Too Much Dreaming

Some days are just really really tough. Even when things go right if you sleep really really poorly then nothing really works out very well. Last night I had horrible dreams. Sometimes I'm able to forget that I have PTSD and then I'll go to sleep and I wake up a few hours shaking and sweating and unable to actually recognize that I'm in my own bed and everything is safe. It's a really, really weird thing. I have dreams of policemen coming into my bedroom when I'm sleeping and dreams of my mother sitting on me and folding me into the living room floor in front of friends. I have so many dreams of different things that have happened that really seem to stick and even when I think I forgotten them they seem to come to back to life at night. I keep trying different medications to forget that they are there and yet they still just seem to come. Sometimes I'll go a whole week without one and I can actually forget for a moment that I have them and then I go to sleep and they're back.

All you can do is force yourself to wake up and take the several seconds needed to realize where I am and then try to calm down and remember that everything is okay now even if it wasn't okay then. I've had family members say that I shouldn't talk about this becasue what happened in the past is a personal family matter and you don't share these things with other people even if it is on an anonymous blog where most readers do not know who you are. However, I've never found that anything is successfully solved without talking about it and acknowledging the problem. That's one of the things that I watch people do at church in the past where it's just easier to tell people that have problems to ignore them or pray them away instead of listening to what their actual problems are and trying to help them solve them. Sometimes whatever is easier is not what's right and sometimes the only way to deal with something... no matter how messy and awful and painful it is... is to really talk about it, chew on it, take the time to really remember it for what it is and then try to put it behind you. The more you push something down and try to pretend its not there the more it grows and festers and poisons your soul.

I would truly love to forget so much of what is in my head and I am sort of bothered that I seem to forget so many things that are useful and I can't seem to forget the past. My doctor told me once that PTSD is not a person who is unable to forget the past... It is really that the past along with the experience and emotions of that past will not let go of the person in the present. I will admit that no matter how hard I try to forget things some of them just will not go away ... and they may not show up in my everyday mornings, but they will show up in the night when it's dark and quiet and I feel peaceful and relaxed... and then I'm blindsided by them. I sometimes wish they would go away and sometimes I'm scared of what will happen when they do because I wonder what else worse will come out of my mind.

I wonder sometimes if it is easier to have the same few dreams over and over because at least when I wake up I'm now in the habit of trying to shake them off and trying to calm down. It's sometimes throws me for a loop when I see and hear something old but feels 'new' and I wake up and I can't forget and it seems to take an eternity for me to realize that I am in bed and I am okay. I guess that's one reason that I love cats. If you wake up and you're scared and you're shaking, there's always somebody who's going to come over and ask to be petted and will rub against you to let you know that they are there. I feel quite comfortable embracing my 'old cat lady' persona because they do give me so much joy.

I was reading a book yesterday and one of the characters told Hamish Macbeth that he clearly didn't want to find love. Elspeth felt that what he really wanted was only companionship and if he only wanted to be alone and stuck with a dog and cat for his whole life then that was his choice. At that point, Hamish was really offended and stomped off in a huff... As I read that paragraph, I will admit that I am okay with that for the rest of my life. I think I am more than happy to take companionship over any kind of expressive love with someone else just to have my own place... to be able to feel peace and to have a place of my own that is quiet and safe. I know some would see that relationships of companionship are lesser, but on nights when I wake up and I'm shaking and I'm cold and I'm scared and I'm sweaty and I have no idea what to do I realized I'm also grateful for being alone because I don't have to share this with anybody else anymore. My ex and my son sleep and they hear nothing because they are no longer here. For that I am sometimes intensely grateful.

So Many Blessings

I'm a bit worn out and frantic tonight with a head full of thoughts traveling a hundred miles a minute. I will confess I should be doing homework and I can't seem to. I am finding myself just thinking and wishing and trying to think good thoughts about angry people. As I realized today that I am spiraling into a bad place, I thought that I would take a moment to really count out some blessings that I have. I am sure that I will not remember enough- I take many blessings for granted, but I will admit that I am a pretty lucky lady.

I have five amazing cats! They are so happy on the days that I only work half days because we can spend time together. We eat and laugh and run on the treadmill together as they jump on and slide off. It is hard to get lost in your thoughts when you have to watch for cats underfoot on a fast moving belt. My treadmill is starting to wear out which is pretty sad but i have had it a few years and i will admit I do beat them up. :)

I have a great place to live. It's cute and small and just feels comfortable. Brock loves it as well and we spent some of today wandering in the woods looking at the birds and picking up trash from the previous tenants that had blown into woods behind the house. We filled up the trunk of my car with trash- not that much but it's bulky stuff and I'll drop it off on my way to work tomorrow.

My Boo is my joy. It is awesome that he still wants to spend so much time with me. I always imagined a teenager who was aloof and somewhat distant, but that isn't what I have. I have a young man who still loves my hugs, wants kisses on his nose and is willing to talk my ear off on walks about what's in his mind. I know that will probably change someday, but I am enjoying it while it lasts.

I have a well running car, Old but useful, and an ex who loves to fix it when it has problems. I use the car for so much between CPR and pharmacy work and school that I am constantly racking up the miles. But it rarely lets me down. That's awesome considering its 20 years old.

I have fallen in love with the ferrets myself. I never really imagined having such silly pets- they are weasels you know.... but they are awesome. Sometimes they will climb into bed with me and curl up under the covers like cats. They are soft and Strawberry will lie there and lick my chin as I fall asleep. It's neat. yes, they can be a pain but they are teaching me so much and Brock loves them so much I sometimes wonder if his heart would burst with feeling of it. He gives them horsey rides on his back, extra treats and just snuggles and chats with them, giggling when they kiss him. I look at them and smile... I can't help it.

