Resources for dealing with what might be PTSD
October 11, 2017 4:46 PM   Subscribe

I was raped a few weeks ago. I've got a lot of great support, and I'm generally doing well and recovering. But I've got a few things going on that seem like incipient PTSD. I am, of course, discussing things with my therapist, but I thought the mefi hive mind might know of good resources (books or online) on dealing with the symptoms of PTSD in the early days after trauma.

In particular, my sleep is very disturbed (lots of nightmares, lots of wakefulness) and I'm very easily startled and it takes me a long time to recuperate from being startled.

I'm not having flashbacks, thank goodness, though I do sometimes perseverate on what happened to me.

My goal is to do what I can to proactively deal with these symptoms so I'm not stuck with them long term.
posted by superswell to Health & Fitness (8 answers total) 9 users marked this as a favorite
Bessel Van der Kolk has written the book on the physical effects of trauma: the Body Keeps The Score. It might be a lot for acute help, and it talks a lot about stuff that might not be of immediate interest or might not be practical, but it's a good book.

Peter Levine's somatice experiencing therapy might be helpful for you (I think the forward for this is by van der kolk?), but it is suggested that you explore it with a therapist who is trained in the techniques to avoid re-living the trauma. He's got a few books available; is the one I read.

David Bercelli writes about a sort of DIY version of somatic experiencing
here. I've been doing these and have seen wonderful improvements over the past few months, but I've also had to be careful not to overdo it or I end up in anxiety-land, and I'm not dealing with a recent trauma.

Does your therapist specialize in trauma? Would you consider someone seeing someone who does, perhaps in addition to your regular therapist?

I'm sorry you're going through this, and I hope this stuff can help.
posted by schadenfrau at 5:37 PM on October 11, 2017 [3 favorites]

(Feel free to MeMail me, too.)
posted by schadenfrau at 5:45 PM on October 11, 2017

I'm going to preface this with the note that what might be appropriate or helpful in the early days after living through a rape is going to be different for everyone. I've lived through sexual assaults; these are a few resources that were helpful for me when I was working through the aftermath and PTSD symptoms. (I no longer have any PTSD symptoms -- yay!) So, I'm a pretty intense person who usually needs to tackle things head-on. It's not always a virtue but it's how I work. And so I think I would have appreciated this stuff I'm recommending below earlier in my process. However, everybody is different, what you need will probably different than what I needed, and so of course absolutely trust your own judgment of what will be helpful.

Trauma and Recovery by Judith Miller is an excellent, if intense, book about PTSD. She examines the experiences of victims of sexual assault, wartime trauma, and childhood abuse. Reading it really put powerful words to wordless thoughts and feelings I'd had, and feeling seen and understood like that was in itself helpful. It's a book more of analysis and case-studies of survivors, as well as detailing therapeutic approaches. I personally found it comforting to have a wider analytical framework to think about my experiences.

I am also the kind of person who learns things best by experiencing them in my body. So I found full-force self-defense classes helpful in a way that talk therapy just wasn't for me personally. The full-force self-defense classes gave me specific physical skills I know I can rely on, allowed me to use my body to work through some of the trauma, and helped me learn to think more clearly when I'm adrenalized. For me, this class (taken a few times) was the thing that cleared up my PTSD symptoms after time and therapy didn't manage to. Same caveat applies: of course individual people may or may not find this kind of thing helpful, and when during their process they find it helpful will vary. I don't know enough about your situation to know whether this suggestion will be relevant for you, but I'm offering it in case.

I took classes through the Impact/Prepare program. I know there's chapters in NYC, Portland, OR, Chicago, and other cities around the country. I can't personally vouch for anybody but the Portland and NYC folks.

The classes I took involved a "whistle instructor", who coaches students in fights with a "suited instructor" (the assailant). The suited instructor wears a protective padded suit that allows him (or sometimes her) to take full-force strikes without actually getting injured. We also covered verbal strategies, engaged with some of the social justice and "isms" questions that come up in this sort of work, and did complex personalized boundary-setting exercises (that gave me helpful skills I've used in my day to day life).

For contrast: I did not find conventional self-defense classes helpful. By conventional classes, I mean we were not training while deliberately adrenalized, there was not an "assailant" instructor wearing a sophisticated protective padded suit, and thus we were not able to train with full force. I found conventional classes unrealistic (when compared to my experiences), and therefore on the spectrum from disappointing/frustrating to triggering.

