Breathe. All the way in, and all the way out.
This is an in-depth snapshot of the techniques that have worked for me to survive and recover from traumatic experiences. I share them here in the hope they can help you with any nightmares, flashbacks, anxiety, panic attacks, trembling, stuttering, depression, numbness, depersonalization, and derealization as you might be experiencing as well.
Trauma refers to any event that led me to feel a lasting sense of terror, horror, perception of complete helplessness, or loss of autonomy.
Recovery means I can talk about it without stuttering, trembling, flashbacks, or becoming upset, emotionally overwhelmed, or numb.
And remember no matter what happens, you are needed and loved, even if you can't see it right now. You aren't broken, you aren't alone, it wasn't your fault, and there are people you can talk to right now.
In the United States, the national suicide prevention lifeline is 1-800-273-8255. That's 1-800-273-TALK. They will pick up the phone, and they do care.
There's also a lifeline specifically dedicated to transgender people. In the United States, dial (877) 565-8860. In Canada, dial (877) 330-6366.
When texting is the most you can handle, there's a lifeline service for that, too. Text “GO” TO 741741. It's free, 24/7, and fully confidential.
Finally, these self-care questions have helped me immensely.
Once I learned that what I was experiencing was called PTSD, The first thing I did was make a spreadsheet of the traumatic events that've happened in my life so far: Event, year, age, synopsis, whether I've recovered from it, guilt to release, losses to accept, triggers to reroute, and notes. A blank copy of this spreadsheet is available at:
Trauma Recovery Spreadsheet Template
To use this spreadsheet, open it, click on "File", then "Make a copy..." and give it a new name.
Once I had the list as complete as I could make it, I narrowed it to just the trauma that still affected me. Next, I recorded any points of lingering anger, guilt, or losses (tangible or intangible) that I haven't yet mourned and accepted.
Tangible losses can include:
Symbolic losses can be just as significant—such as:
These types of losses are by no means exhaustive lists. Processing through this spreadsheet was a many-years-long process that required the help of a professional trauma therapist. Having a list to start from made a lot of recovery possible. We identified where anger, guilt, losses, and triggers were rooted, then found more helpful ways to think and talk about each event and their effects on my life. This involves describing how my body feels when triggered (so we can isolate where that trauma is learned) and what my present environment and facets of myself look and feel like.
Like a wise friend once shared, you can't remove the big, ugly painting that trauma has installed in the hallway of your mind. But you can put something bigger and nicer next to it, and sometimes kind of in front. There are losses to accept, emotions to experience, and triggers to re-route in every case. And knowing what experiences those are rooted in was step one.
Derealization was my first hint that I had PTSD. Feeling like I was disconnected from a construction of reality that affected me or that I could meaningfully affect. Not experiencing healthy emotional responses to stimuli. Feeling like I was driving my body as if through piloting a remote control airplane through a tiny screen with glitchy audio and video feeds coming at me. Not feeling at home in my own body any longer. Pervasive emotional and mental numbness.
To dig into dissociation, I adopted a meditation practice that first focuses on breath and posture alignment. First, I sit up straight or otherwise get my back where it is healthy. Then, using the set of mala prayer beads that live on my left wrist:
The next big things that got me back in touch with my body were yoga and dancing. With yoga, I had to start off really easy due to a variety of past injuries. I got online, found a routine that looked like something I could do, got a yoga mat, and just started doing it at home every morning. Moving through the poses, I pay attention to feedback my body is giving me, reaffirming that this is the body I have. And I talk about it in words and writing. Eventually and gradually, things started to reconnect.
The path out of depersonalization was one of reconnecting with my physical self.
For the first year or so after the biggest shockwave of trauma, I'd experience nightmares and flashbacks daily. For nightmares, I changed a few things that made things better: I stopped drinking caffeine in the evenings, stopped eating heavy dinners for a few months, time-boxed when I allowed myself to focus and work on trauma stuff (only before 5pm), and got into a habit of cuddling and co-sleeping with close and trusted friends. After a few months of these new habits, the nightmares stopped. They seem to have been mostly keyed off of anxiety.
For flashbacks (which usually co-occurred with panic attacks for me), using words to describe my surroundings helped the most. The point for me was reminding myself that I'm here and now rather than then and there. "My desk is clean today, my screen is off, quiet psytrance is playing, birds are tweeting outside, the sun is shining in Seattle, and it's currently sunny out and cool, mid-November in 2016." Tapping on things and on my legs helped, too—having tactile feedback that I was present was usually the first step out of a flashback.
I'd move from there to meditating and describing sensations within my body and other derealization recovery tools, since flashbacks frequently co-occurred with instances of derealization for me.
A few folks I know have had success wearing a rubber band on their wrist and flicking it whenever they sense themselves not being present. I wasn't able do that, myself, but did take to carrying tins of altoids with me everywhere. The point was to poke one of my senses gently-but-firmly enough to recognize that I'm actually somewhere (here/now) other than where I thought I was (in the flashback). That helped immensely. Clove oil also works well for this.
These same techniques work for me when I'm in the middle of a flash-forward / fear scenario / worry spiral. Reminding myself that I'm here and now, using those same techniques. Gently poke a sense (sight, smell, touch, etc). Ground and center. Let go of any illusion of or need for control.
Another noteworthy tool for surviving nightmares for me was floating in sensory deprivation tanks. After my first couple experiences in those, knowing that all of the terrifying stuff in my head could only have been coming from my head, I had the perspective I needed to get out in front of the negative thoughts and point them in more constructive directions.
