Grief as Trauma Recovery

-a dispatch from the grief process

Grief resembles a trauma recovery process in many ways, especially if the death of the loved one is sudden and unexpected, and even if it’s not.

Some sources list the first reaction to such news as shock, the kind of shock that one receives when one undergoes a trauma situation. Reactions to trauma are fairly well documented. These are the kinds of reactions one sees in PTSD situations as well. They may all be present or perhaps only a few of them. A reaction to a traumatic event is post-traumatic. It is stressful. Hence we get post-traumatic stress. When it goes on for a very long time it becomes something of a disorder which cannot be coped with. Hence PTSD.

One doesn’t often see things like the death of a family member, partner or even friend as a potential trigger for traumatic reaction. “Normal” grief has been exempted from inclusion for some reason and I think that’s a mistake.

For example in some listings of potentially traumatic experiences we see things like this:

Situations and events that can lead a person to experience psychological trauma include:

  • Acts of violence such as an armed robbery, war or terrorism
  • Natural disasters such as bushfire, earthquake or floods
  • Interpersonal violence such as rape, child abuse, or suicide of a family member or friend
  • Involvement in a serious motor vehicle or workplace accident.

Other less severe but still stressful situations can also trigger traumatic reactions in some people.

There is mention of violent death of others but nothing about any other kind of death. Why not? A sudden natural death, like a heart attack, can be just as shocking and unexpected to those in the person’s life as a death by car accident. The lives of those who remain is thoroughly disrupted. They’ve had no time to prepare, as one might if the person were diagnosed with a terminal illness. Even with a loved one dying of a terminal illness, there is still the time immediately after their death in which “normal” life is no longer so. We cannot anticipate all the changes that will arise even when a loved one’s death is immanent and we are aware of that. There will be surprises and they will be discomforting, unpleasant, and in some cases maybe even shocking.

So there is a lot of overlap between the grief process and traumatic reaction.

In the aftermath of trauma there are many reactions that have been documented. Here are some of them:

Many people have strong emotional or physical reactions following experience of a traumatic event. For most, these reactions subside over a few days or weeks. For some, the symptoms may last longer and be more severe. This may be due to several factors such as the nature of the traumatic event, the level of available support, previous and current life stress, personality, and coping resources.

Symptoms of trauma can be described as physical, cognitive (thinking), behavioural (things we do) and emotional.

Physical

  • Excessive alertness, on the look-out for signs of danger
  • Easily startled
  • Fatigue/exhaustion
  • Disturbed sleep
  • General aches and pains

Cognitive
(thinking)

  • Intrusive thoughts and memories of the event
  • Visual images of the event
  • Nightmares
  • Poor concentration and memory
  • Disorientation
  • Confusion

Behavioural

  • Avoidance of places or activities that are reminders of the event
  • Social withdrawal and isolation
  • Loss of interest in normal activities

Emotional

  • Fear
  • Numbness and detachment
  • Depression
  • Guilt
  • Anger and irritability
  • Anxiety and panic

As long as they are not too severe or last for too long, the symptoms described above are normal reactions to trauma. Although these symptoms can be distressing, they will settle quickly in most people. They are part of the natural healing process of adjusting to a very powerful event, making some sense out of what happened, and putting it into perspective. With understanding and support from family, friends and colleagues the stress symptoms usually resolve more rapidly. A minority of people will develop more serious conditions such as depression, posttraumatic stress disorder, anxiety disorders, or alcohol and drug problems.

~Australian Psychological Society, Understanding and managing psychological trauma

Another thing that needs to be cleared up is the idea that grief and depression are the same. They are not. They are often mistaken to be so however. I have certain view about depression which I’ll write about at a later time but for now I just want to talk about some of the grief reactions in terms of trauma that I have outlined above.

I was reading an interview with psychologist and grief counselor Sameet Kumar, Q&A with Sameet Kumar, PhD, Part Two on Mindfulness for Prolonged Grief and he made a very interesting observation in one of the questions.

Do you believe there to be a distinguishable and diagnosable difference between symptoms of grief, and those of major depression?

