Irritable Hearts: A PTSD Love Story (42 page)

parts of the brain go off-line during trauma: Decreased activity in the prefrontal cortex. Lower brain regions (limbic system) take over and begin to stop higher functioning. Van der Kolk 1; Goodyear-Brown, p. 34; Szalavitz.

PTSD-sufferers’ symptoms are similar: Burgess and Holmstrom; Courtois; Foa and Rothbaum, p. 10; Scheeringa.

simple vs. complex trauma: Complex PTSD, now known as the dissociative subtype, is a more severe kind of disorder that often arises from chronic trauma. It features the core symptoms of PTSD but includes impairments in affective, self, and relational functioning. The
DSM-5
also features the preschool subtype, which affects children under 6 who are unable to verbalize their traumatic experiences. See sources in previous note.

attachment difficulties following trauma: Buczynski and Lanius, p. 6.

personality disorders following trauma: People with PTSD often receive personality disorder diagnoses, too. Some researchers question whether the latter is merely latent, existing before the former. They consider the relationship unclear. Bollinger et al; Schore.

traumatic event intrudes like reality: Herman 1, p. 37; Van der Kolk 3, p. 4.

hyperawareness and hyperarousal: McClelland 35; National Center for PTSD 1.

traumatic nightmares can occur during REM, as well as NREM, stages: Lydiard and Hamner.

World War I method of trying to electrically shock and emotionally abuse PTSD out of soldiers: Herman, p. 21; Jones and Wessely, p. 33; Linden.

VA funding more than a hundred treatment studies: Ballesteros.

more than a quarter of a million Iraq and Afghanistan vets with PTSD: Tanielian et al, p. xxi.

methods ranged from giving patients hypertension drugs to mitigate intrusive symptoms: U.S. Department of Veterans Affairs 9; Raskind et al.

to quantifying the effectiveness of meditation therapy: U.S. Department of Veterans Affairs 3 and 4; Hölzel et al.

trials where people took Ecstasy while talking about trauma to promote more positive associations with the events: Mithoefer et al; Oehen et al.

acupuncture as treatment: Kim et al.

meditation as treatment: U.S. Department of Veterans Affairs 3 and 4; Hölzel et al.

some methods played to the same principle as somatic therapy, namely getting the body to feel safe: Emerson; Korn.

eating synthetic pot: Rabinak et al.

trials where rats were lightly tortured and then injected with a peptide that stopped enzymes in their brains from being able to form memories of it: Shema, Sacktor, and Dudai.

centers dedicated to teaching yoga for traumatized people: Emerson.

all of the above had got great results: Mithoefer et al; Oehen et al; Kim et al; Hölzel et al; Shema, Sacktor, and Dudai; Rabinak et al; Raskind et al.

reports of vast improvement in cognitive-behavioral-therapy and exposure-therapy patients: Schnurr. Not all practitioners agree that these improvements/desensitizations offer a high enough bar for healing. See Interlandi.

much of the treatment community endorsed EMDR, including the VA: U.S. Department of Veterans Affairs 10.

some experts believe that EMDR is effective primarily in cases of single-trauma events: Schore; Brunet 3.

can’t cure PTSD with pills alone: National Collaborating Centre for Mental Health; Van der Kolk 3, p. 15; Brunet 1. According to the aforementioned they should be used as second-line intervention.

importance of validation to healing: Brewin, Andrews, and Valentine; Fanflik.

TBI difficult to treat on top of PTSD: Schore; Sornborger.

Denise didn’t think I was ready to handle EMDR: See Herman 1, p. 173 for more on need for stability in exploring memories.

first stage of treatment: Buczynski and Lanius, p. 15; Herman 1, p. 155; Ogden, Minton, and Pain, p. 206.

Freud’s speculation that new trauma is often about old trauma: Freud.

researchers’ screening cops and soldiers to determine who gets PTSD: Marmar et al; Litz.

contemporary studies’ identifying risk factors of PTSD: Ozer et al; Brewin, Andrews, and Valentine.

risk factors for PTSD: Brewin, Andrews, and Valentine; Mayo Clinic staff; National Institute of Mental Health.

group therapy inappropriate during intrusive symptoms: Herman 1, p. 218. Inadequate for recovery: Acierno. Herman 1, pp. 231-232, calls
expertly
run group sessions helpful
in coordination with
individual sessions.

