(Not to worry, once work begins, I will definitely never post two days in a row again. :D)
We humans like everything in boxes. We like to categorize, even science. This was not complete news to me the first time I heard Robert Sapolsky explain this in his opening lecture on Human Behavioral Biology. But his discussion of it, and his breaking down of those boxes until none could remain for any but the most stubborn of people, has been the explanation that has stuck with me.
Life is holistic. Everything is connected. You cannot study one branch of science without spilling over into another branch. However, our minds do not like that because that is not easy. And doctors and scientists are just as human as the rest of us.
When I read articles on trauma recovery, I inevitably come across some author who has made a list. The lists generally follow the same categories or structure as the so-called stages of grief I learned over thirty years ago when I was being trained as a nurse’s aid.
DABDA. Denial. Anger. Bargaining. Depression. Acceptance.
Now, it was mentioned that these stages are not something we march through and tick off one by one. True, but by putting them into this category structure, my mind, and the minds of most of my fellow students, trapped grief into steps. Even though we knew it was not so simple, our minds insisted we keep it in neat little boxes. That’s because our minds are lazy, if I may be so bold as to summarize Subliminal by Leonard Mlodinov so simply.
When I come across the lists, I am cautious. I have been made aware, through a lot of reading and study, how easily the mind is captured by the simplicity of these lists. In the case of trauma recovery, I suppose it is due to the need to get over it and move on, the pressure from outside ourselves from the culture, and inside ourselves from the exhaustion.
I came across such a list in my daily online reading of trauma related articles. It’s from a treatment center that most people who have PTSD will never be able to afford (but that’s all of them folks, reality in the US is we really don’t care about victims of anything). I read such sights sparingly due to this fact.
The list was this:
- The Emergency Stage
- The Numbing Stage
- The Intrusive/Repetitive Stage
- The Transition Stage
- The Integration Stage
Each of these stages had a pleasant description and I understood what the writers meant. But the reason it stuck with me is because I’m really tired of the “Intrusive/Repetitive” stage. I just want to move on. No, that’s not quite right. I need to move on. Not in the dismissive way your fake friends might say, but in a personal way because I am weary of the flashbacks and tired of the knowledge that I will never be normal.
The list describes the stage after as “Transition.” In this stage one supposedly enters into recovery. And it sounds lovely. You “begin to move into a new level of acceptance and understanding.” You will be more positive. And, most importantly, you will begin to “overcome” PTSD.
But as I further contemplated this list, especially in light of the tasks I have set out for myself today–phone calls and forms, two things I fear more than death–I thought how odd that they make it sound as if during the transition stage, flashbacks do not exist. There should be a sub-note, a little asterisk guiding you to the end of the page that says, *flashbacks will persist.
As my teachers tried to point out when I was in training, the stages meld together in a way that is not as simple as the list. One might think they have worked through their grief, only to be thrown back into depression. I believe they were trying to say, but might have been afraid to–because this is America, dammit–that grief is never truly over. The hard edges of the memories may soften over time, but how can one ever get over the loss of a loved one? We don’t. We simply move forward because that is the direction of time.
PTSD does not end. We may work through our trauma. You might even be lucky enough to have enough money to cover good treatment. That will put you ahead of the rest of us who do not have money, and, on the poor side of the spectrum, I would say that adequate money in itself would be one less stress on my PTSD. But the trauma is always there. Trauma, stated sarcastically, is “the gift that keeps on giving.”
But I move forward, because that is the direction of time.