Read "How to Reduce your Symptoms of Stress" offline:
One of the fastest ways to reduce your stress is to reevaluate your boundaries with people that drain you. Apply that concept to cognitive therapy for PTSD, emotional health and spiritual growth and you have a way out!

Cognitive Therapy for PTSD

Mentally, how do you reduce symptoms of stress? The very first thing, of course, you have to do is be honest. I’m talking about being honest with yourself, thoroughly and completely. You realize many people walk around this life totally disconnected, not really being honest with anyone, maybe a handful of times in their life. I’m talking about the dirty secrets, the deep dark stuff, the shame, the things that shame and guilt are sorting of pounding on them, right?
What I’ve noticed in my observations in treating, and writing, and researching about post-traumatic stress is that so many times people will have multiple events in their life that contribute to a single stuck point, right? Different kinds of things feed their shame and guilt, so if you are too cut off, have not dealt with your shame, don’t have healing or peace, can’t be honest with anyone, you need to start reducing your symptoms of stress by being at least honest with yourself. I recommend journaling for that purpose, to get some of these thoughts rolling around in your head outside of your head and onto paper.Many, many people talk to me about anxiety, anxiety, and it’s a complicated topic. It’s a bit of a trash can word because it just means so many different things to so many different people. About half the people I see, anxiety means procrastination. There are things that they know they need to do in their life, and they’re just not doing them, you know, and expecting a pill to mask that symptom, to cover it up. We have many, many thousands of people on medications that are enabling their disorder, and their discomfort, and even prolonging their disease process.If you’re tired of dealing with post-traumatic stress or symptoms of stress, one thing you have to really wrap your mind around is that avoiding this issue is not helping. You’re going to have to face it. You’re going to have to stop procrastinating. If you know there are some self-care things that you need to do for yourself, make a list. I recommend a legal pad and a pencil.

Emotional Recovery from PTSD

Emotionally, there are several things you can do. In that same vein of being authentic, you have to accept yourself, connect with other people, you’re going to feel a venting. These have to be safe people. How do you know who’s safe? Well, I recommend reading or listening to Brene Brown on Look her up. I recently listened to the audio book, The Gifts of Imperfection, while riding my mountain bike. Fantastic stuff, really good stuff that will make you reflect on your life, and be a more authentic version of yourself, as my therapist likes to say. The subtitle for the book is, Letting Go of Who You Think You’re Supposed to Be and Embracing Who You Actually Are, so this will help decrease symptoms of stress.The key feature I really wanted to bring you today, and talk to you about is who do we trust, how well do we trust, at what level of honesty and transparency are we to have with people? It’s helpful to think of our relationships with different people as having an inner, closed circle of tight friends or family or supporters, and an outer circle. Some psychologists, well meaning, have good constructs for this, and they have middle circles and all this kind of stuff. In my mind, you’re either 100% transparent and honest about your deepest, darkest fears and secrets with people or you’re not, period. If you’re not, you’re cut off and you’re not connected.To actually heal and not just cope from post-traumatic stress, you’re going to have to be 100% authentic and transparent, at least somewhere, so how many transparent people can you have? When I learned about this, I wanted to have that all the time. I’m still told you can’t have it all the time. There are things you can’t say and do in the workplace and keep your job. There are crimes we might confess to that could get us in trouble, so I get it, but inner circle means real people, people you can be your real, actual self, the self that God created you to be, in all of its beautiful ways and all of its imperfections, and all of its glory. It’s who you actually are, and so chances are if you have any of these friends, it’s a miracle. Maybe a few, maybe one person that you can really be real with, that knows all your stuff and loves you anyway. That’s what we’re after is connection and unconditional love. We are wired for connection. Our brains are hardwired.What about the outer circle? This might surprise you that family that you just see at holidays, and that you think of as close friends and family, if you will look at that group, how interested are they in your life, in your inner well-being all year? Recently I did not go to a family function around the holidays, and at first had some guilt until I caught myself and said, “Wait a minute. I don’t owe them anything,” but they’re bloodline family that I care about on a level, but when I’m going through stuff I don’t call them and tell them everything, so what do you do with those people in your outer circle, or your middle circle, you know, that are not your core, authentic people when you’ve got to change or you’ve got something going on in your own personal life, to set boundaries and limitations for your emotional health, your emotional wellbeing, and what you’re physically going to put up and tolerate from other people.
For example, around the holidays, when people expect you to be there. Well, if they’re not your close inner circle, what I’m suggesting is only tell them what they need to know. They’re on a need to know basis, so if you’re going through a separation or have a job loss or something, and you just don’t want to talk about it with them, you don’t have to be there. You don’t have to tell them what’s going on unless it affects them directly. If they are going to come meet you for coffee, and you don’t work at that shop anymore, you might send them a message that says, “Listen, you need to know before we meet X, Y, and Z.” What they need to know. You don’t have to go through emotional, lengthy explanations of all the things in your life that are causing you turmoil with everyone.Many people that are just so nice, helpful to everyone, they’ve put this tremendous of load of pressure or guilt on themselves that they have to keep everybody happy, people pleasing at its finest here, and they can beat themselves up pretty bad when they’re just overwhelmed. I’m giving you permission, I’m inviting you to give yourself permission to not necessarily have to explain every physical, emotional thing that’s going on with you to people that are outside of your inner circle. They don’t need to know everything.

