Cherophobia is a phobia where a person has an irrational aversion to being happy. The term comes from the Greek word “chero,” which means “to rejoice.” When a person experiences cherophobia, they’re often afraid to participate in activities that many would characterize as fun, or of being happy.
This condition is one that’s not widely researched or defined. Psychiatrists most commonly use criteria in the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to diagnose mental health conditions. Currently, the DSM-5 doesn’t list cherophobia as a disorder. However, there are some mental health experts that discuss this phobia and its potential treatments.
What are the symptoms of cherophobia?
Some medical experts classify cherophobia as a form of anxiety disorder. Anxiety is an irrational or heightened sense of fear related to the perceived threat. In the case of cherophobia, the anxiety is related to participation in activities that would be thought to make you happy.
Someone who has cherophobia isn’t necessarily a sad person, but instead is one that avoids activities that could lead to happiness or joy. Examples of symptoms associated with cherophobia could include:
experiencing anxiety at the thought of going to a joyful social gathering, like a party, concert, or other similar event
rejecting opportunities that could lead to positive life changes due to fear that something bad will follow
refusal to participate in activities that most would call fun
Some of the key thoughts a person who experiences cherophobia may express include:
Being happy will mean something bad will happen to me.
Happiness makes you a bad or worse person.
Showing that you’re happy is bad for you or for your friends and family.
Trying to be happy is a waste of time and effort.
In an article from the Journal of Cross-Cultural Psychology, the authors created a Fear of Happiness Scale. Created to compare fear of happiness across 14 cultures, the scale can also help a person or their doctor to evaluate if they have symptoms of cherophobia. Some statements include:
I prefer not to be too joyful, because usually joy is followed by sadness.
Disasters often follow good fortune.
Excessive joy has some bad consequences.
By rating these statements on a 1 to 7 scale of how much you agree, it may be able to show that you have a fear or misperception of happiness.
What are the causes of cherophobia?
Sometimes cherophobia can stem from the belief that if something very good happens to a person, or if their life is going well, that a bad event is destined to happen. As a result, they may fear activities related to happiness because they believe they can ward off something bad from happening. This is often the case when someone has experienced a past physical or emotional traumatic event.
An introvert may be more likely to experience cherophobia. An introvert is a person who typically prefers to do activities alone or with one to two people at a time. They’re often seen as reflective and reserved. They may feel intimidated or uncomfortable in group settings, loud places, and places with a lot of people.
Perfectionists are another personality type that may be associated with cherophobia. Those who are perfectionists may feel happiness is a trait only of lazy or unproductive people. As a result, they may avoid activities that could bring happiness to them because these activities are seen as unproductive.
What are the treatments for cherophobia?
Because cherophobia hasn’t been largely detailed or studied as its own separate disorder, there aren’t FDA-approved medications or other definitive treatments that a person may pursue to treat the condition.
However, some suggested treatments include:
cognitive behavioral therapy (CBT), a therapy that helps a person recognize faulty lines of thinking and identify behaviors that can help them change
relaxation strategies, such as deep breathing, journaling, or exercising
exposure to happiness-provoking events as a means to help a person identify that happiness doesn’t have to have adverse effects
Not everyone with an aversion to happiness necessarily needs treatment. Some people feel happier and more secure when they’re avoiding happiness. Unless cherophobia is interfering with their own personal quality of life or ability to maintain a job, they may not require treatment at all.
However, if the symptoms of cherophobia are related to a past trauma, treating an underlying condition may help to treat cherophobia.
“Words can inspire, and words can destroy. Choose yours well.” ~ Robin Sharma
We do not see the world as it is, but rather as we are. The thoughts, beliefs and expectations we hold about ourselves, others or life in general are what we spotlight and amplify in the physical world.
For example, if a person repeatedly thinks the thought, “No one ever helps me do anything, I always have to do everything myself,” it will eventually turn into a deep rooted belief. Once the belief is strongly held, that person will start to recognize every situation that reinforces the belief.
Eventually the power of belief and intention takes over and starts to draw situations to that person that reinforces the thought. They find themselves in circumstance after circumstance where no one is helping.
There are certain life lessons that we may have heard over the years that have gotten embedded in our subconscious. Often, a belief is so deep in our unconscious mind that we may not even know that we hold the belief, because we have never taken the time to confront it.
Because of this, we may be participating in a limited belief system that is having a negative effect on our life without our even realizing it.
Here are five “life lessons” that we may have heard that need to be confronted and unlearned in order to help us live a happier existence:
1. Money is the root of all evil
Has money motivated people to be greedy, power-hungry, or participate in any number of unspeakable acts? Yes, of course. But is this the money’s fault or the person’s? When we really think about it, money is just a piece of paper. It is the person holding the bill who decides whether to use it to make the world a better place or a worse one.
Since we live in a society that requires money to live, we must not look at money as the enemy. Greed, power, selfishness, etc…yes… but money… it’s just a piece of paper. When we see money as evil we limit our own ability to use money as a means to help others and live a fulfilling life ourselves.
2. Nothing in life comes easy
Life is formed off of our expectations. If we are always expecting everything to be so difficult, we can’t complain when things actually are. Yes, there will be unplanned events, difficult days, and times when we will be forced to face our fears.
But, if we remember that our success rate at getting through a bad day is 100% so far, and when we look back at something we were going through 5 years ago and realize how trivial it seems now, it puts things in a different perspective.Life doesn’t always have to be hard. Think of failures and obstacles as opportunities for growth and redirection. If we expect the best case scenario in all situations, we may actually be surprised to find that most things aren’t as hard as we thought they would be.
3. A leopard never changes it’s spots
Life is about change. We aren’t the same person we were 10 years ago. We aren’t the same person we were yesterday, even. Everyone has the power to become a better person. If we wouldn’t want people to hold us to the same person we were in the past, we must give others the benefit of being able to evolve and mature as well. Expect the best from people.
Yes, there may be some times when we are disappointed with the actions of others, but there will also be those people who learned from their mistakes, and decide to turn their mistakes into their reason to change.
4. You can’t depend on anyone but yourself
This one can be tricky, because essentially it is true. Really, the only person we have control over and therefore can depend on or expect anything from is ourselves.
However, the problem comes in when we become so attached to this idea that we refuse to accept help from others, because of pride or some other ego-driven reason.
What most people don’t realize is the act of receiving is just as important as the act of giving. Both actions keep the flow of energy moving to and through us. So yes, depend on yourself, but when someone comes along that is happy to help us with something, let them.
Help in our lives can come from any number of ways, and we must be open to all of it in order to receive it. We must not only give joyfully, but receive joyfully as well.
5. Time is limited
All we really have is time. And by the time the time runs out we won’t care about not having enough time because we will no longer be here. Anytime we tell ourselves that something is going to take too much time to accomplish something, we set ourselves up for failure because time is going to pass regardless.
Either we can spend it working towards something we really want or we can spend it thinking about what we want, and then talking ourselves out of it because it’s going to take too much time. The present moment is all that truly exists, and we can either spend it taking action and doing something we love, or we can waste it talking ourselves out of following what we really truly want out of life.
Take the time to confront every belief that you are holding. Make sure you aren’t holding on to something that is actually making your life less fulfilling and harder. Just because we’ve heard a phrase a million times doesn’t mean it has to be true for us.
Make your own life lessons. Expect amazingness. Make the “impossible” possi
If you’ve ever cried about getting a B+ or ending up in second place, there’s a good chance you’re a perfectionist.
As a culture, we tend to reward perfectionists for their insistence on setting high standards and relentless drive to meet those standards. And perfectionists frequently are high achievers — but the price they pay for success can be chronic unhappiness and dissatisfaction.
“Reaching for the stars, perfectionists may end up clutching at air,” psychologist David Burns warned in a 1980 Psychology Today essay. “[Perfectionists] are especially given to troubled relationships and mood disorders.”
Perfectionism doesn’t have to reach Black Swan levels to wreak havoc on your life and health. Even casual perfectionists (who may not think of themselves as perfectionists at all) can experience the negative side-effects of their personal demand for excellence. Here are 14 signs that perfectionism could actually be holding you back — and simple ways to start letting go.
1. You’ve always been eager to please.
Perfectionism often starts in childhood. At a young age, we’re told to reach for the stars — parents and teachers encourage their children to become high achievers and give them gold stars for work well done (and in some cases, punishing them for failing to measure up). Perfectionists learn early on to live by the words “I achieve, therefore I am” — and nothing thrills them quite like impressing others (or themselves) with their performance.
Unfortunately, chasing those straight A’s — in school, work and life — can lead to a lifetime of frustration and self-doubt.
“The reach for perfection can be painful because it is often driven by both a desire to do well and a fear of the consequences of not doing well,” says psychologist Monica Ramirez Basco. “This is the double-edged sword of perfectionism.”
2. You know your drive to perfection is hurting you, but you consider it the price you pay for success.
The prototypical perfectionist is someone who will go to great (and often unhealthy) lengths to avoid being average or mediocre, and who takes on a “no pain, no gain” mentality in their pursuit of greatness. Although perfectionists aren’t necessarily high achievers, perfectionism is frequently tied to workaholism.
“[The perfectionist] acknowledges that his relentless standards are stressful and somewhat unreasonable, but he believes they drive him to levels of excellence and productivity he could never attain otherwise,” Burns writes.
