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CHAPTER 1
Section 1 – Inventories
A major influence on my thinking about getting a handle on my PTSD came from the writings of Abraham H. Maslow. Way back in the early 1940s, he put forth his concept of a "Hierarchy of Needs" that he believed applied to all mankind. Below is his pyramid.
His peers went on to explain this theory, in summary, as the following:
• Maslow's hierarchy of needs is constructed in a specific order. It is depicted as a pyramid consisting of five levels.
• The lowest level is associated with physiological needs.
• The higher needs only come into focus when the lower needs are met.
• Once an individual has moved upward to the next level, needs in the lower level will no longer be prioritized.
• If a lower set of needs is no longer being met, the individual will temporarily focus his/her attention on the unfulfilled needs, but will not permanently slip back to the lower level.
• The uppermost level is associated with self-actualization needs, particularly those related to identity and purpose.
For instance, a businessman at the Esteem level who is diagnosed with cancer will spend a great deal of time concentrating on his health (physiological needs), but will continue to value his work performance (esteem needs) and will likely return to work during periods of remission.
I liked the idea of having an order of needs and a sequence of them, one following another until one pyramid level was completed and then moving up to the next one.
Biological Needs Assessment
However, I took his ideas and stretched them backward, finding biological needs that I felt should be looked at and worked on before I got into the psychological aspects of repairing myself. Here are the steps:
• Get yourself a notebook with a lot of blank sheets. You'll be making notes for later reference as we go along.
• Look at (or imagine) your skeleton, from the tips of your toes, up to the tips of your fingers, up to the top of your head, and every bone in between.
• Are they all there? If any of them are broken, can they be repaired by a doctor? If any of them are missing, can they be replaced with artificial limbs? Are the broken or missing bones necessary for you to live a reasonably normal life?
• If you need to work on or repair your skeleton, write down what needs attention in your notebook.
• Look at (or imagine) your muscles and skin, again from tip to tip.
• If you have to repair or replace injured or missing flesh, write it down.
• Look at (or imagine) your internal organs, each of them independently.
• If you have to repair or replace injured or missing organs, write it down.
• Look at (or imagine) your body chemistry, mainly blood, breathing, and hormones.
• If you have to correct your body chemistry, write it down.
NOTE: Don't put off health care needs. If you have been functioning in an OK manner until now, maybe you can discuss them with your health care provider after you've finished the work I encourage you to do here.
I know that you probably skimmed over the preceding questions and put off the writing work. Please don't take these exercises too lightly.
Think of your body as a vehicle. This is the only transportation you'll have to take you from your psychological pain to the sanctuary of life in the present-time world. You want to be assured that it can transport you from start to finish without worrying that it may break down between here and there.
Now we can take a look at your emotional experiences. We'll do that with inventory-like questions. Just be completely honest and nonjudgmental with yourself when you read and answer the questions.
CHAPTER 2
Section 2 – Taking Your Needs Inventory
NOTE: Make copies of the pages that I ask you to mark on. You'll be referring to these sheets from time to time for many months. If you mark the book pages, you won't have clean sheets to record any new information.
Now we have a handle on the condition of Our physical body. Let's have a look at your psychological. We'll be doing these inventories in preparation for the PTSD work later on.
In order to humanely survive and thrive, people should experience satisfaction that their basic needs have been met. Ask yourself if each of these statements is currently and personally true for you without passing any judgment on yourself.
Place a checkmark to the left of the statement if you believe it's TRUE for you, otherwise leave the line unchanged.
Has your need been satisfied?
_______ to have good health
_______ for shelter
_______ for clean water
_______ to breathe clean air
_______ for healthy food
_______ for access to consistent and sustainable sources of energy
_______ to exercise caution in uncertain times/places
_______ to believe (have "faith")
_______ to rationalize
_______ to dream
_______ to seek, define and understand your own identity
_______ to be free
_______ to have the opportunity to follow and act on your own will
_______ to be self-determinate
_______ to not be dominated
_______ to dominate or manipulate a situation, scenario or person
_______ to be aggressive
_______ to be passive
_______ to be complacent
_______ to understand and seek truth
_______ to be curious
_______ to be mischievous
_______ to be "good"
_______ to be "bad"
_______ to be expressive, physically, intellectually and emotionally
_______ to receive expressions of love, admiration, and/or affection
_______ to outwardly express love, admiration or affection
_______ to destroy
_______ to create
_______ to procreate
_______ to accomplish and move on to the next satisfaction
_______ to feel secure with your emotions, resources, and society (environment)
_______ to enjoy or experience pleasure (in whatever)
_______ to be entertained
_______ to be entertaining
_______ to laugh
_______ to cry
_______ to be angry
_______ to be happy
_______ to desire
_______ to grieve
_______ to seek guidance or help: parental, peer, and/or supernatural
_______ for social interaction
_______ for privacy
_______ to share
_______ to covet
_______ to hope for an even better future
_______ to learn through experience and repetition
_______ to apply learned knowledge
_______ to communicate
_______ to leave a legacy
_______ to receive love from yourself
_______ to forgive
_______ to be forgiven
_______ to feel safe
_______ to show respect
_______ to be respected
_______ to contribute to our common humanity
_______ to receive contributions from our common humanity
"Bubbles"
I now take pleasure in introducing you to "Bubbles." It will be a template for many sessions of "color in the bubbles". "Bubbles" is neither male nor female, so the image will work for you regardless of your gender.
