The ptsd cup explanation

Nearly a decade ago (2006) I wrote The PTSD Cup Explanation, a simple view of how PTSD causes symptoms in day-to-day life. This article is an update to that original piece.

Regardless of the type of trauma endured, the PTSD Cup does not change, deviate or apply differently to your circumstance. The PTSD Cup is a basic representation of your capacity for tolerating stressors. As your cup fills, symptoms get worse. When your cup overflows, you may break down crying, become psychotic or manic, attempt to kill yourself, and many other possible outcomes.

The differences unique to each individual lay within their environment (exposure to daily life), their ability to manage stressors, and finally, the actions that occur upon overflow.

One example of this uniqueness is seen in a high functioning PTSD sufferer. They have the same cup as any PTSD sufferer; however, they may differ in their ability to manage work stressors. Their work may make them feel positive, good about themselves. Another area of their life may suffer, say... relationships. They feel good about their work, but a partner or friendship may cause stress they can't reconcile.

ptsd-cup.png


The above image contains one cup, through three stages. There is a fourth stage to the PTSD cup, applicable only to combat veterans. I will discuss that briefly at the end.

Variability

Each block within a cup is variable. Simply put, each block will move up or down with some predictability, based on your daily activities, how you feel, what you're thinking, and so forth.

Cup One (Left Cup)

Many people think good things don't cause stress. Well, they do! The difference is the net effect. When you get out of bed, have a shower, brush your teeth, comb your hair, drink your morning coffee, and so forth, you feel good after performing these daily tasks. This is called "good stress," and creates positive emotion.

These menial, often disregarded, tasks help reduce your bad stress. Positive and joyous interactions and feelings continuously counter negative stressors.

Cup Two (Middle Cup)

Here we've introduced bad stress. Bad stress is just that -- negative interactions that create negative emotion.

This cup represents everyone without PTSD. You can see how much room there is in that cup. Lots! People without PTSD have the capacity to deal with daily stressors. They balance their day with good stressors, and rarely overflow their cup.

When you go to sleep, sleep reduces negative stressors from your cup so you start the next day fresh. When a person ruminates overnight, they may awake with bad stress in their cup. An example is a teenager giving a presentation. They awake tired, grumpy and partially stressed, thinking they aren't prepared, or their presentation lacks something. When they deliver their presentation without incident, and obtain positive feedback, this creates positive emotion and removes the negative stress. That night, they will sleep better and remove all their remaining bad stress.

Think broadly when applying this to yourself.

Cup Three (Right Cup)

Now we introduce PTSD. The problem is that we still have the same good and bad stressors, but without the same overall capacity as a non-PTSD sufferer.

Who thought good stress could make you overflow? With PTSD, it can do just that - not to mention what bad stressors can do.

Think about it like this -- the reason you don't want to get out of bed, have a shower, do anything at all, is that your cup is full. Your brain tells you to stay in bed, otherwise you overflow. Place your own situation here; the model does not change.

The Obvious Question

It's easy to talk about a problem, ignoring its solution -- but this solution isn't rocket science.

Trauma is the problem. Trauma is full of bad stressors. Work through trauma and you reduce bad stressors. Make life changes where you're negatively stressed. Reduce your traumatic effect, you reduce your PTSD symptoms.

Depending on your level of trauma, this may take months, a year, or many years.

The Fourth Cup (Military Training)

The cup I didn't show is specific to those who have deployed within an operational zone where military training kept them alive. Add an additional block to the cup, call it "training." Now you have good and bad stress, PTSD, and training.

The above cup has little capacity already, so how does training fit? Well, it's squeezed and compresses all blocks. Part of the military training block is a lid with button. This lid and button is effective within a military environment, the cup is full, compresses, an order is given, the soldier explodes against the enemy.

Notice how overflow has been removed from the below image? Combat veterans have a lid and button. Everything builds-up, compresses, then explodes -- instead of overflowing.

ptsd-cup-military.png


This is useful in active service, but not very effective in regular society. The military used to control the button, for the most part; post-service, PTSD is in control. The cup can only take so much pressure before the button fails. With a constantly full and compressed cup, all it takes is for the toilet roll to be around the wrong way -- the veteran explodes at someone (spouse or child), or something (wall or door), and only then will the pressure be released.