3. You’re a big procrastinator.
The great irony of perfectionism is that while it’s characterized by an intense drive to succeed, it can be the very thing that prevents success. Perfectionism is highly correlated with fear of failure (which is generally not the best motivator) and self-defeating behavior, such as excessive procrastination.
Studies have shows that other-oriented perfectionism (a maladaptive form of perfectionism which is motivated by the desire for social approval), is linked with the tendency to put off tasks. Among these other-oriented perfectionists, procrastination stems largely from the anticipation of disapproval from others, according to York University researchers. Adaptive perfectionists, on the other hand, are less prone to procrastination.
By being less tough on others, some perfectionists might find that they start easing up on themselves.
“Look not to the faults of others, nor to their omissions and commissions,” the Buddha wisely advised. “But rather look to your own acts, to what you have done and left undone.”
5. You go big or go home.
Many perfectionists struggle with black-and-white thinking — you’re a success one moment and a failure the next, based on your lastest accomplishment or failure — and they do things in extremes. If you have perfectionist tendencies, you’ll probably only throw yourself into a new project or task if you know there’s a good chance you can succeed — and if there’s a risk of failure, you’ll likely avoid it altogether. Studies have found perfectionists to be risk-averse, which can inhibit innovation and creativity.
For perfectionists, life is an all or nothing game. When a perfectionist sets her mind to something, her powerful drive and ambition can lead her to stop at nothing to accomplish that goal. It’s unsurprising, then, that perfectionists are at high risk for eating disorders.
6. You have a hard time opening up to other people.
Author and researcher Brene Brown has called perfectionism a “20-ton shield” that we carry around to protect ourselves from getting hurt — but in most cases, perfectionism simply prevents us from truly connecting with others.
“It is very hard for a perfectionist to share his or her internal experience with a partner,” Springer writes in Psychology Today. “Perfectionists often feel that they must always be strong and in control of their emotions. A perfectionist may avoid talking about personal fears, inadequacies, insecurities, and disappointments with others, even with those with whom they are closest.”
7. You know there’s no use crying over spilt milk… but you do anyway.
Whether it’s burning the cookies or being five minutes late for a meeting, the perfection-seeking tend to obsess over every little mistake. This can add up to a whole lot of meltdowns, existential crises, and grown-up temper tantrums. When your main focus is on failure and you’re driven by the desire to avoid it at all costs, even the smallest infraction is evidence for a grand thesis of personal failure.
“Lacking a deep and consistent source of self-esteem, failures hit especially hard for perfectionists, and may lead to long bouts of depression and withdrawal in some individuals,” writes Springer.
8. You take everything personally.
Because they take every setback and criticism personally, perfectionists tend to be less resilient than others. Rather than bouncing back from challenges and mistakes, the perfectionist is beaten down by them, taking every misstep as evidence for the truth of their deepest, continually plaguing fear: “I’m not good enough.”
9. … And you get really defensive when criticized.
You might be able to pick out a perfectionist in conversation when they jump to defend themselves at even the slightest hint of a criticism. In an effort to preserve their fragile self-image and the way they appear to others, a perfectionist tries to take control by defending themselves against any threat — even when no defense is needed.
10. You’re never quite “there yet.”
Because perfection is, of course, an impossible pursuit, perfectionists tend to have the perpetual feeling that they’re not quite there yet. Self-described perfectionist Christina Aguilera told InStyle in 2010 that she focuses on all the things she hasn’t yet accomplished, which gives her a drive to constantly out-do herself.
“I am an overachiever and an extreme perfectionist,” Aguilera said. “I would like to do more film and I feel that I still have yet to acquire the type of success that I desire. I’m sure there will definitely be a place that I will be at peace with knowing I’ve accomplished a lot.”
11. The image below makes you nervous.
12. You take pleasure in someone else’s failure, even though it has nothing to do with you.
Misery loves company, and perfectionists — who spend a lot of time and energy thinking and worrying about their own failure — can find relief and even pleasure in others’ challenges. For a moment, taking pleasure in someone else’s shortcomings might make you feel better about yourself, but in the long term, it only reinforces the kind of competitive and judgmental thinking that perfectionists thrive on.
13. You get secretly nostalgic for your school days.
Some people hated school, but you loved it, because success was quantifiable — you had assignments, grades, feedback, and a teacher whose job it was to provide positive feedback and a pat on the back for a job well-done. You might have been a teacher’s pet, or maybe you were voted “Most likely to succeed” in the yearbook. The structure of school and easy equation of “work hard, do well, be rewarded” is a comfort for most perfectionists.
In the real world, success is measured differently. Everything is structured differently. And while you might not ever tell anyone, there’s a part of you that misses that world where it was possible to get an A+ and call it a day.
14. You have a guilty soul.
Underneath it all, perfectionists are often plagued by guilt and shame. Maladaptive perfectionism — a drive to perfection that generally has social roots, and a feeling of pressure to succeed that derives from external, rather than internal, sources — is highly correlated with depression, anxiety, shame and guilt.
“Perfectionism is not about striving for excellence or healthy striving,” Brown told Oprah. “It’s… a way of thinking and feeling that says this: ‘If I look perfect, do it perfect, work perfect and live perfect, I can avoid or minimize shame, blame and judgment.'”
Brown’s remedy? Try practicing authenticity. Let others see you, exactly as you are, and let go of the protecting shield of perfectionism in order to express vulnerability.
“Authenticity is a practice and you choose it every day,” she says, “sometimes every hour of every day.”
As a therapist, I have always been a big fan of offering my clients “hands on” practical strategies that can help them self-soothe immediately in times of anger and emotional distress. I refer to these self-soothing boxes by names such as a Calming Box or Coping Skills Toolbox. Self-soothing boxes are made up of a variety of items to distract and soothe. For example, a Hershey Kiss or Hug can remind us to be kind to ourselves and others and give figuratively “Hugs and Kisses” in times of anger and emotional upheaval. It also tastes good and gives ourselves a much needed “Kiss” or Hug!”
Using Calming Boxes are an example of an emotional regulation strategy in Dialectical Behavior Therapy, addressing the need to develop skills for increasing distress tolerance. The Coping Skills Toolbox replaces the urge for angry interpersonal exchanges or even self-destructive behavior, such as substance abuse or self-harm.
To make up a Coping Skills Toolbox, you can take a shoebox or get a decorative box inexpensively at a dollar store or craft store. Using actual objects that serve to distract and self-soothe are great for both children and adults in times of distress. It is one thing to think about something, but another to provide an alternate activity or tangible soothing touchstone. Tangible objects help ground us. They are especially helpful in times of emotional upset to give immediate comfort and can serve as a distraction, as well as offering alternative activities. Each individual collects items in their individual boxes that are personally meaningful. Most items can be inexpensively found at the supermarket, dollar store, or around the house.
The following are some examples of items that could offer self- soothing and increase coping skills in times of distress.
•A stuffed animal to hug
•A Stress Ball to help relieve stress
•A bottle of bubbles to blow out frustration and “lighten up”
•A pencil to write yourself healthy reminders
•Joke books, Soduku or Crossword Puzzle books
•Notebook, journal or notecards to write out feelings
•Cards given to you from friends and family
•Calming oils to touch and smell
•Stress ball or small bouncing ball
•Book or file cards with Affirmations
•Small Play Dough – Good sensory outlet that you can mold and shape
•Yarn and needles for knitters
Self-Soothing boxes are especially fun to make in a group setting, as group participants can get ideas from fellow group members on what works for them to control their anger or impulsive tendencies in times of emotional distress. If you are leading a therapeutic or educational group, have a variety of objects on a table, and go over with the group how these items can help soothe them. This can be a fun brainstorming activity, as there are no right or wrong answers. Sharing ideas of what is soothing can be quite therapeutic in itself, and encourages flexible thinking. At the end of the project, have members share with the group what they chose to put in their boxes, and discuss how their items will be used in times of emotional distress.
For more ideas of how to use these “hands on” boxes for children as well as adults, click here for more details on how to assemble a Calming Box.
Anxiety can affect anyone. It affects the poor, the rich, the young, the old, the sick, the healthy, and more. Anxiety doesn’t discriminate, and while some people may be more prone to anxiety than others, the reality is that anyone from all walks of life can suffer from anxiety disorders.
The most famous, rich, and successful people in the world suffer from anxiety just like everyone else. In this article, we’ll look at thirteen different people that suffer from the three most common anxiety disorders – generalized anxiety disorder, panic disorder, and obsessive compulsive disorder.
Get Help For Your Anxiety
The most successful men and women in the world know how important it is to stop their anxiety. Learn how to stop anxiety yourself. Take my free 7 minute anxiety test to learn more about your anxiety and the best way to cure it.
The reality is that many people struggle with anxiety – including those that do not quality for an anxiety disorder diagnoses. Anxiety can also differ in severity. Many famous people struggle with serious anxiety, and many more struggle with mild to moderate anxiety.
Learn more about your own anxiety by taking my free 7 minute anxiety test. It takes only a short time, and you’ll see charts that compare your anxiety to others and information on how best to treat it.
Famous People With Generalized Anxiety Disorder
Generalized anxiety disorder is a persistent form of daily anxiety that doesn’t have any of the symptoms of other anxiety disorders. Some of the most famous celebrities have suffered at one time or another with this type of anxiety, which plagues a large percentage of the general population. Notable celebrities include:
As recently as the middle of 2012, Leann Rhymes decided to enter a treatment facility for severe anxiety and stress. While the nature of her anxiety is not listed in any reports (and shouldn’t be, since patient information is always confidential), her representative stated that Ms. Rimes simply needs to re-learn coping tools for the significant anxiety that comes with being a celebrity.