Full House
abuse episode: No. 137, “Silence Is Not Golden.”

people drive out of their way to avoid neighborhoods in New Orleans, have nervous breakdowns: McClelland 2.

my female friends, also eighteen, also knowing nothing: See Caplan-Bricker for research/discussion of how commonly young women shrug off sexual assault.

at least 25 percent of Americans have experienced trauma by adulthood and by age 45 almost all have: Norris and Slone.

getting divorced, other emotional stressors can lead to PTSD: Lilienfeld and Arkowitz.

ditto watching too much terrorist-attack footage: Holman, Garfin, and Silver; Silver et al.

long assignments risk factor for journalists: Smith and Newman.

other studies found that trauma’s character, not person’s, mattered most: Brewin, Andrews, and Valentine; King, Vogt, and King.

previous trauma risk factor, but not guarantee: Buczynski and Lanius, p. 9.

resilience factors: National Institute of Mental Health.

“anyone can get PTSD at any age”: National Institute of Mental Health.

“doctors aren’t sure why”: Mayo Clinic staff.

dissociation in Haiti likely predictor of long-lasting PTSD: Brunet 2; Schore; Brewin, Andrews, and Valentine; DePrince, Chu, and Visvanathan.

need to stay on the bench until trauma is healed: See Herman 1, p. 60, for discussion of how extant psychological trauma makes it harder to deal with trauma.

incidence of PTSD in soldiers goes up with number of tours and amount of combat: Kline et al; Reger et al; Phillips et al; Smith et al. 2008; Clancy et al; Cozza.

repeated exposure to trauma can affect difficulty of recovery: Brunet 3; Sornborger; Emerson.

PTSD sufferers move between intrusive and constrictive symptoms: Van der Kolk 3, p. 4; Herman 1, pp. 34-35, 162.

trauma turns sneaky: See Herman 1, p. 49; Van der Kolk 3, p. 13.

might get misdiagnosed: Herman 1, pp. 118, 122.

triggered because of nothing at all: Van der Kolk 3, p. 4.

“A secure sense of connection…”: Herman 1, p. 52.

playing Whac-A-Mole: Normal: Herman 1, p. 155. “[P]atients and therapists alike frequently become discouraged when issues that have supposedly been put to rest stubbornly reappear.”

CHAPTER TEN

seventeenth-century French writer: de Guilleragues.

“as the psyche matures…”: Boulanger, p. 74.

no longer knew the person I was supposed to be looking for: Normal. Herman 1, p. 96. “Repeated trauma in adult life erodes the structure of the personality already formed.”

CHAPTER ELEVEN

not unlike some cutters: Studies show that people cut for many reasons. To feel anything at all, to avoid emotional pain, to avoid doing something else unpleasant, for attention. Nock and Prinstein.

work part time to take recovery/falling-apart time: Herman 1, p. 176. “The patient should also expect that she will not be able to function at the highest level of her ability, or even at her usual level, during this time.”

acute stress inducing shaking in animals: Beerda et al.

VA provides Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) therapy to veterans: National Center for PTSD 2.

needs of trauma patients are changing and complex: Herman 1, p. 156.

EMDR best for simple trauma: Van der Kolk 2; Brunet 3.

between 500 and 600 tons of ordnance are collected and detonated a year; since the French demining department was founded, after World War II, 632 French
démineurs
have been killed: Hannauer.

The book in which I’d recently been reading about the leftover ordnance was Hochschild.

CHAPTER TWELVE

on the merits of grounding: Goleman; Schawbel.

fear that everything will fall apart: Herman 1, p. 188 talks about trauma patients’ fear that once they start grieving they won’t be able to stop. Page 189, she points to resistance to mourning as “probably the most common cause of stagnation in the second stage of recovery.”

difference between surrender and submission: Denise and Strozzi-Heckler call it “blending.” His book, p. 92.

3,000 repetitions: Strozzi-Heckler 2.

10,000 hours: Ericsson et al; Ericsson interview.

changing motor patterns is very difficult: Schmidt.

the National Institutes of Health funded Van der Kolk’s yoga research: Emerson; Van der Kolk et al. 2014.

trauma damaging sensory-processing and self-care parts of brain: Van der Kolk 3, p. 14.

Australian soldiers’ EEGs showed increased hyperarousal/memory problems/attention-processing problems: Davy et al.

limbic system overreacting: Van der Kolk 4.

limbic system includes the amygdala, the structure responsible for conditioned fear, emotional memory, and motivation: Davis; Wright.

chemical hangover: Dysregulation of stress hormones, such as cortisol. Delaney.

trauma-sensitive yoga can teach tolerance of feelings and sensations:
Integral Yoga Magazine.

army giving out millions in grants for “alternative” research: Shachtman.

evidence that yoga could change your brain: Emerson; Van der Kolk 3, p. 14.