One of the most consistent experiences people share in grief are the “supernatural” ones. This is very different from depression criteria. People do very often have visions, sensations, and experiences they struggle to explain, and often attribute them to their deceased loved one or loved ones. The most common ones I hear about are people hearing their loved one calling their name or laying down next to them in the middle of the night, or causing electrical malfunctions. All of these phenomena are very normal no matter what your belief system is, but they can feel strange when they occur, and sometimes even more distressing when they don’t occur. This is unique to grief. Something else unique to grief is yearning for someone who has died and the relationship to a loved one’s belongings that results. Every therapist working with grieving people should ask them where they sleep. I think many might be surprised at how few people return to the bed or change sheets after the death of a spouse. These sorts of things distinguish grief from depression.

In the list above we have seen some of the trauma reactions that include things like visual images and intrusive thoughts and so on. Here Kumar writes about some of the cognitive dysfunction that accompanies grief and how people misattribute the causes of that. That is also common in traumatic reaction.

I will tell you about a few of the things that have been happening to me that are in this vein. I do not attribute them to any supernatural cause, but to cognitive and emotional adjustments I am undergoing at a subconscious level through the grief process.

-One afternoon I was looking out the window and I thought I saw him through the fog in the alley across the street. There was a man standing with his back to me. He had a similar build and posture to Manoj. For a moment I thought is was him. This is of course impossible.

-On another day, and this has happened a few times, I thought I saw a cat in my house. I don’t keep a cat. It was maybe part of the memory of the feral cat that used to sneak into our place if we’d leave the door open too long. We could never catch it. The first time this memory appeared as a hallucination here it was caused by the shadow of a passing bird that moved on the floor as the bird passed the window. I don’t know what triggered the notion the second time. These all occur in peripheral vision and not directly. That’s kind of a clue that they are hallucinations. Hallucinations generally occur that way except in major psychotic episodes or as a result of taking hallucinogenic drugs. Most people have a hallucination or a few in their lifetime but they get dismissed as “imagination” or something like that. They are really common. That’s something a lot of psychologists and psychiatrists don’t tell you. Most people will recognize them if they appear in the context of hypnogogic or hypnopompic imagery. That’s the time when you’re just drifting off to sleep or just waking up. You think you see a flash of light or hear a noise in the house, or feel something touch you or something like that. It is a neurological phenomenon.

Mental phenomena that occur during this “threshold consciousness” phase include lucid dreaming, hallucinations, and sleep paralysis.

~Wikipedia, Hypnogogia

In grief they can become more apparent and specific regarding the dead person and can occur at times not just related to sleep.

-Yesterday as I walked down the hallway in my apartment I was sure I heard a kind of sigh very softly in my ear as if someone were whispering from behind me. It was a little bit unnerving. It could have been air movement in the plumbing, or the refrigerator making a noise that I misinterpreted or all kinds of things.

When these things happen it’s “different”. I know it’s a misperception or misinterpretation on my part and I know why (aka grief process). It’s not really annoying. It just gives me pause for a while after it happens which is maybe why it happens. Some unattended fragment of memory, desire, emotion emerging into consciousness looking for some attention. OK. I’ll give it the attention so it can be fully processed. It’s going to keep happening for a while, maybe a long while.

Here’s a thought on that from Sameet Kumar. Or at least that’s the way I’m choosing to interpret his statement.


Miscellaneous further notes:

I’ve been reading more of Sameet Kumar’s work on grief. It’s very good. He works with people dying of cancer. Here’s a few links:

Q&A with Sameet Kumar, author of Mindfulness for Prolonged Grief, Part One

Q&A with Sameet Kumar, PhD, Part Two on Mindfulness for Prolonged Grief

His blog is Mindful Synergy and he’s on Twitter and Facebook. He has a couple of books out. I’ve not read them yet but might.

I also read a fairly recent interview done with Joan Halifax, who also has worked with dying people, Roshi Joan Halifax on compassion, women in Buddhism, and altruism There’s a few statements she makes that I find pertinent:

what we try to do to prepare for dying is to develop the qualities of the mind that allow us to be with whatever is arising.

