The question I would like to ask is... can anyone guide me to some literature or studies of the possible long term effects of PTSD (even if you overcome the nightmares etc of the trauma itself). In other words can PTSD permanently alter you even if you "get better".

I was attacked by a pack of dogs 6 years ago and was nearly killed. I developed chronic PTSD which steadily worsened over the next 4 years until I completely withdrew, was no longer able to work (I had absolutely loved my 25 year career) and saw absolutely no future. During this period I went through the gruelling drawn out phase of the criminal matter (in court) regarding the dog attack which finished with the owners admitting guilt and paying a very small fine - the dogs remained alive and, although the owners were more vigilent, the dogs attacked more people. I was on SSRI's, sleeping tablets and for the last two years had seen a psychologist once a week. The civil matter began and the owners claimed from their insurance company so I was "fighting" an insurance company - which I remain unable to do. The psychologist and I eventually agreed I should try hypnotherapy. The hypnotherapy was really effective removing the nightmares and allowing me to think I may be able to get through this. I tried to go back to work (thinking I was now better) but as soon as I left the 'safety' of home I constantly felt the same way you feel for the few seconds after someone gives you big fright - I felt I was in a washing machine and the 'noise' of all this was unmanageable... within days I became incredibly forgetful and just could not concentrate - I also felt I was no longer part of the world. I suppose it was a relapse but without the nightmares. I stopped working after only two months as I was visibly deteriorating. I went onto anti-depressants which have been very good at helping me to feel calmer and to sleep better and I have not gone back to work. Now a year later I cannot manage a stressful situation at all (I deteriorate very quickly), I have a serious problem with my memory (especially short term) and I have no patience.

Start reading in the information sections, you will find everything you need there. What you state is normal for PTSD.... there is no cure, it doesn't just go away.... it is incurable if you did not know that. It is treatable, it is workable to face all your fears and learn strategies, techniques and skills to manage it, but not curable and will always be with you. How much is up to you though....

This is a good question.
If you could wave a magic wand in front of a person, remove the symptoms of PTSD, what kind of person would there be?
Guess who will be thinking about this question for a few days!!!

Hi, Milo...welcome

Your question is one that I've been pondering for a long time. I'm 49 years old, was severely traumatized in infancy and childhood...have been working more or less consciously with my history and its effects since 1982.

My sense is that trauma marks us, somehow, permanently.

So does grace...

I'm at a point in my own journey where I'm discerning what can (still) be moderated, gentled, tamed (?) ... and what is not likely to change ... What do I have to simply accept and live with?

I went through a solid decade of therapy (1982 - 1992) and no longer experience flashbacks or intrusive memories. (Sweet relief!!) What I seem to have the most trouble with are chronic, lifelong symptoms of PTSD like major depression, chronic exhaustion, and hyperalertness. I am presently beginning to resolve a major depression -- the first in the last seven years, and a surprise.

I find, as a long-term survivor, that with PTSD, "Expect nothing and anticipate anything." I am generally settled into my personality, and that includes how I was neurologically marked by trauma in infancy. I'm learning, slowly (!), how to be kind to myself. I find that some of my retraumatization is at my own hands. Sometimes I think that I don't know how to live in a state of relative quiet. My brain seems to have been wired on "red alert." It's no surprise to me, as I spent my first three months of life in a neonatal intensive care unit, circa 1959

I think that anything is possible in the always surprising realm of healing. I tend to think that there is no "cure" for PTSD -- I don't believe that it is a disease in the way that cancer is a disease.

Healing I think of as anything that brings on a state of relative peace, presence, quietude...

I also turned 49 recently and I want to go into perimenopause as aware and prepared as I can.

A pivotal question for me now, 16 years after my long engagement with psychotherapy, is How can I best live with what I must live with?

I hope this makes some sense to you

I want to add one thing to this Milo, so that you and other who do not understand this can do so. Firstly you mentioned hypnotherapy, which is an art in trying to forget traumatic memory. Sorry, no such thing nor will your sub-conscious brain allow it. You said it best, you thought it worked until you walked outside, but the same reaction is still present.

You cannot hide or ignore your trauma, you must face it. I have dealt with people who have been in over 15 years of therapy, all of which achieved nothing to little towards helping them cope with PTSD. Why? Because the entire time they where never fully challenged towards their traumatic experience, instead they where nurtured to look at it, but if it got all too hard the therapist had a legal duty to cease due to being sued for professional negligence.

