What’s going on? You are continually being traumatized and re-traumatized, can’t get your footing and instead of becoming stronger, you’re becoming more anxious. And if the following hold true, there’s a good chance that you have Financial PTSD.

Re-experiencing the traumatic event

• Intrusive, upsetting memories of the event
• Flashbacks (acting or feeling like the event is happening again)
• Nightmares (either of the event or of other frightening things)
• Feelings of intense distress when reminded of the trauma
• Intense physical reactions to reminders of the event (e.g. pounding heart, rapid breathing, nausea, muscle tension, sweating)

PTSD symptoms of avoidance and emotional numbing

• Avoiding activities, places, thoughts, or feelings that remind you of the trauma
• Inability to remember important aspects of the trauma
• Loss of interest in activities and life in general
• Feeling detached from others and emotionally numb
• Sense of a limited future (you don’t expect to live a normal life span, get married, have a career)

PTSD symptoms of increased arousal

• Difficulty falling or staying asleep
• Irritability or outbursts of anger
• Difficulty concentrating
• Hypervigilance (on constant “red alert”)
• Feeling jumpy and easily startled

Other common symptoms of post-traumatic stress disorder

• Anger and irritability
• Guilt, shame, or self-blame
• Substance abuse
• Depression and hopelessness
• Suicidal thoughts and feelings
• Feeling alienated and alone
• Feelings of mistrust and betrayal
• Headaches, stomach problems, chest pain

What can you do? You can actually seek the same treatment that soldiers with PTSD or rape victims (and doesn’t a part of you feel raped by the economic events of the past couple years?) including support groups, seeking out a therapist or psychiatrist and checking out resources such as those at the bottom of this blog.

You also might do well to heed and follow the famed Serenity Prayer (so embedded in the fabric of 12 step programs): “God grant me the serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference.”

Too inspirational for you? Need something more concrete?

Then how about:

1. Each day when you wake up say to yourself and write down the answer to: “What do I need to do today (or the next week), to make my company/department/organization a better company/department/organization and my marriage and family happier and my health healthier?”
2. Then “Just Schedule It.” Either for today or the next few days, because you haven’t made a commitment until you’ve scheduled it and you haven’t kept a commitment until you’ve checked it off after you have done it.

Resources:

• NIHM: PTSD
• About.com: PTSD
• Mayo Clinic: PTSD
• The Post Traumatic Stress Disorder Sourcebook
• The PTSD Workbook
• PTSD for Dummies

A few years ago, I realized I had been holding a grudge against someone for twenty years.  I wasn’t aware of it except when I realized that this person and I had been very close friends until an upset happened, that in retrospect was a result of my taking something personally that wasn’t meant that way.  Shortly thereafter we moved away from each other because our jobs took us to different cities.  Following that I never stayed in touch with him, because I was harboring this long standing animosity.  When twenty years later I became aware of it, I felt guilty and ashamed.  I called my former friend and told him that I believed I owed him an apology for not being in contact with him (truth be told, he had not reached out to me either), because I had been holding a grudge against him that was completely unfounded.

Not being as neurotic as I and not having felt a grudge toward me, my friend responded: “Hey Mark, it’s great to hear from you.  I never thought anything came between us.  I just thought we moved away from each other and went about living our lives. Glad you called, what’s been happening to you after all these years?”

I hemmed and hawed and filled him in about my life and then he filled me in.  After we hung up, I felt better, but felt like an idiot.  I felt he hadn’t given it another thought, since he was not bothered by the kinds of hang ups that I have.  Then a few days later, he called me and said: “Hey Mark, where will you be this coming weekend?  Because if you’ll be at your home in Los Angeles, I would like to bring my wife and kids to meet your family.”  Which is what we did.  Apparently, my call had an impact.  I also realized that I hadn’t completely let go of my grudge until I called my friend to apologize.  He didn’t need to hear my apology, but I needed to hear me make it so that I could be freed from my negative feelings.

I think what holds us back from letting go of anger is that we don’t forgive as long as we need to blame.  And we need to blame as long as we are unable to admit and feel the hurt from being injured by someone else.  And we are unable to feel the hurt underneath, because doing so makes us feel vulnerable and fearful of a second attack that we are convinced would be too much to bear.

Apologizing to someone you have a grudge against who has hurt you is about letting go of your anger at them.  It doesn’t mean giving a hurtful person a second chance to hurt you again.  It also doesn’t mean doing this with a violent or abusive person, who you’d do best to steer clear of.