I think that moral outrage is not a bad thing, but you have to understand that if you get in too outraged a state, then you go into distress, and that has outcomes which are not wholesome. On the other side of the equation, it can fuel you to move forward in terms of taking action.

I learned to accept the unacceptable.

So the practice, for me, is about creating the kind of resilience or buoyancy where you can be present to bear witness to the truth of suffering.

She mentions something regarding an illness she had as a child and frames it as “a blessing”. I’m not going to pick on her interpretation of her own experience. That’s a common framing for a lot of people.

In a larger, more general social way I’m uncomfortable with thinking that characterizes sickness, death, or tragedy as a blessing. That removes it’s power and downplays it’s significance. I’ll write about that more fully in some future post because it relates to the whole positive psychology movement, what Barbara Ehrenreich calls being “bright-sided”. One doesn’t have to be either a hero or victim. That’s a false dichotomy. There are thousands of other options.

But I really like her phrase, “I learned to accept the unacceptable.” That is a good part of what the grief process entails.

Dostoyevsky isn’t wrong in my opinion. Though I’d phrase it differently about the God part being an atheist and all.

“The darker the night, the brighter the stars,
The deeper the grief, the closer is God!”
Fyodor Dostoyevsky, Crime and Punishment

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On Trauma Counseling and Intra-generational PTSD

 

Am going to start including more on PTSD in this blog since many people seem to land here via that search term and I run across quite a few articles about it.

This affects you even if you have never encountered trauma or don’t think you know anyone who has.

One-off Trauma Debriefing

Psychologist Vaughn Bell, has written a piece for the Guardian, Minds traumatised by disaster heal themselves without therapy:Aid agencies that promote one-off counselling sessions after major traumas only prolong victims’ suffering and done a little follow up on his excellent Mind Hacks blog (in which he objects to the Guardian’s headline on his article as being somewhat misleading) Disaster response psychology needs to change

In his blog addendum he summarizes the article and corrects the headline:

Unfortunately, the article has been given a rather misleading headline (‘Minds traumatised by disaster heal themselves without therapy’) which suggests that mental health services are not needed. This is not the case and this is not what the article says.

What it does say is that the common idea of disaster response is that everyone affected by the tragedy will need help from mental health professionals when only a minority will.

It also says that aid agencies often use single-session counselling sessions which have been found to raise the risk of long-term mental health problems. This stems from a understandable desire to ‘do something’ but this motivation is not enough to actually help.

Disaster, war, violence and conflict, raise the number of mental health problems in the affected population. The appropriate response is to build or enhance high-quality, long-term, culturally relevant mental health services – not parachuting in counsellors to do single counselling sessions.

The World Health Organizations textbook Psychological First Aid:Guide for Field Workers [PDF] outlines best practices for assisting in trauma situations. They are against the “debriefing” methods:

WHO (2010) and Sphere (2011) describe psychological debriefing as promoting ventilation by asking a person to briefly but systematically recount their perceptions, thoughts and emotional reactions during a recent stressful event. This intervention is not recommended. This is distinct from routine operational debriefing of aid workers used by some organizations at the end of a mission or work task. (p. 3 footnote)

In the future we are all going to be “Field Workers” dealing with people experiencing trauma so that’s a good read to get some information. We’ve only just begun to recognize the effects of trauma. Additionally the likelihood of a relative or friend experiencing some kind of trauma is rather high. If that sounds a bit dire read on.

Intra-generational PTSD

Mother Jones had an article not too long ago on the effects of PTSD on the family. Is PTSD Contagious? It’s rampant among returning vets—and now their spouses and kids are starting to show the same symptoms.

If you have lived with anyone who has PTSD you know it has profound effects on relationships. You also know that some of the symptoms are “contagious”. For example if a person is constantly hyper-vigilant there is a tendency for others to start experiencing anxiety and having it manifest in similar hyper-vigilence. As well there is STSD-secondary traumatic stress disorder sometimes called Compassion Fatigue and/or Burnout, although I think both are serious misnomers and are too generic for specific STSD. Compassion fatigue and burnout are generally related to people who work with those who have PTSD or have been otherwise traumatized. STSD is not necessarily related to work and is more oriented to continuing relationships. Here’s a webpage about STSD in relation to veterans. Additionally there is a good page there on what is termed Secondary Wounding. Secondary Wounding occurs when people around don’t understand trauma and it’s effects. Mostly it’s due to people’s ignorance and wish to distance themselves from anything unpleasant. This is one reason we should all be “Field Workers” as I mentioned above.

