Treating PTSD: How Do You Talk To Yourself?
Friday, July 24th, 2009 • Uncategorized •
In order to heal we have to create the right environment for healing to occur. This means our minds must be filled with our belief in the healing process and our ability to navigate it.
One of the major negative influences we have on ourselves is our internal dialogue. In order to be aware of the mental environment you’re creating – and how that may be negatively impacting your healing -
It’s incredibly necessary to listen to how you talk to yourself.
What sounds are you using in your mind? Are they harsh or comforting? High or low? Loud or soft? What’s the tone of the voice?
80% of the meaning we find in language comes from the tone in which it’s spoken. Are you speaking in a way that makes you feel unhappy? Are you saying things that are unkind and demeaning?
If the answer is Yes! it’s time to make some changes!
Here’s the fact: You are responsible for the environment in your head. No one helping you heal can do anything about that space but you. And no one can help you heal if that space is poisoned by the way you speak to yourself and the things you allow yourself to continually say.
It’s up to you to create the internal environment in which you live. It’s up to you to make your self-talk champion and cheerlead not accuse, denigrate or destroy your sense of self, worth and possibility. The environment you create informs everything you feel and do.
Take a second. Be quiet. Close your eyes and think, “I want to heal my PTSD.”
And then listen to the chatter that ensues.
What are you saying? How do you treat yourself? Do you offer support, faith, hope and belief? Or do you speak to yourself in a slew of negatives that further stress out your already stressed PTSD mind?
My mother used to always tell me, “Michele, your mind knows only what you tell it. Stop telling it bad things.”
And I would snarl something about my mind having a mind of its own and what did she know about it anyway?
But the truth is she knew a lot. Thoughts only spring to mind because we create them and allow them to live and breathe.
As Richard Bandler says, “All the things that come into our minds are there because we can, NOT because we have to.”
Neurologically speaking all thoughts – the good, the bad and the ugly - occur by the same voluntary processes. Fortunately, this means you have the ultimate control. Unfortunately this means you have to stand up and take that control and make it work for you.
No emotion exists without a preceding thought. Thoughts arise from the environment you create in your mind. It’s a simple equation. Memorize it. Act on it. Get on with the business of healing.
BRIDGE THE GAP EXERCISE
Remember the earlier BTG exercises when you made lists after listening to your internal dialogue? Time to take them out again. Today, go over each statement you wrote down and rewrite it in the positive. As you go through the next few days monitor your thoughts; each time you hear negative self-talk revise the statement in the positive. For example, “Healing won’t happen for me,” becomes, “Healing is happening for me.”
Changing your state of mind means changing how you build that state. Vocabulary is key!
(Photo: Atantys)
Tags: Changing Unhealthy Perceptions, mind, neurologically, ptsd, self-talk
Just a thought on this!
When you first start doing this kind of thing it’s quite easy to beat yourself up over having all these ‘bad’ thoughts and of course that makes matters worse.
Instead it’s the case that thoughts often appear for no apparent reason (it might become apparent one day).
So what you can do is consider it to be a garden – you pull up and discourage the weeds and encourage the flowers.
So if you think “I’ll never heal” you don’t have to go chasing it. If you think “today was tough but I did OK” you can add to it “and this shows that I’m making steady progress”.
I just wrote that same / similar analagy the other day in my blog, Mike.
“I have to find away to turn my hyper-vigilance inside myself. I need to use it to root out the weeds / thoughts when they’re tiny instead of letting them grow big and strong. I need to finish my landscaping project, and free myself from the weeds in my mind.”
Nice addition, Mike. Thanks.
You’ve been reading too much cognitive therapy ideology. ;o)
You say, “No emotion exists without a preceding thought.” Not quite true. Conditioned Emotional Responses can be triggered directly by the environment, our thoughts or other related emotions. CERs are the core symptom of PTSD. We remember intense emotional experiences with both an emotional memory and a thinking memory. A preverbal child can only remember with the emotional memory. To overcome PTSD, we have to change our thinking memory and our thoughts about them, but we also have to change our emotional memories. Emotional memories are the most difficult to change, especially if they are from our childhood say before about 8 years old.
“Thoughts arise from the environment you create in your mind.” Thoughts too can be triggered by the environment, another thought, an emotion or a combination.
Thoughts and feelings can come to us without our choice. What we always have control over is how we think about our thoughts and feelings. We can always replace a thought with another. And we can reassure and nurture ourselves through our emotions.
Read more here: http://www.dare-to-dream.us/archives/2009/06/positive_thoughts_make_things_worse_for_poor_selfe.php
and here: http://www.dare-to-dream.us/archives/2008/09/is_there_a_place_for_emotion_in_cognitive_theory.php
I love your blog and all the energy you have to do it all!
