General I Need Help Dealing With Middle Of Episode

[Wrong way]

Hi Everyone, This is my first post here, and I had read many posts about PTSD. My on/off girlfriend suffers from PTSD and BPD. She was raped by a family member and was severely abused as a child. She even has major trust issues with men, and rightfully so. She continued to have bad relationships through her adult life. Some of them were abusive. Some of them abandoned her. She has three kids who are now grown up. One son was taken by his father to a faraway place with no contact. The other 2 sons are a positive influence in her life. I’m glad that she has her sons to create a stable foundation. She is on medication for years, but has sought little to no therapy.

I have observed that when a trigger occurs, she will go into an abusive tirade: Swearing, incomplete sentences, and just utter meanness. I know this is her PTSD kicking in. I have a question though.

How do you deal with a PTSD sufferer in the middle of an episode?

I’ve heard mixed solutions to the problem. Some caregivers say that this is an emotional time and that we should talk about it later. Other caregivers say to try to get her back to the present by listening, holding her hand. I have heard that walking away may exacerbate the episode.

Her triggers revolve around her rape and abuse. So I have to be even careful about stretching my arms out when I’m tired like when I’m raising my hand.

So what would be the proper way to handle her in the middle of an episode? Any advice will be well appreciated.

-Wrong Way

 

[Lost Pup]

I once had a therapist describe it as sewing yourself a PTSD raincoat to deal with your partner during episodes.

The thing I value most is that my partner is able to see the activation as me-in-PTSD-activation rather than simply me. There's a huge discrepancy for me between what is sometimes called the apparently normal personality (ANP) and the emotional personality (EP). Like grand canyon huge. And I am fortunate that my partner can hang with that, most of the time and just stay present. I can't speak for your GF but I can say that, for me, I am extremely aware that I am behaving erratically when it is happening, and it is really as unpleasant for me as for anyone else. Mostly just try to balance taking care of your self and needs and simply being WITH her, including the her "underneath."

Good luck. Hope it gets easier for you both.

 

[Lost Pup]

PS. I wanted to add that, generally speaking, your GF is not likely to improve much without therapy. There is no medication *for* PTSD. Although there are medications that may be useful in alleviating particular symptoms (anxiety, depression, nightmares), PTSD is not something that can be fixed/cured/managed with pharmaceuticals the way that other "mental illness" sometimes can be.

 

[Wrong way]

LP,
Thank you for your responses. I do know she will have to heal herself. I have only seen a few episodes/flashbacks. Her medication is primarily for her to get sleep. Without it she will wake up in nightmares. Without it, she will get no rest.

I guess a trigger/episode can be dealt with in different ways depending on the circumstance and environment. From what I understand being there for her is the best thing I can do. I hear a lot about taking care of yourself, and setting boundaries for myself. I’ve read that being an active listener is helpful. In her case where she was raped and beaten repeatedly that keeping at an arm’s length & no touching is helpful. (No hugs or holding hands) . If she asks for space, I should respect her decision and give her space.

You’re correct. She needs to go to therapy. She started to go last month, but I didn’t press the issue if she has continued to attend. I will ask when the time is appropriate. She is such a sweet and loving woman. I know she has lots of baggage, but who doesn’t these days. I see her for what she is today. I don’t view her because of her history.

If you have any other suggestions or things I should prepare myself for, I would appreciate any advice.

-Wrong way

 

[Lost Pup]

Good on you for seeing what is strong and kind in her.

PTSD activation is a pretty horrific thing to witness and eminently confusing for those experiencing it from the outside, or so I hear.... :)

I did not mean to speak ill of meds. They can be extremely helpful when prescribed by an understanding doctor. Many of us struggle with sleep and nightmares, so I am very sympathetic to that. However, if she is not seeing a therapist, I wonder if she is getting a PTSD-specific sleep aid (ie. an alpha-blocker), rather than something more simply sedative. The best scenario would likely be for her to see a psychologist and psychiatrist and for them to be in dialogue.

I think not wanting to be touched can be very confusing for the other person. I can only speak for myself but sometimes, when I am activated and do not want to be touched, I actually very much want to be held, but I also want to feel safe. Or, IOW, those are times when I am most aware of the internal conflict between wanting emotional connection but feeling un-trusting. I suppose I am advising that you fully respect her boundaries and follow her lead, but also be aware that what she is saying may be only half the story at any given time. This requires HUGE patience and a lot of toleration for frustration.

Also, please be aware that if you are not seriously committed to her, supporting her in the PTSD could be very hurtful. That is to say, becoming a support system in her life or a symbol of trust, and then leaving her could be absolutely devastating. Just something to keep in mind.

There is a meditation practice I like quite a bit in which you actively listen to someone but make a point of remaining silent and not nodding or saying "yeah" or "uh-huh" or anything while they talk. I find this extremely helpful to do when someone else is emotionally enervated. It might be useful for you. The idea is that you are not influencing what the other person is saying to you. People in traumatized states can be extremely impressionable and even subconsciously submissive so it is important not to lead them by sending the message that some things are good or bad to say to you. Hope that makes sense.

Thanks for being here and trying to understand.