I have a few really amazing friends. They watch over me and put up with my silliness, my PTSD, my fears and anxieties and more foibles that I would like to admit. They keep me smiling when things get tough and love me no matter how weird I get. Those are some of the most amazing blessings of my life. :)

I have the gospel of Jesus Christ in my life. I have my scriptures- both large print and small- that I can use when ever I want. I have opportunities to pray, to ask questions, to love, and to talk with my Heavenly Parents. While everyone should have that opportunity, I am grateful that I do see it as an opportunity and not a must do or requirement. I am grateful for books and chat groups that help bring me closer to him, to other members, to gospel principles, to change, and to revelation.

I am grateful for opportunities to provide service for others, whether its a couple of bucks so that someone can get gas, or a hug, or laughter. I love to give others laughter. I just love to be able to serve other people and dive deep into their humanity and therefore, my own. And I am grateful for those who serve me. Thanks for my awesome home teacher and friend who gave me a blessing last month even though I live so far away. And my awesome visiting teacher who tries to keep up with me even when I am so busy I am running around in circles. She is one of the most amazing people I have ever met. I am very blessed to know some very good people from church and from my community. We may not agree on everything, but for the most part.... we all agree on love and I can't ask for more than that!

I am grateful for my son's service dog. He always sees me and just seems so amazingly happy. He grunts with pleasure and rubs up against me until he is exhausted. If I get behind on walks, he comes back to find me and to motivate me to join the group again even if I have to push myself harder. He wags every time he sees me and will happily climb up and join me on my lap- a tough feat for a huge labrador retriever.... he does it though.

I am extremely grateful for the relationship that I have with my ex. So many people see us chatting and working together with Brock and just seems astonished. I get at least one comment from somebody a month about how they simply couldn't do it- they just couldn't be nice to someone who has hurt them so badly. It's funny but I do not see my relationship with him as that remarkable. We were always such strong friends.... I can't imagine living with just anger directed at someone I need to work with on a daily basis. I think that would kill us all. So instead, we are building a different cell... where Bug is still the nucleus and we work together to create peace and beauty in both of our lives. That both of us could come to this place is a blessing that I do not take for granted.

I am grateful for music. I have so much music that I can surround myself with to bring myself joy or to help sort difficult emotions that I am trying to deal with. I love being able to walk on the tread mill and sing to the music that I am listening to ... to be able to dance to music even though I am a terrible dancer. I enjoy making breakthroughs in both thought and writing through poetry and music. I do not want to imagine life without it. Currently Rob Thomas/ Matchbox 20 and Barenaked Ladies seem to be what keeps pulling me in. I can really accomplish things when I'm listening to them.

I am grateful for food and clean water. So many people are not blessed to have that and to have them pretty accessible to me is a great blessing indeed.

I love my Fitbit. Even when I am struggling, it helps to motivate me to keep moving and to move more. To keep moving, even when I am tired or depressed. Even when I feel lazy. heck, just the idea of it keeps me moving even when I forget to wear it or it dies because I didn't charge it. A good placebo. :)

I love my bed. It was given to me a few months ago and I have been stunned about how well i love it. I have always been a futon girl and couldn't imagine anything better. But the bed I have now with memory foam and other stuff is simply amazing. I tend to sleep quite well as long as my head lets me. And since its a king size there is plenty of room for the cats to share with me. Heck, I can sit and watch a movie with two other people on my bed and three cats and we all have room. It's pretty awesome.

I have warmth, fun and snuggly blankets and decent clothing. I tend to wear out my clothing faster than I should so I am always on the hunt for more- threw out six socks,some garments, 1 pair of PJ pants this week alone due to tears, huge holes, etc... I am really hard on socks... but I think they are my favorite form of clothing.... so I have on a new pair tonight and my feet are definitely ready for bed.

I love books and I have no shortage of them. I have spiritual and religious books, history, self help, children's, literature, mystery, novels, comic books... some of everything. I love reading and can't imagine life without books either. I have a book with me everywhere I go... even if I know that the chances of having time to read are slim. I just feel like my bag is empty until I have a book in it. What a blessing to live in a country where I can get books everywhere. I probably spent too much on books, but I figure there are worse hobbies. ;)

There is so much more, but I am headed to bed. I am grateful to be home early so that I can go to sleep and prepare for the morning... for work and friends and food and love. What are you grateful for? What means the most to you tonight as it gets cold and the sky turns dark...?

My Recent Confusion on Forgetting... :)

I was listening to a testimony in church almost two weeks ago and one phrase from a speaker has been rolling around in my head off and on. I thought it was an interesting perspective on things that we don't like that have happened to us.

“Sometimes events happen because there are reasons for them... and so we should not forget them.”

In the most recent conference talk titled “Look Ahead and Believe” by Elder Edward Dube, he tells a story about a conversation with his mother when he was younger. He was pleased and proud of how much work he had accomplished with his mother that day and wanted her to stop working to look. Her response was “Edward, never look back. Look ahead at what we still have to do.” A beautiful talk to listen too and I liked the thoughts he expressed. When I was listening to this testimony, this story came back to me as an interesting juxtaposition to the phrase that had just been uttered... and yet the more I have thought about it I feel like the phrases, while appearing to be opposites actually compliment each other.

All of us have had experiences that we have struggled with and tried to come to terms with in our lives. The number of people with PSTD around the globe is expanding as just a small example of those who are dealing with extraordinary circumstances and trauma and the challenges that they face from it. If there is anyone on this earth would has lead a challenge and struggle free life... I would like to chat with them because I just I can't fathom that they actually exist. :) So when I have had challenges and confusion and struggled to move forward and deal with the trial at hand, much of the advice that people have given me (and I have been taught through lessons and experience over the years) has been to ponder, pray and recognize that these trials and sorrows are for our good and for personal growth. And so as you move ahead in life, you should always look forward to where you are going and not dwell on the past. From some lessons and from things people have told me, they seem to be able to forget these trials in their present and so it's almost as if they have never happened. I will admit that I do not think that at least right now I am built that way. I try to forget and I try to forget but the bigger the impact it had on me, the less successful I seem to be. So I find myself remembering really bad things and situations that caused pain and remorse... sometimes through my own actions and sometimes for reasons that I can't find a way to blame myself for- I'm pretty good at blaming myself actually.

