Re-visiting the trauma stuff

I am about to embark on editing – for a new publication – the paper on trauma that I first drafted a decade ago (can it possibly be that long?), just a year after the head injury which triggered the PTSD.

This is going to be both interesting and challenging.  It might be painful, because I will be re-visiting some of the trauma.  But it will also, I think, be fruitful, because it will give me an opportunity to reflect on how far I have come – and, in God’s grace, it can bear fruit in the lives of others who will read it.

Any praying folk out there:  please pray for me as I try to do this.

What happens in trauma therapy?

It’s interesting to look back on what has helped me to journey through PTSD towards ‘normality’.  I have had 4 therapists, 3 of whom have used a remarkable technique called ‘EMDR’.  The other used ‘Cognitive Behavioural Therapy’.  My major observation is that I made more progress with therapists who paid a great deal of attention to me and to my reactions, and had a range of techniques they could use as tools.  That takes a lot of experience!

‘Cognitive Behaviour Therapy’ helped me to MANAGE the trauma/head injury.  the therapist encouraged me to plan forward carefully for anything I was going to do, to pace myself and to find simple ways of reducing the adrenalin levels when I got over-stimulated.  For example, she introduced me to a very simple breathing exercise that really works:  you breath right out, then breath in and out but deliberately make the ‘out’ breath longer than the ‘in’ breath.  You can make it a bit more effective by counting and increasing the ‘out’ time e.g. in-2-3-4 out-2-3-4-5 in-2-3-4 out-2-3-4-5-6 in-2-3-4 out-2-3-4-5-6-7 etc.

Then, she tried to help me deal with my ‘startle response’ – that is, the way that I jump and ‘freeze’ in response to certain stimuli.  I was to choose something positive and think of that every time a certain stimulus arose.  For example, traffic could make me ‘freeze’ – so she asked me to think of something positive about people driving cars past me.  The problem was that I couldn’t think of anything that I really believed was positive about all those cars.  Eventually, I decided that I would find something to thank God for every day, and deliberately thank Him for it when I met traffic.  It did help me to manage my immediate problems, but I don’t think it dealt with the underlying condition.

I realized that people with PTSD need both to learn to manage their immediate reactions and to deal with the memories that are producing the trauma.  CBT helps with the former but not, I think, with the latter.  It also helps with something else that is very important:  teaching the body to react to stimuli in different ways.

People can help!

So thankful that I could be part of the Wycliffe Hall commissioning day yesterday!  I’m very tired today, and haven’t even tried to go to church or to anything else.  But I have a great sense of achievement, and of being INCLUDED.

I am not only thankful for the therapy that has got me well enough to cope.  I am also thankful to the people who helped me to cope.

My David came too, and was there to stand with me after I got shocked by a boom over the loud speaker system, and to take me home at the end, when the adrenalin ran down and I was so tired I could hardly walk.

Some of the students know that I have problems with noise and crowds, and were very considerate when I needed to get somewhere quiet.

Kerstin, the college receptionist, and Kristina, the principal’s PA, made sure I had a seat at the end of a row (I find it difficult to have people sitting on both sides of me and I need to be able to go somewhere quiet during the hymns) and made sure that I got into that seat.

If anyone reading this knows someone suffering from PTSD:  be assured that your help in thinking about how that person can be included in things will be hugely appreciated.

Trauma can cause isolation

I’m going to church today!  I’m going to try to attend a full church service, in a full church, with hymns and everything!  For years, I have hardly ever even attempted to do that.  I’ve not been able to cope with the music or the crowds.  I’ve stayed away, or arrived late and left early, or gone outside during the music, or sat in the back corner where I felt safe.  Or all of those.  Mostly, I’ve only gone to much smaller and quieter services.

Today, we have the commissioning service for the Wycliffe Hall students who are leaving and going on into Christian ministry.  I am SO much better, and I have determined to go.  I’ve only been to one of these services in the 7 years I’ve been associate staff at Wycliffe, and I stayed outside until after the first hymn, sat near the back, and left after the students had been presented.  Today, I am planning to sit at the front with other staff, to stay for the whole time (I’ll take ear plugs and maybe slip out if there are any really noisy hymns) – I am even going to put on my academic dress!