This is behavioral conditioning that helped the veteran remain alive. When differentiating between a combat zone and civilian life -- the brain knows the difference, but still functions on instinct, in the ways that have been proven effective in order to stay alive.

The most obvious question is, why do combat veterans have this extra block and not all military?

When military are trained, they're trained to have some PTSD symptoms, especially Army, Marines, or Special Forces-type training. Hyper-vigilance, startle response, alertness -- these are all symptoms of PTSD. When leaving the military and without combat, this training quickly subsides and the person reverts to civilian behavior.

Once a soldier enters a combat zone the brain accepts that this training saved their life, or their buddy's life. This makes training a priority for survival. The training becomes instinctual, regardless of whether they are in a combat zone, or not. This block is one of the most difficult to lessen, and typically only diminishes from a combination of time, and decreasing the traumatic effect.

Conclusion

The PTSD cup is a simple representation that defines your internal stress. We all react differently when our cup overflows. Some may cry, some may dissociate, some may become angry. A soldier may explode with horrific rage and violence. To control the effect is to minimize the cup's content, where possible.

I might wish we could remove the PTSD block -- that would be ideal. Unfortunately, there is no cure. So, work with what is within your reach. What immediate stressors can you reduce or remove with the least amount of change? What did you used to do that made you happy? Remember, good stress counters bad stress, so do things that make you happy to create capacity within your cup.

Remember that this is, more often than not, a long-term process. Managing your internal stressor cup takes time, education, and skills learned for future improvement.
 
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I have to say that while I was not in the military, I was trained as a child and through many years of marriage. I was trained as an infant that I did not matter and to be safe, I had to be invisible. I was trained to to be compliant, not argue, accept that I did not matter. Then there was the teacher in high school. I learn again that everything was my fault. I was trained to hold it all in. Never talk. Then the marriage – again, I did not matter. Be compliant. Agree. My opinions didn’t matter. Cap the anger. Never let it show. Hide the pain and frustration. Until I couldn’t do it any more and then the consequence was divorce. I was thrown aside because I stopped being compliant because my own survival depended on it. I was as trained as anyone I have ever known. Hold it in. Don’t share. Don’t complain. Just survive. It isn’t just military that are trained. I didn’t choose to be trained. It just was.
This is really heartbreaking, it's extremely hard to continue with life after being thrown aside. My stepdad abused me (emotionally, verbally, psychologically, physically and spiritually) while sporting a clean pastor image. I pried myself from their grasp at age 21, I couldn't do it any longer. We have had no contact the past year, it's tough to be me in the same town they live in. The mental training of being perfect, being polite in every situation and hiding behind a very fragile projection of a reputation. I trust you rise again into the Queen you are <3
 

comfort zone

New Here
Nearly a decade ago (2006) I wrote The PTSD Cup Explanation, a simple view of how PTSD causes symptoms in day-to-day life. This article is an update to that original piece.

Regardless of the type of trauma endured, the PTSD Cup does not change, deviate or apply differently to your circumstance. The PTSD Cup is a basic representation of your capacity for tolerating stressors. As your cup fills, symptoms get worse. When your cup overflows, you may break down crying, become psychotic or manic, attempt to kill yourself, and many other possible outcomes.

The differences unique to each individual lay within their environment (exposure to daily life), their ability to manage stressors, and finally, the actions that occur upon overflow.

One example of this uniqueness is seen in a high functioning PTSD sufferer. They have the same cup as any PTSD sufferer; however, they may differ in their ability to manage work stressors. Their work may make them feel positive, good about themselves. Another area of their life may suffer, say... relationships. They feel good about their work, but a partner or friendship may cause stress they can't reconcile.

View attachment 52917

The above image contains one cup, through three stages. There is a fourth stage to the PTSD cup, applicable only to combat veterans. I will discuss that briefly at the end.

