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Ptsd Quotes

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“A child's (or an adult's) nervous system may detect danger or a threat to life when the child enters a new environment or meets a strange person. Cognitively, there is no reason for them to be frightened. But often, even if they understand this, their bodies betray them. Sometimes this betrayal is private; only they are aware that their hearts are beating fast and contracting with such force that they start to sway. For others, the responses are more overt. They may tremble. Their faces may flush, or perspiration may pour from their hands and forehead. Still others may become pale and dizzy and feel precipitously faint.”

“By processing information from the environment through the senses, the nervous system continually evaluates risk. I have coined the term neuroception to describe how neural circuits distinguish whether situations or people are safe, dangerous, or life-threatening. Because of our heritage as a species, neuroception takes place in primitive parts of the brain, without our conscious awareness.”

“DID is often dragged into the debates about recovered and false memory. For example, it might be alleged that a person recovered memories from a state of dissociation. Such a claim reflects a misunderstanding of dissociation and a confusion with repression (Mollon 1998). If a piece of mental content (e.g. a feeling, a memory, a fantasy, a perception) is in a state of repression, it is not directly available to consciousness. Its existence may be inferred from its displaced and disguised expression. For example, a patient who is angry with the therapist may speak of anger with someone else - a kind of unconscious hinting. Gradually the patient may become more consciously aware of the previously repressed material. By contrast, the feelings, memories and other mental contents ofdissociated parts of the mind may be quite accessible to consciousness in that state of mind. Those contents may not be available, however, when the patient is in a different state of mind, or when another personality is in executive control. It is not that the objectionable mental content is kept in 'the unconscious (a horizontal splitting, implying a hierarchical gradation of consciousness), but rather that consciousness is distributed among the dissociated parts of the mind. Thus, in state of mind A, the patient may speak of a narrative of events of which he or she appears completely unaware when in state of mind B. When asked what she thought about the accounts of abuse that she had presented, in a childlike state of mind, during a previous session, a patient replied that she had no idea whether the memories were true or not because they were not her memories. In this way, what is claimed in one state of mind may be disowned in another stale of mind. There may be a repudiation not only of the content of what has been said, but also of the fact of ever having said it.”

“Somatic Symptoms: People with Complex PTSD often have medical unexplained physical symptoms such as abdominal pains, headaches, joint and muscle pain, stomach problems, and elimination problems. These people are sometimes most unfortunately mislabeled as hypochondriacs or as exaggerating their physical problems. But these problems are real, even though they may not be related to a specific physical diagnosis. Some dissociative parts are stuck in the past experiences that involved pain may intrude such that a person experiences unexplained pain or other physical symptoms. And more generally, chronic stress affects the body in all kinds of ways, just as it does the mind. In fact, the mind and body cannot be separated. Unfortunately, the connection between current physical symptoms and past traumatizing events is not always so clear to either the individual or the physician, at least for a while. At the same time we know that people who have suffered from serious medical, problems. It is therefore very important that you have physical problems checked out, to make sure you do not have a problem from which you need medical help.”

“Reporters go through four stages in a war zone. In the first stage, you’re Superman, invincible. In the second, you’re aware that things are dangerous and you need to be careful. In the third, you conclude that math and probability are working against you. In the fourth, you know you’re going to die because you’ve played the game too long. I was drifting into stage three.”

“Tonight the thoughts were about how to end things, with a heavy emphasis on the how. The process of suicide isn't exactly easy. It takes preparation, scheduling, and a certain level-headedness to kill yourself. A person has to be ready for it. He has to make the necessary plans, take the necessary steps. And, most importantly, he has to not only feel like dying, but also like killing. And the two feelings couldn't be more different.”

“We place such a crushing burden on knights,” I said. “We tell them they’re supposed to be heroes, defenders of the realm, people of superior character. Then we send them into a slaughter and force them to butcher. They experience fear. They exist in constant vigilance, always ready to fight for their lives. It exhausts their body and soul. They watch their friends bleed out and die, and they have no time to grieve. Nobody warns them about this. Nobody sings songs about a young man trying to push his guts back into his stomach, or being so scared that the world turns dark, or being knocked off your horse and drowning in a muddy field in heavy armor while riders stomp on your back.” The two men in front of me were very still. “We do this to them and then we expect them to return to a peaceful life as if nothing happened. Some of them get a taste for the killing and can’t let it go. Some of them learn to distance themselves from their war selves. Others, like Pelegrin, need help and time.”