Amen to all you have said. I feel that the cognitive approach is repressive and makes me feel further oppressed. PTSD is a form of learned helplessness blocking our ability to express our needs associated with trauma or deprivation. Love and grieving and even rejoicing can help to make these needs conscious and help us to overcome our helplessness concerning them. Rejoice with those who rejoice and grieve with those who grieve, this is good advice and it also helps to do the same thing for yourself. The choice comes in when we decide to open to love and to try to give love, and to respond in more and more emotionally honest ways to what happened to us. Again, well said.
@ Dave — Couldn’t one argue that even CERs have a preceding thought, one that flashes by so quickly we’re not aware of it? An environmental trigger stimulates a emotional memory (not necessarily an *emotion*) that produces a thought that causes an emotion… (The semantics of this are tough!)
I agree with all you say about how thoughts arise and that they come without our choice, but here’s where I was coming from: bad thoughts arise because we don’t put our minds in the right state or frame to disallow them. If the mind is focused on the future and what we want and wish for and experience as joy then the mind cannot keep going back to the bad thoughts about the past. A lot of oxytocin and endomorphines make it tough to wallow in misery!
I agree also with what you say about control when a thought arises, but I’d like to take it back to even earlier, before the moment of the bad thought itself: we control the environment in our minds in terms of where it’s focused to begin with, which changes entirely what direction it goes in. With this control when the environment triggers something the mind is stronger and busy and the triggering thoughts have less weight and appeal. When the environment we create in our mind is based on a joyful, busy and looking toward the future perspective the mind has more control over its intruders until ultimately they no longer intrude with any more impact than the nuisance of a fly.
Looking forward to reading your work… and glad you like the blog!
Michele:
Dave is correct. Emotional response can arise before or wthout a thought response. The more primitive parts of the brain integrate a picture of current sense stimuli to create a snapshot which appears then as an emotion that indicates how to then proceed.
Emotions can also arise in response to thoughts but they are a second-order thing.
Emotions that arise can then generate a thought or cascade of thoughts. The process is symmetrical.
I can give you another book to read
I know that as a side-effect of Zen I think a lot less than I once did and as part of awareness meditations that I’ve done I used to watch to see which way things arose – whether the thought came before the emotion or the emotion before the thought.
If the emotion came first then it was a matter of just letting it be and de-escalating anything that came after. If the thought arose first then it was a case of backtracking to identify the root.
The important thing to remember is that the brain is at best a collaborative system and what you consider to be thinking – in words – is the last system that activates and the slowest. All the other systems in the brain are faster.
There is a classic expirement that is done to evoke emotions in people. They insert graphic emotive images into a sequence and maybe leave them on the screen for less than 1/10 sec. It’s there for long enough for the fast parts of the brain to pick it up and emote on it but not long enough for the the higher brain functions to kick in.
I’ve remembered the title:
Antonia R. Damasio – “The feeling of what happens”. It’s not really Pop-Sci but is about the state of the art on what we know about consciousness.
There’s tons written about this stuff in Zen but most of it is technical and experential.
I’m rambling but emotions can lead to thoughts and thoughts can lead to emotions but there is no need for that to happen. The two systems work in parallel and are linked but they are very much two systems.
Now it’s bedtime..
In response to this discussion, I’ve been reading about trauma and the body, and apparently there are three systems at work – somatic or body, emotional and cognitive. To heal trauma, you could intervene on any one of these levels. And to me, it does seem that trauma is encoded in the body, and that thought kind of goes on top of it.
I totally agree Michelle about creating a healing mental environment. But for trauma stemming from abuse, at least, it’s also important to feel the emotions before you can heal. I wouldn’t want to use cognitive therapy to further shut myself down either.
Maybe it’s a balancing act.
I’m just coming in at the tail end of this discussion but Ellen – I agree with what you are saying about cognitive therapy shutting us down further which is kind of what happened to me for over 15 years (once I finally entered therapy and committed to the process). It wasn’t working but then my past experiences as a survivor of childhood abuse and neglect were eliminated from the discussion as we focussed on my current cognitive state.
I only began to heal once my past became a part of my pain today. Only then, once I – my existence – was validated was I able to begin to heal fully and completely. It was vital for me to return to finding a way to experience the emotional pain and reconnect with my body that I was able to DO the CBT type work and reconnect with my body and manage my thoughts.
We’re getting off topic here.
First, I don’t read one theory to the exclusion of others. My ideas come from a broad range of research.
Second, I would never suggest trauma survivors ‘shut down’ their emotions. In my opinion healing only comes from feeling everything and learning to appropriately process emotions.