So when I heard that phrase … to suggest that we should not forget, I was momentarily frozen while my brain tried to process what that really meant. It seemed so different from many things I've heard... Yet as he continued to keep speaking, I found that my brain was no longer there. It was dicing and processing and taking apart every bit of this phrase and the story by Elder Dube and the confusion the thoughts were created. Like a strong tangle to two wires, both true and unbreakable, but impossible to separate. And over time, I think I finally really got it. When I stopped trying to separate the tangles of wire and tried to understand I recognized that in different working both men said the same thing. Events that happen in our lives do happen for reasons- whether through consequences of our own free agency or even because of someone else... or even because we need the trial to teach us, to strengthen us, and to mold our spirit into a more malleable shape for the Lord to refine. And there are reasons that we should never forget them. These experiences have developed the individual that exists today. The biases, perspectives and thoughts of the person exist and have been shaped by these struggles and their existence- to pretend or forget why the person is the way they are is to forget who the individual is. But to stand backwards, looking back in pleasure at what all we have accomplished over time and not focus on what needs to happen in the future is also not correct. Because if we allow ourselves to become stuck in past pain and sorrow, we force ourselves into a very difficult trap. We can no longer try to grow and move forward and are simply stuck.... trapped in a vortex of pain and misery that will seem never ending and will be never ending unless we can find a way forward.

This is why the balance is needed. We need to remember, to understand ourselves and our past, to see how we have become who we are today. Yet we need to be able to let go of the pain and the blame -whether towards others or ourselves- to move forward towards the joy and exaltation that we seek. A challenging balancing act to be sure... For those of you reading, what techniques have you used in your life that have been successful in helping maintain this even path forward? What hasn't worked for you? If you feel stuck and trapped, what things might you be able to do to move forward and release yourself from the painful snare you are in?

Ethical Concerns for Providers when Dealing with Refugee Populations

There is no doubt that mental health professionals and other service providers can help alleviate the effects of trauma, torture and other crimes that are perpetrated against people and communities due to circumstances, religion, war, etc... Throughout this class, I have learned quite a bit about the consequences to both individuals and groups based on trauma/ torture and have even broadened my views of how those terms should be defined. Between therapies that are individualized or set up for groups (such as a family, community or people with the same traumas and problems in common) and interactions that attempt to alleviate suffering through the use of medical training, pharmaceuticals, neurobiological or cognitive therapies, etc... Many groups and professional have been focused on – and continue to try- to help victims and the society as a whole heal, develop techniques for survival and daily care, as well as trying to improve the quality of health and life of those affected. However, there can be challenges as well as ethical problems that the mental health / medical provider can face in these situations.

One challenge can come in the form of using pharmaceuticals to help the patient deal with some of the symptoms that cause difficulty in their lives. While studies do suggest that medication makes a bigger impact on an individual's symptoms, the issue is not that black and white. How the patient and/or their family feels about medical care in general (or mental health medication specifically) has an effect on how the medication is used and therefore, how successful it can be. An individual's culture may also weigh into the decision to use medical treatments/ medicine of any kind. And how the services are provided might also affect the utilization of those services. Language, economics, and other barriers can cause misunderstandings and challenges as well. A perfect example of this problem can be found in the book, “The Spirit Catches You and You Fall Down” written by Anne Fadiman. An amazing and very sad biography.

Another thing that is very important for the provider to acknowledge and understand is that the trauma itself may be what the provider wishes to treat and focus on... but the provider is still treating a person. An individual with different perceptions, biases, experiences and other ways of seeing and moving through the world. And so while trying to treat the troublesome symptoms of the past trauma, it is imperative that the person being treated isn't seen in the narrow sense as a label or a diagnosis. The patient needs to be viewed and looked at in the 'prism' of their views and life... so recommendations and therapies need to be available to the patient in a way that fits their current set of circumstance and needs. I thought of an experience in my life when I had a few sick animals who lived with me and my family in a one room yurt. The vet said that one cat needed to be fed a special food, another cat needed a different special food and the other cats couldn't eat either food. When I mentioned that I lived in one room, I was told to deal with it. I did figure out a solution that worked, but it took a while and I didn't use the resources that had been offered nor have I been back to that clinic. I probably would have felt differently and used the resources offered if the provider had made them seem possible. Just a thought on that topic.... So making sure that the resources used are more helpful than stressful and really address the 'whole person' are needed. That takes more time and energy as well as an understanding of an an attempt to put your own biases, etc... aside. That is a bit difficult to do for most of us. :) Also making sure that the resources are available to use in a way that works for the client makes them more likely to be utilized and more likely to help the patient with lasting change in their lives... which is the goal!