All the best to you. I'm sorry you're going through this and I'm glad to hear you have good support.
posted by cnidaria at 5:59 PM on October 11, 2017 [1 favorite]

Best answer: IANY therapist, I am doing my doctorate in clinical psychology.

I work in a specialist service dealing with complex PTSD. I want to stress it is COMPLETELY NORMAL, shortly after a traumatic event, to have symptoms that resemble what we call PTSD, like nightmares, reliving, hypervigilance, more anxiety than usual etc. This is what happens when our brains try to process the traumatic memories. The diagnosis of PTSD is only given when these symptoms persist beyond 6 months and significantly impact on functioning, because having them before is so common and not a sign of disorder.

Although we cannot predict who will or will not develop PTSD perfectly, what is thought to be protective in the immediate and mid-term after a trauma is social support, coping style, a sense of safety, etc. Debriefing, or other methods that involve re-exposure to the memories (e.g. most psychological treatment for PTSD) have no clear benefit and may even be harmful when done too soon after a traumatic event.

I'm sorry you experienced this - it's good that you have a therapist you can rely on. Take care and seek all the support you need for this.
posted by monocot at 5:27 AM on October 12, 2017 [6 favorites]

Best answer: I want to echo monocat. I'm a licensed therapist with training and experience in treating trauma, and I've found that most clients find it extremely helpful to realize that "PTSD symptoms" are totally normal immediately after a trauma. It's how the body and mind start to process what happened, and having those symptoms immediately after the trauma does not mean they will last long-term.

Self-care, especially just being gentle with one's self (e.g., not feeling like one has to "get over" what happened), and social support can be really helpful for most people. I'm sorry you're having to deal with this.
posted by lazuli at 8:50 AM on October 12, 2017 [1 favorite]

Best answer: I'm so sorry you're dealing with this.

I'm a PhD research psychologist. I specialize in PTSD, especially as it relates to sexual assault, and have specific expertise in early intervention. Other posters are correct that most people experience symptoms of PTSD in the early aftermath, but few go on to develop PTSD, and having the symptoms doesn't mean something's wrong. It means your brain is going through the steps of processing something very intense.

Debriefing, or other methods that involve re-exposure to the memories (e.g. most psychological treatment for PTSD) have no clear benefit and may even be harmful when done too soon after a traumatic event.

This is only half true. Debriefing is thought to be ineffective/harmful because it forced everyone to tell the story of what happened, often in a group setting including coworkers and others, regardless of how they were coping, not because it included exposure. In fact, several early interventions including exposure principles have support in randomized controlled trials. The key is that avoidance of trauma-related thoughts, memories, and other safe stimuli (e.g., places) can prolong fear of those things and prevent healthy processing of emotions. So monitoring the desire to avoid and helping oneself approach those things in whatever way works, and sticking with those things until the fear comes down is, we think, key to recovery. For example, if someone feels too scared to talk about it, that may mean talking about it with a safe friend, crying it out, not suppressing those emotions with alcohol or drugs, etc. If someone starts noticing that they're avoiding all people who look like the perpetrator, or feeling a ton of distress when they see someone who looks like them, that could mean looking at pictures online of people who look like the perpetrator until that person feels more comfortable. People who do this naturally tend to recover on their own, and some people need a little extra support to do it. Another thing that appears to be helpful is identifying negative thoughts about oneself or the trauma (e.g., "it was my fault") and finding convincing things to tell oneself in response to those thoughts (e.g., "I can't have known that was going to happen, and I made the decisions I made for a reason, so it wasn't my fault").

Feel free to memail me if you need additional resources. If you happen to be in the Seattle area, we have an active early intervention study that may be helpful to you if you qualify.
posted by quiet coyote at 8:50 AM on October 12, 2017 [2 favorites]

i have PTSD and am also a rape survivor -- i'm so incredibly sorry you are going through this. "irritable hearts: a ptsd love story" was a super helpful book for me, as was / is the previously mentioned "the body keeps the score."

something you might find particularly interesting in relation to preventing long-term symptoms is this recent research about the prevention of PTSD with tetris! even long after my trauma, i've found this kind of bilateral processing super helpful and lighthearted after so much super intense therapy. ymmv!

feel free to memail me anytime. sending so much validation and healing thoughts <333
posted by crawfo at 6:49 AM on October 13, 2017

Response by poster: Thank you all for your responses! They have been very helpful.
posted by superswell at 11:48 AM on October 13, 2017

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