While it’s difficult to diagnose someone before diagnoses existed, many believe that Abraham Lincoln suffered from severe anxiety and depression. It should come as no surprise. The most famous president in history was bombarded with challenges, and the world around him was often in chaos. As he himself once said: We live in the midst of alarms; anxiety beclouds the future; we expect some new disaster with each newspaper we read.
Famous People With Panic Disorder
While generalized anxiety disorder is extremely common, it’s also “manageable.” As severe as the anxiety can be (and it can be extremely severe), many people with GAD are able to hide the disorder and go about their day as if it doesn’t bother them. Generalized Anxiety Disorder is incredible stressful and requires treatment, but a person can go their whole lives without admitting to others that the anxiety exists.
The same is not true of panic disorder. Panic disorder often causes severe, debilitating anxiety attacks that can frighten not only the person suffering from panic attacks, but also those around them. Because it’s difficult to hide panic disorder, far more celebrities are willing to openly share their panic attack problems, including the following individuals:
Johnny Depp may be one of the most popular actors in the world, but that hasn’t stopped him from suffering from panic attacks for years. The actor doesn’t speak about them very often, but his struggles with panic disorder are well known.
Johnny Depp’s old girlfriend, Kate Moss, also revealed that she had been dealing with panic attacks for years – especially in her youth. She revealed in a magazine interview that her panic attacks may have been related to severe stress over the idea that she needed to make provocative poses with men and women in a way that made her distressed.
Speaking of famous actors and actresses, Emma Stone may be one of the most popular young women in movies today, but she also dealt with numerous panic attacks to the point where she developed agoraphobia. While most people get panic attacks in their 20’s, Emma Stone got her first panic attack in her youth. Today, she says she still deals with panic attacks once in a while, but has found that she’s developed healthy coping strategies to deal with them.
For those that only pay attention to movies and film, the name “Joey Votto” may not ring any bells. But those that follow baseball know that as of this writing Joey Votto is one of the best players in major league baseball, and has been for many years. But while he was working his way up the minor leagues and even into the majors, Joey Votto suffered from severe panic attacks, to the point where he shared the one phrase that those with panic attacks know all too well: “I thought I was going to die.”
Some people get their first panic attacks when they’re severely stressed. Others get their first one out of the blue, with no way to see it coming. The latter is what happened to famous actress and model Kim Basinger, who had her first panic attack in the middle of a grocery store. Her panic attacks were so terrible that she developed agoraphobia and depression as a result.
Charlie Beljan is a golfer that became the face of panic attacks when he suffered from one while playing on the PGA tour. He managed to finish with one of the lowest scores of his career despite himself and the paramedics believing he was having a heart attack that turned out to be nothing more than a severe panic attack.
Being beautiful and famous doesn’t stop anxiety. Scarlett Johansson, who shared that she often feels nervous on sets before filming a movie, has also said that right before filming she has suffered from some severe anxiety attacks. It’s not clear if she’s talking about “severe anxiety” or “panic attacks,” but it’s obvious that the actress is not without that added stress.
The most famous singer in the world in 2011 and 2012 appears to have suffered from not only panic attacks, but also social phobia and severe stage fright. Performing in front of crowds of thousands can give anyone stage fright, but there is a strong likelihood that her anxiety attacks were an issue long before she ever stepped on stage.
Anxiety Comes in All Shapes and Sizes
Take my free 7 minute anxiety test now to get a graph of your anxiety compared to others, and an idea of what’s affecting you the most.
Famous People With Obsessive Compulsive Disorder
Many celebrities claim to suffer from obsessive compulsive disorder. Most of them do not. Being OCD has become a very unusual badge of honor for a lot of different famous people, who see it as a neat eccentricity rather than a significant disruption in their lives.
But those that live with OCD know how debilitating and stressful it can be. It’s not just liking order or never using a public bathroom. Those with OCD develop severe anxiety, have unusual thoughts or fears, and perform ritualistic behaviors specifically to get through their day to day life.
There are several famous people that feel your pain. A small sample of these people includes:
A “fear of germs” doesn’t necessarily make you obsessive compulsive, but Howie Mandel’s lifestyle changes are indicative of a person that is overcoming a real mental health disorder. Mandel not only doesn’t shake hands or touch dirty things – he even keeps his hair shaved to help him feel cleaner.
While he’s managed to live a fairly decent quality of life despite his disorder, David Beckham has all of the qualities of a real celebrity living with OCD. Beckham’s obsession is order, specifically with pairs. He needs to have even numbers or he becomes very uncomfortable, and has been known to throw out or add to things in order to make sure they’re an even number.
The former lead singer of Limp Bizkit has said that he has struggled with terrible OCD, but he prefers to keep the details of his obsessive compulsive disorder private. He claims that he has looked for several tools, including books, to try to get rid of his ticks behavioral troubles, but that he still struggles with it to this day.
What to Learn From Celebrities With Anxiety Disorders
There are countless more examples of celebrities and famous individuals with various anxiety disorders. From Carry Underwood to Amanda Seyfried, it doesn’t matter if you’re famous or not famous – anxiety disorders can affect everyone.
But one thing you can learn from these celebrities is that nearly all of them sought help. They recognized that their anxiety was a problem and they committed themselves to controlling it.
Take my anxiety test to start finding out more about your anxiety, and learn how you can successfully stop your anxiety forever.
Happiness is one aspiration all people share. No one wants to be sad and depressed. We’ve all seen people who are always happy – even amidst agonizing life trials. I’m not saying happy people don’t feel grief, sorrow or sadness; they just don’t let it overtake their life. The following are 21 things happy people make a habit of doing:
1. Appreciate Life Be thankful that you woke up alive each morning. Develop a childlike sense of wonder towards life. Focus on the beauty of every living thing. Make the most of each day. Don’t take anything for granted. Don’t sweat the small stuff.
2. Choose Friends Wisely Surround yourself with happy, positive people who share your values and goals. Friends that have the same ethics as you will encourage you to achieve your dreams. They help you to feel good about yourself. They are there to lend a helping hand when needed.
3. Be Considerate Accept others for who they are as well as where they are in life. Respect them for who they are. Touch them with a kind and generous spirit. Help when you are able, without trying to change the other person. Try to brighten the day of everyone you come into contact with.
4. Learn Continuously Keep up to date with the latest news regarding your career and hobbies. Try new and daring things that has sparked your interest – such as dancing, skiing, surfing or sky-diving.
5. Creative Problem Solving Don’t wallow in self-pity. As soon as you face a challenge get busy finding a solution. Don’t let the set backs affect your mood, instead see each new obstacle you face as an opportunity to make a positive change. Learn to trust your gut instincts – it’s almost always right.
6. Do What They Love Some statistics show that 80% of people dislike their jobs! No wonder there’s so many unhappy people running around. We spend a great deal of our life working. Choose a career that you enjoy – the extra money of a job you detest isn’t worth it. Make time to enjoy your hobbies and pursue special interests.
7. Enjoy Life Take the time to see the beauty around you. There’s more to life than work. Take time to smell the roses, watch a sunset or sunrise with a loved one, take a walk along the seashore, hike in the woods etc. Learn to live in the present moment and cherish it. Don’t live in the past or the future.
8. Laugh Don’t take yourself – or life to seriously. You can find humor in just about any situation. Laugh at yourself – no one’s perfect. When appropriate laugh and make light of the circumstances. (Naturally there are times that you should be serious as it would be improper to laugh.)
9. Forgive Holding a grudge will hurt no one but you. Forgive others for your own peace of mind. When you make a mistake – own up to it – learn from it – and FORGIVE yourself.
10. Gratitude Develop an attitude of gratitude. Count your blessings; All of them – even the things that seem trivial. Be grateful for your home, your work and most importantly your family and friends. Take the time to tell them that you are happy they are in your life.
11. Invest in Relationships Always make sure your loved ones know you love them even in times of conflict. Nurture and grow your relationships with your family and friends by making the time to spend with them. Don’t break your promises to them. Be supportive.
12. Keep Their Word Honesty is the best policy. Every action and decision you make should be based on honesty. Be honest with yourself and with your loved ones.
13. Meditate Meditation gives your very active brain a rest. When it’s rested you will have more energy and function at a higher level. Types of meditation include yoga, hypnosis, relaxation tapes, affirmations, visualization or just sitting in complete silence. Find something you enjoy and make the time to practice daily.
14. Mind Their Own Business Concentrate on creating your life the way you want it. Take care of you and your family. Don’t get overly concerned with what other people are doing or saying. Don’t get caught up with gossip or name calling. Don’t judge. Everyone has a right to live their own life the way they want to – including you.
15. Optimism See the glass as half full. Find the positive side of any given situation. It’s there – even though it may be hard to find. Know that everything happens for a reason, even though you may never know what the reason is. Steer clear of negative thoughts. If a negative thought creeps in – replace it with a positive thought.
16. Love Unconditionally Accept others for who they are. You don’t put limitations on your love. Even though you may not always like the actions of your loved ones – you continue to love them.