 

[Wrong way]

Hi LP,

She is taking Clonazapam. I'm not sure which catagory this falls into, but it help reduce her anxiety. I think what iis difficult for be to figure on helping her is that when her PTSD is activated, she cannot form complete sentences. Single words come out. The first time I saw this, we were with a bunch of friends at a restaurant. Some trashy lady called her outfit 'Slutty,' and everything went down hill. She doesn't remember any of the side details where all of us were trying to help her. In her recollection, she thought none of us helped her. Especially me. None of us knew she had PTSD. We couldn't understand what she was saying, and she was absolutely bu115h1t at us.The only thing we understood was that she was upset. I took her home as she was screaming at me with those same single words. I had no idea what to do at that time. To be honest, I'm not exactly sure if I would do anything different except bring her home earlier, and reassure her she was safe with us. When i got to her apartment, she stormed off in a complete rage. I was so confused. She finally after several weeks on no contact, she reached out to me. She remembers all the insults she said to me and apologized. That's when she finally reveraled to me that she suffers from PTSD and BPD.

I am also recovering from my own mental illness, but I have successfully controlled my disease through medication, proper diet, exercise, and therapy. I suffer from Bipolar 2, so many of the steps in handling a PTSD person as a caregiver are the same as a BP2 sufferer. BUT many things are different, and I want to help her as best I can.

I can definitely see how abandonement of her support system can do more harm. Everyone has abandoned her with the exception of 2 sons. Her parents, brother, friends, past husband and 1 son have completely separated themselves from her life. I don't have a hero complex, but I do want to help. She is so sweet and caring. I can't imagine going through all of this on top of repeated rape and abuse as a child. It's just horrible and mind boggling. At the same time, she needs to help herself.

You mention a meditation practice in active listening. So, staying silent is helpful for you? I know I will have trouble not 'nodding' while she talks. I never realized even saying, "Uh-huh" or "Yeah" may be leading. What kind of acknowledgement would be helpful to show I'm listening besides eye-contact and slightly forward posture? Any suggestions?

Thank you for your feedback.

-Wrong way

 

[Lost Pup]

For the listening you do not need to do anything but relax and listen and have your eyes available for eye contact if she wants to make it. Can be challenging and a bit odd at first but I promise it is a good tool to have at hand.

Also, from what you are describing, it sounds like there may be some significant dissociation going on. That is something a therapist would need to explore but her amnesia and her language being affected certainly sound consistent with a dissociative disorder, which is often an aspect of PTSD or C-PTSD.

Hopefully some others will come along and offer more than I have. This board is usually quite active but seems a bit slow today.

Best Wishes.

 

[Ladyhope Somerset]

Hi WW & LP
You two have a good dialogue going here and have covered a lot of ground. It's been said already but I will add my support that being there and being a good listener is probably the most useful tool to develop. You have empathy which doesn't always need words and I like the way LP describes having "eyes available for eye contact". An internal dialogue about empathy, staying calm in a crisis and having a delicate touch (metaphorical) will help keep you on track with this.

I also know about not wanting to be touched and there was a useful little tiny book published some years ago called the book of hugs which taught my husband (and me) different ways. we use simple thumbs up and other non contact gestures to check out if physical contact is ok. This takes time and patience to develop but it's defo do-able.
LHS

 

[Wrong way]

LHS: Thank you for the tips. I just want to be able to help out when I can. If anyone else has any other tips/pitfalls, please let me know.

 

[Wrong way]

Thank you everyone for your suggestions. I had an emergency call today from her about a massive meltdown. In short, her whole world is falling apart around her. She has tried so hard to mask the pain, but it has become too much for her. Her home life is a complete wreck; she is dealing with CPTSD from years of abusive parents; one of her parents is terminally ill; her shame and guilt from her behaviors from years of drug & alcohol abuse; a job that is completely demoralizing (exotic dancer); intermittent DID which results in violent rages; a drug dealing stalker; a plethora of regretful behaviors; and overwhelming feeling of hopelessness.

I had prepared myself for this outpouring. I made sure I set some boundaries for myself to listen. I listened for 5 hours. It was tough to hear all of this, but I listened. She needs professional help. I can only listen and give advice when she wants it. She has to take the step forward to heal herself. She was so thankful I got up at 4 in the morning to drive out to listen to her.

I found out looking at her eyes bothered her. She thought I was staring at her. I blinked more rapidly when she looked at me. I wanted to show her I was processing her whole story.
Again, thank you for all your suggestions on helping. I will keep you updated.

 

[Lost Pup]

Sounds like a hallmark mix of progress and collapse that often shortly precedes real healing. One thing - DID is a very contentious diagnosis. Some docs call the same basic condition by different names and understand it quite differently. Plus there are lots of other conditions that might cause that kind of intermittent rage and change in personality. Might want to be careful not to start naming it that before she gets into therapy. I've noticed that some people, when they self-diagnose as DID, almost seem to begin using it more as a form of self-expression. Only my own perception and opinion thereof but do consider being mindful.

Hang in there and take care of yourself.

 

[Wrong way]

Hi LP,
During her meltdown, she finally admitted to me she has been seeing a psychiatrist for 14 years. I now know why therapists put a time limit on therapy sessions. I’m absolutely mentally exhausted. I tried to reach out to her today. I haven’t heard a response. Par for the course. I just hope she didn’t do anything to hurt herself. I’m worried I might not be able take too much more of this. I don’t know if I can support someone that:
· Consistently lies
· Not being honest with her own doctor about alcohol and drug use
· Not
· Not
· Not
There is just so many ‘nots.’ I feel like I’m on rough waters at the edge of a really large whirlpool. I don’t know how supporters handle sufferers in such horrible situations. I know she needs to help herself. I think her lack of honesty will prevent any further recovery. At least be honest with yourself and your doctor. I don’t know how you all can stand by and watch an inevitable train wreck. I usually can type out my feeling pretty well, but tonight I don’t have the vocabulary to describe how I feel.