“Hey, how are you?" they'd say. And I'd answer, "I feel like I'm being eaten from the inside out and I can't tell anyone what's going on because everyone is so grateful to me all the time and I'll feel like I'm ungrateful or something. Or like I'll give away that I don't deserve anyone's gratitude and really they should all hate me for what I've done but everyone loves me for it and it's driving me crazy." Right. Or should I have said that I wanted to die, not in the sense of wanting to throw myself off of that train bridge over there, but more like wanting to be asleep forever because there isn't any making up for killing women or even watching women get killed, or for that matter killing men and shooting them in the back and shooting them more times than necessary to actually kill them and it was like just trying to kill everything you saw sometimes because it felt like there was acid seeping down into your soul and then your soul is gone and knowing from being taught your whole life that there is no making up for what you are doing, your're taught that your whole life, but then even your mother is so happy and proud because you lined up your sight posts and made people crumple and they were not getting up ever and yeah they might have been trying to kill you too, so you say, What are you gonna do?, but really it doesn't matter because by the end you failed at the one good thing you could have done, the one person you promised would live is dead, and you have seen all things die in more manners than you'd like to recall...”

“This book appears at a time when public discussion of the common atrocities of sexual and domestic life has been made possible by the women’s movement, and when public discussion of the common atrocities of political life has been made possible by the movement for human rights. I expect the book to be controversial—first, because it is written from a feminist perspective; second, because it challenges established diagnostic concepts; but third and perhaps most importantly, because it speaks about horrible things, things that no one really wants to hear about.”

“Trying to find the proper care in a civilization where only a small part of the population will ever understand what you are going through is a burden many first responders are saddled with. PTSI, injuries, and politics weigh heavily on the officer, yet we continue to turn a blind eye to them. We have made officers into robotic super heroes that aren’t allowed feelings, intellect, or human error. They have been ostracized by society and stripped of their basic human behaviors. We also have yet to admit there are husbands, wives, children, and parents actively involved in these officers’ lives hoping to help them cope with their trauma. Families who do more than make sure they get enough sleep, a hot meal and fresh uniforms in the closet. The faces of the families are yet to be seen.”

“The power we discover inside ourselves as we survive a life-threatening experience can be utilized equally well outside of crisis, too. I am, in every moment, capable of mustering the strength to survive again—or of tapping that strength in other good, productive, healthy ways.”

“Dissociative parts of the personality are not actually separate identities or personalities in one body, but rather parts of a single individual that are not yet functioning together in a smooth, coordinated, flexible way. P14”

“Imagine this garden; one you’ve planted from seed, cultivated with love. When the seeds break the ground, they seek sunshine, warmth, and nutrients. The seeds have no control over the weather. They are as dependent on it as we are on our minds. You may have control over the location of your garden, the frequency with which you tend to it, and the amount of care you give it, but you can’t control the weather. It may be sunny one day, rainy the next. You prop the vines in the hopes they will flourish once the rain passes. And they may, until the next rain comes. The weather changes, sometimes without warning. Sometimes you can see it coming, much like the triggers a depressed person avoids, and you try to protect the plants before the storm. The intensity of the labor can get frustrating, especially if there is no relief in sight. One day, a tornado or hurricane passes through. Even though you see it on the horizon, you can’t stop it and you may not be able to seek shelter soon enough. The plants are torn from their roots, the garden completely destroyed. You may have thought you could protect it yourself, that the storm wouldn’t be that bad, or you simply didn’t know how or were afraid to ask for help. Your neighbors and family couldn’t help or didn’t know you needed help. The garden is gone. This is the way of depression; if you don’t have it, it’s very difficult to understand this cycle.”

“The next significant incident would change Steven forever: an apartment building fire. Steven and another officer arrived to the sounds of the screams of parents desperately trying to find their children. They ran inside believing there were three children trapped; they scooped them up and ran outside with a feeling of elation and relief. They had saved the children from certain death. The feeling was short lived. A frantic mother approached them, “Where’s my daughter?” Steven and the other officer tried to reenter the building but the fire had become too intense. All they could do was watch in horror as a partial wall of the building collapsed, revealing the child’s location. They could see and hear her, but they couldn’t save her. Her screams were mixed with the screams of her mother. Eventually her screams were silenced and she was no longer visible. Her mother continued to wail in pain, others dropped to their knees and sobbed while the first responders choked back their own tears and finished their jobs, the emotion overwhelming. Every person on the scene was altered that day. A piece of every one of them became part of the ashes.”