There are certainly overlaps between all of these terms but I think there needs to be much better delineation in the psychological literature and much better explanations available to the public.

The effects of trauma are extended a number of ways. Dr. Joy DeGruy has begun research on the continuing effects that slavery has had on African-American populations. Here is one presentation of hers:

 

Post Traumatic Slave Syndrome can be categorized under both Historical trauma and Transgenerational trauma

This approach holds true, I believe, for other populations as well. Children of refugees and children of war for example. Or children of Holocaust victims and survivors. Or people who have been wrongly convicted or people who have been political prisoners or people who have been marginalized and scapegoated by their societies…it doesn’t end.

We cannot compartmentalize trauma to the directly affected victims only. This is a mistake many treatment modalities make. It affects everyone to some degree. Even if one is not a direct descendent nor had a family member involved in a traumatic situation (that’s getting ever more rare these days) we all interact with those who have experienced trauma so it is important that we become familiar with the effects of trauma and what we can do, in the first instance to mitigate that, and secondly to curtail the types of circumstances that brought about the trauma.

I Wish You Great Heartbreak

 

I have no mercy for a society that will crush people, and then penalize them for not being able to stand up under the weight.

~Malcolm X

Last night I watched an hour long documentary called War in the Mind. The full program is on the web so you can watch it too. It was about soldiers with PTSD and the consequences they face having participated in war. Some of the soldiers were young and newly returned, some were very old and still affected by the conflicts they participated in such as WWII, Korea, Vietnam and other places and at other times. I had an uncle who was in the Navy in the Pacific in WWII. For decades after he was a genteel alcoholic, and many years later he hung himself in his garage. No one really knew what PTSD was back then. Once you have an experience of any kind but particularly an experience of horror, you can never return to the world you thought you knew or to whoever you thought you were before. Experience is a one-way street.

This documentary stuck with me all day today. It kind of shook me up. Sometimes I enjoy being shook up or upset. Enjoy may not be the right word there…more like “do not turn away from” or accepting, although accepting is also not wholly correct since that which is causing the disruption is not something that is accepted passively and filed away. It is more accepting the fact of being shook up and the reactions that arise because of the content of the trigger. I find when I have the urge to turn away or compartmentalize “that stuff”, the content, into some corner that will allow me to be numb to it, then it is often at that time, if I allow it to continue, that a moment of recognition or connection is at hand. It is hard to be vulnerable to anything but especially to horror and other people’s pain.

These kinds of things were on my mind when I read a Twitter discussion about Islamophobia. The gist of it was Islamophobia was merely racist. That description “merely racist” is not meant to downplay the seriousness of racism, but to point out that there is more to it than that. There’s always more.

This was followed by an article in Mother Jones, America’s 10 Worst Prisons: Pelican Bay, which describes what is a monument to inhumanity where prisoners spend, literally, decades in solitary confinement. There are currently 1,500 in solitary there. Entombed alive for life. Think about that for a moment.

The reaction of people to these kinds of things is often unthinking. It goes something like “Well that’s OK because they are “enemies” or “criminals” or “illegal” or <insert dehumanizing label of your choice>”

There’s two main ways that these kinds of reductionisms are understood and dealt with. In the first instance the label is used simply to dismiss something or somebody we don’t want to deal with in any substantive way. That’s the most common. In the second instance it is a call to action. I have consciously been shifting myself into that mode over the years after being well-conditioned to using the dismissive mode. [We all are similarly conditioned.] When I find myself using labels, I consciously try to separate the behavior and the human being. I’ve used labels in a derogatory way. My set of labels include, “fascists”, “Americans”, “capitalists” and so forth. By adjusting some of my thinking, and some of my language, what I am discussing becomes fascist behavior and ideology, nationalism as an identity, capitalism as a system that influence people to act in exploitative ways, etc. It takes a lot more work to be more precise in this way but it also brings a certain amount of clarity to issues of social structure and behavior. One starts to see the bigger picture then.