Third, there is no ‘right’ or ‘wrong’ theory about what comes first, thought or emotion. I put out in this post what I believe and what I see happening. In the past 6 months I’ve developed an extensive network of scientists, neuropsychologists, clinical psychiatrists, therapists and neuroscientists. The beliefs I hold are the culmination of hours of research both in physical discussion and communication with this network, plus extensive reading. In my own practice now I see this theory working on a daily basis as I coach trauma survivors through the healing process.
Let’s keep the comments as a place to suggest alternatives, add and build on ideas and further each other’s exploration of concepts. There is no single path to healing. On this blog we can suggest every alternative that might help someone. We don’t need to do that by telling each other we’re wrong when the truth is the arguments and citations given in these comments are not exclusively definitive. We each witness and experience things that work. The point of this blog and these comments is to foster creative and self-empowered healing. Let’s keep the focus there.
I think that is what s wrong with psychology today, the lack of a cohesive predictive theory. There are things that work because they block symptoms, and things that work because they actually resolve the problem. Give me the course that resolves. Cognitive therapy treats symptoms and avoiding a cohesive predictive theory is not science it is just eclectic meddling. My money is on Arthur Janov’s latest approaches which can be perused at his site http://www.primaltherapy.com/. Recently I had this cognitive approach pushed on me and it was totally ineffective for my back pain. Feeling deeply the traumas and their connections to the present actually alleviated my pain more and I could feel the blood flow increase there. I would never choose symptom relief alone unless there was no other choice. Feelings are what integrate us, thoughts ride on top and can be used for repression. I have been repressed enough in my life. I did things that according to cognitive theory should have made me worse, and I got better. Cognitive is not healing in the best sense. I have seen enough people high on thoughts on televangelist shows. Study doesn’t mean much if you don’t find a predictive theory that creates predictable and healthy results. Eclectic approaches are ways to study but real science shows a clear course to follow.
I’m not going to write much as I have just been saturated with information. Taking a quote from Daves Comments
“Emotional Responses can be triggered directly by the environment”
I have learned over the years that this does actually occure. I made an earlier statment that, If I was to sit in the middle of a theater with no way out but climb over everyone” This has been in my experience that most of the time I will unknowingly be in a situation when emotion overwhelms me and I have to leave that environment. I am usually not sure what part of my environment triggered the emotion and panic. Michele, your writings have been so helpful to me but the picture I am starting to see is that there are many types of PTSD and each may be helped in different ways. Some times when I have a huge surge in emotion and panic, I have to look around and try to figure out what exactly was the trigger. Some I know what Im walking into but in many others I do not not.
A fair and thoughtful statement, but I suspect the underlying causes are much the same. It is true that we need breaks and distance from overwhelming feelings but the goal should still be integration and slowly desensitizing to the underlying helplessness that blocked our original full feeling integration of the event. When I feel in a way that integrates, meaning I feel what was once intolerable under more comforting conditions, which would even be knowing that the feeling is from the past, then I get better. But some are so hurt that the trauma comes up all at once and then we need things that lower that intensity.
I think this is a very lively forum. I hope it continues unhindered.
I love how you are getting at the fact that believing in victory is part of what helps us to be victorious. I know that this is true whether ptsd is in the picture or not. And with the amount of negativie thinking that is involved with ptsd this has got to be a huge part of the answer in curing ptsd-believing that it can and will happen. Victory is yours.
Feeling helpless ends helplessness. Feeling the hopelessness brings a positive outlook. Positive and negative feelings are each a part of a meaningful continuum. Grieve to rejoice, rejoice to grieve. This is a natural process evidenced at most funerals among families and friends. PTSD is a form of grief as it involves a sense of traumatic loss, which is the learned helplessness that stepped in to hold back full honest reactions and allowed us to react to symbols of the grief instead. Feelings connect all the symbols and feelings integrate us. Being overwhelmed blocks feelings and integration. PTSD is an overwhelmed state. Creativity, empathy, and objectivity can all be helpful in its integration but feeling is the integration itself.
Being new to the realization of the depth of the destruction done onto me, which left me with this stinking life altering, tho unknowingly so, illness of PTSD. You just showed me just how long I been sufferring this thing given to me by my so called most loving people in my life, by telling me what PTSD means in short form. Helpless and hopeless. Now I see for the first time that this didn’t just come to surface in me recently. 4 weeks ago. Helpless and hopeless I felt all my days. Suicide and death thoughts because of hopeless and helpless. Yep. Now I see it.
I was diagnosed with PTSD about eight weeks ago. I am in my sixth week of Cognitive Processing Therapy with the VA. I’ve been searching the Internet to learn more about how and why PTSD has been controlling my life for the past thirty-one years and why the symptoms (at least the disfunctional symptoms) are just now coming to bear on me. I want to heal. I cannot keep on being locked inside the darkness that has captured my mind and is clouding my thoughts, feelings, emotions, and actions.
