Resilience Cafe

Petaluma’s Aqus Café was filled to capacity November 11^th for the first meeting of Resilience Café, a public forum for the discussion and healing of trauma. Community members of all kinds – veterans, treatment professionals, ordinary individuals – came to learn about trauma and how it might be impacting their lives. Billed as an opportunity to “Listen, Share, Heal”, Resilience Café was created jointly by the Bernstein Institute and Aqus Community. Together, we want to fight the stigma often associated with mental health challenges and the isolation trauma sufferers experience from this “hidden epidemic”.

Aqus Community founder John Crowley opened the evening with a welcome for the packed crowd and an explanation of our goals for the event. In my remarks, I offered a definition for trauma and then briefly outlined the several types of trauma and their symptoms and effects, in simple terms for everyone to understand. Wes Easley, a military and law enforcement veteran and staff member at the Bernstein Institute, shared a personal account of his self-isolating tendencies following a sudden career-ending injury in the line of duty. Small group discussions followed, with an opportunity for all to open up, if they wished, to be heard and to receive support. The evening ended with summaries of each group discussion and my parting message.

My message – then and now – is one of hope. With help and hard work, trauma can be resolved and transformed to restore meaning and purpose to our lives.

Steve Rustad, board chairman for Sonoma Coast Trauma Treatment, filmed portions of the evening and his recording is available on UTube, by following this link.

We plan to make Resilience Café a monthly event at the Aqus Café, 189 H Street, Petaluma. We encourage everyone to join us at our next meeting, December 9^th from 7:00 – 9:00 PM.

Meet Me at the Sebastopol Copperfield’s on Saturday, November 2nd!

On Saturday, November 2nd, from 12:00 to 2:00 PM I will be signing copies of my new book, Trauma: Healing the Hidden Epidemic, at Copperfield’s Books, 138 N Main Street in Sebastopol.  Please drop by.  I would love to meet you and personally autograph your copy.

As I’ve mentioned in recent posts, I’ve written my book to describe trauma—its nature, symptoms, and effects—in terms everyone can understand. I’ve included very practical actions you can take to begin to heal the often minimized or dismissed burdens of trauma, for yourself or for someone you love.

I’ll be happy to answer any questions you have about trauma and how it can be healed.  I’d also like to ask you to consider buying an additional copy—or copies—to give to people you know who are struggling with difficult circumstances or have been exposed to trauma.  I want to get my book into the hands of anyone and everyone who needs to hear a message of hope in hard times.

My thanks to Michael Fanning, and to Sebastopol Copperfield’s for hosting this event and for being an all-around great bookstore!

Hope to see you then!

Inaugural Issue of the Trauma Newsletter

I’m excited to announce the arrival of the first issue of our newest publication, the Bernstein Institute Trauma Newsletter.  Each issue of the newsletter will contain helpful, practical articles on the subject of trauma, along with a personal note from me on a vital issue catching my attention.  My aim is to consistently provide accurate information and positive inspiration for everyone who has been touched by what I’m calling the “hidden epidemic” of our time.

This first issue includes two articles: “Financial Crisis, Trauma, and Reinvention”, covering the continuing, painful repercussions from our Great Recession; and “Military Suicides: Part One”, the first in a series exploring the facts and trauma-related issues underlying the dismaying spike in suicides by military personnel.  Also, in “From Peter”, my personal answer to the question, “What is emotional trauma?”

Soon, we’ll have a way for readers to subscribe to the newsletter through our website.  For now, please follow the link to download your copy today.

Meet Me at the Montgomery Village Copperfield’s on Sunday, October 6th!

On Sunday, October 6th, from 1:30 to 3:30 PM I will be signing copies of my new book, Trauma: Healing the Hidden Epidemic, at Copperfield’s Books in the Montgomery Village shopping center, 775 Village Court in Santa Rosa.  Please drop by!  I would love to meet you and personally autograph your copy.

As I’ve mentioned in recent posts, I’ve written my book to describe trauma—its nature, symptoms, and effects—in terms everyone can understand. I’ve included very practical actions you can take to begin to heal the often minimized or dismissed burdens of trauma, for yourself or for someone you love.