Physical Boundaries and PTSD

Let’s talk about physical dimensions here. Boundaries, physical boundaries, whether or not you’re going to go somewhere, the importance of sleep is a huge thing in the PTSD Academy. I did not know when I entered psychiatry that I would become a sleep expert, that I would deal with that all the time in practically every patient, 90% of patients, didn’t know that. Of course, when I did emergency medicine previously, I did not realize, it wasn’t on the brochure when I signed up for that medical specialty that you had to do a rectal exam and put your finger up the rear end of everyone that had a complaint, a physical complaint from the neck down. You pretty much do in the ER, and they don’t put that on the sexy TV shows that sell headlines and get good ratings. They don’t tell you the dirty side, but sleep is sort of the dirty side of mental health.Every good day starts with a good night’s sleep before. That’s what I tell people in my programs, classes and books. Stop avoidance, physically stop, you know, work with your doctor, but stop avoiding your emotions, your past, whatever is unprocessed, the nightmare content that’s coming up for you over and over again, especially when you’re using prescription medications. Yes, there are a lot of people that have drug and alcohol problems, but there is a lot of co-opting of avoidance and prescription drug abuse in the country, and it’s a form of avoidance for some people, and so be careful that you’re not using it as a coping strategy and just years and years are going by, taking medications that can double your risk of dementia, lower your IQ by nine points, and worsen sleep over time, and become habit forming, like Benzodiazepines, such as Clonazepam, Ativan, Diazepam, and Xanax.

Spiritual Growth and PTSD

Spiritually, I really like the Serenity Prayer, especially if we’re talking about symptoms of stress. The Serenity Prayer says, “God, grant us the serenity to accept the things that we cannot change, courage to change the things we can, and the wisdom to know the difference.” It’s a pretty famous prayer. The middle section is what I want to point out. Courage to change the things that we can. If we have symptoms of stress, there’s a fair chance that you’re not giving yourself permission to either one, be honest and label, and accept what’s actually really going on, because it would hurt people’s feelings or you’re not ready to accept it. You’re still in avoidance, or you’re just procrastinating, and you have anxiety tension building up. I’d like you to think about that. I invite you to think about that as the energy you need to go out and accomplish the goal, so if you’re just sitting around, procrastinating, it’s no wonder you have anxiety. Re-label it, it’s not anxiety, it’s the energy you need to get something done, and when you can get productive, you will feel better. Don’t live life defeated. Pray for that courage to change the things that you can and step through the fear, and acknowledge it for what it is. Process it, let it go, all right? Those are the tips for the day.

By Doctor Dan

[veteran, physician, psychiatrist]

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