So while the reductionism of labels can confine issues to small words it can also be used to see beyond them if one is willing to do the necessary work.

That was something of a digression but it underpins what I thought about after being exposed to those particular pieces of disruptive information.

On Twitter I wrote:

I don’t think Islamophobia is *only* about bigotry. There’s a whole lot of hegemony underneath it.

Also the notion of a threat of collective (Ummah) identity which intimidates those who highly value individualism above all else.

[Hegemony is] Not necessarily state sponsored. It is now more of a dominance at all costs by anyone (or generally a group)ie cultural, economic

PB [Pelican Bay] and other supermax prisons are an abomination. It’s like entombing people alive.

That doc I watched last night on soldiers with PTSD kind of shook me.

Mainly the part when some recounted looking at their "enemies" and realizing the people they killed were human.

Imagine looking at everyone dehumanized with labels like "enemy", "criminal", "illegal", etc as humans. Hearts would break.

I wish that great collective heartbreak on every person in the world.

Important article about PTSD

I get a lot of people searching this blog for information on PTSD. It’s one of the top search terms that leads people here. I don’t write about it much but have once in a while. That shows you the paucity of information out there if this obscure blog is one of the Google hits in the first few pages of listings. There is a notion that Buddhist practice can be of assistance to those suffering PTSD. That can be true but there are a lot of caveats I’d add.

PTSD doesn’t just affect the person who experienced trauma. It affects everybody around them as well. Here is an excellent new article on that.

Is PTSD Contagious? from Mother Jones magazine. Read it before you continue here. I’ll wait.

Those who are around people suffering from PTSD will recognize themselves immediately. From the experience of having been the partner of someone with severe PTSD for 12 years I acknowledge the veracity of this article. It is contagious. It conditions you to view life in a completely different way. It is stressful and can become debilitating. It takes a very long time and a lot of work to recognize how that conditioning happens because it is very insidious. [No we didn’t get divorced because of PTSD but because he wanted children, which he now has with his second wife, and I didn’t. People ask that when I mention how come I am familiar with the topic so I’ll save someone the trouble.]

The effects on those around PTSD sufferers is something that we all need to become aware of because PTSD is far more common that many people realize. It’s not something that just happens to military personnel but also to police, doctors, nurses, rape victims, accident victims, prisoners of any sort, refugees, children who are bullied or otherwise abused, victims of assault and other crime…in general people who have experienced trauma.

In any social matrix (family, club, work place, school class, sangha, etc) if one or more people are experiencing PTSD symptoms, and in any large group there is a likelihood that there will be at least one or two people, this will to some extent begin to generalize to the group. That is one of the reasons we all need to get more education on the subject.

From the National Institute of Mental Health:

What are the symptoms of PTSD?

PTSD can cause many symptoms. These symptoms can be grouped into three categories:

1. Re-experiencing symptoms:

  • Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating
  • Bad dreams
  • Frightening thoughts.

Re-experiencing symptoms may cause problems in a person’s everyday routine. They can start from the person’s own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing.

2. Avoidance symptoms:

  • Staying away from places, events, or objects that are reminders of the experience
  • Feeling emotionally numb
  • Feeling strong guilt, depression, or worry
  • Losing interest in activities that were enjoyable in the past
  • Having trouble remembering the dangerous event.

Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.

3. Hyperarousal symptoms:

  • Being easily startled
  • Feeling tense or “on edge”
  • Having difficulty sleeping, and/or having angry outbursts.

Hyperarousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic event. They can make the person feel stressed and angry. These symptoms may make it hard to do daily tasks, such as sleeping, eating, or concentrating.

It’s natural to have some of these symptoms after a dangerous event. Sometimes people have very serious symptoms that go away after a few weeks. This is called acute stress disorder, or ASD. When the symptoms last more than a few weeks and become an ongoing problem, they might be PTSD. Some people with PTSD don’t show any symptoms for weeks or months.