Very very few physicians will actually push a person to the levels they need be pushed towards their traumatic experience in order to fully deal with and face their greatest fears. Once you do it, you know it, because you WILL go down for months before coming back up. Once you do it though, once you come up, once you work through wanting to kill yourself daily and face the terrible issues that will arise, you come out of a place that nothing will ever be so bad again.

The more you work on your trauma from that point forward, being challenged and pushed the entire time, the better the outcome you will have at near permanently removing the majority of your symptoms for the longevity of your life, providing you change your lifestyle to suit a more stress free life period. If a person goes through this and wants to work in a job that deals with people or the public daily, you may as well know now and accept that you will need to be medicated and you will endure constant symptoms that PTSD presents daily.

You can work with PTSD, you just won't do well with public type positions for a long period. Not one person here who works in such a job has done overtly well from my reading. They have tried, they have given it their best, but PTSD has won every single time. Enough stress, enough buildup, and the sufferer will snap every single time. To work with PTSD you must make choices in your employment to begin with. Such jobs that allow a person to work alone, without deadlines, without public or constant interference.... these are just some of the knowns.

A train driver is often a good job for a PTSD sufferer, where you are alone all day to do a job that comes with giving satisfaction but without public interference or contact with people constantly. Lots of jobs exist, you just have to choose wisely. A taxi driver is not a good choice because of the traffic issues, as an example. Teaching, usually doesn't last long or you will find your attitude will have you pushed out eventually because of the stress your under constantly, and that is with medication, lots of it. Just ask the few here who do it, which only one or two are still doing it due to PTSD just not allowing them to continue.

There are just certain things you will never be able to do again, but they can be substituted with other things to compensate. I have helped people through this time and time again, not one yet has succeeded actually because the job is just too stressful. Every person eventually gives up the stress for a less stressful position or job. This is just acceptance, and regardless how much you want to fight PTSD, it will win every single time due to it very nature and seriousness. No amount of alcohol, drugs, cigarettes or medication can keep it at bay without consequences in a very short term.

I am also a longterm survivor. As both replies indicated, the trick is "managing" our responses to thoughts or situations that place us on edge.

Try to figure out what puts you on edge, if you can't avoid it, then you have to come up with a strategy to minimize it. A good therapist can help you to both figure out what triggers you specifically and help you to develop strategies to work around them.

Once the strategies are in place and become automatic or accessible for you, things will smooth out. It may mean altering your lifestyle, profession, and even the way you do things. There may even be some things that you can't change or avoid but you can survive if medicated. (I can't go to the dentist; it is a complete trigger for me - everything about it. I take sedatives, a mega dose, just to walk in the door - let alone sitting in the chair etc ...)The only way I go to the dentist is drugged up - but I survive. Sometimes, you reach a point, you just can't get over a specific mountain and no matter what you try it doesn't work, I gave up on the dentist trigger and accepted it was too big to manage.

As you continue your journey, post what you are trying and if anyone has experience with your triggers they will offer their strategies. Some may work for you and others not.

#1 BE PATIENT WITH YOURSELF!!!!

It is so easy for us to expect quick results. We so desperately want to return to 'normal'.

Cindy

When I first contacted Anthony, and later Dr Roerich, the question you are asking now, WAS the big question.

I do not know of a guide, or any literature that pertains to your question. I don’t know if anyone has yet to address this issue because PTSD is still considered incurable.
But I can relate my own experience.

Four years ago I found myself asking this question, and I have been asking myself this question since then.
I was 44 at the time. My childhood was terrible, my adult life was dysfunctional. Even at 44, I was a socially and emotionally immature person. I had been diagnosed with PTSD, I fought drug addiction, and my mental state was deteriorating. PTSD was incurable, and there seemed to be no hope. That is how it was.

Then there was this day, which I will never forget. I realized that for the first time my mind was not ruminating out of control, reliving terrible things from the past, or imagining new terrible things. I felt clear and relaxed. I had not had any nightmares in more than a week.
I literally asked myself, “Now what do I do?”
I have no professional education, training or experience in psychology or a related field. All I had to go on was my own intuition based on my experiences as a patient and a recovering drug addict / alcoholic. At that time I had 2 years sobriety.
I did have the benefit of the knowledge and experience of the AA program, and being a patient in 2 residential treatment centers.
In AA, the most important thing I have come away with, is that you MUST live a life of RIGOROUS honesty.
In my opinion, the man who started AA was a genius, and wrote 2 books that are among the most profound writings of our time. Much of the program applies to insane thinking and believe it or not, many of us have this.
Some of these principles could certainly lend themselves to a portion of an after care program for PTSD, if aftercare was needed.