One of the best approaches I know to short circuit your emotions when you’re upset and before you become angry and start down the road of holding a grudge is to:

1. Say to yourself, “I’m reacting!”
2. Answer the question to yourself: “What am I feeling hurt or disappointed about right now?” (If you can’t get through the anger to the hurt or at least to the disappointment, it may be because the narcissistic part of your personality is too strong).
3. Answer the question to yourself: “What is my evidence that the other person meant to hurt or disappoint me? And might I be taking something personal that wasn’t meant that way? And if I am taking it personally and it is not meant that way, I need to let it go.”

Another approach to nip anger in the bud comes from one of my friends, Bob Pratt, President of Volunteers of America Los Angeles, is one of the least grudge holding and most even tempered people I know.  I asked him his secret.  He told me, “Whenever somebody does something hurtful to me, I assume innocence and that they are doing it, because someone has done something hurtful to them.  So, the person who acts with Road Rage to you is behaving that way, because something bad happened to them. My view is one should stop evil people when you encounter them, but there really are very few evil people in the world.  Everyone else is flawed including you and me.  And just as I would like people to cut me some slack because of my flaws, I have a policy of doing the same to them.”

I converted a Road Rager to a friend some years ago by virtue of the lesson that Bob has learned (i.e by having them see that my bad driving was because I was having a bad day).  I was having one of the most frustrating days of my life where it seemed that everything I did went wrong.  I was driving on Sepulveda Blvd. in Los Angeles as it enters into the San Fernando Valley in a place called Sherman Oaks.  I was so preoccupied that I cut off this older 6 foot 5 guy in his pick up truck, not once, but twice.  After the second time, he pulled in front of me and stopped and I was so dazed I just stopped when he did.  I could see that his wife was telling him not to go out to confront me.  He didn’t listen and stormed out of his truck to start a fight with me.  He came over beside my window and started swearing and yelling at me.  I was so out of it, I opened my driver side window to hear what he was saying.  He continued to make threatening gestures at me.

When he paused for a moment I said to him, “Have you ever had such an awful day where everything has blown up in your face, and that you just wish someone would come along and shoot you to put you out of your misery? Are you that person?”

He immediately changed and said, “What?”

I repeated, “Have you ever had such an awful day where everything has blown up in your face, and that you just wish someone would come along and shoot you to put you out of your misery? Are you that person?”

He then said in a calming voice, “Hey, it’s okay, calm down, it’s all going to be alright.”

“That’s easy for you to say,” I blurted back, “you haven’t had a day where everything you have done turned to crap.  Really, I’m not kidding.”

He then proceeded to try to calm me down and reassure me some more.  After a couple minutes he went back into his truck, and waved to me in the rear view mirror as if to say, “Now settle down, it’s going to be alright.”  And then he drove away and in a few moments I did the same.

Please share in the comments what you have discovered that has helped you to let go of a grudge (I assume that if you enjoy holding grudges, you will not have read this far).

8 Signs of a Jerk

1. Interrupts.
2. Doesn’t take turns.
3. Takes advantage of people who are down
4. Gloats in victory.
5. Is sullen in defeat.
6. Is not fair.
7. Lack integrity.
8. Is the kind of person you’ll avoid if you possibly can.

One of the reasons that most jerks get to you is that first they appall you, then they frustrate you, then they anger you and then they outrage you. And if you’re not comfortable with feeling outraged (as is true for most people), that is when they push you off balance and get the better of you.

Click on picture above to get printable PDF

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8 Signs of a Jerk

1. Interrupts.
2. Doesn’t take turns.
3. Takes advantage of people who are down
4. Gloats in victory.
5. Is sullen in defeat.
6. Is not fair.
7. Lack integrity.
8. Is the kind of person you’ll avoid if you possibly can.

Click on picture above to get printable PDF

Subscribe to Bottom Line Personal

* Mental Real Estate – When you can name something that already has emotions attached to it in your customer’s or client’s mind, you own a piece of their “mental real estate” and have the beginning of traction (Familiarity + Emotion = Traction). When you twist or tweak or re-purpose that name in a certain way that surprises them, the Traction + Novelty deepens your connection to people’s emotions and in the end, their minds. For instance, the word “pirates” is kind of sexy in the minds of children, therefore “Pirates of the Caribbean” (and Disney) owns that mental real estate connected to “pirates” in children’s minds. Similarly, “jerk off” occupies some mental real estate in the minds of many adolescent and young adult men. So, voila, “Jerk Off Kit” may have caused many of you to open this when you normally wouldn’t have. On the other hand, because of that same embarrassment/shame laden mental real estate, it triggered a number of you to not open the email and furthermore to unsubscribe from my list. If that is the case, that’s too bad, because if you had opened it, you may have learned something that would be useful to you.