While I appreciate this website for what it is trying to do, this discussion is utterly confusing. After reading the post and all the commets to it, I am left wondering if there is really any hope of healing at all. I can hear both your experience and knowledge, as well as your compassionate caring in your voices, but here I sit at an intersection of unfamiliar roads to my journey wondering which one to take and which one to avoid.
John, please see my post. I hear and feel your concern. My heart goes out to you as one who knows how alarming it can be when these things rise out of the abyss of our past lives
This article is so very helpful! Thank you for the insight and pointers. I think that some of the people that replied may have looked to far into what you were saying and/or ended up generalizing/making assumptions. This is a great addition to the many steps that we can use to overcome PTSD, I have heard that yoga can also help with focus
Thanks again.
@Tiffany – I’m so glad the post resonated with you. Yoga can be a great tool. Take a look at this post: http://healmyptsd.com/2011/05/ptsd-professional-perspective-yoga-trauma-and-the-body-mind.html
And also, I did a whole radio show devoted to the idea of trauma and yoga. Check out the free archive for July 14, 2011, here: http://healmyptsd.com/education/your-life-after-trauma2/archives
Hi there. I find it typical that the responses that seam to want to correct you, come from men. Why is it that men continually feel the needed to correct or to ‘point us’ in the right direction, as if we have no ability to determine truth for ourselves. I lived in a DV situation for some years, harbored by the church and when i finally left, some 15 years ago, i also left my support system, my circle of friends etc etc. My daughter subsequently has married and this year had a baby girl. I have found m,y ‘flashbacks’ to the abuse when I was pregnant and vulnerable, alarming and a challenging to say the least. Lets not forget whilst we pontificate about this approach or that approach, these are peoples lives, and their lives and experiences should be respected and validated, not made the conjecture of some new theoretical debate.
I live with severe and chronic PTSD. That diagnosis was a relief in that it helped made me feel normal for the experiences I was having. Here’s my addition to this discussion…. While accompanying my mother to an acupuncturist for her treatments, I developed a friendship with one of the clinicians. Upon noticing that my breathing was routinely extremely shallow, she asked if she could help me–I consented. After just a few needles, I began sweating and convulsing violently, bouncing all over the table as though someone had put electrodes in me. As the convulsions increased, all I heard was her soft voice singing John Lennon’s “Let it Be”. Eventually, after the convulsions ceased, I became aware that other assistants had silently come in and surrounded me so I would not fall off the table. My hair and clothes were glued to me as though I had taken a shower fully clothed. I felt light, rejuvenated, and free-spirited as a young child, breathing in long, deep breaths. I don’t remember ever feeling so free and youthful (I am near 60). I don’t know what did it; I just surmise it was cellular memory of some kind that may have been released. But I do know it was unsought, unexpected, and unconscious.
I am an analytical person who thrives on knowledge and research; yet experience shows me that healing has many avenues, some that tax our ability to comprehend. Suffice to say there is power in positive thinking and in accepting the unspoken wisdom of our bodies as they seek homeostasis.
The way I see it, the harm is already done. At any present time, we can choose to say to ourselves when triggered, “there it is–let it be”.
@Jan What a powerful experience. Since it took me over 25 years and ten different treatment modalities (plus many feelings of failed attempts) to reach freedom I’m very well aware that there are many paths to healing and none of them simply fall from the sky. It takes work. From your post, it appears that perhaps this is your avenue. You may also want to check out this page on my site which discusses PTSD treatment: http://healmyptsd.com/treatment. I am also including the link to a blog post that discusses understanding and identifying triggers: http://healmyptsd.com/2012/05/ptsd-spirituality-triggers.html I wish you the absolute best in continuing your journey!
John…Michelle…I agree…these conversations are very confusing…as if I wasn’t confused enough already!!..I was diagnosed with PTSD 10 months ago after keeping everything inside..s.abuse from the age of 5 to abandonment and then verbal and physical abuse for the next 12 years..I kept this in for 42 years and struggle every hour and every day with guilt,unworthiness and helplessness. Most days I do not see a way out or the apparent light at the end of the road and have unfortunately unsuccessfully attempted to end this ‘process’ several times. The once a week therapies do not cut it…all the in between is where it all gets out of control…anyway..I just wanted to say that. Thanks.
@CFCD — You’re right, the healing process can be, in a word, exhausting! I’ve actually never met anyone who’s ever healed PTSD purely from talk therapy alone. If you decide to supplement what you’re doing, check out the great modalities highlighted here: http://www.healmyptsd.com/treatment
Release can be attained… Onward toward freedom.