NOTE: The only "bubble" you should not color in is the Bubbles' head. No cheating! ... I'll explain why later.
• In keeping with our "home construction" theme, start at the foundation (bottom; feet) of Bubbles, and work your way from left to right, then up a level, and then left to right again.
• For each answer from the needs list, if it's checked, color in the bubble. If it's unchecked, do NOT color in the bubble; skip to the next bubble.
• Starting with another Bubbles, for each answer from the needs list, if it's NOT checked, color in the bubble. If it's checked, do NOT color in the bubble; skip to the next bubble.
Now you have two physical representations of your needs; fulfilled and unfulfilled. Ask yourself this: "With this kind of structure, can I move on to harder psychological work, or do I need to repair this structure before I proceed?"
I recommend you work on your unfulfilled needs so you can more aggressively work on your traumas.
If you are the kind of person who likes to have a set of goals you'd like to achieve, then you might want to have a look at your list of unfulfilled needs and make them your goals. As you're going over the questions today, I'll bet you'll see where you can pick up "spare time" you can use for more productive purposes.
CHAPTER 3
Section 3 – PTSD Inventory for Military Casualties
• If you DO NOT have military-related traumas, you may SKIP this Section.
• If you DO, please continue on.
Digging up the answers to these questions can be difficult. You may (likely will) dig up some painful memories and images. If you get stressed out — take a break. Write down your traumatic events in your notebook. Use a voice recorder if writing isn't your cup of tea.
I've heard some people say you might find a friend to write down your information as you talk. I say do not do that! Earlier, I said peers provide a therapeutic setting because trauma survivors are able to risk sharing traumatic material with the safety, cohesion, and empathy provided by other survivors. Friends usually aren't peers, in the sense that they aren't usually trauma survivors.
The following questions are designed to stimulate your recollection of your military experiences. We'll be working on each of your traumatic events in the next Section.
PTSD Worksheet
[Mark your answers in the table following this worksheet]
During your Military Assignment:
1. How often were you on a base?
2. How often were you in the field? How often did you do the following?
3. Fire a weapon at the enemy
4. Kill or likely kill your target
5. See someone killed or dying
6. Think you'd be killed
7. Think you'd be seriously wounded
8. See dead bodies, civilian or enemy
9. See dead comrades
10. Did you handle any human bodies?
11. Did you participate in firefights? Did you or your unit experience any of the following?
12. Sniper Fire
13. Rocket/Mortar attacks
14. Personnel Mines/Booby Traps
15. IEDs (targeted at vehicles)
16. Ambush
17. Did you feel that your experiences were overwhelmingly stressful?
18. Did you feel overwhelmed by thirst?
19. Did you feel overwhelmed by hunger?
20. Did you feel overwhelmed by exhaustion?
21. Did you feel there were NO safe places?
Using the table on the next page, mark a box with an "X" (or color in the block) for each answer you gave, selecting the column that matches your answer. Start at the top of each column and work your way down toward the bottom.
When you have finished filling in the table, you'll see a graphic representation of where you used up some of your "spare time." Although the graphics are interesting, they are past-tense experiences, and should be stored in your long-term memory bank. There isn't a civilian-life, present-time use for them.
Here's an idea: How about setting up another set of goals for yourself? This time you could work on moving the checked items in the 3rd and 4th columns back into the first and second ones. As you're going over the questions today, I'll bet you'll see where you can pick up "spare time" you can use for more productive purposes. Although you can't change your history, you can change what you do with it.
CHAPTER 4
Section 4 – PTSD Inventory for All Casualties
You've experienced or witnessed life-threatening event(s) that caused you intense fear, helplessness or horror. Of course, the PTSD range of emotions is considerably wider than this, whatever you've experienced is true for you.
Digging up the answers to these questions can be difficult. You may (likely will) dig up some painful memories and images. If you get stressed out — take a break. Write down your traumatic events in your notebook. Use a voice or video recorder if writing isn't your cup of tea.
