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.