17. Persistence Never give up. Face each new challenge with the attitude that it will bring you one step closer to your goal. You will never fail, as long as you never give up. Focus on what you want, learn the required skills, make a plan to succeed and take action. We are always happiest while pursuing something of value to us.
18. Be Proactive Accept what can not be changed. Happy people don’t waste energy on circumstances beyond their control. Accept your limitations as a human being. Determine how you can take control by creating the outcome you desire – rather than waiting to respond.
19. Self Care Take care of your mind, body and health. Get regular medical check ups. Eat healthy and work out. Get plenty of rest. Drink lots of water. Exercise your mind by continually energizing it with interesting and exciting challenges.
20. Self Confidence Don’t try to be someone that you’re not. After all no one likes a phony. Determine who you are in the inside – your own personal likes and dislikes. Be confident in who you are. Do the best you can and don’t second guess yourself.
21. Take Responsibility Happy people know and understand that they are 100% responsible for their life. They take responsibility for their moods, attitude, thoughts, feelings, actions and words. They are the first to admit when they’ve made a mistake. Begin today by taking responsibility for your happiness. Work on developing these habits as you own.
I’ve skirted, danced, bogled and boogeyed around it and kinda explained why it happened but never really gone into much “depth” as to – what happened, how it happened, how it felt – so I’m bored, have a few hours, am tired of talking to Meadhbh so am gonna blabber here for a while.
What is a “nervous breakdown”? You could also call it an emotional breakdown or perhaps a mental breakdown, but in essence a “breakdown” has occurred when someone becomes unable to deal with normal day-to-day life.
It can be ignited following a particular trauma, a series of events, or can even happen randomly and out of the blue with no precipitating identifiable cause.
“Nervous breakdown” isn’t even a medical term: it’s a colloquial phrase designed to try and hide what is actually happening, which is the sudden acute attack of a mental illness, because a breakdown is far more easily accepted than bipolar, depression or anxiety; it is stigma at work!
Why I had a breakdown… A breakdown generally occurs when your circuits become overloaded. Your brain, heart, soul, emotions – whatever – are under so much stress that they short circuit, and then shut off, and then you can’t find a nice clean unbroken fuse to mend them.
As mentioned previously, I was diagnosed with CLL and then dumped by my girlfriend by text message which set in motion a chain of events which caused me to lose my college course, my income, my best friend and all of this happening whilst I was suffering from glandular fever – a pretty serious physical illness which could have killed me – and all in the period of ten days.
I think any one or two of those things could have the power to trigger a breakdown, but to have so many stressful emotional events hitting you when you are already physically, mentally and emotionally devastated from glandular fever, the fact I had a breakdown doesn’t surprise me.
What happened? The day I realised something was seriously wrong was the Tuesday I spent walking around the sleepy hamlet of Port Fairy talking to myself at an audibly obvious level for six continuous hours before sitting on a beach and burning myself with a flaming stick. Now I had wanted to phone someone at this point, I knew something was brewing and I was worried I wasn’t going to be able to stop myself…but no working public phone box anywhere close and…dammit…mobile phone battery was dead!
So I burnt myself twice, used the ocean to cool the burns, and then stood there for an hour or so staring at the black expanse of the horizon before retreating to where I was staying whilst I was in Port Fairy.
I spent the next day glued to the bed, unable to move, writing obscure journal entries which skipped, danced and evaded the actual events which had happened the night before. I thought that by not writing about them I would be able to forget them. I watched an entire season of 24 that day and wished to high fracking heaven my mobile phone charger had been packed because at this point I really desperately needed to speak to someone. Oh well.
On the Thursday I crawled to the Doctor, on the Friday I saw a psychologist, on the Saturday I sat on a beach again, on the Sunday I spent another 7 hours walking around talking to myself, on the Monday I returned to Melbourne.
How did it feel to have a breakdown? I literally felt nothing. I literally could do nothing. There was all this stuff I needed to do, all this stuff I wanted to do, but I just – couldn’t – I literally could not do any of it. My brain was not functioning on any level, all I could do for a few days was lie there watching other seasons of 24 (as this had helped the week before) trying not to harm myself.
Now that I had my charger back I couldn’t even bring myself to phone anyone because I didn’t have any words to say. I was doing that wee dial the number, delete the number, toss the phone across the room dance.
On the Wednesday I woke up having a panic attack, spent the day in a constant state of anxiety, panic, despair and fear. I wrote in my journal on and off, and for the first time ever mentioned my self harm in it’s pages (which you can read here). Then something happened that night which – well – let’s just say really really really really didn’t fracking help!!! I have never understood why that person thought it was a good idea, never will, but what they did that night was fucked up to the extreme!
On the Thursday I wanted to kill myself. I sat on the floor of my room staring at a knife and wondering what it would feel like. Tears were streaming down my face and I know I made two phone calls, but I can’t remember which order they came in. I either phoned a friend and then the suicide helpline, or I phoned the suicide helpline and then phoned a friend. Either way I spent the vast majority of that day in a constant state of fear of what I may do to myself.
After that week the specific days become blurry, everything is just a mess in my mind. I know I fought my self harm tendencies, I know Meadhbh came back, I know I did self harm, I know I was suicidal, I know I saw friends, I know I tried to rebuild my life, I know I saw doctors, I know I saw the occasional psychologist, I know I tried to do anything and everything that I could to fight what was happening to me and get my life back to something I was able to enjoy.
I wasn’t able to work. That’s a fact. Simple and pure. My health was fucked up to the point of unbearable, I couldn’t concentrate on a job advertisement let alone work an 8 hour shift, but I job hunted nonetheless.
As all this was happening I was having to sell all of my possessions in order to survive (rent, food, occasional social outings or cinema trips to make myself feel normal, which I would have to plan in advance in order to have the strength to do it without a panic attack) and try not to tell any of my friends what was really happening because, well, you have to pretend and not ever talk about your problems or negative incidents remember! Internalise, never externalise, because it was attempting to externalise that contributed to the problem in the first place!
My decision making capacity was shot to fuck, my conversational ability had gone; anxiety, depression, suicidal inclinations and self harm reigned supreme. The fact I had overcome all of this only a few months before contributed to the continuation of my depressive episode – all of those years of work for nothing!
My conversations with Meadhbh were driving my ever more insane, my ex was driving me nuts with her consistent emotional/psychological abuse, which Meadhbh was loving because it backed up everything she was telling me. Meadhbh would often say something which my ex would then reiterate word for word a few weeks later; “You have to help people,”, “You’re selfish,”, “You should kill yourself,”, “You never care about anyone!” oh how Meadhbh loved those moments!
Physically I was a wreck; fighting glandular fever was made almost impossible and my recovery time was lengthed by months. I had chronic pain in my back, splitting migraines, I wasn’t able to sleep and never felt hungry. I had to go to hospital several times for a recurring polynoidal sinus, though unrelated to the breakdown, has been recurring ever since due to the stress I have been under and have been waiting for an operation to have it removed. The meds I was on threw all sorts of side effects in my direction, which further messed with my body (and mind) and viruses seemed to claim their hold on my body on a regular basis.
I don’t think anyone can truly understand what having a breakdown feels like unless they have experienced one. Like depression “breakdown” is an overused word and does not in any way fully describe the pain and torment your mind is constantly under. You literally cannot function on a normal day-to-day level; your body is besieged with physical pain and your mind is engulfed with the sort of emotional pain I would never wish on anyone.
Overcoming a breakdown… Like with all forms of mental illness there is only so much help you can garner from other people. You can see doctors and psychologists and MH professionals but you still have to do a hell of a lot of work yourself. I saw my GP regularly and fought for months for professional mental health care, which even after two suicide attempts only really came a few weeks ago.
So how can you help yourself fight an emotional breakdown? These are some of the things I tried:
Be kind to yourself! You are going to have bad days and you are going to have good days. Don’t berate yourself for the bad days and think of yourself as a failure as this will only feed the breakdown demons.
Find ways to reduce your stress level… – Eat healthily; brown rice, fruit, vegetables, natural foods… – Find ways for regular relaxation (I used to walk, play in parks in the night-time, sit under trees, watch movies, write [we’ll get to that in a minute]) – Have baths! – Try to socialise with friends and do things you enjoy (trivia nights, movies, coffee and tea, pizza lunches) – Do regular relaxation exercises. – Keep a daily ‘things to do list’ to refer to.
Be physical Regular exercise and activity helps relieve stress and tension and keeps your body fit and active, in can be hard to do this after having a breakdown or going through a depressive phase, but it is important. Walking, swimming, cycling, yoga, pilates…if you do something you enjoy it will make things easier.
Research and learn about what is happening to you. Understanding your problems/illness better may make it easier to cope.
Find your own coping strategy Everyone is different, what works for one person will not work for another. So find your own ways to deal with what you are feeling and your own techniques to get you through your bad days. – Writing is something I did, the vast majority of my novel “The Ghosts that Haunt Us” was written during this period. However, in order for me to achieve the state of mind I needed to be in, in order to write, I had to self-harm (sometimes severely) in order to get there. – Other people find art, music, drawing or poetry effective. – To get through the bad periods I would play video games. I’m a Zelda aficionado so would replay my Gameboy Zelda games to occupy my mind. – Meditation and yoga can help. – Although I was unable to write a journal (still can’t to this day, won’t go into why), I did keep a mood diary to help identify and chart what I was feeling. There are lots of ways you can find to cope with what is happening. I would be interested in hearing your own coping strategies as they may help other people.
