training with PTSD

[thedude47111]

I think if all of these people who argue with Rip's claim of having PTSD knew the situation which caused it, I doubt anyone would argue against that claim. It's seriously about as horrible as anything I could imagine. I've witnessed and been the victim of some pretty awful stuff in my life, but I never had to deal with what he did. As he said, I can't really complain about what happened to me when most of the world has a worse story than me.

I wouldn't argue with whether or not he had PTSD. But I'm suspicious of the idea that one can give one's self permission not to have a flashback or get triggered. The way I understand these things is that they're involuntary.

[Mark Rippetoe]

As usual, your understanding is limited.

[thedude47111]

As usual, your understanding is limited.

Why don't you just explain how one controls flashbacks (or, "flashbacks") so we all can benefit from your knowledge.

[Pluripotent]

I don't judge anyone who has more adverse reactions to what they've been through, and I certainly don't feel my service is comparable to those who've served in the military. I do however, in my own mind, question many of my peers who seem to play the stress/PTSD card a bit too readily in my opinion, although I am aware I am an opinionated dinosaur.

This puzzles me, too. I've seen some pretty terrible things and been around a fair amount of death and dying and pronounced people dead. It can be emotional, but this is just not the same as when things happen to you or your family. While I could make myself sad if I were to dwell on it over much, I can't imagine it causing lasting psychological damage. PTSD is something different.

[Pluripotent]

So, my opinion on problems in general: eventually -- if you are going to recover at all -- you end up at the point were you just decide to move on. If you are not there yet, therapy may be useful up to the point where you realize that you just have to put it behind you. So, as is often the case, Rip is right.

And so was Barney...

[Dalton Clark]

I wouldn't argue with whether or not he had PTSD. But I'm suspicious of the idea that one can give one's self permission not to have a flashback or get triggered. The way I understand these things is that they're involuntary.

I don't have enough experience with PTSD to definitely say whether this is true or not. I have a sneaking suspicion that Hollywood flashbacks might have dramatized this beyond any hope of getting what the actual experience is like. I have only known one person (rape victim) who was diagnosed as such. She did not start to improve until she didn't allow herself to be labelled as 'damaged' by PTSD. While I only experience issues related to depression, social anxiety (and not the 'I don't like parties' type, the real one), and emotional dysregulation, many mental health concerns are impacted by a "self-fulfilling prophecy". If you believe that you have condition X and that it impacts your life in a certain way that is beyond your control, you will continue to experience the negative impacts.

Yes, talk therapy and other mechanisms might be extremely useful in treating such things but the end result is that the person with the condition must come to the decision to not allow that condition to run their lives for them. There is an entire branch of therapy that deals with your mental responses to emotional occurrences: Cognitive Behavioral Therapy. You would be very hard pressed to convince many experts that anything other than the most acute emotional responses are entirely involuntary.

[Mark E. Hurling]

I wouldn't argue with whether or not he had PTSD. But I'm suspicious of the idea that one can give one's self permission not to have a flashback or get triggered. The way I understand these things is that they're involuntary.

Have you ever heard of self talk? It works on a whole host of fronts.

[JHG]

I wouldn't argue with whether or not he had PTSD. But I'm suspicious of the idea that one can give one's self permission not to have a flashback or get triggered. The way I understand these things is that they're involuntary.

Are you also suspicious of mental toughness and the conscious decision one makes to be more resilient, confident and take charge of his/her life as opposed to leaving things to “fate”? Or might you be suspicious of the conscious psychological defense mechanism of suppression?

Given that you reportedly work in mental health, it would do you some good to meet and talk with immigrants and refugees that have come to North America from war-torn countries and who feel blessed that they are still alive and can start all over again. Do you believe that they forgot about their former lives and all their memories have vanished? No, they instead have a greater appreciation for life and often thrive in their new environment where they do not have to worry about being hit by stray bullets or worrying whether their college campus or local hospital will be bombed etc...

In my opinion, some of the posts on this thread are completely asinine. If you ask Rip (or anyone for that matter) for advice on how he dealt with hardship in his life, accept his response and move on. Understand that (1) He is not obligated to share this information with you and (2) He did not invite you to analyze or criticize his approach.

If I were you, I would first appreciate Rip's candor and openness and then exercise some restraint and self-reflection to see if you are capable of executing such an approach in your own life rather than immediately negating his views, which is a sign that they do not comport with your own and perhaps that you are more fragile than you believe.

[JFord]

I had and have a completely different approach to this than you do. I got on with my fucking life.

Thing 1) as an internist, I deal only peripherally with PTSD and am hardly an expert.

Thing 2) I myself have never had a personal experience with the emotional trauma sufficient to throw me into PTSD so I can't speak from personal experience.

That said, I do believe there is some clinical reports to support Mark's position (though clearly not definitively). A study performed after 911 showed that patients directly effected by that event who participated in group therapy did signicantly worse than those who didn't. Obvious limitations on these results were that the study was observational, not randomized.

Also, the VA has had particularly bad experience with Prolonged Exposure Therapy (PET) with significant negative outcomes and side-effects greatly limiting its efficacy. This therapy involves having the patient repeatedly "relive" the precipitating experience in the patient's mind. I can easily imagine group therapy or even individual therapy devolving into a form of PET.

Years ago, I attended a Grand Rounds lecture by a psychiatrist (a specialist in PTSD) who theorized that persistently reliving traumatic events through group therapy may actual cause the brain to lay down neural pathways that can prove virtually impossible to disrupt later. He actually felt that "just moving on" rather than being maladaptive might actually be beneficial for many patients.

Mark's approach may be harmful for some patients but I fully believe that for many (Mark for example) it may be the best solution. I can honestly say that for some of the highest functioning PTSD patients I've knowingly taken care of over the years, this has been their approach. Admittedly self-selection might explain my anecdotal observations but they have deeply colored my own thoughts about this problem. And trust me, I've heard some awful shit.

I realize that my opinion may be anathema to many in the mental health profession. On the other hand, I think that the efficacy and side-effects of ANY therapy, even something as seemingly benign as psychotherapy or group therapy need to be critically examined.

Just my two cents.

[F.G. Tonyas]

Wow, this is sad. Never mind, then this was a misunderstanding. You seem to have made yourself believe you have a disorder without ever experiencing the disorder..? I would not have asked you if I knew you self diagnosed yourself in a mood, Mark. It is clear you should be in therapy for something else. But as long as you only write books about exercising, who cares.

But thanks to you guys who shared their actual experiences.