Irritable Hearts: A PTSD Love Story (19 page)

“Yeah, that’s PTSD stuff,” Denise said, shrugging or waving a hand when I came to therapy and recounted these episodes, or how I’d lost all emotional sensation in Paris. She was almost dismissive. But to me, even after almost a year of alternating between being totally numb and an all-feeling uncooked mess (“Yeah, that’s normal,” she said of that, too), every symptom was somehow still a terrible surprise. In the way that Brannan Vines, the Family of a Vet founder, was an old hand at PTSD, Denise also was used to it—having treated sisters who’d been serially molested and sons and daughters who’d been unspeakably abused and even single-episode-trauma-havers, such as car-accident victims. Someday, the tone both Denise and Brannan took suggested, I would be used to PTSD symptoms, and to their oscillating extremes.

In the service of that goal—increasing my threshold, Denise called it—she and I started with the simple but surprisingly big task of trying to get me to inhabit my body. I would lie on the table, and she would prompt me to notice how I felt. What I felt. What body parts I could feel the most and the least, and what felt like it wasn’t connected to me, or didn’t exist at all.

I hated it. I was so afraid of it. And I didn’t really want to know how much of my body I had dissociated from. But as scary as the idea of experiencing all the feelings in my body was, scarier was the prospect of being so disconnected from it that I didn’t have reflexes anymore.

Denise encouraged me to try not being scared of and mad at my body. My guts were misfiring for good reason. My symptoms were not a dysfunction, but an adaptation to some very dysfunctional situations, situations I hadn’t fully processed. Trauma had been perpetrated upon my body, and lived in my body. It was my body that was reacting to trauma. It was my body that was trying to, and going to have to, work through it.

It wasn’t like I hadn’t noticed that I couldn’t count on my mind. Not only could it not intellectualize my symptoms away, it sometimes seemed like the bigger traitor here. It had been through so much learning and socialization and corruption; a mind could tell a dangerously underweight anorexic that he was fat, or a genius that she was an idiot, and it certainly was telling me, when my symptoms or an episode flared, that I was a fucking loser, which eventually led me to think that I was ruined and would suffer like this forever, which could quickly, ultimately lead me to the thought that it would be better if I was dead.

Every time I got on the table, I was prompted to feel. It started with breathing. Increasing my breathing, or doing different kinds of breathing. Lying still to give time and space to any feelings that felt like emerging. Sometimes Denise would put her hand on my chest and press. Sometimes she would cup her hands around my rib cage and apply light pressure, replicating the tension there from the outside so it might feel safe enough to give a little from the inside. Sometimes she would bind me tight in a sheet. But as I had after Haiti Part I, the moment I started relaxing, I started panicking, crying, and pulling back. I didn’t want to do this anymore.

“OK,” Denise would say. “What’s going to happen?”

“I’ll die,” I would say, and saying that would make me cry harder, because I knew it wasn’t true, but there it was: my body’s truth. And I meant it literally. I didn’t have to specify that to Denise. She knew.

“Got it,” she would say.

We progressed to mixing in centering exercises. The more centered and grounded I was—that is, the more in my body, not in denial or dissociation or just in my head, since memory and fantasy and rationalization weren’t concerned with the actual experience of being alive—the more fully I could stay with and enter into any experience. And the more I practiced centering, dropping down into my body, fully experiential, connected to reality and to who I was—the easier it would be to get back when I was thrown off.

“Just because our feet and legs are on the ground does not mean that we are grounded,” Strozzi-Heckler writes in
The Anatomy of Change
. “We establish our contact with ground by allowing our energetic presence to move as a living charge through our legs and feet into the ground.”

In the simplest centering exercises, Denise and I would stand up and face each other, and I would ground the best I could. I concentrated on my feet’s connection to the floor. I dropped my weight into my hips rather than supporting it up top with scrunched shoulders, lowering my center of gravity to where my guts were, focusing on what was in there, what I was really made of. Denise had directed me to store what was important to me an inch or two below my navel. I’d picked my convictions, my friends, my work. My relationship with Nico. Letting my weight and attention gather there, I would breathe deep into my chest and belly. And then Denise would lunge and grab my arm.

