I offer the two most widely researched and most widely utilized PTSD therapies to date. Not only do research studies say they work, but I've had 11 years of seeing them work. I've seen people smile again and reconnect with others. I've seen people start living again. Read here to learn a little more about Cognitive Processing Therapy (CPT) and Prolonged Exposure Therapy (PE).
Some of the traumatic things you were exposed to probably got better over time, however sometimes there can be events you don't recover from as expected. Instead, you may feel stuck. You may even go on to develop PTSD. Being a combat vet you were trained to be ready for the unexpected. When the unexpected happened, your training kicked in and you did your job to the best of your ability often without even thinking. But what do you do when the unexpected injured you or one of your brothers? Or took their life? There's not really any good place to process this stuff while in combat- it's onto the next mission. While this makes sense to keep you focused, it takes it's toll over time. You stuff it down, and keep going because that is what you have to do.
Yes, you- the one who has trained hard and works tirelessly in a job most could never do. There is no question that you serve your community with everything you can. But where do you go after a tough run or shift? What happens then? First responders have a higher likelihood of developing PTSD. Don’t suffer alone, effective treatments are available. Read here about PTSD, first responders, and how you can take care of yourself so that you can keep helping others.
Today I want you to try to be nice to yourself. Yes, really. We tend to hold ourselves to higher standards than we do everyone else. We also tend to be less forgiving of our own shortcomings, mistakes, and flaws. Have you ever lost sleep over something that already happened? Ruminating on what you could have said and done differently, where you screwed up, and then continuing to beat yourself up creates a lot of anxiety. Not only does this make us more anxious, but it changes how we think about ourselves. If the dialogue inside your mind is critical and negative, this can greatly impact your self-esteem, willingness to take risks, relationships, and overall quality of life.
Our thoughts impact how we feel and behave. Our minds are powerful and can be used to encourage or destroy our confidence and growth. But you know what? Thoughts are just that- thoughts. We create them and we have the power to change them, creating new habits of thinking that are self-enhancing instead of self-defeating.
For today, here are a couple of exercises to consider doing to encourage positive self-talk!
- Write down your top ten accomplishments. These can be big or small, it does not matter. Don't judge them, just write them.
- Review that list. What did it take from you to accomplish these things? Spend some time answering honestly and taking ownership of this.
- What are your favorite physical attributes? Write them down, taking time to appreciate yourself.
- What are your favorite personality traits about yourself? Why?
- Do something nice for yourself daily, without having to earn it.
- The next time you make a mistake, practice love and acceptance as you would if a loved one had made the same mistake. Many of my patients find it helpful to write out this narrative to be able to see it in black and white.
- Start your day out with a genuine compliment to yourself.
- Practice gratitude, see this post for more on that topic.
- When someone compliments you, respond by making eye contact and saying "thank you,” instead of dismissing it.
- Answer the question, "If I loved myself more, I would ____". And take one small step toward that today.
Remember above where I said that we can create new, positive habits? A habit is something we do over and over again, eventually not even having to think about it. Positive self-talk can feel weird at first, especially if you are used to tearing yourself down. It can also take effort and work to practice. However, like anything else, the more you practice the easier it gets and these new habits will be created.
If you find yourself struggling or not feeling yourself, it's natural to try to figure out what is going on. Sometimes these struggles show up after a trauma and you may be questioning if you may have Post-Traumatic Stress Disorder, or PTSD. I talk about PTSD as a disorder, here, but in this post I thought I'd include a brief self-screener as well.
The only way to know for sure if you do have PTSD is to meet with a mental health professional, preferably one with training in diagnostic evaluation and some familiarity with trauma-related problems and disorders. In the meantime, however, there are a few questions you can review on the Primary Care PTSD Checklist for DSM-5, or the PC-PTSD-5 screen. Please remember, the PC-PTSD-5 isn't a tool to diagnose PTSD, however a screen to see if PTSD may be likely.
Sometimes things happen to people that are unusually or especially frightening, horrible, or traumatic. For example:
a serious accident or fire
a physical or sexual assault or abuse
an earthquake or flood
seeing someone be killed or seriously injured
having a loved one die through homicide or suicide
Have you ever experienced this kind of event? YES / NO
If no, screen total = 0. Please stop here.
If yes, please answer the questions below:
In the past month, have you ...
had nightmares about the event(s) or thought about the event(s) when you did not want to? YES / NO
tried hard not to think about the event(s) or went out of your way to avoid situations that reminded you of the event(s)? YES / NO
been constantly on guard, watchful, or easily startled? YES / NO
felt numb or detached from people, activities, or your surroundings? YES / NO
felt guilty or unable to stop blaming yourself or others for the event(s) or any problems the event(s) may have caused? YES / NO
If you answer "yes" to at least three items, you should talk to a mental health care provider to learn more about PTSD and PTSD treatment.
If you did answer "yes" to at least three of the items above, it's recommended that you be evaluated for PTSD. Based upon this assessment, you will then be able to discuss appropriate treatment options for you. If you didn't answer "yes" to at least three items, but you are still struggling with things related to past trauma, keep in mind trauma can affect you in many ways. Depression and anxiety are incredibly common (more common than PTSD) and are disruptive as well. A thorough assessment will help to flesh out where your symptoms fall and determine how you'd best be treated.
Please don't hesitate to reach out to me, here, if you are interested in a free 15-minute consult to see if coming in for further assessment is indicated. You don't have to keep suffering alone, help is available.
I've learned that sometimes some of the best self-care is to protect ourselves by protecting our time, our energy, our schedule, our health, our sanity, is to recognize your own limits and to get ok with saying no. You may just find out you get to say "yes!" to things that are most meaningful to you in your life.
One common concern I'm repeatedly hearing is that folks think treatment will somehow make things worse. PTSD is a disorder that worsens over time, and the more that you avoid dealing with it, the worse it becomes and the longer it lasts. With that said, the symptoms of avoidance can be the very symptoms maintaining your PTSD and preventing you from taking the leap into getting help you need.
A piece on Thrive Therapy, Inc. was shared by Cincy Chic. I share this article on Cincinnati PTSD treatment here.