Irritable Hearts: A PTSD Love Story (20 page)

Regular people, whether they realize it or not, walk around believing, as you cannot make your way in the world without believing, that the universe is holding them.

Well
, the people on our side of the line thought,
the fuck it does
.

After our first e-mail exchange, Chris and I continued writing each other, united by our total distrust of the world and ourselves. Whatever our backstories, we still had a lot in common. Flashbacks. (Flashbacks! Not just for veterans!) Crippling numbness, while alternately, or at the same time, our physiologies had a new baseline: hyperawareness and hyperarousal. Adrenaline-sharp quick-scanning for danger and triggers. For PTSD sufferers, this incessant alertness persists even in sleep, and people with PTSD can have nightmares and twitch during sleep stages in which regular people don’t move at all, waking up as if from torture, physically exhausted and sore. Like me, Chris moved through life both uninterested in and cowed by it. And like me, he was in therapy to help him adapt to it.

Chris’s therapy was talk-based. The Department of Veterans Affairs, which was responsible for his treatment, most commonly used cognitive-behavioral therapy and exposure therapy, in which you talk and talk about the traumatic things that have happened to you until they eventually, theoretically, lose their traumatizing power. Often at the VA, this was done in groups. But often, talking about being traumatized was not something marines were particularly interested in doing, never mind in front of other marines.

“We just suck it up!” Chris wrote me one day. “What we have is our training that keeps us focused on the mission 100%. We don’t have time to think about our ‘FEELINGS’ because the Marine next [to] you depends on you doing your job at 100%.” Now that he was home, he was finding it impossible to adjust. “I get very reclusive and don’t want to be around anybody. I don’t like going to the store, mall or movies. I feel like people are watching me. I only drive on the far left side of the road because of IED’s. Been hit by 2 and near numerous others. I get irritable easy. Have medication that makes me sleep because I can’t on my own. And to get personal, I don’t even like sex anymore. I can’t get that personal with anyone.”

Some of what Chris was experiencing was applicable to traumatized civilians. Not the IED (improvised explosive device) paranoia, but the irritability, the intimacy and avoidance issues, are classic post-trauma symptoms that can last long after intrusive craziness has worn off, even a lifetime. Other people will say about these people, like people say about alcoholics, “His childhood was super messed up.” Or “He has
issues
.” And then shrug. Ruined person. Fact of life. End of story. What they are often talking about, though less obviously than in a combat veteran’s case, is unresolved trauma. And there are lots of treatments for unresolved trauma.

I was doing more research for the story about veterans’ sex lives, which I’d conceived before my PTSD essay had been published. But now that e-mails such as Chris’s were coming into my life, I was obsessed with the topic, and I did have to go to work anyway. My bosses had asked me, after the essay’s publication, if I thought I still had PTSD, and I told them it was Denise and my GP’s opinion that I did; they knew I was in treatment, and that was the end of that conversation. I didn’t know how long I could keep it all up, but I forced myself through a demanding schedule of appointments and interviews and meetings that—with the help of getting drunk a couple of times a week—made me numb enough to function for long hours at a time when I wasn’t at home or with Denise sobbing hysterically. When the sobbing distress and distaste for life broke through at the office, I took it into the bathroom or the stairwell. I wasn’t functional enough to write, having to request multiple deadline extensions for the magazine feature about Ohio because every time I sat down to do it I found myself unfocused and without the energy or ability to make my brain create anything. But research I could mostly handle.

As I dug into it, I was learning that there were nearly as many treatments for PTSD as there were causes. We’d come a long way from the World War I–era method of trying to electrically shock and emotionally abuse PTSD out of soldiers. The VA was funding more than a hundred treatment studies, given its care of more than a quarter of a million Iraq and Afghanistan vets with PTSD. Their methods ranged from the ultra-Western, such as giving patients hypertension drugs to mitigate intrusive symptoms, to quantifying the effectiveness of meditation therapy. Brannan Vines would call to tell me about one wife on her unpaid Family of a Vet staff whose veteran husband had enrolled in a private clinical trial in which a needleful of anesthetic had been injected into a bundle of nerves at the top of his collarbone. Within minutes, he was a completely different, calmed person—though it eventually wore off.

