Tag Archives: Commenting; in vivo exposure

The Snipers Never Go Away with #PTSD

Ok, so, I’m editing this post and renaming it. I will start with what I wrote prior and fill in the during and after:

I’m currently preparing to march in a parade. I have been actively mentally preparing for this since Thursday.

I drove with my family down to DC Thursday. No issue. Some fireworks last night and my two kids, my wife and I in asleep in a Queen sized bed left me a bit on edge this morning.

The Metro ride was uncomfortable but manageable. I struck up a conversation with a rider and it seemed to help.

So, here is the the challenge in front of me:

A crowd of people, most of whom I do not know.

Heat. Muggy, hot. Yuck.

Punchy. No sleep, plus the other two equals Angry Mike closer to the surface.

So, here are my steps to keeping it cool:

1. Remind myself that I am in a safe environment. Be on guard but not combative.

2. I have done this before and succeeded.

I will update this more later, but just wanted to capture my before state of being: anxious, nervous and punchy.

Talk to you later!

The parade was packed. It was seven people deep at the most crowded parts and had people lining the streets for the miles we walked. As we started, I was on high alert.

Actual thoughts that crossed through my mind:

Someone is going to blow themselves up.

Someone is going to run into our group and start a fight.

I looked for snipers on buildings and in the windows.

There are more, but for the sake of space, you get the picture. All of these thoughts and the subsequent memories of my experiences with them resulted in me being on edge. For the first ten minutes into the march I was very overwhelmed. But, I was there, committed to my friends and myself, and there was no turning back. I had to keep telling myself I was safe, and to relax.

The thoughts above cover scenarios I was taught to identify in Cognitive Processing Therapy. More specifically the therapy helped to identify the difference between low probability and high probability. I utilized my skills from Prolonged Exposure therapy by immersing myself into an In Vivo Exposure. I tested those feelings of safety and anxiety. Given the nature and length of the parade it was a very good assignment.

Low Probability v High Probability

Is there a chance a Sniper was on a building? Yes. But that probability was very low. In my own brain, just because it had happened in the past I over emphasized and addressed the scenario as though it were highly probable. Snipers and mortars are things that keep many Veterans awake at night. Chaos surrounds their intervention. One minute calm, the next all hell is breaking loose and to make matters worse, most of the time you have no idea where the hell they came from.

I think most Vets will agree that getting punched in the face is far better because at least you can see who is giving you the black eye. The canyons of building surrounding the parade route and gaggle we walked in were enough to remind me of a patrol on the mean streets.

Still, we were in Washington Freaking D.C. I am fairly certain that city has air defense missile systems now, let alone a slew of plain clothes cops… So, acknowledge the probability, but don’t let is consume you.

In Vivo Exposure

Again my summary of In Vivo Exposure: Don’t like doing it? Do it, and do it some more. Ok, maybe that is a bit too simplified. There are some instructions that go a long with the therapy: Take notes on how uncomfortable the situation is. Stay in the situation long enough for the comfort level to increase. Pay attention to the thoughts and specifics. As I stated earlier, I was hard up for comfort as the parade began. It was very loud and there were thousands of people all focused on the parade. After the parade I hung out on the streets for a bit to keep the exposure going. I was selective where we stood and watched the rest of the parade with no incident.

All in all I had a good time. I made it home late that night after another Metro ride and I was mentally and physically exhausted Sunday and into today.

The therapy works but it requires sharpening the edges constantly to remain effective. Shooting is a perishable skill. So is your own mental health.

Moral of the story: Keep at it. Attack the PTSD just as you had attacked other things in other times. Be smart about it and you will see results!

Feedback welcome!