I've heard some people say you might find a friend to write down your information as you talk. I say do not do that! Earlier, I said peers provide a therapeutic setting because trauma survivors are able to risk sharingtraumatic material with the safety, cohesion and empathy provided by other survivors. Likely, your friends aren't peers, in the sense that they aren't usually trauma survivors.
We're trying to capture your traumatic experiences. For each event, write down your answer to the question you are being asked in a brief narrative in enough detail to be able to complete a thorough description of it at a later time.
In a few sentences, write down an overall description of the experience. Examples:
• "We were ambushed while on a patrol in early December 1966."
• "On May 23, 1998, at 8:13 pm, the bastard knocked me out and raped me."
Complete a detailed write-up of each one. Write each one separately, on as much paper as you need.
NOTE: It may help you get through this exercise if you imagine yourself to be a Newspaper Reporter while you are working on this. This way you may remain somewhat unattached to the material and these tasks may be more bearable.
I'm about to ask you some very probing, intimate questions. They'll demand you to use your utmost courage to answer them. Here are a few affirmations I used to get through them:
• "I am alive and can give my answers."
• "It isn't happening again."
• "I can answer them at my own pace; no rush."
• "The answers are my secrets and they can stay that way."
• "The better my answers are, the clearer the experience becomes."
• "I'm the only one who can answer the questions. No one else knows what I went through."
OK, my friend, time to take a deep breath, say a prayer or whatever, and dig in. Here are questions to answer for each event you recall.
Ask yourself:
• How you felt immediately before the event
• What you experienced (the event)
• How long did the "pinnacle" last (1 second, a few seconds, a few minutes)
• Who was there, in addition to yourself
• What did you see hear, taste, touch, smell and think
• When did it happen (time of day, day of the week, calendar date, etc.)
• Where were you (geography, surroundings, standing, sitting, etc.)
• Why did the event happen (not just "duty" but your motivations, theirs, etc.)
• What you did during the event
• How you felt about yourself immediately after the event
• How you felt about the others involved after the event
• How you feel about the others involved now
When you have finished the last traumatic event (that you can recall right now), go back and look at each narrative you wrote. Go through the sub-level questions below and provide any details you may have left out the first time through.
When you're finished, answer the following questions.
Post-Traumatic Stress Disorder Self-Test
(Circle Best Answer for Each Item) DO YOU ...
1. have repeated, distressing memories and/or dreams of it? Never Rarely Sometimes Often Frequently
2. act or feel like the event is happening again? (Flashbacks) Never Rarely Sometimes Often Frequently
3. feel intense physical and/or emotional pain when you are exposed to things that remind you of it? Never Rarely Sometimes Often Frequently
4. avoid reminders of it? Never Rarely Sometimes Often Frequently
5. avoid thoughts, feelings, or conversations about it? Never Rarely Sometimes Often Frequently
6. avoid activities, places, or people who remind you of it? Never Rarely Sometimes Often Frequently
7. "blank out" on important parts of it? Never Rarely Sometimes Often Frequently
8. avoid things that remind you of the trauma? Never Rarely Sometimes Often Frequently Since your traumatic experience, do you have ...
9. frequent, disturbing memories: Never Rarely Sometimes Often Frequently
10. nightmares: Never Rarely Sometimes Often Frequently
11. flashbacks: Never Rarely Sometimes Often Frequently
12. Has your interest in activities changed since you began experiencing problems related to the trauma? Never Rarely Sometimes Often Frequently
Using a clean "table" (from Section 3), mark a box with an "X" (or color in the block) for each answer you gave, selecting the column that matches your answer. Start at the top of each column and work your way down toward the bottom.
When you have finished filling in the table, you'll see a graphic representation of how your thoughts about your traumas have altered your quality of life, and where you spent some of your "spare time."
Here's an idea: How about setting up another set of goals for yourself? This time you could work on moving the checked items in the third and fourth columns back into the first and second ones.
Now we move to another set of questions about Your traumatized life in general. DID/DO YOU:
1. lose interest in significant activities of you life? Never Rarely Sometimes Often Frequently
2. feel detached from other people? Never Rarely Sometimes Often Frequently
3. feel your range of emotions is restricted? Never Rarely Sometimes Often Frequently
4. sense that your future has shrunken? (For example, you don't expect to have, or keep a career, marriage, children, or a normal life.) Never Rarely Sometimes Often Frequently
5. have problems sleeping? Never Rarely Sometimes Often Frequently
6. become irritable or have outbursts of anger? Never Rarely Sometimes Often Frequently
7. have problems concentrating? Never Rarely Sometimes Often Frequently
8. feel "on guard"? Never Rarely Sometimes Often Frequently
(Continues…)
Excerpted from "Reboot!"
by .
Copyright © 2011 David W. Powell.
Excerpted by permission of Loving Healing Press, Inc..
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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