Another important element – which I touched on in the last paragraph is to make sure that a thorough understand of the person and their culture are attained. By understanding what is important to the individual and what they use to not only make decisions but base most of what is important in their life on.... the suggestions and recommendations that are given by the mental health providers are more likely to not only be followed but misunderstandings are more likely to be caught quickly and early in the process. That helps develop the trust relationship between the provider and the patient as well as help the patient to work harder to help themselves because not only does it matter to them as individuals, the provider has shown that it matter to them too. (Aren't we all more likely to accomplish our goals when we have a friendly goal 'buddy'?) So by having decent understanding of the background and viewpoint of the patient, the service providers can make fewer but more meaningful referrals and help keep the patient on task. An example is not suggesting a patient with PTSD have an occasional drink to relax but maybe a cookie or a walk with a friend instead. If the culture sees nightmares and terrors as a curse from God that must be overcome.... then they are much less likely to take the Ambien to sleep nor will their family encourage them to do so. Telling an individual to eat pork or stop smoking for their health when smoking is part of their religious practices or the eating of pork is against their beliefs will either cause total noncompliance or partial uncompliance as the patient will only do it when they feel pressed to do so or have another compelling reason to do so. It is important that the clinician recognizes what his values are and recognize when he is potentially pushing values and cultural norms on the patient and not actual treatment. I know those examples are not mental health related, but I thought they did help me make the point I was attempting to make. :)

Another thing that it is imperative that mental health providers think about when dealing with challenged and refugee populations is to follow the information and tools that have work in the past as evidenced by studies and their own observations and life experience, but to also recognize that the current work that is being done can give good insights into potential therapies simply because if it appears to be currently working, with so few good studies out there.... if every is in agreement to try something new... that has the potential to help victims now as well as future populations. This kind of flexibility to look outside the box but also to be cautious and thoughtful about trying therapies that haven't had a lot of use and study is a challenging but needed trait in these providers. It is also this flexibility that allows the clinician to look at the individual in a well rounded way, and not just the way that they have been taught to see certain symptoms or mental distress.

Lastly, it is important that the clinician recognize and maintain clear boundaries between themselves and their patients so that both parties can work together for improvement and satisfaction. When the boundaries are loosened, both parties may find it very challenging to continue to work together and to work towards progress in the manner that was possible when the division between the two was clearly laid out. Providing services that also allow the individual to have privacy not only from strangers who do not have a legitimate need to know their information, but also family can also help the patient by making things clearer and less likely to be misunderstood through another person's biases and thoughts mixing into the mix. An example could be when the parties involved have a language barrier – a translator from outside the patients inner circle may make a different translation that a family member or a friend who may interpret what the patient is saying or needs based on what they think the patient needs... not quite the same thing. This kind of translation can also compromise a patient's need and right for confidentiality making services more challenging for them to get and undermining the trust needed between the patient and the provider. The provider must also to make sure to care for and recognize problems that may crop up with themselves from working with this population and take care to not allow themselves to become burned out or harmed in the process of helping others... which can cause them to be unable to continue to help or even to cause more trauma to the patient.

To be a provider to such a challenged population comes with both risks and rewards for the clinician and the patients. Understanding the important ethical concerns that should be addressed can help everyone involved do a better job, be safer, and to help people gain more resiliency and a better quality of life through the therapies. What more can we ask for? :)

Fear and Loathing… for “Four Friends”

So after missing a week of class, I arrived last week feeling shaky and tired but, with a drink and tissues in hand and a computer, pen and paper in front of me, I settled down ready for another provocative evening of film and thought. I cannot say that isn't what I got.... ;)

I cannot say that I liked the film “Four Friends” and I dearly wish that I could. At least I wish I could say something definitive about it.... whether I hated it or loved it or something. Instead I feel this mass of emotions that hours later I cannot seem to dispel. I feel twisted up and almost suffocated by the waves of them that flow over my thoughts and are buffeted by the winds of memory, hopes, dreams, and regret. Hours after I arrived home I found myself awake, restless and sweating... feeling the darkness close in as my eyes stared into the nothingness. Every attempt that I made to clear my mind was insufficient and only seemed to throw the distractions into sharper relief... causing even more agitation and restlessness in my heart. So, here I am, trying to empty the swirl of thought vomit in my brain onto the page in the hopes of some relief, some small amount of weariness to be allowed to enter my brain and slow it down enough for the oblivion of sleep to take over and allow the darkness to pull me into the deep. I was vaguely horrified by my reaction and to stay sitting and not to leave... to not walk out of the film and to go home... well, that was a serious amount of work. I am still not sure how I accomplished it.

Within the first few seconds of watching Georgia almost literally waltzed onto the screen, I felt feelings of deep loathing and disgust. She appeared to be a character/ person with traits that I dislike intensely. I felt she had self-confidence bordered on arrogance and an immaturity that frustrated me. I saw her as vain, overly flirtatious, manipulative and even a little benign. And as I watched I was torn between my feelings of dislike and a growing amount of dismay as I started to realize that I didn't like her not only for the 'legitimate' reasons, but I think I also didn't like her because I saw some 'parts' of her that I felt were mirror images of some of the things that I hate in myself. And so, as I sat there loathing her, I realized how much I really loath myself. How I want to be pretty and I'm not. How I want to be liked and to be wanted by the people that really matter to me... and I am not. And how I would love to be able to enjoy things more... and I can't. And I could see her confusion and her hopes and her dreams written all over every aspect of her being... and I could feel my confusion in my youth. I could feel the dreams that I had to be loved and to have a wonderful normal family and to be me... to be cared for as myself even though I am eccentric and I have too much energy and I speak without thinking and I also think a bit too much of myself. I worry about whether I am accomplishing enough and what other people think and all sorts of stuff! So watching Georgia and her behavior was a bit like watching a distorted image of myself and things I wished I was brave to do or feel comfortable doing... and feeling jealous. And feeling angry because I want so much and I can't have it whether I'm good or bad or anything. It's like nothing I do that's right and nice gives me anything positive at all... except the comfort I feel from doing it. And then I feel scared because I think that I am running from life too and I'm not sure that I feel like I want to find it but I don’t want to feel like I've wasted it either. In essence, Georgia is a spitfire... and I am conflicted about them.