“In 2006, there is no army of recovered memory therapists, and Dr McNally’s assumptions about patients with PTSD and those working in this field are troubling. Owing to past debates, those working in the PTSD field are perhaps more knowledgeable than others about malingered, factitious, and iatrogenic variants. Why, then, does Dr McNally attack PTSD as a valid diagnosis, demean those working in the field, and suggest that sufferers are mostly malingered or iatrogenic, while giving little or no consideration is given to such variants of other psychiatric conditions? Perhaps the trauma field has been “so often embroiled in serious controversy” (4, p 816) for the same reason Dr McNally and others have trouble imagining the traumatization of a Vietnam War cook or clerk. One theory suggests that there is a conscious decision on the part of some individuals to deny trauma and its impact. Another suggests that some individuals may use dissociation or repression to block from consciousness what is quite obvious to those who listen to real-life patients." Cameron, C., & Heber, A. (2006). Re: Troubles in Traumatology, and Debunking Myths about Trauma and Memory/Reply: Troubles in Traumatology and Debunking Myths about Trauma and Memory. Canadian journal of psychiatry, 51(6), 402.”

“In his recent guest editorial, Richard McNally voices skepticism about the National Vietnam Veteran’s Readjustment Study (NVVRS) data reporting that over one-half of those who served in the Vietnam War have posttraumatic stress disorder (PTSD) or subclinical PTSD. Dr McNally is particularly skeptical because only 15% of soldiers served in combat units (1). He writes, “the mystery behind the discrepancy in numbers of those with the disease and of those in combat remains unsolved today” (4, p 815). He talks about bizarre facts and implies many, if not most, cases of PTSD are malingered or iatrogenic. Dr McNally ignores the obvious reality that when people are deployed to a war zone, exposure to trauma is not limited to members of combat units (2,3). At the Operational Trauma and Stress Support Centre of the Canadian Forces in Ottawa, we have assessed over 100 Canadian soldiers, many of whom have never been in combat units, who have experienced a range of horrific traumas and threats in places like Rwanda, Somalia, Bosnia, and Afghanistan. We must inform Dr McNally that, in real world practice, even cooks and clerks are affected when faced with death, genocide, ethnic cleansing, bombs, landmines, snipers, and suicide bombers ... One theory suggests that there is a conscious decision on the part of some individuals to deny trauma and its impact. Another suggests that some individuals may use dissociation or repression to block from consciousness what is quite obvious to those who listen to real-life patients." Cameron, C., & Heber, A. (2006). Re: Troubles in Traumatology, and Debunking Myths about Trauma and Memory/Reply: Troubles in Traumatology and Debunking Myths about Trauma and Memory. Canadian journal of psychiatry, 51(6), 402.”

“It has become clear that, as Janet observed one hundred years ago, dissociation lies at the heart of the traumatic stress disorders. Studies of survivors of disasters, terrorist attacks, and combat have demonstrated that people who enter a dissociative state at the time of the traumatic event are among most likely to develop long-lasting PTSD.”

“According to Hoge and colleagues (2007), the key to reducing stigma is to present mental health care as a routine aspect of health care, similar to getting a check up or an X-ray. Soldiers need to understand that stress reactions-difficulty sleeping, reliving incidents in your mind, and emotional detachment-are common and expected after combat... The soldier should be told that wherever they go, they should remember that what they're feeling is "normal and it's nothing to be ashamed of.”

“Memory has ambushed her again, slamming down a wall between her and the present moment. Sometimes it comes in order, like a story, sometimes in flashes, like a series of snapshots. Sometimes it comes in a split second, cutting through the middle of another thought. It grabs her and won't let her pay attention to what is being said around her. Other times it just settles softly down on her like a pillow, cutting off air.”

“Some survivors can be wary of most people, yet blinded by compassion toward fellow survivors or others who suffer — or who pretend to suffer, or exaggerate their sufferings, in order to take advantage of the survivor. Some survivors overidentify with other survivors, not realizing that even if someone was traumatized or suffers in a similar way, it doesn’t necessarily mean that person is honest. Being either overly suspicious or overly trusting can create problems with a partner who is able to judge the sincerity of others more realistically.”

“Someone just broke into your house and they are looking for you…you don’t have a phone to call the police. Do you A. Go toward them w/a weapon of sorts to combat or B. Hide w/weapon of sorts until they find you? I’m going straight toward them because the way my anxiety is set up, nobody puts baby in a corner! Sitting in a closet wouldn’t work for me. I’m shooting everything that moves.”

