PTSD reactivity

PTSD: The Reactivity Switch

What it is and how it affects you.

By Mary Tendall, VietNow National PTSD Chairperson

For many Vietnam veterans, the war has not yet died. It lurks inside, only to be awakened in the form of a nightmare, angry outburst, avoidance of family or friends, or a desperate need for isolation. As confusing as it seems, there is a reason for reactivity that goes well beyond what the situation calls for. As I’ve stressed in other articles, after combat, the combat-ready brain does not just go away by itself, nor can the veteran just forget. Depending on life before, during, and after a war, each individual will experience adjustment in a different manner. If severe or even mild symptoms occur, lack of effective treatment can cause the symptoms to increase with time.

Sometimes the symptoms are dormant during a busy and distracting lifestyle, only to sneak back during a quiet time of day or a phase of life such as retirement. Numerous Vietnam veterans have found retirement to be an especially stressful time. Relationships become more complicated, whether long-term or short-term.

Mike* asked, “How can I privately love and appreciate my wife so deeply when I am alone, then resent the heck out of her when we are together?” Good question. Many veterans in long-term relationships have also said, “My wife is a saint. I don’t know how she puts up with me,” yet it would be rare for him to say that directly to her.

Sometimes the symptoms are dormant during a busy and distracting lifestyle, only to sneak back during a quiet time of day or a phase of life such as retirement. Numerous Vietnam veterans have found retirement to be an especially stressful time.

So what is the reason for such confusing reactivity, and why does resentment, anger, and the need for isolation still occur so often? The problem is partially due to the reactors in the brain that are ontinuing to take in sensory input as if the veteran was still in a war-time situation. They cause a physical as well as an emotional reaction that can often cause an altered perception of a situation. When the body calms down, it is not unusual for a war veteran to “forget about it” and move on, leaving a loved one angry and confused.

Mark* said that he gets angry easily at his wife, and then just as easily lets it go. His wife, Marsha,* then wants to talk about it, and may follow him around. (Note to Marsha: Don’t follow him.) While Mark lets it go, he doesn’t realize that Marsha has taken his inappropriate reactivity as a personal affront. Mark could avoid the confrontation altogether if he could notice that he is physically and/or emotionally activated, and then wait until he calmed down, before any discussion ensues. Marsha also needs to wait if she is feeling reactive, then let Mark know how his behavior impacted her. The waiting is crucial for both Mark and Marsha.

More confusing is how abruptly veterans can switch from one mood to another. Daniel* reported, “I was having an unusually fine day. I’m retired with a pension, and I had time to refurbish an old truck – with all the time I needed. All of a sudden, a car drove by, driven with teenagers blaring loud music and driving way too fast. There was no one around, and they had long gone, but I was still upset. When my wife opened the door to the garage and asked me how much longer I was going to be working on the truck, I yelled at her, threw my tools down, and went inside and watched TV in my den for the rest of the day.”

More confusing is how abruptly veterans can switch from one mood to another.

Incidents like this are not uncommon, and can create long-term resentment on both sides. It’s as if a mechanism goes off inside, and people have to be very mindful to not act from that emotional place. Daniel calls it “the switch,” and when that “switch” goes off, husband and wife need to be mindful that nothing can be resolved under those circumstances.

Sensory triggers are instant, but if you feel that “switch” flip, be aware that you are experiencing an old coping mechanism that is no longer appropriate for what the circumstances call for. You may be correct about needing to have a say regarding an issue, but it is the intense reactivity that needs to deactivate before responding.

What so many wives and friends of combat veterans do not know is that as soon as a young man goes into a combat zone for a sustained time, his identity is in a jumble except as a combat soldier. Without combat, a man’s identity is usually in place by the age range of 19 to 25 years. But a young man going into a war-time situation does not have the opportunity to form his identity in any clear manner with the chaos of war. Coming home is especially difficult because, for a war veteran, everyone becomes a stranger except for his brothers in arms – and possibly the family dog.