Relationships and Friendships following a breakdown… One of the hardest things I had to deal with was being told repeatedly that who I thought were my friends were not really my friends (an example of being isolated by my abuser) and wouldn’t be there for me. Thus I was unable to talk to them about what I was going through as I was afraid of pushing them away – which was inevitably going to happen anyway – so had to fight my breakdown alone. They knew I had had a breakdown, and self harmed to some extent, but were not aware of the full extent of what I was dealing with.
After a breakdown your self confidence and self worth will be virtually non-existent, thus your ability to retain friendships and relationships will be put under further strain. As you are not thinking clearly your actions may cause harm to those people you care about, even if it is inadvertent, so you may need to apologise for anything which happened during the breakdown and work on rebuilding those friendships.
Although you will need to work out whether the problem was caused by you, or by them, if it was their problem they will need to find a way to deal with it as you should not have to accept responsibility.
I can’t sit here and talk about friendship really, I don’t have any, and as I am still fighting my breakdown cannot give profound advice on healing rifts and repairing damage.
I will say however that, like everyone, a show of kindness and love can help someone who has suffered from a breakdown. We all want to feel loved, we all need kindness, to help us get by.
Can you overcome a nervous breakdown? The breakdown I experienced earlier this year was singularly the most painful, distressing, chaotic and fear inducing period of my life. I literally just could think straight in any way, my brain shut down and wasn’t functioning on any level. It was a constant daily fight to get through each conversation, each hour, each day.
The road to recovery following a nervous breakdown is hard work, it could take anywhere from 6 months to 3 years to fully recover. It can be done however, it’s not going to be easy, pretending it isn’t there won’t help but just cause longer term problems, it’s going to be painful, destructive and the hardest fight of your life.
Why I wrote the book… I considered writing this book for a few years but really got going on it recently. I was incredibly inspired by the novel “Shake Hands with the Devil” by General (retired) and now Senator Romeo Dallaire some years ago as he was instrumental in achieving Post Traumatic Stress Disorder or PTSD being recognized and placed on the “map” for Canadians! For the first time, as a result of reading his book, my shame faded and I began to open my eyes to the possibility I too could be healthy again!
I started to write of my military deployed operations many times but found it too difficult to think of the emotionally charged events. Many of the memories were disturbing and evoked a significant anxiety response in my head, chest and shoulders. The anxiety made it extremely difficult to think clearly and in depth about the specifics of certain events during my deployments, not to mention how they impacted my life both personally and professionally.
Recently, and after a year of intense therapy for PTSD at the Canadian Forces Health Services Centre (Pacific) in Esquimalt BC, I achieved the best health I have known for several years. I was able to concentrate again and think in detail of the stories in particular from Rwanda and Afghanistan without becoming agitated and overwhelmed; I had some new “tools” in my pack! I found the place in my head and soul where I could remember these events with clarity and honesty and was inspired to make my story available to everyone as so many Canadians are unaware of what can occur on military deployments and the illnesses and injuries we sometimes acquire. The stories need to be told, but the impact of those events is perhaps the most important part including the impact on military families.
I am 52 years old and awaiting medical release from the CF; my time for deployments is over. I have served 24 years in the Regular Force and 8 years with the Reserves. It has been a great career and I see my role changing from that of a medical commander to that of a “helper” or “peer” to those who have not yet figured out what steps need to be taken to claim life and personal health back.
I waited 10 years to get help after my Rwandan deployment as I thought I was okay and that I could manage the symptoms of anger, hyper arousal, depression and insomnia. I could not accept that I may be judged as a malingerer or as weak. I thought I could do it, but I was wrong. This is the reason I wrote this book, as many wait for years and try everything and anything we can to keep from asking for help to manage symptoms; alcohol and drugs are often the answer for so many.
The stigma surrounding mental health within the military community is still very prevalent and must be eliminated to open the door for thousands of combat veterans to confidently present themselves to receive the help they deserve and not feel guilty or less of a soldier, sailor, airman or airwoman for doing so! Courage can be demonstrated in many ways, and exercising it earlier rather than later is by far the best approach to enable veterans to effectively manage the stress of combat deployments and return to full and active military or civilian careers and lives.
The intent of this book is to get that premise understood. It needs to be in the public domain as it is the “community” that will diminish the stigma of “weakness” by insisting their military sons and daughters receive treatment early. So many veterans suffer and will continue in silence long after the combat missions are over and the media has gone on to new and more dynamic stories. For the Canadian public at large, the war is over in Afghanistan as the CF now concentrates upon a mentoring role of Afghan military and police forces. The war for hundreds, and perhaps thousands of CF veterans will continue in the form of an insidious, invisible war injury; an Operational Stress Injury (OSI) which includes Post Traumatic Stress Disorder.
I was diagnosed with PTSD in 2004, almost 10 years after my deployment to Rwanda Africa just after the terrible genocide inflicted upon the Tutsi Tribe by the Hutu’s. I struggled emotionally for several years but eventually I had to ask for help as I became professionally and personally dysfunctional and unable to cope with even “normal” levels of daily stress! My wife Kathryn and my children would tell you that they knew something was wrong long before I thought people would notice. I played a game in my head using all my personal resources and energy to hide the fact that I was not well.
I achieved very good health once I was treated for my initial PTSD, which took about a year of therapy as well as medications. I was able to continue my military career and eventually go on to command medical units, as well as deploy again to Kandahar to be the Executive Officer (XO) of the NATO Role 3 Combat Surgical Hospital. This was an important event in my life and I would not change any of it. I did get very sick again through this mission but looking back on it now, I would do it again as I was able to do what I was trained to do.
I hope my story will be helpful to all veterans, who need to know that they are not alone with this war injury, and there exists significant resources to help in their recovery; they just need to step forward and ask for it! It doesn’t always mean the end of a military career especially if it can be identified and treated early. This book is also for family members of those individuals as they often feel isolated and “at a loss” for what to do to help their loved one. Lastly, this book is for the Canadian public.
I have been asked many times if the CF is treating our veterans with PTSD better now. I have seen many changes since the first Gulf War in 1991, to Rwanda in 1994, to present day, and I can say with certainty that the CF is doing much better with treatment resources. After all, I am “walking talking proof” that what the CF Mental Health world offers worked for me! However, I do believe that more can be done, but it is important that only proven therapies are offered to CF Vets. Having said that, it is incumbent upon Mental Health professionals and senior leadership in the Canadian Forces Health Services to actively research and provide the finest treatment protocols. They must recognize that there is no “magic pill”, but in fact many worthy resources to treat this terrible injury. The right combination of therapies over time will enable Vets afflicted with PTSD to return to a good and healthy lifestyle.
Warrior Rising describes not only what made me ill with PTSD, but also what I did to battle it down. In the last chapter, I reflect upon my twice weekly therapy sessions and the practices I took on between those sessions. The road back to health can only be guided by the therapy; it is the veteran that must do the really hard work! These were difficult times for me and my family and I hope the honesty and frankness of this chapter will serve as encouragement for those on that path, as well as those not yet started. This is a very personal story and thus it is told as seen through my eyes and in the first person.
In the first chapter I present a short background of my life as a young person purely to demonstrate that I came from a fairly “normal” home with two parents and lived in a suburb of Montreal in the 60’s and 70’s. I also present my initial military experiences just to provide some context of my life leading up to my deployment to the first Gulf War in 1991. I minimized that deployment as it was less than 60 days and in the grand scheme of things was a “blip” on the radar. I provide a few significant moments of this first deployment as it really gave my wife Kathryn and I a quick lesson on how a military deployment can so incredibly impact family life!
I look back upon my career with pride now. It hasn’t always been that way as when I was really sick I had difficulty feeling pride thus, it was very difficult to even put on my uniform. Even though my deployment experiences made me very ill with PTSD and depression, I hold no resentment towards my military career history as it has led me to the place I am today with an incredibly improved understanding of myself, my injury, and my personal and professional relationships. It has also led me to a new focus in life to come to the aid of those veterans who have not yet found the way to get help. I hope this book can play a role to that end.
The button below is now linked to the Friesen Press Bookstore to purchase Warrior Rising in either hard/softcover format. It will be available in early July and will appear on their website when ready to order. For eBook readers, you can download it by doing a search for the title: Warrior Rising- A Soldier’s Journey to PTSD and Back. Thanks to all of you for your patience and your purchase.
“PTSD is going to color everything you write,” came the warning from a stepmother of a Marine, a woman who keeps track of such things. That was in 2005, when post-traumatic stress disorder, a.k.a. PTSD, wasn’t getting much attention, but soon it was pretty much all anyone wrote about. Story upon story about the damage done to our guys in uniform — drinking, divorce, depression, destitution — a laundry list of miseries and victimhood. When it comes to veterans, it seems like the only response we can imagine is to feel sorry for them.
Victim is one of the two roles we allow our soldiers and veterans (the other is, of course, hero), but most don’t have PTSD, and this isn’t one of those stories.
Civilian to the core, I’ve escaped any firsthand experience of war, but I’ve spent the past seven years talking with current GIs and recent veterans, and among the many things they’ve taught me is that nobody gets out of war unmarked. That’s especially true when your war turns out to be a shadowy, relentless occupation of a distant land, which requires you to do things that you regret and that continue to haunt you.
