version of the Just World fallacy in my head, where good people always act good, good things happen to good people, bad things happen to bad people. I still blamed myself then for what happened, even though I wanted to believe that it wasn't my fault. I thought since I wanted to believe it, it must not have been true. It doesn't make sense to actually wonder why something happened when you think it's your fault. Therefore, I must not have really been asking why it happened, and so my question was rhetorical.
Maybe?
I feel like I've rambled myself in circles and not really come up or come out with much. Maybe I just needed to write something because the TV episode numbed me and I wanted myself back. Maybe the numbness explains why I don't actually care about why it happened and why I'm not really emotionally connected to this post. I wanted an epiphany, but either I couldn't find it because Fate says it wasn't meant to be, I couldn't find it because I'm not good enough, or I couldn't find it because it's not there to begin with. Regardless of why, I still don't have an epiphany.
I think the conclusion I've been able to reach is that the concept of Fate confuses me. The alternatives are believing that my actions determine my life or that events happen randomly. If I believe the former, then how do I reconcile that with believing the rapes weren't my fault? Does this mean that I have to believe I have no free will in order to exonerate myself from my trauma?
Also, is it weird that I can write all this yet not really... care? Maybe it's just the numbness. I don't know. It's a little unnerving to have written a whole blog post yet not really feel any emotional involvement at all.
...
So far today I have had edamame for breakfast, watched House, and hugged cats. I think it's time to reboot my day and start over.
Showing posts with label cognitive behavioral therapy. Show all posts
Showing posts with label cognitive behavioral therapy. Show all posts
Friday, August 5, 2011
Sunday, August 22, 2010
PTSD under a directed microscope
I haven't written here for a long time because life has been overwhelming, so much so that the thought of trying to write about everything--or anything!--is too much and I can't sit down and choose one thing and just type. But I am going to try, now, because I think I have learned something.
A little over a month ago, I finally left Hanover. Hanover...Dartmouth...I still do not know what my final thoughts on it are, what is left when I subtract my pain from my joys. I made friends, but I lost friends. I learned to be social, then had my trust in people painfully punished. I do not know if I can trust anyone from that era of my life. But that was not the subject of this post.
What I wanted to talk about was the biggest change I am experiencing now. As part of a study, I am undergoing a couples-based cognitive behavioral therapy program designed for PTSD. I am not sure how much I can go into the details of it, since it is still a study, so instead of the mechanics, I will talk about what I have learned. Namely, I have learned that PTSD is not just a collection of symptoms like nightmares, flashbacks, emotional numbness, and hyperarousal. It is a damaging way of thought and of living life that results from trauma. I have been told, and am still trying to accept, that PTSD is not me. I am not my pain, and my pain is not me. My therapist likes to call PTSD a gremlin that invaded my life, something that can be eradicated that isn't part of myself. That is a stuck point for many people with PTSD, she says-- thinking that your suffering is part of you and so it becomes much more difficult and terrifying to fight it.
Fear. Fear is what PTSD thrives on. I have learned that my particular PTSD gremlin delights in constantly making me worry about the worst thing that could happen at any moment. I am filled with the dread and conviction that I am always in danger, or at the brink of losing what is dearest to me because bad things can and do happen at a moment's notice. Every time D* leaves, I am scared sick that I will never see him again. I live in a state of hyperarousal, jumping at the slightest noise, terrified that my door rattling means someone is going to break in, always watching, always looking.
Fear wants control. I have to be in control of what happens both around me and in me so I can be prepared for when something bad inevitably happens. The way I subconsciously try to control my emotions and prepare myself for the worst that can happen is what was destroying my ability to lead a happy and healthy life. For example, because of the lack of validation that I received from others each time after I was raped, I rely on my pain as evidence that something terrible did in fact happen. I control my displays of distress until I know they are happening for a reason (such as after a stimulus that I consciously recognize as a trigger-- e.g. a mention of rape, seeing someone who looks like him, realizing it's Friday night or the 25th/26th of each month), and then I allow myself to feel distressed and show visible pain. That is the only way I found to believe that what happened to me was legitimately bad. This is another stuck point for PTSD: believing that you have to keep your pain around as proof that something bad really happened.
Lack of control is severely distressing and leads to a spiral of negative thoughts. For example, after one evaluative session, I was feeling tense and a little numb but otherwise okay. I met up with D* and, after a little while, ventured up the courage to ask for a hug. As I was trying to relax, I very suddenly started sobbing. I had no idea that I was about to cry, and the feeling of being startled and totally helpless was terrifying. I could not stop sobbing no matter how hard I tried. Don't get me wrong-- I cry all the time. It wasn't the fact that I was crying that terrified me. It was the fact that I was crying and didn't know why and hadn't found a trigger or reason to allow myself to.