I’ll be happy to answer any questions you have about trauma and how it can be healed.  I’d also like to ask you to consider buying an additional copy—or copies—to give to people you know who are struggling with difficult circumstances or have been exposed to trauma.  I want to get my book into the hands of anyone and everyone who needs to hear a message of hope in hard times.

My thanks to the Montgomery Village Copperfield’s for hosting this event, and for being an all-around great bookstore!

Hope to see you then!

A Lone Star State PTSD Debate

In 2014, George Bush will run for the office of Texas Land Commissioner.  He’s campaigning already, according to a recent article in the Mid-Valley Town Crier, and, as a veteran, he has plenty to say about PTSD and other issues regarding military service.

Julie Silva’s Crier article first caught my eye for an obvious reason—is Former President George W. Bush running for Texas Land Commissioner?  After my double-take, I discovered that US Navy Reserve Ensign George P. Bush (and nephew to our former president) is actually the commissioner-hopeful.

The next reason for my interest in the Crier article is a debate about PTSD that arose during Bush’s visit to VFW Post No. 7473 in Elsa, Texas.

George Prescott Bush served in Afghanistan in 2010 as an intelligence officer.  On returning to the homefront, he explained to his VFW audience, his greatest concerns for fellow veterans were the high rates of suicide and unemployment, as well as providing increased access to education.

Bush created some controversy when he began to talk about fellow Texan and former Navy SEAL Chris Kyle, who was killed earlier this year on a shooting range, allegedly by a fellow veteran with post-traumatic stress disorder.  Based on his own experience with PTSD, Kyle had decided to create FITCO Cares, a foundation with the goal to help veterans overcome PTSD.  “He proved that PTSD is not something permanent,” Bush stated of Kyle.  “To me, this was a call to action, not only to my generation of veterans, but to all veterans.”

But a member of the VFW audience objected to Bush’s statement.  “Many times we have a hard time getting our benefits and the last thing we need is for somebody to say that PTSD is not permanent,” a Vietnam veteran responded.  “A lot of times PTSD doesn’t hit you until years later.”  Bush clarified his stance by explaining that he believes that the condition can be permanent if left untreated.

Whether PTSD is “permanent” is a thorny issue and I’m not going to go into all the background for taking one position over another in this post.  What I want to highlight today is a point I make in my new book, Trauma: Healing the Hidden Epidemic.  There is a crucial difference between “healing” and “a cure”.

In short, I believe there can be healing for post-traumatic stress disorder.  But there is no cure.

Let me quote from “To the Reader” in Trauma:

“Healing is possible.  We have witnessed such healing time and again at the Bernstein Institute for Trauma Treatment in Petaluma, California.  However, only by addressing the wounds lodged deep in our subconscious mind and, quite literally, in our bodies can true healing begin.  The process of discovering and developing a method of healing at this profound level is described in this book.”

Notice my carefully chosen term: healing.  Not cure.  I suffer from PTSD myself (you’ll discover the multiple sources of trauma in my life as you read my book).  And although I’ve done much work to heal my PTSD and the PTSD of my patients, I know there’s no cure.  Put me in a particular set of circumstances, in the “right” situation, and I can be triggered into a reaction of violence and rage.  And to their dismay and regret, this is true for my patients as well.  For them and for myself, getting triggered happens a lot less often than it used to, but it can and does happen.  Most of the time, I’m able to stop myself from acting on my violent emotions, but their intensity can still be consuming.

Let me say, briefly, that healing PTSD means being less frequently triggered into the past, less frequently confused and overcome with potentially destructive emotions and pain.  Healing means being more often in the present, enjoying the sometimes stressful challenges of a fulfilling life and relationships, with fewer debilitating intrusions from memories of the past.

No, there is no cure for PTSD.  But there is hope.  Our veterans can find healing.  And if you suffer from PTSD, so can you.

Meet Me at Copperfield’s on Saturday, August 3rd!

