Day By Day By Day – Living with mental ill-health Part 3: PTSD Rituals

day by day 03 PTSD

Other Chapters: Introduction / Part 1 – Work / Part 2 – The Enemy Within

Part3 – Living with PTSD

Earlier parts of this series have focussed on Anxiety and Depression as I live with both; however since an assault I experienced in 2000 I have also suffered from PTSD.

Content note: Please note that as well as coping mechanisms this blog will feature descriptions of my PTSD symptoms and triggers; and thus others who suffer may find some of the content difficult. 

PTSD frrtIn the days and weeks directly after the assault, my sleep was affected and I found it hard to leave the house, catch a bus, walk home from the bus stop, go to the shops. I couldn’t be around lots of people but equally I struggled to be alone. Silence and noise were equally terrifying. I couldn’t have the light off, but hated the way the light created dark corners and shadows. A rush of adrenaline leading to a state of panic would be triggered immediately by an unexpected sound, or someone touching me when I wasn’t expecting it. I had flashbacks regularly – particularly when trying to sleep or rest. The flashbacks were never full replays of the assault, muddled and confused as my recollections were due to the concussion and fear, rather they tended to be small snippets of the event: flashes of his face as I noticed him appear in the distance behind me; the glow of my phone as I glanced at the time and wondered whether to call a friend; the sound of quickening footsteps behind me; the sense of the weight of his body holding me down; the sound of someone screaming and the slow, sickening realisation it was me. The expression on the Triage nurse when she said “drinking, were we?” or the doctor saying “got in a fight?”.  Of all of these, the worst was the footsteps. Even now, almost 17 years later, it’s a sound I can recall all too easily.

My jaw healed and the bruises faded; the trauma remained. As the months passed the flashbacks subsided, and I started trying to reclaim my life, and myself.

Dealing with the lingering trauma, which has never truly gone, has become so much a part of my life that much of the time I don’t even think about it. Most of the time it’s dormant, curled up somewhere dark and deep. Occasionally I even have the luxury of forgetting I even have it – unless one of my specific triggers sets off a sudden reaction which can lead to a panic attack, throwing up or passing out. It’s an intensely physical response; it’s not pure emotion.

It’s not quite that as the years pass that the trauma fades – that’s not really how trauma works – but that as the traumatic events move further into the past you can learn how to live with your PTSD, you can learn shortcuts or tricks to minimise the impact of the trauma. We might not even recognise them as tricks, or rituals. All we know is they make us feel safer; they make us less likely to be exposed to something that will trigger panic or a flashback.

For example, some of my specific triggers – as a result of the nature of the assault – are around people being behind me when I can’t see them or appearing suddenly from behind me, people touching me when I am not expecting it,  men I don’t know shouting loudly or staring intently at me,  and perhaps unsurprisingly – suddenly escalating footsteps. For a few years after the assault I couldn’t watch movies of films which featured physical violence, particularly people being punched in the head; which meant that I could only watch things my friends had already seen so that I had a warning around whether it was “safe”.

Over the years ways to prevent these happening or to mitigate their effects have become ingrained, habitual, and part of my life. I will wear headphones when I am out, whether there’s music playing or not, to reduce ambient sound, but I will never wear noise cancelling headphones or listen to music so loud that I can’t hear my surroundings. At work, where we have “hot desking”, I spoke to my manager (and it is no small feat to “come out” to a work colleague that you have PTSD) to request a fixed seat with a wall behind me so that people can’t surprise me. In a café or restaurant I will always have to sit in a seat with the back to the wall or the corner. My close friends know not to appear behind me and are pretty good at making sure they move into my peripheral vision before talking to me – and friends that don’t know about this will usually remember after the first time they surprise me.  I have two reactions to being surprised like this – I either react defensively, or freak the fuck out. As getting an unexpected punch in the face or seeing your friend leap 10 feet in the air while making high pitched noises and then falling to the floor are pretty memorable and unpleasant experiences most people will take care to avoid experiencing them more than once. Unless they are enormous shitweasels and therefore they’re almost certainly not worth being friends with at all.

If someone tells you they have a trigger around people appearing behind them for the love of Bob please don’t creep up behind them and go GUESS WHO loudly in their ear. Doing that is kind of a dick move anyway, but doing it when you know it’s a specific issue for them that just makes you a straight up arsehole.  It’s also helpful to understand that to be triggered by something when you have PTSD is genuine, and can have a real physical and emotional effect. In the last few years the word “triggered” has been misappropriated and used to mean “oversensitive” or “offended” when in fact it’s something quite different and more specific. A trigger warning on something which could cause a flashback or panic attack does no harm to someone without PTSD, but could make a huge difference to someone with it. If you complain about the existence of “trigger warnings” then what you’re actually saying is “I don’t care that people have experienced trauma”.

If you have friends with PTSD and you want to support them, it can be as simple as understanding that these rituals, as silly or irritating as they may sometimes seem, help make them feel safer, or help them establish control, or just feel like they are living as normal a life as they can. That’s not much to ask, and it can make a huge difference.

RDPP