Additionally from Casa Palmera Mental Health facility:

TOP SIGNS OF C-PTSD

Prolonged exposure to traumatic events can result in C-PTSD, or complex post-traumatic stress disorder. Survivors of prolonged physical and sexual abuse, hostage situations, religious cults and prisoners of war are all examples of people susceptible to C-PTSD.

The symptoms of C-PTSD are similar to PTSD, but also include:
* Persistent feelings of depression
* Problems controlling feelings
* Preoccupation with suicidal thoughts
* Self-injury or self-mutilation
* Explosive or inhibited anger
* Compulsive or inhibited sexuality
* Amnesia or hyperamnesia regarding the traumatic events
* Episodes of dissociative behavior
* Preoccupation with the perpetrator
* Seeing the perpetrator as all-powerful

TOP SIGNS OF PTSD IN CHILDREN

Following the traumatic event, children may exhibit signs of confusion or agitation and show intense fear, helplessness, anger, sadness, horror or denial. Children who experience repeated trauma will dissociate, or numb their emotions to deaden the pain.

Children will exhibit many of the same symptoms of PTSD as adults do, but with the following exceptions:
* Worrying about dying at an early age/anxiety about death
* Acting younger than their age (e.g.; clingy or whiny behavior, thumbsucking, etc.)
* Repeating behavior that reminds them of the trauma. For example, repeatedly playing in a way that re-enacts the trauma.
* Regressive symptoms (e.g.; bed-wetting or losing speech or motor skills)
* Freezing (sudden immobility)
* Separation anxiety

Other sources of information:

I mentioned conditioning at the beginning of this piece. For those with STSD (Secondary Traumatic Stress Disorder) conditioning is how the symptoms begin to manifest, through the daily rituals and reactions that accompany PTSD symptoms in one’s loved one. When one becomes used to their partner waking up from nightmares, sleep becomes fragmented and lighter. When one becomes used to checking someone else’s psychological status in case a hospital visit may be needed, one starts reading everyone from that perspective. When one is in the company of another who sees the entire world as a threat one starts to examine the world through a similar lens. When one becomes used to checking their own emotional and psychological status in order to thwart an inappropriate reaction to someone else’s fear, introspection can become almost obsessive. When one is frequently and abruptly alarmed by a loved ones erratic behavior, hyper-vigilance, startle reactions and anxiety become constant.

The reasons for the manifestation of symptoms are different between PTSD and STSD. One has not experienced the same trauma as the loved one. But one becomes very defensive and protective of that loved one. When you see their pain daily you want to prevent anything more from hurting them. You feel the need to intervene in all their interactions. You feel the need to stand against any criticism of them. And if they ever act out in a violent way due to their fear then one has some trauma of their own to deal with. This can cause a lot of internal conflict, both wanting to protect someone and feeling the after effects of personal trauma. It can get very complicated.

One other thing I notice among those I know with PTSD is the tendency towards denial. Denial is an attempt to regain control of the situation and of the person’s thoughts and emotions. It is a poor coping strategy because it does not address the problems which then continue. Confrontation of this denial though is not only pointless because it only causes the person to distance themselves further from those who would support them but can also further traumatize the person. As a loved one, if the situation is stress inducing for you, take counseling for yourself and reach out to community support groups (for military personnel veterans departments may have some suggestions), do research and modify your own reactions to their behavior. If you can remain calm and open during a time your loved one is experiencing symptoms, this may assist the person in feeling more secure and comfortable in talking about their issues. If you react with agitation, excitation and stress-based reactivity the situation will escalate and not be resolved. This is part of the PTSD syndrome. It tends to reinforce itself in ever larger circles.

These situations can be very complicated to resolve. Some kinds of mindfulness training can be beneficial if it is supported by counseling. I am not an advocate of pharmaceutical approaches to mental health issues generally but if someone is feeling really out of control initial use of some drugs may be helpful as long as it is supported by counseling, self-help techniques to relieve stress, learning further coping skills, community/family support and education on the causes and available treatments. Unfortunately a lot of people only go to their doctor, get a wrong diagnosis from a 10 minute interview (ie social anxiety disorder, depression, bipolar, etc) and get a prescription for something which doesn’t help much.