Advanced treatments weren’t just for soldiers anymore. Between government funding and the private sector, veterans and civilians, there were trials in which people took Ecstasy while talking about trauma to promote positive associations with the events. Acupuncture as treatment, meditation as treatment: These methods played to the same principle as somatic therapy, namely getting the body to feel safe. But there were all sorts of innovations now. There was a study looking at whether eating synthetic pot extinguished fearful memory recovery. There were trials in which rats were lightly tortured and then injected with a peptide that stopped enzymes in their brains from being able to form memories of it. And long-established centers existed that were dedicated to teaching yoga for traumatized people. All of the above had got great results, but so did the more standard, older guard of existing therapies. Practitioners of cognitive behavioral therapy and exposure therapy, such as the methods the VA used, reported vast improvements in their patients. Much of the treatment community, including the VA, endorsed EMDR; the VA evidently didn’t accept some experts’ feelings that it was primarily effective in cases of single-trauma events. Many practitioners didn’t subscribe to just one or another of these methods, mixing and matching as they saw fit. Medications were almost always prescribed by conventional therapists, but they needed to be accompanied by other interventions. There was no evidence that you could cure PTSD with pills alone.

If only the science of treating PTSD were as precise as baking a cake. It was erratic and imperfect. But it still helped a lot of people get better. The available treatments still saved lives.

Chris didn’t say how long he’d been in his therapy. But unfortunately, he didn’t think it was working. “Marines are a rare breed,” he wrote me. “We don’t ask for help when we need it. That’s why I have lost 6 of my buddies to suicide after we got back to the States. Including myself. I think about it allot. I wish sometimes that I was with my buddies so they know they are not alone. I don’t know what keeps me from suicide. I don’t do drugs and I’m not an alcoholic. I don’t know what keeps me sane anymore.”

“I have not spoken to anybody about allot [of] personal stuff,” he wrote in another e-mail. “I have a huge (China) wall up is what the VA Docs say. But, I would love to try and talk to you. Maybe it’s what I need.”

We agreed to talk on the phone. On my end, I told him, I wanted to talk because our experiences were important, because I wanted to talk to someone else who understood—and because I wanted to thank him more personally for being so supportive. If validation was crucial to healing, Chris was my first big leg up in accepting my trauma as valid.
His
trauma was valid, I was sure, so if he believed in mine, maybe I could, too. I wasn’t sure if I had much to offer him. He was additionally suffering from traumatic brain injury—long-term damage from multiple concussions—and I was learning from research that that could make it harder to treat PTSD.

But if he was willing to explore our usefulness to each other, so was I.

*   *   *

One thing Denise shared in common with the VA was EMDR. She used the process in her sessions sometimes. But not with me. Not yet, because she didn’t think I was ready to handle it.

In the meantime, we plugged away at keeping me from wanting to die. I had told Denise, though I was hardly broadcasting it otherwise, how the feeling had come over me a few times. We did more grounding exercises, practiced centering. It was important to practice when I wasn’t triggered, because the more my body experienced centeredness, the easier it would be to find it even when I was triggered. Denise almost never talked about Haiti without mentioning that it had come right after Deepwater Horizon and Oklahoma; she thought that my being so tired and long-displaced—big contributors to being off center—when I arrived there likely helped make the difference between a tough trip to Haiti and the beginning of a long bout with mental illness.

In Denise’s experience, there were three things that made a person more likely to develop PTSD. She jokingly once referred to them as a trifecta of doom. The first thing, obviously, was experiencing trauma. The second was being bright—bright enough to see what’s going on around you and to see the big picture. The third was sensitivity. And in addition to having been off center, having arrived a bit discombobulated in Haiti, I had all the elements of the trifecta.

First: trauma. As an expert, Denise measured trauma according to how it impacted someone, not by whether the trauma won the pissing contest of whose was worse or bad enough. Regardless, she would brook no arguments that mine wasn’t that bad to begin with.