Variability

Each block within a cup is variable. Simply put, each block will move up or down with some predictability, based on your daily activities, how you feel, what you're thinking, and so forth.

Cup One (Left Cup)

Many people think good things don't cause stress. Well, they do! The difference is the net effect. When you get out of bed, have a shower, brush your teeth, comb your hair, drink your morning coffee, and so forth, you feel good after performing these daily tasks. This is called "good stress," and creates positive emotion.

These menial, often disregarded, tasks help reduce your bad stress. Positive and joyous interactions and feelings continuously counter negative stressors.

Cup Two (Middle Cup)

Here we've introduced bad stress. Bad stress is just that -- negative interactions that create negative emotion.

This cup represents everyone without PTSD. You can see how much room there is in that cup. Lots! People without PTSD have the capacity to deal with daily stressors. They balance their day with good stressors, and rarely overflow their cup.

When you go to sleep, sleep reduces negative stressors from your cup so you start the next day fresh. When a person ruminates overnight, they may awake with bad stress in their cup. An example is a teenager giving a presentation. They awake tired, grumpy and partially stressed, thinking they aren't prepared, or their presentation lacks something. When they deliver their presentation without incident, and obtain positive feedback, this creates positive emotion and removes the negative stress. That night, they will sleep better and remove all their remaining bad stress.

Think broadly when applying this to yourself.

Cup Three (Right Cup)

Now we introduce PTSD. The problem is that we still have the same good and bad stressors, but without the same overall capacity as a non-PTSD sufferer.

Who thought good stress could make you overflow? With PTSD, it can do just that - not to mention what bad stressors can do.

Think about it like this -- the reason you don't want to get out of bed, have a shower, do anything at all, is that your cup is full. Your brain tells you to stay in bed, otherwise you overflow. Place your own situation here; the model does not change.

The Obvious Question

It's easy to talk about a problem, ignoring its solution -- but this solution isn't rocket science.

Trauma is the problem. Trauma is full of bad stressors. Work through trauma and you reduce bad stressors. Make life changes where you're negatively stressed. Reduce your traumatic effect, you reduce your PTSD symptoms.

Depending on your level of trauma, this may take months, a year, or many years.

The Fourth Cup (Military Training)

The cup I didn't show is specific to those who have deployed within an operational zone where military training kept them alive. Add an additional block to the cup, call it "training." Now you have good and bad stress, PTSD, and training.

The above cup has little capacity already, so how does training fit? Well, it's squeezed and compresses all blocks. Part of the military training block is a lid with button. This lid and button is effective within a military environment, the cup is full, compresses, an order is given, the soldier explodes against the enemy.

Notice how overflow has been removed from the below image? Combat veterans have a lid and button. Everything builds-up, compresses, then explodes -- instead of overflowing.

View attachment 52918

This is useful in active service, but not very effective in regular society. The military used to control the button, for the most part; post-service, PTSD is in control. The cup can only take so much pressure before the button fails. With a constantly full and compressed cup, all it takes is for the toilet roll to be around the wrong way -- the veteran explodes at someone (spouse or child), or something (wall or door), and only then will the pressure be released.

This is behavioral conditioning that helped the veteran remain alive. When differentiating between a combat zone and civilian life -- the brain knows the difference, but still functions on instinct, in the ways that have been proven effective in order to stay alive.

The most obvious question is, why do combat veterans have this extra block and not all military?

When military are trained, they're trained to have some PTSD symptoms, especially Army, Marines, or Special Forces-type training. Hyper-vigilance, startle response, alertness -- these are all symptoms of PTSD. When leaving the military and without combat, this training quickly subsides and the person reverts to civilian behavior.

Once a soldier enters a combat zone the brain accepts that this training saved their life, or their buddy's life. This makes training a priority for survival. The training becomes instinctual, regardless of whether they are in a combat zone, or not. This block is one of the most difficult to lessen, and typically only diminishes from a combination of time, and decreasing the traumatic effect.