One important thing I want to point out is the difference between mindfulness and hyper-vigilance. I’ve seen some suggestions that mindfulness is similar to hyper-vigilance. It is not. They are very different modes of attention. Mindfulness is fully attending to the present situation. It is reality based and unmediated by out of control emotions, projections of threat or re-emergent memories of past trauma. Hyper-vigilance does not attend to the present situation realistically. Instead hyper-vigilance attends to fear and potential psychologically manufactured threats in the environment whether the environment is safe or not. Hyper-vigilance is seeing every situation, through a filter of fear and anxiety, as a threat. The hyper-vigilant person does not relax enough to be able to attend to the present and accurately assess the situation. The ability to reality-test does not fully function. Sometimes cognitive behavioral techniques can help with that and sometimes mindfulness training can help with that provided the instructor is aware of the situation of hyper-vigilance and is knowledgeable about PTSD. That is the biggest caveat to undertaking any sort of Buddhist technique to help with PTSD symptoms.

Other caveats include:

  • denial. “You are Buddha already.” therefore you can’t have those problems. This “Buddha already” is problematic in far more ways than just denial of psychological issues but that is beyond the scope of this post. [I’m trying to curb my tendency to go off on tangents so maybe I’ll address it in a future post]
  • positivity. Not really a Buddhist approach but one that does occasionally creep in, the positivity approach simply exhorts people to “banish the negative”, “be positive” and shies away from dealing with any actual problems. It often gets mixed in with “The Secret” type notions. The “what you think manifests” or just by believing something it shall come to be. Also known as wishful thinking or Magical Thinking which has as much of a history in the West as elsewhere—see Magic (paranormal)—theories of adherents for more. You cannot wish PTSD away.
  • dismissal. of trauma based hallucinations, flashbacks, etc as “delusion”, “a dream”, “makyo” etc. A person’s subjective reality is their reality and has to be deal with as such.
  • catharsis. I have read some Buddhist teachers advocating meditation as a way to face trauma and be present with the feelings that arise. This is dangerous if there is no psychological support in place to deal with the fall out.
  • breaking through. This is an extreme form of catharsis. A few seem to think that prolonged retreats or intense sessions of meditation “through the pain” will somehow break the hold of PTSD or other psychological distress. This is also dangerous. For example a brilliant young man recently took his own life—Aaron Swartz held to the idea of “leaning into the pain” in order to overcome it. He suffered from bouts of depression in his life. [He wrote about it here Lean into the pain-if you read it notice that some of the impetus for “self-help” and “self-improvement” is very similar to what some Buddhist teachers put out, particularly those who do large group training and related sorts of seminars. People like Arianna Huffington are even praising the approach on her Google plus profile after his death.] While Swartz was not a Buddhist, nor did he have PTSD, as far as I know, this type of approach to any sort of psychological difficulty is problematic and has appeared intermittently in some Buddhist circles.

There’s likely a few more I could come up with but I’m sure you get the idea. The point is using Buddhist techniques as assisting in healing PTSD has to be done knowledgeably, carefully and that this is not the same as simple self-improvement or self-help.

So if you know anyone struggling with PTSD first educate yourself on the topic and then advocate on their behalf. That’s the two best things you can do for them. It will help you too, especially if you are close to them and beginning to experience some of the same issues.

Sex and the Sangha:Update

This is a followup to previous articles including Sex and the Sangha:Forgiveness, Retribution or Justice

The following has been recently posted on the Zen Studies Society ethical guidelines page:

The Zen Studies Society acknowledges that there have been occurrences of improper relationships between teachers and students. In the past, attempts to address concerns about such relationships were not satisfactory. The present board has revised and posted the following Guidelines for Ethical Behavior, including a grievance procedure. The board is adamant that these guidelines be upheld. The board also wishes to begin a process of reconciliation. If you are reading this and feel your concerns have not been acknowledged or heard, please contact a member of the ethics committee. On July 4, 2010, Eido Shimano Roshi and Aiho-san Shimano, who served the Zen Studies Society Board of Directors for the past forty-two years, voluntarily stepped down from the board to facilitate a smooth transition of both temporal authority and spiritual legacy.