On Saturday, August 3^rd, from 1:30 to 3:30 PM I will be signing copies of my new book, Trauma: Healing the Hidden Epidemic, at Copperfield’s Books, 140 Kentucky Street in Petaluma.  Please drop by.  I would love to meet you and personally autograph your copy.

As I’ve mentioned in recent posts, I’ve written my book to describe trauma—its nature, symptoms, and effects—in terms everyone can understand. I’ve included very practical actions you can take to begin to heal the often minimized or dismissed burdens of trauma, for yourself or for someone you love.

I’ll be happy to answer any questions you have about trauma and how it can be healed.  I’d also like to ask you to consider buying an additional copy—or copies—to give to people you know who are struggling with difficult circumstances or have been exposed to trauma.  I want to get my book into the hands of anyone and everyone who needs to hear a message of hope in hard times.

My thanks to the Petaluma Copperfield’s for hosting this event, and for being an all-around great bookstore!

Hope to see you then!

6 Hurting Women

On February 26, 2012, trauma and tragedy entered the lives of Trayvon Martin and George Zimmerman.  It entered the lives of the Martin and Zimmerman families.  And on June 24, 2013, trauma and tragedy entered the lives of six anonymous women called to civic duty in Sanford, Florida.

For 14 days, they listened to and watched the unfolding testimony of violence.  For three weeks, they spent their evenings isolated in a motel room. At the end, to the best of their abilities, they formed an opinion, reached an agreement, and rendered a verdict.  In the case of the State of Florida vs. George Zimmerman: Not Guilty.

It’s abundantly clear that Trayvon Martin and his family, and George Zimmerman and his family have suffered severely—and in Trayvon’s case, suffered the ultimate loss of life.  In the aftermath of the verdict, we might tend to overlook the painful experiences of the jury.  Since the verdict, the media and the nation have been obsessively second-guessing the jury’s decision and questioning their character and integrity.  This onslaught of criticism and blame adds to the burden they now carry from their exposure to emotionally disturbing images and evidence.

I’m not going to weigh in on George Zimmerman’s innocence or guilt.  I believe Mr. Martin and Mr. Zimmerman were both victims of their encounter.  But I do know the women jurors committed no crime and yet are being tried in the court of public opinion.

Another thing I know—they are suffering from secondary trauma.

I define secondary, or vicarious trauma in my recently published book, Trauma: Healing the Hidden Epidemic.  “Secondary trauma,” I explain, is “stress resulting from helping or wanting to help a traumatized or suffering person”.  It can also result from witnessing disturbing or horrific events happening to others.  Anyone who is exposed to suffering is at risk for secondary trauma.  As a psychotherapist who helps people heal emotionally painful issues, I am intimately aware of the professional dangers of vicarious trauma.  Left unaddressed, it can lead to depression, burnout, and the urge to self-medicate with alcohol or drugs.

What do I do to prevent my secondary trauma exposure from taking hold and causing personal deterioration?  I cover that topic in my book also.  There are deliberate, constructive activities and attitudes that can make recovery possible.

Here’s my list of recommendations for the Martin/Zimmerman jury, and for all witnesses to tragedy (from Chapter 8, “Danger Signals and Trauma First Aid”):

1. Know that part of you goes on “pause” when you witness a disturbing event.  You may not be able to fully feel and react to what you’re experiencing at the time.  However, you must go back, after the experience, and work through your feelings and reactions.  Don’t bury them.
2. A caring network of friends and family can be of great support and comfort.  Use them.
3. Take extra care of yourself both physically and emotionally.  As much as possible, slow down, rest, eat well, exercise, put off major decisions, keep your life simple, and stay with what’s easy and familiar.
4. Give yourself permission to feel or see things differently because of your experience.  You are not the same person you were before.  Don’t sink into embarrassment or shame; don’t judge or criticize yourself.
5. Absolutely do not isolate yourself.  Isolation will start you on a fast downward spiral.  Share what has happened to you with supportive loved ones.
6. Deliberately cultivate positive experiences, such as creative pursuits, dinner out, or watching a favorite movie, as part of your recovery.  Don’t just anxiously “keep busy”.
7. If necessary—if you feel stuck or haunted by what you’ve been through—seek professional help, either short or long term.