“Many veterans feel guilty because they lived while others died. Some feel ashamed because they didn’t bring all their men home and wonder what they could have done differently to save them. When they get home they wonder if there’s something wrong with them because they find war repugnant but also thrilling. They hate it and miss it.Many of their self-judgments go to extremes. A comrade died because he stepped on an improvised explosive device and his commander feels unrelenting guilt because he didn’t go down a different street. Insurgents used women and children as shields, and soldiers and Marines feel a totalistic black stain on themselves because of an innocent child’s face, killed in the firefight. The self-condemnation can be crippling. The Moral Injury, New York Times. Feb 17, 2015”

“Instead of showing visibly distinct alternate identities, the typical DID patient presents a polysymptomatic mixture of dissociative and posttraumatic stressdisorder (PTSD) symptoms that are embedded in a matrix of ostensibly non-trauma-related symptoms (e.g., depression, panic attacks, substance abuse,somatoform symptoms, eating-disordered symptoms). The prominence of these latter, highly familiar symptoms often leads clinicians to diagnose only these comorbid conditions. When this happens, the undiagnosed DID patient may undergo a long and frequently unsuccessful treatment for these other conditions. - Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision, p5”

“It is morally impossible to remain neutral in this conflict. The bystander is forced to take sides. It is very tempting to take the side of the perpetrator. All the perpetrator asks is that the bystander do nothing. He appeals to the universal desire to see, hear and speak no evil. The victim, on the contrary, asks the bystander to share the burden of pain. The victim demands action, engagement and remembering... In order to escape accountability for his crimes, the perpetrator does everything in his power to promote forgetting. Secrecy and silence are the perpetrator's first line of defense. If secrecy fails, the perpetrator attacks the credibility of his victim. If he cannot silence her absolutely, he tries to make sure that no one listens. To this end, he marshals an impressive array of arguments, from the most blatant denial to the most sophisticated and elegant rationalization. After every atrocity one can expect to hear the same predictable apologies: it never happened, the victim lies, the victim exaggerates, the victim brought it upon herself; and in any case it is time to forget the past and move on. The more powerful the perpetrator, the greater is his prerogative to name and define reality, and the more completely his arguments prevail.”

“How can you explain the loneliness I felt? While In the darkness by myself. How can you explain the hurt that exists from the trauma that persists. My voice seems lost Or as if aside it is tossed. My breath was taken the moment my reality was shaken My defensive behaviors were created to protect me and became automated In my fight, flight or freeze response my intimacy with others was lost at once. Now more darkness falls upon me for the protective behaviors no longer protect me but keeps me in the darkness by myself.”

“HYPERAROUSAL After a traumatic experience, the human system of self-preservation seems to go onto permanent alert, as if the danger might return at any moment. Physiological arousal continues unabated. In this state of hyerarousal, which is the first cardinal symptom of post-traumatic stress disorder, the traumatized person startles easily, reacts irritably to small provocations, and sleeps poorly. Kardiner propsed that "the nucleus of the [traumatic] neurosis is physioneurosis."8 He believed that many of the symptoms observed in combat veterans of the First World War-startle reactions, hyperalertness, vigilance for the return of danger, nightmares, and psychosomatic complaints-could be understood as resulting from chronic arousal of the autonomic nervous system. He also interpreted the irritability and explosively aggressive behavior of traumatized men as disorganized fragments of a shattered "fight or flight" response to overwhelming danger.”

“Secondary structural dissociation involves one ANP and more than one EP. Examples of secondary structural dissociation are complex PTSD, complex forms of acute stress disorder, complex dissociative amnesia, complex somatoform disorders, some forms of trauma-relayed personality disorders, such as borderline personality disorder, and dissociative disorder not otherwise specified (DDNOS).. Secondary structural dissociation is characterized by divideness of two or more defensive subsystems. For example, there may be different EPs that are devoted to flight, fight or freeze, total submission, and so on. (Van der Hart et al., 2004). Gail, a patient of mine, does not have a personality disorder, but describes herself as a "changed person." She survived a horrific car accident that killed several others, and in which she was the driver. Someone not knowing her history might see her as a relatively normal, somewhat anxious and stiff person (ANP). It would not occur to this observer that only a year before, Gail had been a different person: fun-loving, spontaneous, flexible, and untroubled by frightening nightmares and constant anxiety. Fortunately, Gail has been willing to pay attention to her EPs; she has been able to put the process of integration in motion; and she has been able to heal. p134”