Danilo was a very interesting mix of a person and I found myself drawn to him even as I was repulsed by Georgia. I thought I could feel his fear of her and any relationship with her but also his extreme hope and love towards the America that he saw and wanted to exist. He wants a better life than his father has and is frustrated that his father seems so unhappy and doesn't want to better things. As he says, “There is college...” and his father states, “Not for you. In America we work.” His father also says “I'm tired and I have to go to work – that is America.” I heard that line and I can't even express how often I have felt that way. I think I have just thought the ending slightly differently... In my mind, I think “I'm tired and I have to go to work – what else can I do. I'm an adult and I must eat or die.” This is a very different viewpoint than the romantic and fairly extreme viewpoint that Danilo carries in his heart. Danilo is also a bit too honest and speaks his mind and his heart to his detriment. His mouth is both a blessing and a curse as it brings him happiness and a lot of pain. His every word holds so much meaning – when he looked at his father and said ' Dada” … you could hear the hope and joy and 'feel' what that meant to him. That one word became a complex tapestry of images and emotion as we look at his young face.

His friend David was an interesting mix as well. He is overweight and seems to understand life a little more - “between chromosomes and tradition, what else can I do.” He is easy... easy going, easy to lead, easy to love, easy to leave.... easy to forget. And he seems to know this about himself. So he is quick to laugh and think good thoughts of others and worry... sometimes too much... most of the time not much. And Tom.... well, I didn't feel anything much about him at all. I do not feel like until the end of the film he fleshed out much as a character at all. He didn't seem like anything more than a colored shell until he came back from fighting in Vietnam. The funny thing is that I do not feel like he changed that much... but he did in the sense that he seemed more grounded and his character felt more real. I am not sure that I ever really liked him... but I didn't dislike him either. He just seemed like a decent boring guy by the end... isn't that how most of us turn out as adults. :)

And so the movie finally ended. I could still hear the scream of the saddened and distraught mother... who is no longer a mother... and the wife... who is no longer a wife... just a woman. “I don't really know what to do with that word.” Sadly, I am almost in the same situation and I do not know what to do either. I can still feel her loss and her grief and confusion and I can claim those emotions as my own. I hope that someday I will not understand her grief as well as I do now. And I hope I am not offensive if I admit that I never, ever want to watch this movie again. I want to let the images and emotions fade so that I can continue to heal from my past. I want to forget.

Rape, Assault, and the Damage to Individuals and our Society

So, over the last few weeks, we have covered the basic ideas of what trauma and torture are, an understanding of how it affects the individual victims by causing PTSD and other medical problems, and how if affects and changes the actions of family members, friends, and caregivers. So it seems only fitting that this week we look at some of the most common trauma in our society as well as how it changes and impacts our society as well. Some of the most common forms of violence and trauma in American society is physical and sexual assault. Some studies show that the United States has the highest rate of homicide than any other first world nation (approximately 8.3 per 100,000 people) with the exception of the Bahamas and Ecuador. (Isn't that pretty interesting that our country holds itself up as a Superpower and the 'police' of the world, but we as a nation cause just as much harm to each other as we do to other countries... maybe even more. Something to think about when looking at American culture and what we like or want to change about it.) While homicide is at the extreme end of the spectrum of violence, physical assault is much more common place and studies show that a considerable percentage of our population have experienced physical assault at least once in their lives. Adolescents and adults are most likely to be assaulted and both African American and Hispanic populations have higher rates of assault/ homicide over other racial groups.

There are a few subtle and clear paths to see the effects of both physical and sexual assault of the individuals in our society... and therefore, the society as a whole. Studies show that people who have either been victims of crime or family members of the former tend to behave and think differently in a few aspects of their life. Some numbers mentioned in the text express this trend:

1. 36% of family members that have experienced criminal homicide become more careful about their personal safety.

2. 74.7% of people who have had experience with alcohol related vehicular death also admit to taking extra precautions to protect themselves from crime.

3. 11.7% of victims choose to begin carrying a gun

Another number mentioned was that 94% of emergency room visits in 1994 where the patient was seen for violence related injuries, the injuries were attained as part of an assault. In general, women tend to fear being a victim of crime more than men and so they restrict many aspects of their lives and their behavior based on that fear... but most members of our society have some fear of being a victim at some point in their lives and that is a tragic statement in and of itself. Victims of assault (whether physical or sexual) are more likely to develop and have problems with chronic health conditions such as pain, gastrointestinal disorders, headaches as well as other complaints. Other concerns are that these individuals receive more medical care overall, have non normal sexual function, and challenges with somatic symptoms that as twice as frequent as the general population.... as well as bulimia and low body weight. They are less likely to see their health in a favorable light, are more likely to engage in unhealthy behaviors such as smoking and substance abuse and see a future ahead of them that is bleak and devoid of good things. In fact, rape and physical assault victims as associated with the highest levels of PTSD among women when compared with other civilian traumas.

One paradox that I see in our society is that as a rule, the victims of crime are seen as a part of the crime and some blame is attached to them. If a women is raped, it is because of her clothing, her choice to have a drink, her choice of friends, whether she 'fought' hard enough, etc.... I think that we tend to perpetuate this ideal because it helps each of us to 'feel' safer- we don't wear those clothes, etc.... but it is also so embedded into our culture as a way of controlling people – mostly women and minorities- that we don’t even realize that we are doing it. One of the pharmacists that I worked with at one point said that a teenager who was killed was entirely to blame for her own death as she made the choice to go see someone she had only known online and she must have been stupid as well. I was horrified by the statement and nothing I could say to her would change her opinion. However, I think that the textbook worded the thoughts that I was feeling best:

“Predatory assailants, not victims, cause assaults, irrespective of any risk factors the victims might possess.”

“...Studies show that all victim's behaviors are of lesser significance than offender characteristics in determining the outcome of sexual assault...”