She’d told me she was going to do it, of course—she’d asked me if I was ready several times. And she told me why she was doing it: The grab exercise was like life, where you’re going along, fine, and then something happens, and you’re not. The purpose was to help me learn what happened in my body and work back toward normal. But even though I knew Denise’s grab was coming, I flinched and jumped every time.

“Notice the sensations,” she would say, still holding on, the way an episode—or a predator—would. “Feel the uncomfortable sensations. Notice how it shapes you.” When I did, she’d tell me to reclaim my shape. “Get it back,” she would say. Try to feel relaxed
and
grabbed. With my arm extended, her hand gripped around it, I tried to get back to the place from where I’d just been startled. Not to force it, or to trick it, but to acknowledge the agitation, let it be there, and transition into the next phase, back to grounded. “Take your time,” she said as I shifted around her, still not letting me go. “Reclaim your personal space,” she said. “Find your center.”

I felt like I was in kindergarten for aspiring ninjas.

In the remedial class.

We practiced other tools for dealing with episodes—breathing practices, acquainting-myself-with-reality practices, mantras and attempts to let the sensations be. It was crucial that I felt empowered to help myself and that I helped myself not suffer. It would help me feel like I wasn’t a victim of my own system. We had many conversations about compassion, which Denise kept telling me I needed, to accept and not fight against my episodes or make them worse with fear or shame. Trying to steel myself against my crazy, both with physical contractions and emotionally, didn’t help, and just made me more vulnerable. It was like a building that hadn’t been retrofitted. When the earthquake came, it remained rigid, and unable to sway with the shock, it cracked and crumbled to pieces.

“Be nice to your crazy,” Denise said, sometimes adopting my language for it in solidarity, though she didn’t support it. “You don’t have to like it, but you can be welcoming of it.” The somatic principles of using the flow of an obstacle—to go with it, not against it, of welcoming and integrating—weren’t unlike some principles of martial arts. They were the same principles that made up key tenets of Buddhism.

“Hatred never ceases by hatred, but by love alone is healed” goes one of the Buddha’s most central and famous teachings. “This is an ancient and eternal law.”

But I had gone to Catholic school. Self-compassion wasn’t exactly in my skill set. I definitely hadn’t learned self-acceptance from teachers who taught me as a child that if I masturbated, my dead relatives would watch me from heaven as I did it, Aunt Karen and Uncle Timmy gazing upon me in sad, repulsed horror.

So at the age of thirty-one, I was now trying for the first time to be welcoming to natural feelings I couldn’t control. There I would be, sweeping my apartment, standing in the middle of my floor with a broom in my hand, when my system would erupt into turmoil.

Danger
, it would say, all my senses hyperaware.

Dangerdangerdanger. Somebody will attack you. Soon.

Hypervigilance was like having a murderer in your house. It was how you would feel if it was dark outside, and the power was out, and you couldn’t see him—the way your stress responses would spike, readying you as you felt your way along the walls, the sensitivity of your straining ears, the tautness in your muscles. Alertness shooting around inside your skull.

First, I panicked. First, second, third, and fourth, actually. But sometimes, eventually, I remembered to employ my practices.

I started with the simplest breath exercise, three slow in, three slow out. But I couldn’t even get through it. Halfway through the first inhale, futility overwhelmed me, and I was too agitated to even fill up my lungs once, much less for three cycles, and it would not bring a solid feeling back to my middle when I was this far gone.

It’s OK
, I told myself, attempting compassion next.
This is not a dysfunction. It’s an adaptation to dysfunctional situations, and you haven’t fully processed them yet
. But I couldn’t hear it, triggered like that. It sounded meaningless.
These
, my mind countered to its own counsel,
are the sorts of bullshit excuses you make for yourself when in fact You. Are. THE WORST.