My colleagues and many of you would deem it inappropriate for me to imply that Mel Gibson and his ex-girlfriend, Oksana Grigorieva, or for that matter John and Elizabeth Edwards (as the book Game Change would have us believe) are dyed in the wool narcissistic and borderline personalities if I have not met and evaluated them (and then of course I wouldn’t tell you), but the title of this blog probably got your attention.

And I am not saying that either Gibson, his ex-girlfriend or John and Elizabeth Edwards do in fact have these personalities. But from what any of us read and hear in the media (which has its own opportunistic personality), we might view them in that light.

Perhaps a better view of this relationship made in hell that is in the public domain and was captured best in the iconic movie, “The War of the Roses,” which starred Michael Douglas and Kathleen Turner.

The rage however is triggered in different ways in each of these personality disorders. For the narcissistic male it is triggered when their partner refuses to feed into and psychologically conform to their grandiose, entitled core. For the borderline female the rage is triggered when their partner attempts to control or abandon them.

Another thing that both personalities have in common is that they are both primitive and immature. By that I mean that the measure of how evolved and mature you are is how deeply you can feel disappointed, angry, frustrated and/or hurt without striking out at the person doing it to you or to yourself in self-destructive behavior. In other words, the more you can feel and “take the hit” from life, without hitting back, the more grown up you are.

What is the takeaway from this for the Mel Gibson’s, Oksana Grigorieva’s, John and Elizabeth Edwards’ among you? Marriage is for grown ups not for children. And the good news? It’s never too late to grow up.

Addendum: One of my clinical focuses is “Recoupling Therapy” working with couples who are separated or living separately (as in one in a hotel and the other in the family home) who want to give their marriage one last chance before they call it quits. In fact, I won’t see couples who are not in that situation. That is because as long as you are still reactively, immaturely and hatefully living in the same house, that situation alone can bring out the narcissistic and borderline tendencies that lay within people who are not those personalities through and through. But when you have reached the point of sleeping in separate addresses, the possibility arises with that “time out” (which is what we do with immature acting out kids) of each person realizing that there is more to life and love than having to be right and get your way all the time.

Know any Narcissists?

The Neurotic Narcissist Continuum

Wife: “Before I become a burden on my kids, I’m going to take a bottle of pills.”
Husband: “Too chancy, I’d go with a couple of guns.”
- husband and wife after caring for two parents with Alzheimer’s for three years

This is a response I am hearing from an increasing number of white middle class* baby boomers as they face the prospect of becoming old, enfeebled and a financial and emotional burden on their children.

It may also be that they are projecting the burden, drain and resentment they are feeling or have felt towards their own aging parents who have become enfeebled and require nearly round the clock care. And knowing how they have felt towards their own parents, they don’t want their children to carry the burden of taking care of them and feeling the same way towards them.

It may be prescient of them that knowing how impatient** they have been with their own parents and that their Millennial kids have no patience whatsoever, the idea that becoming mentally and physically enfeebled and dependent on these children portends an absolutely horrendous quality of life for both them and their children.

Is there a solution so that baby boomers might go “gently into that good night” instead of taxing their patience challenged adult children? Most likely what will happen is that when the middle class Millennials grow up and are in the position of having to take care of their elderly baby boomer parents, they will find a way (as their baby boomer parents have) to help pay for their care and delegate their caring to third world caretakers who still retain God’s gift of patience towards those in their care (which is why many a middle class baby boomer declares such caretakers “Godsends”).

One highly unlikely alternative is that Millennials will somehow develop patience to calmly follow the admonition of Cicely Saunders, founder of the hospice movement in caring for dying and infirm parents: “Don’t just do something, stand there.” Why so unlikely? Maybe it’s because their baby boomer parents who were the last generation to abandon patience in favor of the race to get more, sooner have been such effective role models.

In closing I am reminded of a quote from Dr. Milton Greenblatt from the 1970′s:

First we are children to our parents,
then parents to our children,
then parents to our parents,
then children to our children.

But then again that was in a galaxy far, far away and a time long, long ago when patience was not just a virtue… it was actually possible.

* This phenomenon may be more of an issue for the white middle class baby boomer, because family is everything for Third World people and the wealthy can and do pay for everything from people (often Third World) to raise their children to caretakers to provide care and loving caring to their aging and infirm parents.

** Another factor involved with the people I have heard these complaints from is the combination of Impatience + Difficult Parent (difficult as in “high maintenance, as in difficult to please, easy to upset).  It’s easy to be patient with parents who are “low maintenance” (easy to please, difficult to upset), generous and gracious even as they lose much of their physical and mental faculties. The takeaway from this is that what goes around, comes around and if you are the one who is “high maintenance,” you might want to change that.