Control becomes an issue in other ways too. Remember what I mentioned earlier about fear? When you put together fear and control, you get fear that you won't be in control of a situation, fear that something bad will happen and you won't be prepared. What that leads to for me is extreme black and white thinking and thinking the worst. This is where my therapist's bumper sticker comes in.
After our first session, I was having trouble calming down and I couldn't stop crying, so D* and I went back to her office (interrupting her lunch :( ) and she spent another hour kindly and patiently explaining the pitfalls of my own mind. Then she gave me a bumper stick that said:
It didn't make sense to me at the time, but I am starting to see its significance now. We have just started the stage of bubble sheets in therapy. What I'm supposed to do is notice a PTSD-fueled thought, write it down, brainstorm alternative thoughts, and evaluate which is the more balanced thought. In short, it is an exercise to literally replace my harmful PTSD thoughts with more balanced, less black-and-white thoughts. As you might be able to imagine, my mind is barely submitting to this, kicking and screaming all the way.
The first time we tried it, the thought we challenged was "If D* leaves, I will be all alone." (This was made all the more poignant by the fact that D* actually had to leave immediately after our therapy session to go to his first day at a new job, and I was crying the whole way through the session because I was thinking about being left all alone right afterwards.) While we were working on this in the session together, I just couldn't come up with any alternatives. My mind simply did not understand that there was any alternative to that thought; it could not conceive of the possibility that there was a more balanced way to think about him leaving. D* and my therapist made a great list of alternatives; for example, "Even though I want to be with D* the most, I am not totally alone when he leaves"; "When D* leaves, I can still reach him by phone"; and "Even if D* leaves, he still cares about me." All my mind could think of was these alternatives are all lies and I don't believe them because I really do think I will be all alone and I will be terrified and despondent and I may never see him again and I just can't do this. To make the rest of the long story short, that day I almost ended up hospitalized. My mind really was not liking this exercise at all.
I tried doing some more bubble sheets with D* again this afternoon. I ended up sobbing hysterically again, but I realized something important: the reason they affect me so is that I am terrified that I could delude myself into thinking that things are better than they are and so I would be caught defenseless and unprepared when it is all revealed that it was a lie. I feel safest believing the worst because that way, I will at least not be caught unprepared (whether The Bad Thing will happen or not is not even up for consideration). The way my therapist puts it, PTSD has given me fear-colored goggles that only see danger everywhere I look. This translates into a desperate need for control and a crippling lack of trust in everyone, even D*. Even though part of me knows he cares about me, I still can't bring myself to fully believe that he does. I don't fully trust that his affections won't stray, or trust that he means what he says. It's an awful barrier between us that he has done nothing to bring on. He is the sweetest, most wonderful boyfriend that I can imagine, who has done everything he can to help me through my PTSD spells and who is sacrificing so much to come with me to therapy even though it means he has to drive down to Boston at least once a week. I am trying to plant in my mind the conviction and determination to go through with this therapy program to beat the PTSD gremlin that is building all kinds of barriers between us.
We're almost halfway through the treatment program. The trauma focus is about to begin, where I will have to challenge my beliefs about blame, trust, and control regarding the rape and the aftermath. I will try to be less intimidated about writing about it and blog more regularly.
A little over a month ago, I finally left Hanover. Hanover...Dartmouth...I still do not know what my final thoughts on it are, what is left when I subtract my pain from my joys. I made friends, but I lost friends. I learned to be social, then had my trust in people painfully punished. I do not know if I can trust anyone from that era of my life. But that was not the subject of this post.
What I wanted to talk about was the biggest change I am experiencing now. As part of a study, I am undergoing a couples-based cognitive behavioral therapy program designed for PTSD. I am not sure how much I can go into the details of it, since it is still a study, so instead of the mechanics, I will talk about what I have learned. Namely, I have learned that PTSD is not just a collection of symptoms like nightmares, flashbacks, emotional numbness, and hyperarousal. It is a damaging way of thought and of living life that results from trauma. I have been told, and am still trying to accept, that PTSD is not me. I am not my pain, and my pain is not me. My therapist likes to call PTSD a gremlin that invaded my life, something that can be eradicated that isn't part of myself. That is a stuck point for many people with PTSD, she says-- thinking that your suffering is part of you and so it becomes much more difficult and terrifying to fight it.
Fear. Fear is what PTSD thrives on. I have learned that my particular PTSD gremlin delights in constantly making me worry about the worst thing that could happen at any moment. I am filled with the dread and conviction that I am always in danger, or at the brink of losing what is dearest to me because bad things can and do happen at a moment's notice. Every time D* leaves, I am scared sick that I will never see him again. I live in a state of hyperarousal, jumping at the slightest noise, terrified that my door rattling means someone is going to break in, always watching, always looking.