July 14, 2010
Apparently the bolded lines above have now been commented out. Here is the current page code (13:37 PDT) which indicates the words are still there but have been set so they don’t display.To access this on the ZSS website go to View in your browser and select Page Source.

Here is a screenshot of the code with the original statement intact. Click on it to read it more clearly.

Notes:

On Bhante Sujato’s blog he has written “On “Sex and the Sangha” and the displacement of pain” which was based on my original post mentioned above. It is a really well thought out read on the dysfunctional aspects of Sangha including the bhikkuni ordination issue in which he is involved. As well there have been many useful comments.

One comment in particular by Linda struck me as pertinent to the above situation and the various discussions going on about it at Robert Aitken Roshi’s blog, Genkaku’s blog and on Zen Forum International.

Linda wrote:

“What i am objecting to is the misuse of “Dhammic” language and ideology in a way that perpetuates suffering.”

Excellent point, Bhante. Unfortunately this seems to happen quite a bit, not only in the ordained sangha, but also among some western (probably others too but I’m speaking from my experience) lay teachers and other practitioners who misuse “Dhammic” language to justify thinking and behavior that is actually just very unexamined and/or “shadow” based. I’ve personally seen this and have also seen the untold damage it can cause.

Ahhh, delusion is a mightily slippery, elusive and powerful force for us all, isn’t it? How to see what we can’t see?

But when group dynamics, community structures, and group-think become increasingly insular, narrow and unresponsive to feedback, combined with dynamics such as undue influence from others one is close to, blaming, other forms of projection (inc. both transference and counter-transference–quite natural but dangerous when unexamined), the (very human) desire to belong, the tendency to control or even ‘get rid of’ those seen as difficult (or those who ‘push one’s buttons’) or just misguided personal perceptions and unwillingness and/or inability to look at one’s own personal and/or group’s shadow issues, it can be particularly difficult to investigate… and very dangerous.
Dysfunctional, dynamics are not even seen, let alone examined or adequately addressed. And much pain ensues…. (I am speaking from my own experience being in a situation like this, and also from working professionally with groups and organizations, not from having actually lived in WPP communities, so this is not specifically about them.)

I guess we would all like to hope for and expect more (in terms of “enlightened” behavior and group dynamics, willingness to listen and examine things deeply, good communication, etc) in spiritual groups/communities, but unfortunately all the worldly dhammas, shadow issues, projection, and group dynamics still exist, and sometimes it seems such groups are no more capable of examining and addressing them than most secular/wordly groups and organizations are (sometimes less so). And even worse, most anything can be justified by whatever view (even the most so-called “spiritual” ones) one wishes to use to justify it. Somehow it seems even worse when “spiritual” views/”teachings”/ideology are used… perhaps because there’s an even greater incongruence, and also because it can get much more subtle and thus more difficult to see the actual issues and problems.

And sadly, in these types of conditions within groups, the worst in each other can get unconsciously fostered, not the best… (not to say the latter doesn’t happen as well at times).

Of course most of these dynamics operate individually as well (e.g. areas one wants to protect, difficult things to see or be with in oneself and the subtle ways one can avoid those, places of fear, contraction, defensiveness, blaming, etc). At least they come up in me! In fact, the deeper I look and the more I practice, the more I see how subtle it can be, and also how difficult at times…

Investigating these areas seems like such an important part of the practice… the process of continually examining one’s views, mind-states, intentions and actions (and the effect they have on both oneself and others) on all levels from the most blatant to the most subtle. And not only individually, but also the willingness to address these issues as a group in terms of group dynamics. Takes a lot of courage, reflection, and radically deep honesty…. and wholehearted (and whole-life) practice, doesn’t it?

This video of Ajahn Brahm on Dealing with Difficult People is great. He discusses the problems authority and the intrinsic attitudes that accompany it as well as the setup of monastic and related Buddhist institutions. Well worth watching.