I, like many others, believe the cause of PTSD lies with errant right brain processing and function, coupled with a hemispherical imbalance of right and left hemispheres. I believe this does not have to be permanent, though it certainly will be, if nothing is done to change it.
It is not difficult to accomplish this. It is relatively simple, if a bit awkward at first. I did it by using a stringed music instrument. The instrument I used was a 5 string banjo, but I think almost any stringed instrument would accomplish the same results, as long as a style of playing is used that has a high degree of difficulty.
I am right handed and had played for almost 25 years. I then changed to a left hand instrument, practiced about 40 minutes a day, and within 3 months I stopped experiencing the symptoms associated with PTSD. I HAVE NOT HAD ANY SYMPTOMS OF PTSD SINCE THAT TIME, which was 4 years ago.

This imbalance and the errant right brain, is responsible for producing the symptoms of PTSD. In addition, this imbalance does not lend itself well to the overall process of normal functioning, reasoning and processing. Instead, what tends to happen is a distorted thinking process.

Going back to that time when my mind was first clear, I intuitively knew I was still the product of a lifetime of dysfunction. Likewise, I intuitively sensed this was going to change.
I did not know what I was supposed to do exactly, and it was a little scary. So I decided the best thing was to keep doing what I was doing, go slow, and be watchfull for anything starting to go wrong.
It took approximately a year to grow and develop from the person who was a product of a lifetime of dysfunctional living. That was such a good year, perhaps the best of my life.

A while back, in a treatment center, a counselor gave me a handout, and I read it. It was a list of types of distorted thinking. I read it while he stood there, then I told him, “Yeah, but if I did not have these thoughts, I would not HAVE any thoughts.”
I have come to believe that an unbalanced mind produces a distorted thinking processes. This type of process has long been known about in the field of psychology.
I did not invent this list, but I feel this best articulates my thinking and view of the world when I had PTSD.