I stayed awake half the night thinking about it, planning forward to how I might cope with whatever may come . . .  that’s actually helpful . . .  if you go through in your mind what might come, it’s easier to cope.  Even now, I am wondering whether I should back out (it’s raining!) . . .  but I won’t.  I’m going!

We’re all doctors and we’re all patients

Growing up as a doctor’s daughter, I learnt that the world was divided into ‘doctors’ and ‘patients’. There were people who needed help and people who gave help.  The doctor’s job was to be always there for the patients (in those days, a GP was 24/7 ‘on call’, and the family dealt with the phone calls), so he should never get sick himself and, if he did, he was to get out of bed and see his patients as soon as he could stand up.

One thing that this trauma journey has taught me:  we can’t divide the world like that.  Everyone is a patient (needing other peoples’ help) and everyone is a doctor (with something to give others).   It’s one of those things that I knew in my head but that hadn’t really got to the rest of me.  I’d always seen myself as a ‘doctor’.

I’d certainly needed help and sought help and received help.  So what has changed? Maybe it’s that I now realize that being a helper and being a helpee are not two modes of being that happen at different times, but all part of being one person.  ‘Splitting’ roles/persona is a classic traumatic coping mechanism, of course (must write on that sometime), but there’s something deep about understanding my humanity here.

And there is also something about how I feel that other people see me.  Can they see me as BOTH someone who needs support through the trauma journey and might react very strangely in some contexts AND someone with a great deal to offer?  My analogy is the Paralympics – people doing amazing things despite a ‘disability’.  But there is no ‘Paralife’ or ‘Paracademia’.  And things feel so competitive!

I am thankful that there is no division of humanity into the good and the bad, the sick and the doctors, the victims and the oppressors:  we are all, in some ways, all of those, and our amazing Lord sees us as whole people and loves us.  It is not only that He can deal with both strength and weakness, but that His strength is ‘made perfect in weakness’.

Celebrations, wheelchairs and ‘invisible disability’

9 years yesterday since my head injury/trauma triggering, and I’m celebrating getting through a whole journey to Amsterdam and back WITHOUT USING A WHEELCHAIR!  Thank you, Lord!  Schiphol was a struggle, hanging hard onto David all the way, but we made it.

Why have a needed a wheelchair through airports (and through train stations if they are strange and I’m alone)?  The multiple stimuli, crowds, noise, people walking past me, banging of trays at security . . .  make me disorientated, slowed down, and sometimes I get me distressed.

Being in a wheelchair can also be distressing, as I’m right down in the crowd; but I can just let myself ‘blank out’ (maybe that’s what the therapist calls ‘dissociation’ again) and someone else will get me through.  Also, in a wheelchair, I’m not in control, and feeling out of control is one of the big problems with trauma.

On one never-to-be-forgot occasion, returning from my very first attempt at an air trip after the accident, I asked the wheelchair pusher to go slowly and to be careful over the bumps.  He was annoyed and started pushing me faster, so I tried to ask him to go slower, but he went faster still, and I found myself screaming – whereupon he panicked and went faster still.  Thankfully, David was there and managed to run up and stand in front of the chair, so the pusher had to stop.

I was in a state of shock!  It took some courage to go in a wheelchair again.  I got myself a big notice that said, ‘HEAD INJURY!  I need to avoid noise, crowds, bumps, bangs, flashing lights and swerves’.  I learnt that people take notice if something is printed and is big, whereas they don’t take you seriously if you just tell them verbally.  They especially don’t take you seriously if you look normal – if you have an ‘invisible disability’.  I don’t know how many times I’ve been left a long time in a noisy place while people who LOOK disabled were collected before me.

It’s been easier since I got an official looking badge from Headway, the head injury support group.  But I’m very thankful to be well enough now to have got through one trip without a wheelchair.