And if this is not sobering enough read how Older Americans Greatest Fear is Outliving Their Money.

Also see: “How Could She Wish Death on the Mother She Loved?”

I start with a disclaimer that what follows is empirically based on thirty years as a practicing psychiatrist and psychotherapist. It has been verified by formerly enlisted and senior officers from the Armed Forces, but has not been validated by any research or double blinded studies.

How does PTSD happen?

Central to nearly all the people I have treated or spoken with who suffer from Post Traumatic Stress Disorder (in preparation of my book, “Post Traumatic Stress Disorder for Dummies”) is the “fear of re-traumatization” and their efforts at any and all costs to avoid it often results in the symptoms they develop.

Soldiers enter basic training as “loosey goosey” enlistees whose minds and personalities are broken down and built back up into fighting machines devoted to fulfilling a mission and the well-being of their fellow soldiers. Imagine those recruits as a “green” rattling Ford pickup truck that can’t take a corner safely, being torn down and rebuilt into a turbo-charged Porsche that can handle any curve thrown at it and you get an idea of what the process is like.

Even Hollywood has jumped on this metaphor with the popular Transformer movies where rattling cars and trucks are broken down and reconfigured and rebuilt into monsters of good and evil. Get the idea?

After they finish basic training, it’s pretty heady, adrenaline driven stuff that can make soldiers feel nearly superhuman. Add to that the notion that they are going to fight evil and they can feel like a band of superheroes out to rid the world of villains.

But then they hit the reality of war face on or rather it hits them in the face. In the process they see horrors and create collateral damage no training can fully prepare you for. Imagine being ordered to run over a young child who will not get out of the way and you can’t swerve to avoid them because of the mine-laden side of the road and hearing the thump of their body as they hit the bottom of your Humvee. Or imagine following orders to take out a sniper nest in a house in a village and then entering it, only to discover a dog, a grandpa, a mother, and two children “shredded” or incinerated by you.

What happens to you when all your training for war runs head on into the debasement of humanity that you perpetrate in waging it?

The trauma cuts you to your core. The horrors that you see and the horrors that you caused won’t leave you alone. You don’t tell anyone else, because you think they’re handling it better than you and that you are just weak and missing the “right stuff” that your fellow soldiers have.

Although you never fully get over that trauma that rips you to the center of your being, as in human being, your training is good enough to enable you to get past it through the days and weeks and possibly even the tour of duty you are on. However the damage is done and the crack in the porcelain of what was once your soul remains.

You don’t let the world know about it and you do everything you can to not feel that fragility. But even though you don’t think about it, you believe that if you were re-traumatized that crack would cause you to shatter from the inside out and like Humpty Dumpty, all the king’s horses and all the king’s medics would never be able to put you back together again.

So you live your life avoiding anything that might re-traumatize you. You numb yourself with alcohol or drugs; you withdraw from family matters especially the yelling of your spouse and young children. Every now and then a car backfires or something catches you by surprise and you jump out of your skin, because you had temporarily relaxed your guard and that temporarily removed the paper thin veneer protective graft above your crack. It’s like someone pouring acid in an open cut, except this cut is in your mind.

If you are put in a situation in which you feel you will be re-traumatized, you can go into a state of near panic, in which you resort to your most basic “fight or flight” instincts.

Why does PTSD happen?

Have you ever passed a cut tree and seen all the exposed rings? Each of those rings represents a year in the life of that tree. Some of those rings may look thick and healthy indicating and good year; some may look very thin indicating a drought; some may look darkened indicating a forest fire that the tree survived; some may look nearly rotted indicating some fungal or insect infestation. In your minds eye you can also imagine that those years will have a lot to do with the eventual health of that tree and its overall resilience.

Trees are not the only living creatures that develop from the inside out. Imagine your brain as actually having three brains. Like the rings of a tree layered one upon the other, imagine your human (neomammalian) upper brain is layered upon your paleomammalian middle brain is layered upon your most primitive reptilian lower brain.

Now imagine figuratively that a recruit’s brain and “loosey gooseyness” is due to their three brains being loosely wired together. Then imagine that during basic training, those loose wires are stretched and even broken. But then those three brain are built up in to a tightly wired machine specialized for waging war.

When a highly trained, tightly wired and molded for war brain suddenly runs face to face into horrors perpetrated upon you and that you perpetrate on others, soldiers show that they are not Transformers, but rather, that they are too human an animal.

When does PTSD happen?