It feel pretty conflicting to realize not only how common rape and assault are in our communities, county and the world overall, but to also learn how much these acts cause such long term harm not only to the individuals affected but also to our society as a whole was pretty challenging for me. I hear the terms rape culture and see the way people of both genders react when talking about cases of rape or sexual assault. But to see a brief view of the ripples that these acts are causing across the society I live in is staggering. Even if all assaults both sexual and physical ended today and never happened again in America... it would be generations (if ever) before our society recovered because of the damage caused in the past. I wonder how many of my reactions are involuntary based on my past. I wonder how as people modify their actions and behaviors that we model for the future generations, if we can ever really lose those behaviors.

What are your thoughts?

The Consequences of Holocaust Trauma on Individuals and Future Generations

When I sat down to this week's readings, I felt like the last several weeks had given me a pretty basic background and preparation for this task. In addition to all the information talked about in this class I also had the benefit (I'm not sure that is the right word) of growing up hearing about the persecution and attempted extermination of the early adherents to my religion so I felt like that gave me an additional potential viewpoint. Yet even with all this preparation and my own past difficulties and trials- as well as a decent understand of how challenging the Holocaust was for those who were victims of the Final Solution (by far mostly Jews, but I believe homosexuals, Jehovah's witnesses and other groups were also targeted), I found myself shocked the depth and length of the trauma's effects even by those who had not experienced the worst horrors of the system... even those who experiences almost none of it, but lived with and loved those who had.

A few weeks ago, I made a comment in one of my discussion posts about a young child who I felt was potentially picking up PTSD from helping and living with her afflicted parent. I wrote it because I have been thinking it for a very long time, but I also have kept that thought to myself for the most part because I do not feel I have the qualifications to back up my belief... but I will admit my fear of the parent's reactions is pretty severe. I also wondered if that was generally possible- to get the symptoms and difficulties of a disorder simply by being around someone who has the problem... after all, you can't get AIDS or Alzheimer's with very few exceptions just by spending time with someone. Our readings definitely suggested to me that it is possible and while I may not be right, maybe there are some things that I can look into to maybe not only help, but also to have a greater understanding and sympathy for the suffering of this family.

In general it appears that the effects of surviving Holocaust trauma may be varied due to differences in people, trauma endured, and other life components, it is easily stated that this is a long lasting, multi generational problem that affects a survivor's social, cultural, medical and daily lives... as well as those individuals that live with, love, and entwine their lives with those that have survived. As mentioned in a paper written by Natan Kellermann, until the traumatic events are properly acknowledged and then the steps of the healing process properly followed, the trauma will continue to affect and distort the daily life of the victim and the secondary sufferers. Some symptoms that were mentioned from either direct sources or the family members of those primarily effected by the trauma are as follows: mourning and other emotions such as guilt, anger, anxiety, grief, etc. Also sleep problems including insomnia, nightmares, and other sleep problems and mental challenges dealing with depression, repression of difficult memories or feelings, overactive defense mechanisms causing problems with excessive fear, anxiety, lack of emotive or 'numb' response, etc... (Most of the symptoms of PTSD are present in this population.) Also, behavior that is defensive and not appropriate to the current situation is often found exhibited by victims. Some of these cognitive and behavioral challenges may affect the victim by holding them back from many social activities / events either emotionally or making special events that usually provoke joy to also cause sorrow and anger. These behaviors may vary per person and how the trauma has affected them, but it causes many parts of their daily life and activities to be challenged in a way that other unaffected individuals do not have to deal with. Other long term problems that sufferers may find are easier susceptibility to numerous other mental difficulties as well as stress related medical disorders.

A difficult and challenging problem to deal with... especially as we have had a few massacres performed on other groups since. I was listening to a commentary on a new music CD that was released by a group called 'Split Enz' (I think) a little bit ago and some of the songs on this album as well as past albums discuss the pain of the lead writer who is dealing with genocide of past relatives and his life of having to move and sometimes live a confusing existence as a refugee. One song was a poem by his mother who at the age of five lost many family members to genocide and he mixes his and her thoughts and feelings together in one song. As I was reading this week I thought about that interview and the struggles of people generations after the event as I hadn't really thought that much about it before.

A very difficult topic to be sure... what are your thoughts on this issue? Do you have any personal experience that you are willing to share? What do you think that we can do as a society to not only help victims of all crimes, but also try to help the families, caregivers and friends of those who have these challenges? Please share....

PTSD : The struggle between Homeostasis and Protection

Have I mentioned how much taking the class on “Genocide and Torture” this semester has really been such a blessing? I have known so little about PTSD and other symptoms and consequences of horrific human behavior and I feel like I have learned so much not only about other people, but also about how my body and my brain reacts to things which I have never understood before- at least not very well. I spent some time this week looking at how two specific systems in our body are used to help the body in times of threat and how it returns to its 'normal' state of being. And while doing these readings, it was really interesting to find out how PTSD actually changes the way that these systems function and causes some of the symptoms that cause sufferers of this disorder so many problems.

So the first group we looked at was a part of the nervous system called the sympathetic nervous system. It is actually one of the divisions in the autonomic nervous system. From my past medical days, I would remember what it used to do by reminding myself that the autonomic system controls almost all of our involuntary functions such as cardiac muscle, all smooth muscle in the body and also some of the glands. The sympathetic system is easily remembered (to me anyway) because it is the 'action committee' or it could also be seen as the person who feels sorrow for the hurts of a friend and leaps into action to try and help. “Fight or Flight” is the name of its mission statement per se and so when the body (or the mind) needs or believes it has encountered a threat to the body, the 'committee' leaps into action. Our heart rate gets faster (usually our breathing does too), our body shuts down its 'temporarily' unnecessary organs from normal blood flow to improve circulation to the heart, lungs, brain and muscles and the body also starts to release its reserves of stored energy so that the body has extra strength and zip when needed. There are two key neurotransmitters that are released into the body which help create this response; they are epinephrine and nor-epinephrine. The sympathetic nervous system plays a key role in how individuals can recognize a threat, feel fear and how each person will react and remember responses to future stimulus that I considered threatening.