Add to that the horrific reception most Vietnam veterans faced from an ungrateful country that used young veterans as the scapegoats for their anger at the government. Identity and belonging suffer greatly, and there’s a lot of difficulty dealing with the normal reactivity that occurs with someone who has experienced war. It’s a wonder that so many Vietnam veterans have done so well! I know that veterans are just as confused as their loved ones regarding the irrational behavior that can arise in an instant. Relationships suffer as veterans are so often asked questions like, “Why did you do that?” or, “Why can’t you…(fill in the blank)?” Activities that would be easy for most people become problematic for many combat veterans who feel uncomfortable with emotional intimacy, crowds, strangers, or enclosed spaces. And what does a veteran who knew himself in a very different way prior to the war do now?

Joe* was so sick of his wife’s discomfort with him that he thought about separating from her after thirty-two years of marriage. He planned a two-week fishing trip to help clear his head and make a decision. He booked a lakeside cabin, but after being there for just one day it was all he could do to not call his wife. (They reported later that they were both worried at not receiving a call, and that they had missed each other.)

At this stage of life it’s vital to look at the big picture. Is it worth it to dwell on winning an argument? Learning acceptance of minor irritations can lead to tolerance and the freedom of a more peaceful existence all around.

By the next day they were in back in contact, and they both realized that being away on a permanent basis is not what they wanted. At the same time, they had to consciously develop a new tolerance of each other’s needs, and to avoid discussions when feeling reactive. Joe said with a smile, “Can I think she is a pain in the ass and still love her?”

The answer is yes! At this stage of life it’s vital to look at the big picture. Is it worth it to dwell on winning an argument? Learning acceptance of minor irritations can lead to tolerance and the freedom of a more peaceful existence all around. (That being said, it is understood that verbal or physical abuse should never be tolerated.)

Dave* and his wife have redefined their marriage. They continue to enjoy what they have in common – family, fishing, and movies – but the rest of the time they are mutually content to go about spending much of the rest of their time separately. While they share an evening meal together when they can, Dave’s wife socializes with friends and enjoys going on cruises – while Dave socializes on his computer, watches TV, and enjoys reading. Tolerance has made the difference in their marriage, and he says he can be content with the rest of his life just as it is.

At some point in life, before a veteran’s war-time experiences, there was certainly a time when reactivity made sense, even if the actions were inappropriate. Unfair treatment from a teacher, being picked on by a parent or classmate, losing a game, or even the loss of a pet might have caused extreme feelings, but the cause was usually known and understood. After war-time experiences, the cause is often disguised, only to show up as a reaction later as in Daniel’s case.

The sound of a helicopter, seeing something that reminds the veteran of the war, smelling diesel fuel, feeling confinement in a small space, or even the taste of a food that reminds him of the war.

After talking about it, Daniel realized that the activation happened when the car drove by, and the reaction had been just waiting for something (anything) to release it – and unfortunately, it was his wife who received the reactivity.

All our senses can be activators for “the switch,” and sound is the most direct of all, since it has a direct pathway to the nervous system. I’ve talked about some of the sensory activators in past articles, such as the sound of a helicopter, seeing something that reminds the veteran of the war, smelling diesel fuel, feeling confinement in a small space, or even the taste of a food that reminds him of the war.

Actions such as carelessness, loss of an article, and/or anyone endangering someone else, such as tailgating traffic, can activate the reactions.

Sensory input can also de-trigger activation. For example: Soothing music, a walk in nature, certain pleasant smells, mas­sage, pets, grandkids, carefully chosen vacations, yoga – and time with trusted loved ones including pets and grandkids.

Learning to tolerate the small irritating incidents within a relationship, and by learning to take time outs when the body and mind are activated, can help make life easier – and positive opportunities are more likely to abound.

I am open to hearing your stories and to suggestions for future ­article topics. Please feel free to contact me.

You are invited to contact Mary Tendall with comments and/or questions regarding PTSD. Her e-mail address is maryten@jps.net.

*The names of any veterans and/or family members mentioned in this article have been changed for privacy reasons.

 

Mary TendallMary Tendall, MA, LMFT, serves as the VietNow National PTSD Chairperson. She has worked for over 20 years with combat veterans and their families, specializing in PTSD. She also works with groups such as Soldier’s Heart, Train Down, and America’s Heroes.