Theoretically, whole countries go to war, not just their soldiers, but not this time. Civilian sympathy for “the troops” may be just one more way for us to avoid a real reckoning with our last decade-plus of war, when the hostilities in Iraq and Afghanistan have shown up on the average American’s radar only if somebody screws up or noticeable numbers of Americans get killed. The veterans at the heart of this story — victims, heroes, it doesn’t matter — struggle to reconcile what they did in those countries with the “service” we keep thanking them for. We can see them as sick, with all the stigma, neediness, and expense that entails, or we can recognize them as human beings, confronting the morality of what they’ve done in our name and what they’ve seen and come to know — even as they try to move on.
Sacred Wounds, Moral Injuries
Former Army staff sergeant Andy Sapp spent a year at Forward Operating Base Speicher near Tikrit, Iraq, and has lived for the past six years with PTSD. Seven if you count the year he refused to admit that he had it because he never left the base or fired his weapon, and who was he to suffer when others had it so much worse? Nearly 50 when he deployed, he was much older than most of his National Guard unit. He had put in 17 years in various branches of the military, had a stable family, strong religious ties, a good education, and a satisfying career as a high-school English teacher. He expected all that to insulate him, so it took a while to realize that the whole time he was in Iraq, he was numb. In the end, he would be diagnosed with PTSD and given an 80% disability rating, which, among other benefits, entitles him to sessions with a Veterans Administration psychologist, whom he credits with saving his life.
Andy recalls a 1985 BBC series called “Soldiers” in which a Marine commander says, “It’s not that we can’t take a man who’s 45 years old and turn him into a good soldier. It’s that we can’t make him love it.” Like many soldiers, Andy had assumed that his role would be to protect his country when it was threatened. Instead, he now considers himself part of “something evil.” So at a point when his therapy stalled and his therapist suggested that his spiritual pain was exacerbating his psychological pain, it suddenly clicked. The spiritual part he now calls his sacred wound. Others call it “moral injury.”
It’s a concept in progress, defined as the result of taking part in or witnessing something of consequence that you find wrong, something which violates your deeply held beliefs about yourself and your role in the world. For a moment, at least, you become what you never wanted to be. While the symptoms and causes may overlap with PTSD, moral injury arises from what you did or failed to do, rather than from what was done to you. It’s a sickness of the heart more than the head. Or, possibly, moral injury is what comes first and, if left unattended, can congeal into PTSD.
What we now call PTSD goes way back. In Odysseus in America, psychiatrist (and MacArthur “genius” grantee) Jonathan Shay has traced similar symptoms to Homer’s account of Odysseus’s homecoming from the Trojan War. The idea that a soldier may continue to be haunted by his wartime life has had a name since at least the Civil War. It was called “soldier’s heart” then, a lovely name for a terrible affliction.
In World War I, it went by the names “shell shock” and “war neurosis” and was so widespread that Britain devoted 19 hospitals solely to treating soldiers who suffered from it. During WWII, it was called “battle fatigue,” “combat neurosis,” or “gross stress reaction,” and the problem was severe enough in the U.S. Army that, at one point, psychiatric discharges outpaced new recruits. The Vietnam War gave us the term “post-Vietnam syndrome,” which in time evolved into PTSD, and eventually the insight that, whatever its name, it is probably neurologically based.
PTSD’s status as an anxiety disorder — and as the only mental health condition officially defined as caused by a single, external event — was established in 1980, when it was enshrined in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the bible of psychiatry. The diagnostic criteria have expanded since then and will probably be altered again in next year’s version of the DSM. That troubles many therapists treating the ailment; some don’t think PTSD is a disease, others argue that the symptoms are just a natural response to being at war or that, in labeling it a disorder, political and cultural norms are being invoked to reinforce what is considered orderly. As Katherine Boone, writing in the Wilson Quarterly, put it, “If you react normally to trauma, you have a disorder; if you act abnormally, you don’t.”
Most PTSD is short term, but perhaps one-third of cases become chronic, and those are the ones we keep hearing about, in part because it costs a lot to treat them. For a variety of reasons, no one seems to have an exact number of recent combat veterans with PTSD. The Veterans Administration estimates that between 11% and 20% of the 2.3 million troops who have cycled through Iraq and Afghanistan suffer from it, and the Congressional Budget Office calculates a cost of $8,300 per patient for the first year of treatment. Do the math, and you could be talking about as much as $3.8 billion a year. (What we’re not talking about nearly enough is the best way to prevent PTSD and other war-caused psychic distress, which is not to put soldiers in such untenable situations in the first place.)
Since the early days of diagnosis — when you were either sick with PTSD or you were fine — the medical response to it has gained in nuance and depth, which has brought beneficial funding for research and treatment. In the public mind, though, PTSD still scoops up everything from risky behavior and aggression to substance abuse and suicide — kind of the way “Alzheimer’s” as a catch-all label stands in for forgetfulness over 50 — and that does a disservice to veterans who aren’t sick, but aren’t fine either.
“What you come into the war with will dictate how you come out of war,” Joshua Casteel testified about a soldier’s conscience at the Truth Commission on Conscience and War, which convened in New York in March 2010. He had spent five months as an interrogator at Abu Ghraib shortly after the prisoner abuse scandal broke there. He later left the Army as a conscientious objector after an impassioned conversation about faith and duty with a young Saudi jihadist, whom he was supposed to be questioning, led him to conclude that he could no longer do his job. Casting a soldier’s experience as unfathomable to anyone else was not only inaccurate, but also damaging, he said; he had never felt lonelier than when people were afraid to ask about his life during the war.
Our warriors today are all volunteers who signed up and are apparently supposed to put up with whatever comes their way. As professionals, they’re supposed to be ready to fight, but as counterinsurgents they’re supposed to be tender-hearted and understanding — at least to kids, those village elders they’re fated to drink endless cross-cultural cups of tea with, and their buddies. (Every veteran has a kid story, and mourning lost friends with tattoos, rituals, and drunken sorrow are among the few ways they’re allowed to grieve publicly.) They’re supposed to be anguished when they hear about the “bad apples” whogang-raped, then murdered and set fire to a 15-year-old girl near Mahmoudiya, Iraq, or the “kill team” that hunted Afghan civilians “for sport.”
Maybe it’s the confusion of these mixed signals that makes us treat our soldiers as if they’re tainted by some special, unwanted knowledge, something that should drive them over the edge with grief and guilt and remorse. Maybe we think our soldiers are supposed to suffer.
The Right to Miss
A couple of decades ago, David Grossman, a professor of psychology and former Army Ranger, wrote an eye-opening, bone-chilling book called On Killing. It begins with the premise that people have an inherent resistance to killing other people and goes on to examine how the military overcomes that inhibition.
On Killing examines the concerted effort of the military to increase firing rates among frontline riflemen. Reportedly only about 15%-20% of them pulled the trigger during World War II. Grossman suggests that many who did fire “exercised the soldier’s right to miss.” Displeased, the U.S. Army set out to redesign its combat training to make firing your weapon a more reflexive action. The military (and most police forces) switched to realistic, human-shaped silhouettes, which pop up and fall down when hit, and later added video simulators for the most recent generation of soldiers raised on virtual reality.
This kind of Skinnerian conditioning — Grossman calls it “modern battleproofing” — upped the firing rate steadily to 55% in Korea, 90% in Vietnam, and somewhere near 100% in Iraq. Soldiers are trained to shoot first and evaluate later, but as Grossman observes, “Killing comes with a price, and societies must learn that their soldiers will have to spend the rest of their lives living with what they have done.”
That price could be called moral injury.
The term may have come from Jonathan Shay, though he demurs. Whatever its origin, it wasn’t until the end of 2009 that it began to resonate in therapeutic communities. That was when Brett Litz, the Associate Director of the National Center for PTSD in Boston, and several colleagues involved in a pilot study for the Marines published “Moral injury and moral repair in war veterans,” a paper aimed at other clinicians. Their stated aim was not to create a new diagnostic category, nor to pathologize moral discomfort, but to encourage discussion and research into the lingering effects on soldiers of their moral transgressions in war.
The authors found that emotional distress was caused less by fear of personal harm than by the dissonance between what soldiers had done or seen and what they had previously held to be right. This echoes Grossman, who concludes that the greatest cause of psychological injury to soldiers is the realization that there are people out there who really want to hurt you.
Moral injury seems to be widespread, but the concept is something of an orphan. If it’s an injury, then it needs treatment, which puts it in the realm of medicine, but its overtones of sin and redemption also place it in the realm of the spiritual and so, religion. Chaplains, however, are no better trained to deal with it than clinicians, since their essential job is to patch up soldiers, albeit spiritually, to fight another day.
Yet the idea that many soldiers suffer from a kind of heartsickness is gaining traction. The military began to consider moral injury as a war wound and possible forerunner of PTSD when Litz presented his research at the Navy’s Combat Operational Stress Control conference in 2010. The American Psychiatric Association is also thinking about adding guilt and shame to its diagnostic criteria for PTSD. A small preliminary survey of chaplains, mental health clinicians, and researchers found unanimous support for including some version of moral injury in the description of the consequences of war, though they weren’t all enamored of the term. As if to mark the start of a new era in considering the true costs of war, a new institution, the Soul Repair Center has just been launched at Brite Divinity School in Fort Worth, Texas, with a $650,000 grant from the Lilly Foundation to conduct research and education about moral injury in combat veterans.