Fear wants control. I have to be in control of what happens both around me and in me so I can be prepared for when something bad inevitably happens. The way I subconsciously try to control my emotions and prepare myself for the worst that can happen is what was destroying my ability to lead a happy and healthy life. For example, because of the lack of validation that I received from others each time after I was raped, I rely on my pain as evidence that something terrible did in fact happen. I control my displays of distress until I know they are happening for a reason (such as after a stimulus that I consciously recognize as a trigger-- e.g. a mention of rape, seeing someone who looks like him, realizing it's Friday night or the 25th/26th of each month), and then I allow myself to feel distressed and show visible pain. That is the only way I found to believe that what happened to me was legitimately bad. This is another stuck point for PTSD: believing that you have to keep your pain around as proof that something bad really happened.
Lack of control is severely distressing and leads to a spiral of negative thoughts. For example, after one evaluative session, I was feeling tense and a little numb but otherwise okay. I met up with D* and, after a little while, ventured up the courage to ask for a hug. As I was trying to relax, I very suddenly started sobbing. I had no idea that I was about to cry, and the feeling of being startled and totally helpless was terrifying. I could not stop sobbing no matter how hard I tried. Don't get me wrong-- I cry all the time. It wasn't the fact that I was crying that terrified me. It was the fact that I was crying and didn't know why and hadn't found a trigger or reason to allow myself to.
Control becomes an issue in other ways too. Remember what I mentioned earlier about fear? When you put together fear and control, you get fear that you won't be in control of a situation, fear that something bad will happen and you won't be prepared. What that leads to for me is extreme black and white thinking and thinking the worst. This is where my therapist's bumper sticker comes in.
After our first session, I was having trouble calming down and I couldn't stop crying, so D* and I went back to her office (interrupting her lunch :( ) and she spent another hour kindly and patiently explaining the pitfalls of my own mind. Then she gave me a bumper stick that said:
Don't believe everything you think.
It didn't make sense to me at the time, but I am starting to see its significance now. We have just started the stage of bubble sheets in therapy. What I'm supposed to do is notice a PTSD-fueled thought, write it down, brainstorm alternative thoughts, and evaluate which is the more balanced thought. In short, it is an exercise to literally replace my harmful PTSD thoughts with more balanced, less black-and-white thoughts. As you might be able to imagine, my mind is barely submitting to this, kicking and screaming all the way.
The first time we tried it, the thought we challenged was "If D* leaves, I will be all alone." (This was made all the more poignant by the fact that D* actually had to leave immediately after our therapy session to go to his first day at a new job, and I was crying the whole way through the session because I was thinking about being left all alone right afterwards.) While we were working on this in the session together, I just couldn't come up with any alternatives. My mind simply did not understand that there was any alternative to that thought; it could not conceive of the possibility that there was a more balanced way to think about him leaving. D* and my therapist made a great list of alternatives; for example, "Even though I want to be with D* the most, I am not totally alone when he leaves"; "When D* leaves, I can still reach him by phone"; and "Even if D* leaves, he still cares about me." All my mind could think of was these alternatives are all lies and I don't believe them because I really do think I will be all alone and I will be terrified and despondent and I may never see him again and I just can't do this. To make the rest of the long story short, that day I almost ended up hospitalized. My mind really was not liking this exercise at all.
I tried doing some more bubble sheets with D* again this afternoon. I ended up sobbing hysterically again, but I realized something important: the reason they affect me so is that I am terrified that I could delude myself into thinking that things are better than they are and so I would be caught defenseless and unprepared when it is all revealed that it was a lie. I feel safest believing the worst because that way, I will at least not be caught unprepared (whether The Bad Thing will happen or not is not even up for consideration). The way my therapist puts it, PTSD has given me fear-colored goggles that only see danger everywhere I look. This translates into a desperate need for control and a crippling lack of trust in everyone, even D*. Even though part of me knows he cares about me, I still can't bring myself to fully believe that he does. I don't fully trust that his affections won't stray, or trust that he means what he says. It's an awful barrier between us that he has done nothing to bring on. He is the sweetest, most wonderful boyfriend that I can imagine, who has done everything he can to help me through my PTSD spells and who is sacrificing so much to come with me to therapy even though it means he has to drive down to Boston at least once a week. I am trying to plant in my mind the conviction and determination to go through with this therapy program to beat the PTSD gremlin that is building all kinds of barriers between us.
We're almost halfway through the treatment program. The trauma focus is about to begin, where I will have to challenge my beliefs about blame, trust, and control regarding the rape and the aftermath. I will try to be less intimidated about writing about it and blog more regularly.
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