*FromThoughts & Feelingsby McKay, Davis, & Fanning. New Harbinger, 1981. These styles of thinking (or cognitive distortions) were gleaned from the work of several authors, including Albert Ellis, Aaron Beck, and David Burns, among others.
1. Filtering: You take the negative details and magnify them, while filtering out all positive aspects of a situation. A single detail may be picked out, and the whole event becomes colored by this detail. When you pull negative things out of context, isolated from all the good experiences around you, you make them larger and more awful than they really are.
2. Polarized Thinking: The hallmark of this distortion is an insistence on dichotomous choices. Things are black or white, good or bad. You tend to perceive everything at the extremes, with very little room for a middle ground. The greatest danger in polarized thinking is its impact on how you judge yourself. For example-You have to be perfect or you're a failure.
3. Overgeneralization: You come to a general conclusion based on a single incident or piece of evidence. If something bad happens once, you expect it to happen over and over again. 'Always' and 'never' are cues that this style of thinking is being utilized. This distortion can lead to a restricted life, as you avoid future failures based on the single incident or event.
4. Mind Reading: Without their saying so, you know what people are feeling and why they act the way they do. In particular, you are able to divine how people are feeling toward you. Mind reading depends on a process called projection. You imagine that people feel the same way you do and react to things the same way you do. Therefore, you don't watch or listen carefully enough to notice that they are actually different. Mind readers jump to conclusions that are true for them, without checking whether they are true for the other person.
5. Catastrophizing: You expect disaster. You notice or hear about a problem and start "what if's." What if that happens to me? What if tragedy strikes? There are no limits to a really fertile catastrophic imagination. An underlying catalyst for this style of thinking is that you do not trust in yourself and your capacity to adapt to change.
6. Personalization: This is the tendency to relate everything around you to yourself. For example, thinking that everything people do or say is some kind of reaction to you. You also compare yourself to others, trying to determine who's smarter, better looking, etc. The underlying assumption is that your worth is in question. You are therefore continually forced to test your value as a person by measuring yourself against others. If you come out better, you get a moment's relief. If you come up short, you feel diminished. The basic thinking error is that you interpret each experience, each conversation, each look as a clue to your worth and value.
7. Control Fallacies: There are two ways you can distort your sense of power and control. If you feel externally controlled, you see yourself as helpless, a victim of fate. The fallacy of internal control has you responsible for the pain and happiness of everyone around you. Feeling externally controlled keeps you stuck. You don't believe you can really affect the basic shape of your life, let alone make any difference in the world. The truth of the matter is that we are constantly making decisions, and that every decision affects our lives. On the other hand, the fallacy of internal control leaves you exhausted as you attempt to fill the needs of everyone around you, and feel responsible in doing so (and guilty when you cannot).
8. Fallacy of Fairness: You feel resentful because you think you know what's fair, but other people won't agree with you. Fairness is so conveniently defined, so temptingly self-serving, that each person gets locked into his or her own point of view. It is tempting to make assumptions about how things would change if people were only fair or really valued you. But the other person hardly ever sees it that way, and you end up causing yourself a lot of pain and an ever-growing resentment.
9. Blaming: You hold other people responsible for your pain, or take the other tack and blame yourself for every problem. Blaming often involves making someone else responsible for choices and decisions that are actually our own responsibility. In blame systems, you deny your right (and responsibility) to assert your needs, say no, or go elsewhere for what you want.
10. Shoulds: You have a list of ironclad rules about how you and other people should act. People who break the rules anger you, and you feel guilty if you violate the rules. The rules are right and indisputable and, as a result, you are often in the position of judging and finding fault (in yourself and in others). Cue words indicating the presence of this distortion are should, ought, and must.
11. Emotional Reasoning: You believe that what you feel must be true-automatically. If you feel stupid or boring, then you must be stupid and boring. If you feel guilty, then you must have done something wrong. The problem with emotional reasoning is that our emotions interact and correlate with our thinking process. Therefore, if you have distorted thoughts and beliefs, your emotions will reflect these distortions.
12. Fallacy of Change: You expect that other people will change to suit you if you just pressure or cajole them enough. You need to change people because your hopes for happiness seem to depend entirely on them. The truth is the only person you can really control or have much hope of changing is yourself. The underlying assumption of this thinking style is that your happiness depends on the actions of others. Your happiness actually depends on the thousands of large and small choices you make in your life.
13. Global Labeling: You generalize one or two qualities (in yourself or others) into a negative global judgment. Global labeling ignores all contrary evidence, creating a view of the world that can be stereotyped and one-dimensional. Labeling yourself can have a negative and insidious impact upon your self-esteem; while labeling others can lead to snap-judgments, relationship problems, and prejudice.
14. Being Right: You feel continually on trial to prove that your opinions and actions are correct. Being wrong is unthinkable and you will go to any length to demonstrate your rightness. Having to be 'right' often makes you hard of hearing. You aren't interested in the possible veracity of a differing opinion, only in defending your own. Being right becomes more important than an honest and caring relationship.
15. Heaven's Reward Fallacy: You expect all your sacrifice and self-denial to pay off, as if there were someone keeping score. You fell bitter when the reward doesn't come as expected. The problem is that while you are always doing the 'right thing,' if your heart really isn't in it, you are physically and emotionally depleting yourself.





I use this list as a guide. I have learned that I can consciously exert some control over my thoughts and actions.
I have not mastered the process of Non-Distorted Thinking by any means, but I am much better than I once was.
It is similar to “living a life of rigorous honesty”. It is more involved than one might think, and in fact, is a process that continues daily. I don’t think you can get to point where you can say, “There, I got it.”
My “aftercare” if you will, has been along the lines of the program of AA, and of addressing the distorted thinking produced by PTSD.
I have expressed these thoughts in private to Anthony and to Dr Roerich in the past, but I don’t think I have addressed this area in any posts I have made.

I believe PTSD is curable, although what I accomplished has not been tried by anyone else, to the best of my knowledge. So right now, until others try it, and a bona fide scientific study is done, I am one person making my own statement.

LRS,

Thanks for sharing this list - I had not come across such a detailed list of "distorted thinking" before now and WOW is it familiar.

Best,
Rachel

You may also want to read Unhelpful Thinking Styles Rachel, if not already.

Thanks, Anthony - I will take a look.