Second: big-picture brightness. Take the events of a day, when we were kids, that my mom brought us to the mall. We were waiting outside for her in a side lot I think behind Sears, and I was walking atop a short stack of two-by-fours as if they were a tightrope, my arms out for balance, when I noticed the exhaust pipe of a semitruck parked nearby. Sticking vertically out of the top of the cab, the whole top half of the silver cone was crusted with black. This would’ve been long before the big panic about global warming, but when I looked at the pipe, all I could think about was how much black smoke had had to come out of that one pipe, and how many identical pipes there were spewing black smoke out of all the trucks on all the roads in the world. I was awed by the scale of human pollution. I couldn’t have been older than nine.

Third. Consider my response to the scene in the Disney cartoon
The Sword in the Stone
, which my siblings and I watched dozens of times, where the human protagonist is briefly turned into a squirrel. In that short time he manages to attract the affections of a girl squirrel who clearly thinks they will have a future together. Then he is turned back into a human, right in front of her, and she starts crying.

I remember looking to my siblings for a reaction about this, but finding none on their faces.

I was sick with grief for her.

My sense of empathy was overdeveloped. There was such a thing as too much. “You could see how a kid like that,” Denise said, “might end up struggling with this severity of PTSD, with the things you’ve seen.”

Yeah. I guessed. Although “the things I’d seen” may have got to me even if I hadn’t been a kid like that. Chris probably never cried over Disney characters, and look how he’d ended up.

Anyway, here I was with a disorder that can make people who aren’t sensitive in the first place oversensitive enough to kill themselves. The first stage of treatment, with many trauma-sensitive practitioners, was producing safety and stabilization. I was in a safe environment, which was crucial, but the matter of
feeling
safe could take years, and could continue to need to be reestablished in tandem with moving into the next two stages. These, Denise often illustrated as twin foundations for healing. She held both of her hands out, palms up, when she talked about them. On the left, there was validating, naming, and working on the trauma itself, moving into the uncomfortable feelings it produced and processing them. On the right, there was choosing to go forward, restoring relationships, pursuing the kind of life you wanted now. With her holding her hands out like that, I couldn’t forget: I needed them both.

We were very much still in the validating and processing phase, where we would remain for a long time. But Denise had still asked me, on our first day together, what it was that I wanted in the long run. What was my goal, in the end? What did I want her to help me with?

“I want to be able to feel myself in the world,” I said (sobbing, because I was already sobbing, always sobbing then). I was simply pointing to the basic functionalities I’d lost. “And to be able to deal with the feelings I do have.” I don’t remember having said it, because I was deeply episodic, and there was often a strange amnesia around episodes. I wouldn’t remember what happened for very long after they were over unless I wrote it down. If I didn’t write down the specifics, I remembered only the pain.

But Denise wrote it down that time, and would recite it back to me throughout our work together. She would say it to me when we were working on being present in my body and I could feel how awful I felt, scared and depressed and disgusted and anxious and resigned. When my despair overwhelmed everything else, she would quote me to remind me why I was enduring the torture: “I want to feel myself in the world.”

No, I didn’t. Not now that I was actually doing it. Not when all my feelings were like this.

Even TV, my last sanctuary, was turning against me. A commercial with guinea pigs in it reminded me of my sister Jessica’s guinea pig, which cried incessantly in its basement cage. Not like a puppy’s cry, which is sad and whiny and makes you feel bad that you’re not giving it what it wants; a guinea pig screeches as if it’s being stabbed in the face.
Wheep! Wheep! Wheep!
it screams, like the violins in
Psycho
, as if its tiny frame can’t bear the torment. I think it was thirsty. Maybe it was lonely.
Why didn’t I take better care of that guinea pig?
I demanded of myself while its cries echoed around in my head, and now I was watching Hulu with my eyes scrunched tight and my hands clamped over my ears against a sound that wasn’t happening. In one
Criminal Minds
episode, FBI special agent JJ got a black eye, and though it was a tidy, sexy-tough one, when I looked at her face I could see only my ex-girlfriend, who got two black eyes when she was traveling for work and someone assaulted her at her hotel and she ended up knocked out, waking up on the floor with the guy’s blood on her and no memory of the fight, retaining the big black swollen eye sockets for weeks.