Tuesday, May 15, 2012

Regaining a sense of control: What's been working for me

During the immediate aftermath of my assault when my PTSD symptoms were at their worst, I did not have the slightest clue how to help myself. I didn't know that what I was experiencing was PTSD, much less how to fix it. I did the best I could with what I had, but it wasn't enough.

As I struggled to understand what was going on in my mind and body, I developed whatever coping strategies I could to help alleviate the pain. I now understand that although these coping strategies served a purpose for a while, they eventually failed because they did not address the root of my suffering.

As Jon Allen (1995) notes:
Helplessness is at the core of trauma. If you have PTSD, the sense of helplessness and lack of control does not end when the traumatizing situation is over. Having withstood the assault from without, you may later feel assaulted from within - by physiological arousal or by intrusive memories, flashbacks, and nightmares. Even your attempts to block such assaults by numbing and detachment can take on a life of their own, adding to the feeling of being out of control. Control is the antidote to helplessness. Control over the initial trauma was not possible. But some control over the subsequent effects of trauma is possible. (p. 267)
A focus on reestablishing a sense of control in my life was absent throughout the immediate aftermath of my assault. In fact, it was non-existent from the get-go. Three days following my assault, I was misled into being admitted into the psychiatric ward under the pretense of "sleeping in the hospital for a few days." During my medical leave of absence from college, I was further stripped of my sense of control at the hands of my parents. Being in a vulnerable state, I accepted their treatment as evidence that I was indeed helpless. Prior to my assault, such parental involvement in my life would have elicited immediate and automatic adolescent defiance; however, after my assault, whenever I demonstrated any opposition to my parents (or anyone, really), I always felt engulfed by guilt, shame, and self-loathing. Not a great recipe for reclaiming my life and autonomy.

In the following quotation from Coping With Trauma, A Guide to Self-Understanding, Jon Allen (1995) provides a simple overview of the important role control plays in healing from trauma:
Coping with the internal aftermath of trauma entails self-control. The term self-control, however, may have negative connotations. The admonition "Control yourself!" may add insult to injury. Self-regulation, a term used in much of the psychological literature, is more neutral. Regulation implies being ordered, within limits, and predictable. The ultimate goal is not to squelch yourself but rather to experience an enhanced sense of self-awareness, self-mastery, volition, and freedom of choice (p. 267-268).
A few months ago during my most intense recent flare-up of PTSD symptoms (i.e., when I decided to revisit my past to lessen its grip on my life once and for all), I was at a loss for how to reinstate control in my life. The negative inner dialogue and emotional turmoil did everything it could to counteract my desire to actively deal with the trauma of my past. However, slowly but surely, I have been reestablishing a sense of control in my life, and I am happy to report, I am finally seeing the benefits play out in my life! Although I am still battling triggers and other intrusive PTSD symptoms on a regular basis, my outlook on healing and my sense of self is improving each day. In other words, I am slowly regaining control of my life!

I still have a lot of work to do, but I thought I would go ahead and share my top three coping strategies that have been most helpful in reestablishing a sense of control.
  • "I am making the decision to..." Reciting this very simple phrase either aloud or in my mind has been crucial in helping me overcome "PTSD paralysis" (i.e., avoidance) and rebuild an inner locus of control. When addressing emotionally intense issues in my life, I often find myself glued to the couch and "spaced out," weighted down by anxiety and depression which prevents me from accomplishing anything productive. In this "woe-is-me" state of mind, I feel like I am the product of external circumstances and that I have no control over my life. It's almost like I'm sitting and waiting for something to happen. 
I began using this phrase as a way to reclaim control over these situations. For example, if I was going to be glued to the couch, I wanted to make it clear to myself that I was making the decision to be glued to the couch - not anxiety, not depression, not anything or anyone else. Likewise, if I was going to tackle my to-do list, I wanted to make it clear to myself that I was making a decision to tackle my to-do list. Although I use this phrase even when I make lesser-than-ideal choices (e.g., spacing out on the couch), I have found that overall my choices have improved and I tend to maintain a greater sense of control in my daily life. 
Even during the most mundane tasks (e.g., deciding between a healthy or unhealthy snack), this phrase has been helpful. When I make a good decision, saying this phrase beforehand makes me feel like an active participant in my good choices. This notion is important because I often feel like I am active in making bad decisions but that I just fall into the good decisions passively. I want to own all of my choices, not just the good ones! 
  • Exercise and Healthy Life Choices Making a genuine effort to exercise and focus on maintaining a healthier lifestyle has been invaluable in helping me regain a sense of control in my life. The more I practice healthy living, the more I want to continue to practice healthy living. Treating my body and mind with respect helps reinforce the notion that I deserve respect. I have found that cardiovascular exercise has helped tremendously with anxiety reduction, and resistance training has helped me feel stronger on the inside and outside. Making conscious decisions about my health makes me feel more in control of my body. Having exercised and made healthy eating choices gives me something tangible and positive upon which to reflect at the end of my day.
  • Breathing Very, very simple. When my therapist first shared this coping strategy with me, I must admit, it sounded a little hokie. Despite my initial skepticism, I began practicing deep and conscious breathing, particularly in times of high anxiety, and I have found that this practice is extremely beneficial in preventing the escalation of my anxiety. I have begun to couple deep breathing with thoughts of self-compassion as a way to help alleviate the painful emotions and self-criticism that accompany triggers. I am still experimenting with this strategy, but so far, it seems to be helpful as well.
What strategies do you use?
Which ones have been the most helpful in helping you regain a sense of control in your life?


References
Allen, J. (1995). Coping With Trauma, A Guide to Self-Understanding. Washington, DC: American Psychiatric Press, Inc.

4 comments:

  1. Dear one you have listed some healthy tips to help you through this ordeal. Even though I do not suffer with PTSD, these grounding tools you mentioned seem very beneficial. I am so glad that you are determined. You have a lot of fight in you! Blessings and hugs.

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  2. breathing has definitely worked best for me. helps me stay grounded and present

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    1. Same - it took a little while for me to understand what my therapist was getting at, but now it is a very helpful practice, and I practice conscious breathing daily. Thanks so much for reading and providing feedback, Iris. Hope you had a nice weekend. xx

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