And what about when the treatment doesn’t work?

A lot is now written about post-traumatic stress, to the extent that most people are familiar with the idea that the deepest wounds of war and violence are to the mind. But that is an idea, a concept. I am not sure how much all the column inches actually add to a genuinely deeper understanding.

Many reading these stories of trauma suffering often just end up with the sense that this is something truly awful that makes them shudder to think about.

Why is it so hard to understand?

It seems so easy to be gentle, respectful and caring of those with physical wounds or injuries. But what about when people see a man or woman screaming at someone in the street for no apparent reason? What if they notice someone being hand-cuffed for picking a fight in public, or if an apparently healthy-looking man or woman is overly rude to them for no obvious reason. Most people, actually nearly all of us, will make a quick judgement to stay away because that person must be crazy or dangerous, or both. This is a natural response because we are, after all, designed to protect ourselves.

But while Joe Public is doing the shunning shuffle, another of the multiple cruelties of post-traumatic stress is that if you are the one who is shouting, being cuffed, or skirted around, it feels as though you too are watching the whole thing, witnessing your own ritual humiliation, in graphic, slow-motion detail. And even as you are watching yourself in this horrendous situation the battle goes on raging inside your head.

You have to keep defending yourself from the enemy.

And so the darkness closes in even more.

As I put in the previous post I come at this having experienced it, studied it, and now through working with people using the various methods that I used to treat myself, and many others I have worked with across the past decade.

I do not have any instant answers, and anyone who claims that they do is not being honest, but a lot of these methods seem to be working, and this success is based just as much on the determination of the individual to recover as on the methods being used.

But what about the moment when that determination has run out, when a state of utter exhaustion has taken over?

The rest of this post is for anyone who has reached the end of the line

I am going to write about the various recovery methods in future posts, one-at-a-time, but for the rest of this post I would like to look at a particular aspect of post-traumatic stress that does not get written about very much—the part where people don’t recover.

There is a bitter moment that is very hard for people to understand who have not been through this. It is when someone who has been fighting post-traumatic stress believes that they are doing better, and that they are through the worst, but suddenly the symptoms seem to flood back.

They catch the fighter off-guard. Energy has crashed through the reserve tank, and there is nothing left but a sense of all-pervading darkness. In that moment suicide seems the only option, the only action that can stop the pain. This is the point when many do make the choice to kill themselves because it really does seem to be the only choice.

The Silent War

There will always be fighters in this internal war who are killed in action. We who remain carry a very particular kind of grief for them, rooted in the sense that the wrong soldiers were lost in the wrong battle, and for all the most wrong of reasons.

Those left in the void where that person was must find a way to understand that, in that moment of utter pain, there is no room for the rational questions about the people they loved, for thoughts about the future, the things that had once been planned and hoped for. In that place it is impossible to connect to any of the things that make life seem so imperatively important and worth living. In that place there is only one thing to be done— end the pain.

If you think you are getting anywhere near close to that point, please be aware that there is a possibility that relapse or returning symptoms are not because the treatment is not working or that there is no hope left. It may be that the post-traumatic stress has morphed into something else.

A New Angle

The mind is so brilliantly creative and it is always looking for ways around a problem. Often it will find a route around the endless pain of post-traumatic stress by simply going missing-in-action. In short, your mind learns to leave the room in moments of stress. It is called Dissociative Disorder, and it has various forms. The more we can understand this range of disorder, the more likely it is that many people who feel like giving up could recover.

If any of this resonates, if the meds, the therapy, and the group you joined worked for a while, but then stopped working, please look at these questions.

As you read each one, do consider them carefully. Rather than grabbing for answers, just let each question sit with you for a bit until you get an answer.

Does it often feel that you are just going through the motions of your day-to-day life?

  1. Do you have the feeling that you are living in a dream, and that nothing really feels real anymore?
  2. Do you sometimes see yourself from a distance, as though you are watching yourself from outside your body?
  3. Do you feel that you can easily separate from your emotions?
  4. Does it seem as if your behaviour is sometimes, or often, out of control?
  5. Do you cut yourself, or physically hurt yourself because you just want to be able to feel something?
  6. Do you feel spacey at times?
  7. Are there times when you do not recognise yourself when you look in the mirror, or that you look like a version of yourself that looks very different from how you are feeling?
  8. Do you ever have conversations with the person that you see in the mirror, and does it feel that they have a separate entity to you?
  9. Are there times when it feels as though parts of your body are disconnected from you, or feel alien to you – for example that your arm or leg actually isn’t yours?
  10. Does it ever feel as though everything around you is moving in high-speed, and you cannot understand what people are saying, or it’s as though everyone is speaking in a language that you do not understand?
  11. Or, does it ever feel as though everything is slowing down to the extent that everything is an uncomfortable form of slow motion, and people seem to be speaking in a language that you do not understand?
  12. Have you lost track of chunks of time, not in a day-dreaming way, but to the extent that you just have no memory of a period of time, whether a few minutes, a few hours, or longer?
  13. Do you ever have the experience of feeling invisible?

If you have answered ‘yes’ to more than two or three of these questions your mind may have shifted from post-traumatic stress to somewhere on the range of dissociative disorders, and there is a very good chance that you can recover. If you have a doctor, psychiatrist, therapist, or any kind of professional support, please ask them about dissociative disorders. If you are on medication it may need to be adjusted. And your mind needs to relearn how to stay put, right where it is, and this takes time with a therapist who is confident about working with dissociative disorder.

The next post will be about some of these methods of re-training the mind but the first of these is exactly the same as the end of previous post.

Please stop reading now, put your hands on your belly. Close your eyes take one slow, steady, smooth, relaxed breath, right down to your belly. Feel your hands move as you breathe in, and as you breathe out, slowly and steadily. And take another breath like this. Take as long as you can with each breath.

And just notice how you feel after a few breaths.

Try this breathing each time you notice your mind flipping off somewhere else.

This is the first step.

More soon.