Yes, you. The one who's been through something terrible, has weathered the PTSD diagnosis with determined strategizing. You have been "working on yourself", with the diligence of someone trying to repair a malfunctioning car. You who've researched the effects of trauma and gone to lots of therapy and participated in self-hep groups and worked to improve your overall health.
In the beginning, it was, if not easy, at least hopeful, right? You had a name now for the thing that was wrecking your sleep and flooding you with anxiety and making you feel defective and isolated. A diagnosis meant there were steps you could take, things you could try, specialists to consult.
But now you're wearing out. You feel like the many strategies you've tried have produced limited and temporary results. The nightmares are back, or you can't seem to function well in one or more important areas of your life. You may even be struggling with a brand new problem, like addiction. You consider that maybe in your initial optimism, you set the bar too high for yourself. You feel like a treatment or recovery failure. You wonder if maybe it's time to accept a different quality of life than the one were hoping for.
First, there's this: You are not alone.
Does this sound like a platitude?
I am not making a case here that you have a substantial support system, or that you don't feel alienated or adrift right now. What I'm saying is that you are part of a large number of people who've been at this same thing for a while, many of whom have felt what you are feeling about the difficulty and uncertainty of it all. The importance of that is, we can borrow one another's hope when our own starts to flicker. We can spell one another as we go.
So, dear hope-challenged and battle-weary person, I offer these few thoughts on why you should stay hopeful and keep striving for that quality of life that you deserve.
1) Treatment may still help, even if you feel like it hasn't before or you've hit a treatment plateau. Here's why: New research in areas such as neurplasticity and PTSD-specific treatments are showing that adverse functional and emotional changes caused by trauma can be reduced, reversed, and even eliminated. For instance, a new cognitive behavioral therapy called Image Rehearsal Therapy, or IRT, is proving effective in decreasing or even eliminating post-trauma nightmares, a serious and often highly treatment-resistant problem for many trauma survivors.
Remember, too, that therapy is a relationship, and the client-therapist fit is important. If you are feeling stuck in therapy and discussions with your therapist don't solve it, you may benefit from seeing a different therapist. Expertise is important, but personality and approach are, too.
2) Psychotherapy is not the be all and end all. Strategies which have proven enormously helpful to survivors I've known include exercise, meditation, engagement in creative/expressive arts, and connecting with supportive people. But the list of possibilities goes well beyond that. Experimenting with new, non-destructive outlets and avenues can pleasantly surprise you. If you have one or more children, they can help generate ideas.
If PTSD is a condition, in part, of involuntarily and unhappily revisiting the past, new or novel experiences can build in other, more positive stuff. Kite flying therapy, anyone?
3) As the oft-quoted therapy adage goes, "feelings are not facts". Feeling stuck doesn't mean that you are stuck, and ditto for feeling like you and/or your life are hopeless. This is true in many things, but for survivors, that perception vs. reality line can be especially blurry.
For many survivors, the sense of profound discouragement about one's self, the world, and one's life can feel like trying to speed-walk through quicksand. Therefore, choosing not to accept these ideas as facts, but rather as ugly parts of the landscape which disappear when you look elsewhere, can be empowering and freeing.
Resolve to live the best life you can live, regardless of what you are thinking about at any given time. Behaving as if you know you deserve this will pave the way for that time when you actually do know.
Hey, you're still reading this-- that means you're still hanging in there with all this, still fighting the good fight. I'm glad, because I want that better, happier life to come true for you. And also because I know I'll need you the next time my own hope starts to waver.
We are not alone.
S.
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