The inflection point out of depression, which had lasted more than two decades for me, was tying facets of personal identity together for me in ways that harmonize with my life, goals, and sense of self. Identity can get fragmented through traumatic experiences, and developing a sense of self that I could naturally empathize with and show compassion towards was the first step out of this facet of PTSD for me.
I was able to identify and describe four unique kinds of loneliness and trace those to roles that fit who I am:
Identity loneliness is a disconnection from a personal sense of self—whether developed through depersonalization, derealization, or through more traditional personality disorders, I found the effects to be similar.
Companionship loneliness is a disconnection from someone close to share your day-to-day life with, whether a romantic lover, romantic friend, platonic lover, or platonic friend, roommate, pet, or neighbor.
Social loneliness refers to a lack of social interaction in general—not necessarily meaningful interaction, just interaction at all. This came mainly, in me, from isolation. Even smalltalk with a gas station attendant or grocery store check-out clerk meets this end for me.
Tribal loneliness refers to a lack of a connection with an assembly, gathering, tribe, or culture. When this is present, Buddhists call it sangha. When this is absent, another word for it is anomie, or lack of socio-cultural normative influences.
So, when feeling lonely, my first questions are "which facet of me is lonely" and "how is that facet of me lonely." That helped me answer to what it is that I want. Keeping lists of a few components of my identity helped immensely:
It's noteworthy that I use two of these lists to identify people who are toxic to me. I compare the lists of traits of mine that I value with lists of how I feel valued by a given person. Where those line up, I chose to stay close. Where they didn't, I'd taper back on that relationship. When someone values me for different reasons than I value myself, at best the construction of me that they like bears little resemblance to the me I know, and at worst, they actively want me to be someone I actively don't want to be.
Any amount of compassion that doesn't include self-compassion is incomplete. Keeping lists of my traits and abilities helped. Writing down negative self-talk helped improve that as well. Sharing it to close friends allowed us both to work through negative self-talk together.
Where there are behaviors that you need to encourage or discourage, setting boundaries can help others more clearly understand how you need to be treated moving forward. If people don't know what's on the menu with you and what isn't, they might mistakenly treat you in ways you don't want to be treated. Letting them know can be as simple as a one-sentence request, or it can be more fully expressed through DEAR:
And if all else failed, I keep a folder of emergency cat GIFs on a thumb drive. Makes it impossible not to smile, even through tears! It's even on a Hello Kitty thumb drive. I've compressed this folder of cat GIFs and uploaded it to share with you:
To use this, download it, and unzip it, and use any image viewer to open them.
Anxiety has been a constant struggle. What helps the most for me: breath-centered meditation (described in the Depersonalization section above), describing my environment (also described above), cuddling with friends, progressive muscle relaxation, and the watch trick (five two five). These last three are described here.
Cuddling with friends significantly with anxiety. Generally once, sometimes twice a week. Oxytocin goes a long way to calm me down if I'm tightly-wound at one point or another. Of course, always ask consent first. Consent is voluntary, sober, enthusiastic, verbal, non-coerced, continual, active, and honest. Yes means yes, no means no, maybe means no, and silence is not consent. I accept no without arguing, and say yes when I mean yes!
The watch trick has also helped me pull out of the middle of longer (multi-hour) panic attacks, particularly when they were happening daily. Nearer the tail-end of my recovery from PTSD, panic attacks were usually short (around 15 minutes), every couple of weeks, and usually passed without me having to do much other than accept that they're happening. But in the thick of it, if I could find my watch, I could always find a way out. The 5-2-5 watch trick is to do the following:
And if I forget the numbers, I can look at my hands: five fingers each on two hands. And get back to the business of breathing and taking refuge in impermanence.
Progressive muscle relaxation also helps. A relaxed body is seldom an anxious one. This is a type of biofeedback that I tack on to the beginning (usually) or tail end (occasionally) of meditation, centering, and grounding:
The direction I move in is:
A full treatment of PMR is beyond the scope of this introduction. Check out Mastering your Anxiety and Worry by Craske and Barlow for more information.
Other things that have helped anxiety: cutting back on vaporized nicotine, balancing my diet (refined sugar, nicotine, and caffeine are all incompatible with recovering from anxiety), yoga and occasional bouldering, time-boxing stressful things (or time spent with other anxious people), and setting boundaries more clearly with people.
What do I do when I see a panic attack happening in someone else?
What a panic attack feels like is whatever the traumatic event looked and felt like to me, as I was experiencing it back then. It's clear, vivid, and presently surrounds me again in all of my senses. I'm not consciously present where others are in space and time any longer, nor am I part of anyone else's present consensus reality. I'm viscerally re-living the trauma.
What a panic attack looks like from the perspective of someone else witnessing it: I'd be either on the ground, fetal or limp, gasping for breath or crying or both, and not responding to language or focusing my vision in the near field. It looks (and feels) a lot like a heart attack. If my eyes are open, they have the trademark, unflinching thousand-mile-stare of someone in a flashback, re-living trauma.
What to do, since you can help: To prevent re-triggering (and in general), always ask permission to touch. Stay calm, and if you know this person has trauma in their past, ask "where are you" and "what day is it" rather than starting off with "are you okay?" Ask to hold their hand. Keep them warm and safe. If you're in public, delegate crowd control (also to prevent re-triggering). If you don't get any responses, call for medical help. An average panic attack for me took around 30 minutes to return to baseline, but occasionally lasted up to 2-5 hours.
Breathe. Breath is life, and life is one.
Written by Danne Stayskal on 2016-11-09