The Worst Advice: A Summary of All the Things People Get Wrong About My PTSD

Hey all y’all.

This is something I’ve had to say repeatedly, although it hurts every time, because it reminds me of some of my old shames.

I shall put it in bullet points. Consider this a presentation of what you should not say to me.

1. PTSD is not voluntary.

This is not something I engage in as a conscious coping mechanism. Nor do I do it to get attention. This happens at a subconscious level; indeed, early severe childhood trauma has actually been shown to alter the brain to the point where some of the hallmarks of PTSD, like the startle reflex and constant vigilance, are now the base state of mind.

2. The PTSD I have is chronic.

There are two main kinds of PTSD: the “normal” kind, with a minimum recovery period of at least three months (and usually longer); and the chronic kind, which will take years and years to recover from.

In a way, the normal kind of PTSD can be considered like a car loan on your sanity. You’ll pay it off sooner. Relatively speaking. Whereas chronic PTSD is more like a 30-year mortgage on your house.

Of course, the difference between PTSD and the analogy of loans is that you can’t pay down the principal, which brings me to the next point…

3. PTSD is a severe mental condition.

You’d think I wouldn’t have to say this but—well, PTSD’s severity has gotten seriously downgraded in the media and social circles. At times, “I so have PTSD!” is regarded as being a bit of a mental breakdown.

But PTSD is far from a simple mental breakdown. It’s a complicated, long-term disorder (even the more short-term ones), and there are many interleaving factors, all of which can be very personal.

4. PTSD needs careful treatment.

In other words, the wrong treatment for PTSD often leads to increased damage.

This is why it’s important for psychologists/psychiatrists to be able to diagnose normal PTSD, chronic PTSD, and non-PTSD trauma cases from each other, because treatments for one will result in damage in the others cases.

5. PTSD can easily get worse.

You know what? Triggers are fucking horrible things. Triggers build on each other; triggers can be subtle; triggers can create other triggers; coping with triggers can create still more triggers. They breed like rabbits…

Which led me to the reluctant conclusion that my bartender is right: the war stories—the retelling of the old wounds so that they can be reprocessed again until they’re incorporated into non-traumatic memory store—are the best way to go, that don’t result in exponentially increasing triggers.

6. My bartender has a license.

Before you go about suggesting any techniques to bring back to him, please consider this:

  • He specializes in exactly the kind of trauma I have.
  • Having experienced multiple bartenders over the years, I know a good one when I talk to one over 20 sessions.
  • He has neither pushed me nor shamed me into going beyond what he knows I can do, and what he knows is possible.
  • Just because I call him a bartender doesn’t mean that he’s not a professional; it’s just my term for licensed psychologists.
  • In other words, he’s not a mere counselor.
  • He’s been doing this for years.
  • He’s also considered an award-winning top doctor in the Seattle area.

Basically… just trust me when I say I have the right guy here.

7. Don’t assume I’m not trying hard enough.

Just don’t. Even if you think you mean it kindly.

If you feel like this (and keep adding on wink-wink advice here’s more techniques to try), please remember:

  • I’ve been living with me for years, and you have not.
  • I’ve been trying to find ways to cope for years (sometimes very imaginative ways to cope), and you have not.
  • You don’t know how much I care about resolving this.
  • You don’t know how much damage has been wrought over 20 years of severe abuse ranging from the physical to the emotional.
  • You don’t know what my case of PTSD is like.
  • And most likely you don’t understand what it’s like to have PTSD or have a loved one who has PTSD.

8. Yes, my problems are that severe.

You know, when I say I’ve lost my touch with reality and am terrified as hell and hallucinating/seeing things… it’s really really bad. I’m not being hyperbolic about it, and I’m not exaggerating.

Yes, it’s rather distressing that someone who is as intelligent, or at least as articulate, as I could even have these problems in the first place, but see point 1: PTSD is not voluntary.

9. Advising against any of the above is insulting.

My reaction to insult tends to be hurt and much crying and upset. The attitudes in the above bullets are the ones I’ve been trying to cope with for so long that you’ve just done great damage in messing up just one, much less most, much less all of these.

The points above are also the kind of points that people who think they know better than me have used to justify dragging me back to my parents to the past. Just so you know.

And, as unintentional as your insulting may be, you should know that other people who also have PTSD read my blog—so you’ve just insulted them as well, and one thing I will not abide is a guest insulting others. I will bring out the ban hammer if I need to.

10. Check your non-PTSD privilege at the door.

You aren’t in our shoes. You haven’t studied deeply what it’s like to be in our shoes. Do not attempt to advise us as to how we should wear our shoes and how wrong we be walkin’ in our shoes, because your shoes? They ain’t our shoes.

And now I’m going to go cry in a corner for a while, with my cows.

18 thoughts on “The Worst Advice: A Summary of All the Things People Get Wrong About My PTSD

  1. I want to bake you cookies.

    I don’t have PTSD so I don’t assume to understand, but I have a bunch of things where other people feel they absolutely know what’s best for me, and that if I just try this one thing, all my problems will go away.