Of course, to have a moral injury, you have to have a moral code, and to have a moral code, you have to believe, on some level, that the world is a place where justice will ultimately prevail. Faith in a rightly ordered world must be hard for anyone who has been through war; it’s particularly elusive for soldiers mired in a war that makes little sense to them, one they’ve come, actively or passively, to resent and oppose.
When your job requires you to pull sleeping families from their beds at midnight thousands of miles from your home, or to shoot at oncoming cars without knowing who’s driving them, or to refuse medical care to decrepit old men, you begin to question what doing your job means. When the reasons keep shifting for what you’re supposed to be doing in a country where most of the population wants you to go home even more than you want to, it’s hard to maintain any sense of innocence. When someone going about his daily life is regularly mistaken for someone who means to kill you — as has repetitively been the case in our occupations of both Iraq and Afghanistan — everyone becomes the enemy. And when you try — and fail — to do the right thing in a chaotic and threatening situation, which nothing could have trained you for, the enemy can move inside you and stay there for a very long time.
In trying to heal from a moral injury, people struggle to restore a sense of themselves as decent human beings, but the stumbling block for many veterans of recent U.S. wars is that their judgment about the immorality of their actions may well be correct. Obviously, suffering which can be avoided should be, but it’s not clear what’s gained by robbing soldiers of a moral compass, save a salve to civilian conscience. And despite all the gauzy glory we swath soldiers in when we wave them off to battle, nations need their veterans to remember how horrible war is, if only to remind us not to launch them as heedlessly as the U.S. has done over these last years.
When you’ve done irreparable harm, feeling bad about your acts — haunted, sorrowful, distraught, diminished, unhinged by them — is human. Taking responsibility for them, however, is a step toward maturity. Maybe that’s the way the Army makes a man of you, after all.
Two final observations from veterans who went to war, then committed themselves to waging peace, apparently a much harder task: Dave Cline began his lifetime of antiwar work as a G.I. in the Vietnam War. A few years into the Iraq War, when he was president of Veterans For Peace, he told me, “Returning soldiers always try to make it not a waste.” The second observation comes from Drew Cameron in a preface to a book of poems by a fellow veteran, published by hisCombat Paper Press: “To know war, to understand conflict, to respond to it is not an individual act, nor one of courage. It is rather a very fair and necessary thing.”
Recognizing moral injury isn’t a panacea, but it opens up multiple possibilities. It offers veterans a way to understand themselves, not as mad or bad, but as justifiably sad, and it allows the rest of us a way to avoid reducing their wartime experiences to a sickness or a smiley face. Most important, moral repair is linked to moral restitution. In an effort to waste neither their past nor their future, many veterans work to help heal their fellow veterans or the civilians in the countries they once occupied. Others work for peace so the next generations of soldiers won’t have to know the heartache of moral injury.
Nan Levinson, a Boston-based journalist, reports on civil liberties, politics, and culture. Her next book, War Is Not a Game, is about the recent G.I. antiwar movement. She is the author of Outspoken: Free Speech Stories, was the U.S. correspondent for Index on Censorship, and teaches journalism and fiction writing at Tufts University.
I was recently giving a seminar to therapists on the application of mindfulness in psychotherapy. In that seminar the topic of insomnia came up and I couldn’t help it, I outed myself. I let people know that insomnia used to be a very real part of my life and that my practice in mindfulness was what saved me and continues to from time to time. One woman came up to me during the break and asked me how I applied mindfulness to heal my sleep troubles.
Here is what I said…
For most of us insomnia is a mental dis-ease that over time gets conditioned into our bodies as a habit. The trauma of it is stored in our memories and only serves to make our mind increasingly reactive to the symptoms or anticipations of not falling asleep. It becomes so easy for our anxious or restless mental buttons to get pushed. It’s as if you only need to drop the lightest worry of not being able to sleep, like a feather, and the brain begins swirling with anticipatory anxiety.
I was once told that practicing mindfulness was far more restorative than tossing and turning. Therefore, even if you just practiced being present all night long and you didn’t fall asleep that was still better for you. On top of that, time spent in mindfulness practice is training your mind in mindfulness which is good for so many other parts of life, not the least of which growing a stronger and healthier brain.
With that I could relieve my worries about needing to fall asleep and just make the night time in bed my time to practice. I would put on my ear phones and be guided with a body scan that didn’t have a bell at the end (find a 10-minute body scan here). Initially I noticed my mind getting pulled frequently, thoughts that this wouldn’t work would yank me away, but I stayed disciplined (as best I could) to gently bring myself back to the practice.
Eventually I was able to let go of the audio and either bring a general awareness to my body each time I closed my eyes noting the field of sensations that were moving around. At other times I would just follow my breath.
But first I needed the support of the audio to train me to eventually be able to just do it on my own.
It’s been years since insomnia has been an issue for me now, once in a long while it creeps up, but I am usually able to dispel it with my practice. Studies show mindfulness help with sleep in many people.
The key here is that there needs to be the understanding that you’re using this time to practice to train in mindfulness, not to fall asleep. If the explicit intention is to fall asleep then you set up a monitor in the back of the brain to continually check on that. You need to let that expectation go, it’s okay if you don’t fall asleep.
No matter what, using it as a time to train in mindfulness is a wise use of that time.
As always, please share your thoughts, stories and questions below. Your interaction creates a living wisdom for us all to benefit from.
No matter what time of year it is, stress will likely be a part of it. A little stress is good, it fuels motivation, but there’s a tipping point where it starts to have diminishing returns. When that higher level of stress hits, if it’s left unchecked it can lead to anxiety, depression, chronic pain, addictive behaviors, you name it. Today I want to give you something that you can BET on anywhere, anytime to help turn the volume down on the chaotic mind and bring you back into balance.
I’m a big fan of things that are short and sweet. Something I can remember that can help me in a pinch.
Here’s a short acronym that you can BET on throughout the day:
B – Body – At any point, bring attention to the body. How is it feeling? Is there any tension anywhere, in this moment of awareness, can you take a breath and allow it soften?
E- Emotions – What emotion is there in that moment? Is it anxiety, sadness, anger, confusion, joy, calm, or maybe just a neutral feeling? How does it feel as a sensation in the body? Research shows just labeling emotions turns activity down in the emotional center of the brain.
T – Thoughts – What’s on your mind? Is it busy or calm? If it’s a self-judgment or a judgment of another person, ask yourself, Is it absolutely true? How does this thought make me feel? What’s another way I can see this? Practice opening your mind.
Then just refocus on what matters in the moment.
That’s it, it’s that simple.
You can BET in the morning, before a test, during a business meeting, during stressful travel, while waiting at a stop light or on hold on the phone. You can BET before you open your email, in the midst of your kid’s temper tantrum, or just while taking a nice walk outside.
If you BET a few times a day, my guess is that you’ll break out of routine and back into the wonder of everyday life.
Try it out and let your experience be your teacher.
As always, please share your thoughts, stories and questions below. Your interaction is a living wisdom we can all benefit from.
This is a good video produced by CBC on the issue. examines what anxiety is, and how and why it is being re-defined by medical and pharmaceutical industries. Entertaining and informative. Rory *******************
The three decades since mindfulness meditation was first found to help with anxiety, chronic pain and depression have seen the reversal of a trend that goes back over a century. When Freud founded psychotherapy as “a middle way between philosophy and medicine,” he took pains to keep it on the scientific side of the modern gulf between science and religion. He did this in part by basing his insights on evolutionary neurobiology, and in part by distancing his psychology from its sources in the spiritual philosophy of Romanticism.
Sadly, in cutting his “new science” away from its spiritual roots, he felt a need to jettison not just myth and ritual but contemplative states and practices too. Though spiritually minded analysts like Carl Jung warned this was throwing the baby out with the bathwater, Freud’s rejection of all things spiritual came to earmark mainstream psychotherapy. Jung’s dream was that psychotherapy would not only work as a clinical art to heal mental suffering but also as a spiritual science to help build the best in our nature. The recent film, “A Dangerous Method,” dramatizes with telling accuracy Freud’s break with Jung and the rift this caused in modern psychology.
Fast forward to the present. The more mindfulness has been proven to enhance attention, empathic attunement and neuroplasticity, the more it has found its way into traditional psychotherapy and new cognitive therapies. As this simple technique has made waves in psychotherapy, it has raised a groundswell of interest among researchers and clinicians in contemplative methods in general and Buddhist psychology in particular.
Of course, mindfulness did not turn the anti-contemplative tide of mainstream therapy all by itself. It helped catalyze a complex reaction fueled by new findings in evolutionary biology, the neuroscience of plasticity and emotion, developmental psychology and positive psychology, all of which have converged in a new view of human nature as far more malleable and sociable than we thought. Buttressed by a growing body of research on meditation and yoga, this new consensus has begun to bridge the gulf between science and spirituality. Where the split faces of modern culture are starting to reunite is in two emerging fields for the scientific study and clinical application of humanity’s ancient contemplative traditions: contemplative neuroscience and contemplative psychotherapy.
As clients and therapists have grown more curious about the traditional practice behind mindfulness, they’ve learned that it comes embedded in a complex psychology all its own, including integrated disciplines of cognitive self-analysis, emotional self-healing and behavioral life-change. This second wave of influence has brought mounting awareness of the scientific tradition of classical Buddhist psychology and its core disciplines. With this, the tide has shifted away from simply grafting mindfulness into conventional therapies, toward a fuller confluence of Buddhist and Western psychology.