There was another grounding exercise, too, called GRACE, in which I was supposed to feel the Ground, Relax, become Aware, Center, and Energize, but I didn’t endeavor to try that, either. By then, my spiral of symptoms and agony and shame was so strong that I was convinced the only way to stop it was to distract it with physical trauma, such as throwing myself into the double-paned window looking out onto my backyard.

There were two reasons not to do this. One was the obvious one, that it’s not the sort of thing one should do. The more important one was that wounding myself was another form of dissociating—sure as my leaving my body, or alcoholism—and dissociating is the opposite of processing. One theory for why dissociating during a traumatic event the way I did in Haiti led to long-term PTSD is that the trauma was never fully experienced in the first place. During trauma, parts of the brain—as Van der Kolk, among others, had determined—become overwhelmed by the sensory information coming in about the event and start to shut down. Unprocessed, the sensory information, which meanwhile continued coming in, remains doomed to revisit itself on a person again and again until it is processed.

Avoiding avoidance in general was an important part of my treatment plan. I did still drink decent amounts and watch a lot of TV. I tried to engage in the latter more than the former, but I had to do
something
sometimes; I could not bear dealing with myself for the full number of waking hours in a day. I was trying my hardest, though, to let full-blown episodes run their course when they emerged.

So it was better on multiple counts to not hurl myself into my window.
Stick with it
, I instructed myself.
Try to weather it. Ride it out.
The only tool that was left was to go get the bottle of Ativan and clutch it for comfort. I very rarely took it. But waiting for the excruciation to subside, I coaxed myself away from self-destruction with the promise of pharmaceutically induced relief.
You will be fine
, I said reassuringly.
You don’t have to hurt yourself. Because if it doesn’t end soon, you can drug your way out.

*   *   *

My therapy experience was not at all the kind of therapy experience my new buddy Chris the marine, who’d e-mailed me after my essay came out, was having.

Despite variance in causes and severities, the symptoms of different PTSD sufferers are similar. There are different types of trauma, different degrees. One terrible event—a mugging, a rape—might leave you with “simple” PTSD. A pattern of traumas—domestic abuse, war—can lead to severe or complex PTSD, trauma upon traumas compounding themselves to make worse trauma. Having one trauma doesn’t always mean you end up with only simple PTSD—it can activate or exacerbate complicating issues such as attachment difficulties or personality disorders—and having simple PTSD doesn’t mean your symptoms necessarily go away faster. Obviously, categorizations of something such as trauma aren’t so strict or easy.

But in general, for everyone on the PTSD continuum, traumatic events are improperly encoded and keep intruding as if they were reality. Having not been filed in the brain as memories, they are not really memories at all, but occur in consciousness just as they did the first time. I knew that my experience couldn’t compare with what Chris had been through in Iraq. Yet he, like every other traumatized person I’d ever encounter, didn’t think getting sympathy for PTSD was a question of severity or credentials. As far as he was concerned, we were both suffering. Certainly he knew that some people thought he didn’t have the right to trauma as a perpetrator of the war (and a heavily armed white male one). But in the moments he’d been terrified, that context was irrelevant. Trauma was something of an equalizer that way; in a moment of pure trauma, a man was a woman was a body afraid for its life.

He wasn’t interested in saying to me “What happened to you is not that big of a deal” any more than a penetration-rape victim would say that to a child who’d only been groped. Any more than Chris would say to an earthquake survivor, “You know what’s really awful? War.” Any more than anyone would say to someone in a war that if they thought regular war was tough, they should try surviving a genocide. Although, then, many genocide survivors would need to be reminded that they were lucky to have been spared the longer-lasting and wider-spread horror of the Holocaust.

This atrocity hierarchy, which one’s nervous system is unfortunately unaware of, is imposed on traumatized people by nontraumatized people, and by themselves (consider the e-mail from the gal who said she’d never experienced anything as extreme as I had—only that her guerrilla-fighter father abused her from the age of two to nineteen). I’ve never heard it brought up from one traumatized person to belittle another. In the world of the traumatized, the line of sympathy is drawn between those who have PTSD and those who do not.