    And they get all offended when I point out they’re assuming I’m an idiot. Which really, Really Obvious Advice kind of *is* assuming someone is an idiot – that they won’t have thought of it/researched it themselves.

    I’m sorry you keep having people dumping advice on you. I hope they take this post to heart and learn from it.

  2. ebear,

    Thanks. :)



    Oddly enough, the smaller pieces of advice, the advice about the everyday things, have done well. Having the cows were that kind of advice, as was eating well, and what kind of stories are war stories, and so on. People weren’t very lecturey to me about these, however.

    It’s the sweeping life-change technique advice bestowed upon me like unto a gift that upsets me beyond belief.

  3. *hugs back*

    Yeah – in my experience, how it’s presented makes all the difference. I get “You should try yoga.” pretty much every time I post about my physical health issues (which I’ve had for a decade). Why no, random commenter, I never possibly considered something that’s been a massive craze here since before I got ill, was forced on us in school, and appears everywhere from library posters to the back of cereal packets.

    On the other hand, “Have you tried yoga?” – well, the answer is still “Yes. It doesn’t work” – but it’s not assuming I’m an eejit. And to me, that’s the big thing – outsiders acting like they know better. We both have [age] years of practice at being ourselves. They don’t. And I don’t tell pigs how to oink! (Or cows how to moo, given the location.)

  4. Jay,

    Ah! That does seem to be the difference. Condescension is a nasty sort of thing.

    Abi and Michael,

    Thanks. ^.^

  5. One of the reasons I like talking with you about stuff related to your PTSD is that it’s not, in your view or mine, my job to tell you what to do, or how to better manage anything, anything at all, including when or if you do the dishes.

    I can’t begin to tell you how much I value that.

  6. Hey! I just stumbled over your site, and I haven’t had that much of a chance to look around, but kudos to you for putting it out there. I’m bipolar II, rapid cycling (which I found out about first, so that may be why I’m putting it first) with a side dish of PTSD and anxiety. The PTSD is over being raped, and at times it can really torque my world. It must be rough having twenty years of it built up. I have a memoir I’m working on about growing up bipolar, but I’m not sure I’m ready to write about the rape yet. Just wanted to check in and say, yeah, these things are real. Yeah, real people have them. Yeah, some of us can function through them. But it takes bravery and skill and taking care of ourselves to do it. Again, thanks for putting the voice out there.

  7. I found this, well, I don’t even remember how (I think it was because of your Sherlock Holmes’ posts) and started reading many of your entries about PTSD. I’ve been very depressed for some months, and I found that many of PTSD symptoms match my state. It’s probably just a coincidence; I haven’t seen a specialist and I have no pretension of knowing what I have (in any case is not at all severe nor chronic). However, when I read your descriptions of triggers, different stages and all that, I can’t help feeling related to that. I understood what you meant, or at least that’s what I believe (although I don’t think I can even start to imagine what so many people with PTSD suffer, of course). I was also very surprised to find we have many things in common. I’m a Sherlock Holmes fan since my childhood, I’m studying Systems Engineering and I think I’ll be working in software development in the future (I’m even using that Design Patterns book I saw in your “I’m reading” list right now at university). I’m not even sure of why I’m writing here, I just wanted to thank you for writing all of this (I’ll keep reading), it’s really, really interesting and informative. I’d really like to talk to you, you’re an interesting person. :)

    • I’m glad you’re amused by my posts and may find them useful. ^.^ However, I feel like I must say this, but try not to self-diagnose. Psychology is, well, often a soft science. At least some of my symptoms are likely bipolar things (working with the PTSD, even strengthening its effects). A good psychologist or psychiatrist is invaluable in a diagnosis, but of course the trick is to find good ones.

      • Yes, I know. Sometimes I wish I could go to a good psychologist but I have a little problem that makes it very difficult for me to talk to strangers, and my skepticism regarding psychology wouldn’t make it any easier to trust somebody and tell them the story of my life. Anyway, I’ve been feeling much better lately. I hope you’re doing well. Take care!

  8. You express everything I want to say to the people around me who have no clue what I go through every day of my life. Can I just say how much I think you rock? I have been dealing with PTSD for 30 years. Add a dash of late life bipolar due to major life stress 5 years ago and my life is crazy. Even though I finally have my bipolar under control with medication, I still have lost all my friends and family due to lack of understanding and now basically fight these disorders totally on my own. I truly relate to exactly what you post. You are amazing. Thank you.

  9. Thank you for your blog! A friend of my son’s moved in with us a year ago (he was 18 at the time) and is still here, probably will be for another year or two. He is diagnosed with PTSD from childhood abuse and of course some effects are always visible. But he started college this week and a couple other stressors layered on top and suddenly he was experiencing major panic attacks. I was talking about it with a friend at work and she sent me a link to your blog. I can’t know what it feels like to be him or you, of course, but what you write is very consistent with what I see in his life. I will keep reading you to look for things that might help me support him. I am convinced that if he can get through this college program and become self-supporting financially, it will at least help with self esteem, which seems like it can only be to the good. Again, thanks for writing. Wishing you many blessings in your continued healing!

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