The bottom-line truth in the case of Florida vs. Zimmerman is that no one came out a winner.  Everyone involved, everyone who has been touched by the events in Sanford, has suffered to some degree.  If you have experienced trauma, and I believe everyone does at some time, then I urge you to follow my suggestions above.  Buried trauma never goes away.  It’s never too late to heal.  That’s one of the central messages of my book, Trauma: Healing the Hidden Epidemic.

Would You Talk to a Virtual Therapist?

On June 20^th, I attended the day-long “Brain at War” conference in San Francisco presented by NCIRE – The Veterans Health Research Institute, in cooperation with the San Francisco VA Medical Center, UCSF, and the US Department of Defense.  Annually hosted by the stately Marine’s Memorial Club & Hotel, “Brain at War” reports on the “ongoing examination of the physical and neurological consequences of military combat duty”.  Experts in medicine and science present “the latest innovations and emerging technologies” in the understanding and treatment of PTSD, TBI, and other brain injuries associated with combat experiences.

Some of the presentations were of great value.  Caroline Tanner, MD, PhD, the Director of Clinical Research at the Parkinson’s Institute, gave a fascinating overview of Parkinson’s disease and its possible relation to brain injury and exposure to toxic chemicals.  My father died from complications of Parkinson’s, and while I was familiar with some of the information Dr. Tanner presented, some of her material was new to me.

Robert Obana, Executive Director of NCIRE, graciously included me at a lunch table where I was able to meet several presenters and other important conference attendees.  We had a lively discussion on many topics, one of which included the day’s most thought-provoking presentation.

The presentation came courtesy of Dr. Albert “Skip” Rizzo, the Associate Director for Medical Virtual Reality at the Institute for Creative Technologies, USC.  Skip, who obviously loves his job, gave a fascinating overview of his work developing virtual reality applications for military personnel training and treatment.

Briefly, Skip’s work involves four areas: first, an intense, customized version of the Xbox game “Full Spectrum Warrior” for PTSD exposure therapy; second, a video resilience training program modeled on a “Band of Brothers” format; and third, a somewhat folksy, virtual-online PTSD mentor-coach, dispensing information and coping skills from across the table on a porch.

The fourth application involved the creation of a virtual therapist who conducts a Skype-style counseling session from a comfortable chair.  The program uses a fairly young, female image to probe for emotional dysfunction in her real patient by instantaneously tracking patient verbal responses while reading both vocal patterns of distress (by microphone) and visual body language (by web-cam).  The virtual therapist is programmed to then respond verbally and physically in real-time to the issues shared by the military patient.  “That sounds difficult”, she acknowledges when a veteran reveals a painful memory, and leans forward when her real-life patient leans back.

The therapists, social workers, and counselors in the room reacted strongly to this simulation.  I felt a visceral dislike for what struck me as a removed and cold treatment approach to the complicated issues and deep wounds of many of our traumatized combat veterans.  A “sensitive” machine is still a machine.  Won’t troubled service members feel belittled and dismissed if they assume they don’t rate face-time with the empathetic, skilled professional help of a real, live therapist?

This chilling prospect was remedied, somewhat, by Lieutenant Colonel Steve Countouriotis, US Army (Ret.), NCIRE Board of Directors, and fellow resident of Petaluma, in his closing remarks.  He brought humanity back into the day and touched me deeply.

So, on to the question of this blog post title: Would you talk to a virtual therapist?  There’s a possibility, I admit, that feelings of intense embarrassment or shame could make confiding in a virtual, not-real therapist seem safer or easier.  I would appreciate it if you’d weigh in on this one.  Could you see yourself participating in virtual therapy?  Or, do you see it more as I do, as an approach which could oversimplify and disrespect the complex nature of trauma and being human?

Freedom on the Inside

In 1970, I left New Jersey for California.  This was not a decision freely made.  I was forced to leave because my life was at risk.

When I arrived in San Jose, I felt like a fish out of water.  Seeking some kind of familiar territory, I started working in prisons and juvenile detention facilities.  These were definitely not places where freedom “reigned”.