Conclusion

The PTSD cup is a simple representation that defines your internal stress. We all react differently when our cup overflows. Some may cry, some may dissociate, some may become angry. A soldier may explode with horrific rage and violence. To control the effect is to minimize the cup's content, where possible.

I might wish we could remove the PTSD block -- that would be ideal. Unfortunately, there is no cure. So, work with what is within your reach. What immediate stressors can you reduce or remove with the least amount of change? What did you used to do that made you happy? Remember, good stress counters bad stress, so do things that make you happy to create capacity within your cup.

Remember that this is, more often than not, a long-term process. Managing your internal stressor cup takes time, education, and skills learned for future improvement.

Thank you for this article ‘The ptsd cup explanation’. One thing I found helpful was to learn something about veterans PTSD. You updated your article and you updated my understanding. I have been curious about this for sometime. This description about military training is very intense. Now I understand a little bit about a veterans’ healing process. Another thing I liked was how good stress counters bad stress; and sleep and happyness too. I know these things but the way you wrote about them was helpful and encouraging. It's good to be reminded. I like the cup illustrations/symbols also.
 
Last edited by a moderator:

Littlesoul

New Here
I have often described my experience with PTSD as being in a cup, and that the cup is bubbled at the top. And I’m sitting in a little boat trying to keep the water out with a little bucket and it just barely works. But that any amount of additional stress causes the bubble to pop and spill over taking me with it. And then I have to spend days climbing back into my cup- to save my little boat.
This is so validating
 

Jwill

New Here
I have to say that while I was not in the military, I was trained as a child and through many years of marriage. I was trained as an infant that I did not matter and to be safe, I had to be invisible. I was trained to to be compliant, not argue, accept that I did not matter. Then there was the teacher in high school. I learn again that everything was my fault. I was trained to hold it all in. Never talk. Then the marriage – again, I did not matter. Be compliant. Agree. My opinions didn’t matter. Cap the anger. Never let it show. Hide the pain and frustration. Until I couldn’t do it any more and then the consequence was divorce. I was thrown aside because I stopped being compliant because my own survival depended on it. I was as trained as anyone I have ever known. Hold it in. Don’t share. Don’t complain. Just survive. It isn’t just military that are trained. I didn’t choose to be trained. It just was.
Yes...what you said makes so much sense. You learn to comply and feel unloved and unimportant. It starts when we are infants, our parents style of discipline to keep us in line and then when we enter a marriage that doesn’t offer compassion or nurturing, it reinforces those core beliefs. We never learn to live authentically and by that point its hard to change and if you do there is an upset. That’s exactly how my life went. I have had a lifelong dose of depression, anxiety and now I’ve learned about C-ptsd. It almost feels like there is not hope.
 

FFwife

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I've gotta print this out and give it to my sufferer. He's hesitant to come here. I've gently introduced the topic, but he's not on board yet. He's working with his therapist, and that's good for now.

As I've said elsewhere, my sufferer is a first responder. His treating providers deal mainly with combat veterans, but in the past several years, have branched out to first responders. They've found that the quasi-military and the "constant on" environment mesh well in the therapy realm. Mix that with the regular dose of trauma they see on every shift, and it's a good fit.

As I read the bottom part, about veterans, I found it very familiar. My guy, too, has that cap. His button to trigger release may be different, but his training gets in the way and worsens the other stress. Super interesting to see the whole concept put into this model - thank you. I am pretty sure I witnessed this exact thing yesterday (and many many days before that). I will work on supporting him to minimize those stresses before it explodes.
 
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anthony

Founder
Glad it helped. Something else to help him will be: The Iceberg Of Emotions

As a combat vet, it was me trying to understand why I got so angry about stupid shit, that helped me the most control my response. It didn't happen overnight, and took some years to master, but my response today is very different, even though underneath all the same things are felt inside me.

I would concur, fire, ambulance, police, military, very similar traumatic exposure and the consequential response. Police and military are probably the closest as jobs, but fire and ambulance are first responders to the event itself, where doctors have been taught to deal with the patient and body, they don't often see the event itself and have to deal with that. The event combined with the trauma is profound.
 
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