A vibrant new field blending meditative insights and tools with current neuroscience, contemplative psychotherapy represents a turning of the modern tide away from contemplative methods. And as Buddhist contemplative science has been a catalyst in this turn thus far, it seems likely to play a more influential role in years to come. This is no accident, but reflects Buddhism’s unique bent as a religion which seeks to awaken the human spirit less by myth and ritual than by therapeutic philosophy and contemplative psychology.
Fortunately, the rise of contemplative psychotherapy also comes at a watershed moment in the history of the West’s encounter with Asian Buddhism. As neuroscientists and psychotherapists turn toward contemplative science and practice, Western and Asian scholars of Buddhism for the first time are giving us access to the long isolated Buddhism of Tibet. This most recent confluence seems likely to give rise to a third wave in the convergence of Buddhist and Western psychology, for several reasons.
First, Tibetan civilization preserves in its final form the ancient Buddhist tradition that was most concerned with bringing contemplative tools to lay people in everyday life. This was the socially engaged tradition linked with the rise of the world’s first university at Nalanda, a world-class institution which became India’s beacon of liberative education and a think-tank for contemplative civilization throughout Asia. The second reason is that the Nalanda tradition was and is both scientifically rigorous and psychologically minded. Its core curriculum assumes that success in secular and religious life both require mastery of scientific knowledge and empirical methods, especially the insights and methods of psychology. The third reason is that this tradition is not just universal but comprehensive, enhancing mindfulness and loving kindness with a whole range of industrial-strength tools for building compassion, altruism and inspired leadership in a stress-driven world.
Unfortunately, there’s a rub. Because it forged the religious practice of Indian yoga into a human science of spirituality, the Nalanda legacy is not only the most modern and scientific of Buddhist traditions, but ironically also the one that seems most religious! The challenge contemplative therapists face in integrating its rich archetypal imagery and transformational arts is reminiscent of those faced by analysts like Jung.
Can powerful, mind-altering contemplative states and methods be harnessed to the therapeutic work of building confident, caring and inspired new selves, while staying grounded in objective science and reproducible methods?
Fortunately for us all, this challenge is far simpler in our day than it was only decades ago. Brain science has progressed so dramatically that we now understand how empathy and altruism, archetypal imagery and transmuting affects like joy and bliss work. And direct access to the living masters of the Nalanda tradition offers the time-tested perspective and methodology we need to make the work of reinventing ourselves for interdependence eminently safe, reliable and reproducible. Given the fast-shifting tides of science and civilization, contemplative psychotherapy seems ideally poised now to realize Jung’s dream, with a rigor that would have satisfied even Freud.
The new year is up on the calendar. Will this be another year that you vow to start exercising only to drop your gym membership by Valentine’s Day? Remember the year you were determined to start flossing? Take vitamins? Give up soda?
Studies show that even people with life threatening illnesses are not successful at creating lasting permanent lifestyle changes. Why? Because change is hard work! It takes a tsunami of sustainable energy to effect long term, lasting change.
But what if the changes were such simple shifts of attention that they required virtually no effort? And what if they were prompted by activities that you already do so that you won’t forget? And what if, on top of all that, they actually made your life better?
Sound too good to be true? It’s not! Implement even one of these five simple practices into your day and you’ll find yourself happier and less stressful.
Hint: Use strategically placed Post-it reminders for the first few weeks until these healthy habits become automatic.
While You’re Brushing Your Teeth: “Morning Glory”
As you brush your teeth, think of three things that you’ll be facing in your day. Think, “I will open myself with curiosity to __________” (the meeting, the parent/teacher conference or the luncheon, for example). Set your intention to be open and curious to the events of your upcoming day, rather than negative or judgmental. When you cultivate positive emotions, you de-stress your body and meet your day with optimism!
If all you did was watch TV, you might think social anxiety disorder was as prevalent as depression — or as big a problem. Also called social phobia, social anxiety disorder is often treated first with medications, such as an SSRI antidepressant (you know, regulars like Paxil or Prozac). Psychotherapy is also an option — it’s just not as popular as medication.
In a randomized controlled research study published recently, two psychological interventions were put head to head to see which one would come out on top.
Cognitive therapy (CT) focuses on the modification of biased information processing and dysfunctional beliefs of social anxiety disorder. Interpersonal psychotherapy (IPT) aims to change problematic interpersonal behavior patterns that may have an important role in the maintenance of the problem.
According to the researchers, no previous direct comparison of these two treatment options exists.
In psychotherapy research, often researchers use a condition called a “waiting-list control” group. This group is told they will get treatment in a short time, but they have to be placed on a waiting list because no therapists are readily available. This allows the researchers to test to see if it’s time alone that will result in a person’s condition improving (rather than the therapy treatment).
A total of 117 subjects were gathered from two outpatient treatment centers, and out of those, 106 completed the study.
How was the study conducted?
Treatment comprised 16 individual sessions of either cognitive therapy or interpersonal therapy and one booster session. Twenty weeks after randomization, posttreatment assessment was conducted and participants in the control group received one of the treatments.
The primary outcome was treatment response on the Clinical Global Impression Improvement Scale, as assessed by independent evaluators [blinded to treatment conditions].
The secondary outcome measures were independent assessor ratings using the Liebowitz Social Anxiety Scale, the Hamilton Rating Scale for Depression, and patient self-ratings of SAD symptoms.
What were the results? At the end of the study, the cognitive therapy group have a nearly 66 percent response rate while the interpersonal therapy group had a 42 percent response rate. The control group, in comparison, had only a 7 percent response rate — meaning that just waiting for the problem to resolve on its own is significantly less effective than getting treatment for it.
In the specific measurement of social anxiety disorder, cognitive therapy significantly outperformed interpersonal therapy. Both treatment conditions significantly improved social anxiety symptoms in comparison to the control group.
This study also did something special a lot of studies don’t do — a one year followup. It’s all well and good to measure the effects of a treatment immediately when the study ends. But a one-year followup tells us whether the treatment “sticks” or not.
At the follow-up, the differences between CT and IPT were largely maintained, according to the researchers. The cognitive therapy group again came out on top with significantly higher response rates (68 percent) versus the interpersonal therapy group (32 percent)
The cognitive therapy group also had better outcomes on the Liebowitz Social Anxiety Scale at the one year followup.
So there you have it. For social anxiety disorder, cognitive therapy is the therapy of choice — it’ll give you great results in just 16 weeks. And not results dependent upon taking a medication for a year or two — results that are long-lasting and permanent.
Stangier U, Schramm E, Heidenreich T, Berger M, Clark DM. (2011). Cognitive therapy vs interpersonal psychotherapy in social anxiety disorder: a randomized controlled trial. Arch Gen Psychiatry, 68, 692-700.
Dr. John Grohol is the CEO and founder of Psych Central. He has been writing about online behavior, mental health and psychology issues, and the intersection of technology and psychology since 1992. Dr. Grohol also sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member of the Society for Participatory Medicine.
This article talks about anxiety and its treatment. I have facilitated the 14 week group put on be the Ontario Anxiety Disorders Assoc. (ADAO).
The Ottawa Citizen, The Ottawa Citizen
When they struck hardest, Maria Connell says she feared she was about to die.
A racing heart. Shortness of breath. The shakes, the sweats. And this overpowering, suffocating feeling of fear, so strong it overwhelms any sense of reason.
“It just brings you to your knees.”
Connell, 46, suffers from anxiety disorder, the subject of a talk at the Royal Ottawa Mental Health Centre on Thursday. You can only admire her courage.
We spoke for a couple of hours this week. One story from many:
She was flying from Vancouver to Ottawa when, somewhere over Winnipeg, it hit her. She had to get off the plane.
She reached over and grabbed the arm of a stewardess. She asked if the pilot could land immediately.
The crew member, to her credit, took Connell to the rear of the aircraft. She soothed her, told her it would be just as quick to land in Ottawa than to divert, gave her yogurt, stayed by her side, kept talking.
“When I got off the plane, I looked at (husband) John and said, ‘I will never get on an airplane again.’”
Connell, a mother of two, is not cured, but better, now, thanks to a specialized program at the Royal Ottawa that combines psychiatry with behaviour therapy.
Two of the program leaders, Dr. Jakov Shlik and Dr. Dave Davies, will provide an overview of the problem and treatment methods at a lecture Thursday, beginning at 7 p.m.
Dr. Shlik said Tuesday that about one in five people would at some point suffer from an anxiety disorder, an umbrella description that includes panic disorders, agoraphobia, obsessive-compulsive behaviour and social phobias.
“We want people to reach out for treatment because it works,” Dr. Shlik said.
The ROH program gets about 500 referrals a year, so many that the waiting list can be six months or longer.
(iStock)If the Dow just closed after a dismal day of trading and a tightening sensation is beginning to spread through your chest, stop and try this exercise:
Instead of focusing on the money you’ve already lost or obsessing over future losses, try zeroing in on the present moment. Let go of distractions like a looming bill or the record unemployment rate and concentrate on your breath. Take in all the air you can, pause and then release.
“It’s actually totally boring concentrating on your breath,” says Dr. Michael J. Baime, director of the Penn Program for Stress Management at the University of Pennsylvania Health System. “Lifting a barbell is totally boring too, but it’s exercising a muscle.” After 10 repetitions, he says, you should start to feel some degree of calm.