Van der Kolk’s yoga/training programs: Emerson.

Van der Kolk’s chronic-abuse yoga study: Van der Kolk et al. 2014.

Haitians protest MINUSTAH presence: Associated Press staff; Doucet; McClelland 10.

MINUSTAH and cholera: Quigley; Centers for Disease Control and Prevention.

AA says don’t date during first year of recovery: Moore and Manville.

CHAPTER THIRTEEN

“Navy SEALs are screened carefully for vulnerability to PTSD”:
Criminal Minds
, season 7, episode 3 (“Dorado Falls”), about 20 minutes in.

18 veterans a day/one every 80 minutes commit suicide: Kemp and Bossarte.

Chris’s suicide: KVOA; Gliha and Gilger; interviews author conducted with family.

undercover warehouse story: McClelland 34.

PTSD can alter physiology indefinitely: Schore; Herman 1, p. 238; Bremner et al.

scenes and details from the reported secondary-trauma feature: McClelland 35.

VA had a program to pay spouses as caretakers: U.S. Department of Veterans Affairs 8.

lots of soldiers coming back with degenerative joint disease: Horton; Robbins; Patzkowski et al.

government-funded PTSD service-dog study: U.S. Department of Veterans Affairs 1, 2, and 5.

secondary trauma/STSD definition: Fran
č
i
š
kovi
ć
et al.

documented in spouses of PTSD veterans from Vietnam: Galovski and Lyons; Lyons.

and spouses of Israeli veterans with PTSD: Ben Arzi, Dekel, and Solomon.

and spouses of Dutch veterans with PTSD: Dirkzwager et al.

30 percent secondary trauma in wives of Croatian war vets: Koi
ć
et al.

or 39 percent: Fran
č
i
š
kovi
ć
et al.

symptoms in offspring of veterans: Dekel and Goldblatt.

one study with 45 percent of kids reporting significant PTSD signs, etc.: Beckham et al.

veterans’ kids’ symptoms similar to Holocaust survivors’: Rosenheck and Fontana; Barocas and Barocas; Helen Epstein; Rosenheck 1986.

meta-analysis of Holocaust survivors’ families: Van IJzendoorn.

Jewish groups offer home care, counseling, support groups to Holocaust survivors and families: Pevtzow; Jewish Family Service of North Jersey.

another recent study of PTSD combat vets’ spouses found up to 15.5 percent STSD but mostly generic psychological distress: Renshaw et al.

Twenty-year, 10,000-family study about Iraq and Afghanistan vets under way: Collier; McClelland 35.

“in a family system, every member of that system is going to be impacted…”: Robichaux.

psychiatrists and social workers can speak to contagion of trauma: Pfifferling and Gilley.

people who work with traumatized people have support groups: Herman 1, p. 153; National Child Resource Center for Organizational Improvement.

learn to listen to what my body was saying: Strozzi-Heckler 1, p. 8.

veterans with PTSD 69 percent more likely to have marriages fail: Koenen et al.

65 percent of active-duty suicides precipitated by broken relationships: U.S. Department of Defense Task Force on the Prevention of Suicide by Members of the Armed Forces, p. 105.

active-duty suicides outpacing combat deaths: Timothy Williams.

traumatic brain injury exacerbates problems such as memory, sleep, balance, and irritability issues after PTSD: Hoge et al.

CHAPTER FOURTEEN

e-mails about trauma: Used with permission.

trigger plans for sex: Haines, p. 157.

high proportion of Vietnam veterans in Republic: Hughes.

fifth-highest percentage of vets of any county in Washington: U.S. Department of Veterans Affairs 7.

Washington a vet-heavy state: U.S. Census Bureau 2.

no organization dedicated to vet families: Hughes.

nearly all vets in Republic men: Hughes.

closest VA hospital 130 miles away: “Spokane VA Medical Center.”

nearby Indian reservation had 450 vets: Sherri Williams.

county of 7,500: U.S. Census Bureau 1.

county spread among 2,000 square miles: U.S. Census Bureau 1.

a third of medical disability discharges were psychiatric in World War II: Marble; Reister, pp. 13, 43.

cultural amnesia Herman talked about: Herman 1, pp. 26, 31.

fewer government resources for rape victims than for vets: But there
are
some: Acierno; National Association of Crime Victims Compensation Boards.