Another response mechanism that the physical body has is called the Hypothalamic- Pituitary- Adrenal Axis. One of the most amazing things about our bodies is that all physical beings have a need to homeostasis- or keeping everything at a normal level. So when the body reacts to something, the body also has ways to attempt to bring the body back to its normal way of being. These hormones try to restore the body to a proper natural state after the person has experienced stress, fear, etc... So when a person has been under the influence of a 'stressor', the hypothalamus releases a hormone that goes to work on the pituitary gland to release another hormone. That hormone works of the adrenal glands to stimulate another hormone that helps to calm the body and 'turn off' the signals of the high 'stress' hormones and neuro transmitters.

In the average individual, these systems work together really well to help a person deal with a significant threat (or perceived threat) in good ways and then brings the body back to a normal level of function. In someone with PTSD, however, these systems do not always work the way that they were intended. So, the sympathetic system can be turned on over sounds or events that are not currently happening, memories etc... and the body will response as if the threat is clear and present. Other studies had shown that some people with PTSD have challenges with incorporating or being sensitive enough to the hormones that turn the stress response off. So people with these challenges are more likely to be overly stressed often and have more challenges in getting the body calmed down and focused again for their regular tasks and needs. That seems like an extra challenge to be sure!

So, take a few minutes and think.... How does your body react to stress and how well does it call down? If you have PTSD, how do you think your body reacts differently than someone else that does not? What techniques do you use to try and help your body reach a level of calm faster?

PTSD, Torture Specific Syndrome and the Varied Effects of Torture

In some of my readings, this week I was asked to look into the symptoms of psychological torture and how they differ from 'physical' torture. The psychological effects of torture are many, varied and while not as easily 'seen' by the naked eye as physical torture... as just as damaging to the victim's mental, physical and cultural health. However, unlike physical torture, psychological torture is harder to define, prove cause and effect, as well as determine whether it has occurred at all. (Maybe that is why more 'civilized nations' such as the United States will use it more than physical torture.... it gives the leaders plausible deniability. It also appears to give the perpetrators the 'idea' of being humanitarian but also getting the results that they are looking for.) So, whether torture was provided by physical means, psychological... or some of both, all have many of the same effects on the person affected. Isolation, for example, tends to produce changed brain function, disorientation, etc.... and has been described to have some of the same effects as a severe physical beating.

Other symptoms can be insomnia, PTSD and other mental health challenges, emotions such as guilt, pain, grief, anger, as well as problems that can bring back the images and feelings inappropriately. Many victims can feel pain in different areas of their bodies (constant or intermittent), migraines / headaches, troubles eating, social and relationship difficulties as well as severe problems with self identity. Delusions and other psychosis can be caused as well.

Unfortunately, it is also suggested by statistics and interviews that the people around the persona affected end up with many of the same symptoms, challenges and negative world views as the actual victim. So torture is not just the destruction and damage to one human life, but several... a bit like second hand smoke.... invisible but quietly making some internal changes that become difficulties and illnesses over time.

Torture Specific syndrome is usually described by four categories of symptoms:

1. impaired memory and concentration
2. sleep disturbances / nightmares
3. anxiousness, depression, physical symptoms that come without any findable cause, such as stomach complaints, breathing and heart problems,
4. other mental health problems such as depression or anxiety

These symptoms appear very similar to me as almost the same symptoms of post traumatic stress disorder and I suspect that these disorders are treated very similarly if not in the same ways. I'm actually a bit skeptical (and the textbook suggests many others are as well) that they are actually different disorders. It seems like they are just slightly different ways to describe the same problem. I wonder if people would feel more comfortable with one name over another.... like some parents did with the terms Asperger's over autism even though they are parts of the same thing. Not sure. Definitely some challenging reading this week. :)

What do you think? If you have been diagnosed with either disorder... which name 'feels' more comfortable to you? Any thoughts?

PTSD / Post Traumatic Stress Syndrome - The Basics and the Personal

This week I took an in-depth look at post-traumatic stress syndrome... otherwise known as PTSD. My experience with PTSD is both personal and community orientated. Some of my family knows that I have this diagnosis, but for those that do not... I am coming out of the closet ;) I was diagnosed with PTSD three years ago stemming from experiences that occurred before I was eighteen in my parent's household. (I am not trying to be mean about my parents … I frankly think at this point that they did the best they knew how and complaining or blaming doesn't change anything.) I have some friends who also suffer from this disorder and some acquaintances who struggle with it so badly that they really find it difficult to get through the day... every day. One challenge that people with this disorder face every day is that this problem isn't normally visible to the world around them. Unlike someone who is in a wheelchair or has a different physical problem, the world around you doesn't know for the most part that you need certain care, what that care is, etc... So when a situation changes and puts the individual into instinctual action, everyone surrounding you for the most part is unprepared to deal with it and the individual themselves just struggles to hold themselves together and pull their mind and feelings back to the present.