I had wanted to make a new life for myself in California, but the “New Jersey” in me wouldn’t go away.  I walked around with an armored exterior, always ready for battle even when there was nothing and no one to fight.  I couldn’t turn off my anger and defensiveness.  The fear and anger of my former life were in charge of me despite the fact that there was no need for them in my new environment.

Today, on Independence Day, I want to talk about the loss of freedom on the inside: the freedom to choose how to react or respond to events and people; the freedom to live in the present; the freedom to grow and change; the freedom to live without debilitating fear or destructive rage.

Do you ever feel trapped in your own skin?  That’s what I’m talking about.

I want to introduce a concept you may never have heard about that relates directly to a loss of internal freedom—reenactment.  I explain reenactment from several perspectives in my new book, Trauma: Healing the Hidden Epidemic.  Reenactment is part of what I call the stress response, otherwise known as the “fight, flight, or freeze” response to trauma.  Here’s a definition from my chapter, “Emotional Blueprints and Developmental Trauma”:

“Reenactment occurs when traumatized individuals try to recreate or relive their traumatic experience.  They seek out or even create scenarios similar to their traumatizing event in an unconscious attempt to complete the stress response that was interrupted so that they can resolve their post-traumatic disorder.  Similar experiences re-engage the stress response, the unfinished biological process that left them traumatized in the first place.  Victims seek opportunities to engage the stress response in order to complete it, most often unaware of why they are doing so.  The trapped energy [from fight, flight, or freeze] causes so much emotional and physical pain that the unconscious aspect of trauma victims’ brains will go to any lengths to release that energy.  Unaware of the process, they may even feel puzzled as to why the same painful events happen to them over and over again” [emphasis added].

Not knowing why we keep doing the same things over and over again, particularly if they are unsatisfying, dangerous, or destined for failure can leave us feeling more than “puzzled”.  Being trapped in the reenactment cycle can lead to feelings of rage, panic, discouragement and despair.

Freedom—to make new choices, to grow and change, to become the person we long to be—requires tackling our unresolved trauma and breaking the reenactment chain.  It is possible.  My life today, as a husband, father, and psychotherapist, is infinitely freer now than it was in 1970.  I urge you to read Trauma: Healing the Hidden Epidemic to discover how my life changed, and how yours can change as well.

PTSD Awareness Day

The United States Senate has designated June 27^th as National PTSD Awareness Day.  Every day in my practice I’m doing what I can to bring more awareness to trauma and the “invisible wounds” that contribute to post-traumatic stress.

It isn’t just the military who suffer from PTSD.  Anyone and everyone who has experienced overwhelmingly traumatic events can find themselves suffering from hidden, emotional wounds.  Firefighters, EMTs, police, nurses, emergency room personnel, crime victims, abuse victims—all of these and many more are at risk.

I’ve tried to highlight issues and misunderstandings about PTSD in my recently published book, Trauma: Healing the Hidden Epidemic.  To further contribute to PTSD awareness this day, let me quote from my chapter, “A Note to Veterans and Their Loved Ones”.  What I’ve written in this chapter regarding veterans applies to all those suffering from post-traumatic stress.

“Post-traumatic stress disorder is just a name for a catalogue of symptoms that follow a stressful situation.  Veterans are not the only people on earth with PTSD.  Yet the term has a very negative connotation in the military world.  Veterans often feel that a PTSD diagnosis reduces the uniqueness of their individual reactions, feelings and struggles.  Or they may feel stigmatized, labeled, and devalued by their peers.

“In truth, veterans experience a wide range of reactions following deployment, and the symptoms can be minor or severe.  Instead of using this name as a label, it is important to reestablish post-traumatic stress disorder as merely a collection of possible symptoms caused by trauma.  It is not limited to war veterans, and those suffering from PTSD may not be permanently damaged; they can heal with proper treatment.”

Let me say that again: PTSD is not a permanent condition.  With help, it can be healed.  That is the essential message of my book, a message of hope.  Of all the awarenesses that could occur on this National PTSD Awareness Day, let that be the overriding one.