So for those individuals that do not know much about post traumatic stress disorder, let me share some of the basics. PTSD is usually caused by events that happen to a person (or persons) that are out of the ordinary and which someone's 'life or integrity' is at risk, affected, etc... The action can happen to the person or someone can develop this disorder from witnessing something severely challenging. When described in those words it seems (at least to me) like something simple and most simple things are easy to fix. From my own personal experience as well as the experiences that have been shared with me by friends or family, it is not simple at all. Another thing that I have noticed in my experiences is that PTSD is different and is responded to differently by anyone who has it and when I asked about that idea at a conference last year I was told that happens because people's personalities and how they handle and react to things initially are different and also their experiences and how they feel about them are different. Some healthcare professionals also believe that PTSD is more likely to affect 'vulnerable people' such as those with fewer defense mechanisms, fewer safe resources in family and friends, people with low self esteem, etc.... and others believe that getting the disorder could cause the self esteem, defense problems, etc... (Reminds me a little bit of the age old question of which came first... the chicken or the egg.) While most people have heard of PTSD being a consequence for soldiers who have experienced military combat, it is also common for victims of abuse, rape, torture and more. If there is one part of the definition that seems a bit challenging to define, it's 'out of the ordinary world experience'...? Wouldn't that also depend on the individual involved and what was normal for them? A good reason that even defining what causes the disorder can be difficult!

Even though the exact description of the problem isn't precise, the symptoms of PTSD are very easily defined. There are three categories that symptoms can easily be placed in; re-experience, avoidance, and arousal. Here is a basic breakdown of what those categories cover.

1. Re-experience - These symptoms include flashbacks and /or reliving the traumatic event for minutes or much longer. Some people get difficult dreams about the traumatic event(s)

2. Avoidance - Some symptoms include the attempt to try to avoid thinking or talking about the traumatic event, avoiding activities or people that you used to enjoy, feeling hopeless and anxiety about the future, difficulty with memory as well as emotional challenges (such as feeling numb or unable to feel much), and difficulty concentrating as well as maintain close, personal relationships.

3. Arousal - Some symptoms people may feel are increased anxiety, irritability / anger, trouble sleeping, being easily startled, frightened (jumpy), large quantities of guilt or shame, self destructive behavior in an attempt at self medicating or suppressing the problem, and even other mental disorders that can be caused by the heightened emotional and mental challenges

One thing that I spent a lot of time thinking about was the difference between remembering the experience and reliving it. At first, I didn't see much of a difference, but the more I thought about it ... I realized there is a very big difference! One thing that came to mind, I thought about a few people I know and how this disorder affects the way they do things. I thought of a friend who tends to make chaos in every situation she is in and it gives her something to feel good about and also sets her up as a victim if people get angry at her. She also misinterprets facial expressions and if some one gives her a quizzical look, she is enraged and will shun or try to hurt that person for weeks in her anger... yet also separates herself from anyone but family as well at that time. She never sleeps well and has migraines approximately twelve days of the month. One reason I was interested in this subject was that I want to understand how to help people dealing with trauma better than I do so that maybe I can be of help to others as they struggle. Maybe I can learn how to understand myself better and not have so much fear behind the 'smile'. My friend also fears the future and her children are their mother's PTSD? Not sure and that is just speculation on my part. I really wish there was something I could do for her, but I really can't figure anything out.

There are many treatments out there for this condition, but as people are different they are not always as successful as they could be. Doctors used medications as well as counseling and other therapies to try and help patients. I use medication and prayer as well as an anti-depressant and try to avoid situations which can cause me more challenges and panic. For the most part, that really helps me to do the things I need to and want to do comfortably and not have problems... which is a wonderful thing! I know that some brain problems an be helped by therapy to 'change' the wiring of the brain such as in sensory integration disorder (SID), sensory processing disorder (SPD), etc... I wonder if PTSD is more challenging than some disorders such as the ones I just mentioned because PTSD is something that was forced 'onto' the body and not an original part of it......

I would love to hear some of your thoughts... Do any of you have experience in helping people (or yourself) with this problem? What has been successful and helpful for you? If any of my readers feel comfortable sharing, please feel free to continue the conversation and we can learn together. :)

My Thoughts on our Military Entering Syria....

One of the classes that I am currently taking is called Human Rights Violation: Torture, Trauma and its Effects on Society. I took this class because I thought it might be really interesting to really learn about how challenging and how people are affected by this treatment or affected by and/or deal with witnessing it, etc... In my first reading this week, I found that two sentences really stuck out and I found myself reading the paragraph that they were 'embedded' in and ask your thoughts on them.

The first sentence is: “The US Declaration of Independence state that “all men are created with certain inalienable rights” and makes the case that a people can reject the authority of a government that violates those rights....”

The second phrase is: “Thus, a major focus of human rights law is not only to describe rights that are legally protected but also to prohibit actions by governments that violate such rights...”

So I was hoping for your thoughts on them. When I read these two sentences, the thoughts that came to mind were actually on Syria. I was against the Iraq War and going into Afghanistan, but I have shocked a few of my friends when my pacifist non-violent self admits that I feel we should go into Syria and help. I know that my opinion on both equations is the opposite of what statistics showed of public opinion in 2011 and today. Yet when I was reading these two lines, I realized that these are my thoughts on the issue stated more clearly than I knew how to express. In Iraq and Afghanistan, the need for military intervention was not clear and diplomacy and sanctions and other methods probably would

have brought these countries more in line with human rights and would have improved the lives of those living there. As those governments were only breaking these rights mainly legally (according to their laws), I don't feel like we were likely to change them... and it doesn't really appear that we have made any changes except for who is running the country. In many ways I believe we have left these countries worse off and more likely to have severe human rights abuses without recourse. The people of Syria have been trying to get more rights for over two years now and have been fighting their government with everything as they have 'rejected the authority of a government that violates' their rights. We have 'in theory' been trying diplomacy for two years as well without success. The Syrian government has now used a weapon that single-handed killed over a thousand people- many of whom couldn't have really been fighters or a threat to the government – I'm thinking of the children. So if we as a nation believe in the later quote above, should we not attempt more wholeheartedly to stop these prohibited actions...?

I guess I wonder what is our place in human rights and our responsibility.... my responsibility, my community's responsibility, my federal government's... and the world's. Some of these questions seem so easy to answer unless I think about them long enough. So what do you think your responsibility is towards Syria... or even in your own communities?