In the face of trauma, your three brains lose the way they are wired and coupled to each other. That feeling of being lost (especially when they return home without a mission, a squadron or an activity that creates and lives off the adrenaline they have become accustomed to during war) causes them to feel at a lost. Being used to being tightly coupled their brains will spontaneously recouple around a new mission. But this time the new mission is to avoid re-traumatization at all costs and that is the world in which someone with PTSD now lives.

Addendum: I did not serve in Vietnam, but two of my high school classmates are on the Vietnam War Memorial wall; my children did not serve in the current conflicts, but my friend Jane Bright’s son, Sgt. Evan Ashcraft and she started the Evan Ashcraft Foundation after he was killed.

I believe sacrificing oneself to protect others you have never met is the highest virtue in human beings. Our young men and women returning from Iraq and Afghanistan — as well as all the other veterans who have served in past wars — deserve much better than to fall between the cracks of all the organizations that try as they might are not doing the job and are falling further behind the challenge. Helping our young men and women successfully return to civilian life is the war after the war and if we do not do that better, it will in the end claim more lives than the Iraq and Afghanistan Wars.

To address the challenge of transitioning the military to civilian life I along with Lt. General Marty Steele (USMC retired) am organizing a group of “can do, will do, failure is not an option” decision makers from the military and government to meet as part of Big Task Weekend in Los Angeles that will take place September 30 – October 2, 2010. Big Task Weekend brings together top decision makers from a variety of companies, organization and NGO’s to learn the process of “collaborative action” by actually taking on and solving “big tasks” that affect national and corporate well being. This year’s big tasks will include: The Future of Education, The Future of Corporate Learning, America’s Health and Wellness, Health Care Reform, Financial Literacy, Military Transition to Civilian Life.

The measure of a civilization is how it treats those who have hurt it, and those who are hurting in it.

Me: What? You have a hospital names after you. You’ve created an industry and thousands of jobs.

Patient: I have all the admiration, love and respect that money can buy and that’s all it’s worth. I’m not really close to anyone… not my wife, not my ex’s, not my children from three marriages and not my friends. I always played it close to the chest and never let anyone in and now I’m paying the price. Maybe, just maybe, I out-smarted myself.

Getting to know people like the patient above can teach you a lot about life and what a good life means. Granted there are many people unlike my patient above who are able to feel fulfilled by great accomplishments that benefited others even if it was at the cost of feeling close to anyone. However there are many who like my patient feel a sense of emptiness even after a life of great accomplishment.

Something that I have noticed in a number of those in the second category suffer from what I call the “Syndrome of Disavowed Yearning.”

They often come from parents where their dad was too busy with his job or career and their mother lacked warmth. Often these were not bad parents. The dad was often worried about earning a living and so was focused more on his boss or his customers and clients than his family. The mom often came from a mother who also lacked warmth (it was often a condition passed on for generations).

In the ideal situation, a child feels most solid from the inside out when there is warmth (usually from a mom) to comfort them when they are hurt or afraid or just plain lonely and “you can do it” guidance, support and coaching (usually from a dad) that can lead to confidence and courage.

If these are missing, that child’s personality discovers that instead of feeling the pain from the lack of warmth and enthusiastic support, it hurts less if you disavow needing either.

In the people who become high achievers, they sublimate what would have been an aching yearning into accomplishing things. If you’re like them, even if that doesn’t fill you up from the inside out, the conditional grin of approval for what you do instead of the love and celebration for who you are can certainly distract you from the yearning. However, as great a way as that is to cope, down deep something at your core feels false. And after many years of accomplishments, those grins of conditional love and approval wear thin and you can feel empty.

In contrast to the patient and condition above, I remember an entirely different man I will call Mr. Cohen.

It was 4:30 in the afternoon and I had just finished doing an EKG on Mr. Cohen. Unlike everyone else living at the Jewish Home for the Aged in Jamaica Plain, Massachusetts, Mr. Cohen was spry and totally alert for his 87 years. As a third- year medical student with much living (and learning) ahead of me, I couldn’t understand why he was staying in this place, which well appointed as it was still remained a last holding unit for people who were waiting to die.

I asked Mr. Cohen why he lived in this morgue when he was clearly doing so well. He looked at me with a patient, knowing look and explained: “Two floors below us is my wife, Emma. Three years ago, she developed Alzheimer’s disease and then had a stroke on top of that. On the very best of days, which don’t occur that often, I think she might recognize me. At all other times, she’s lost.”

He went on to tell me to me that Emma and he had fled the Russian revolution together, and that more than a few occasions she had saved his life. The couple made their way to America, started a tailoring business and raised a wonderful family. “I tell my family not to visit as much as they’d like,” he said, “because I want them to make sure they enjoy their families now and because their mom and I are doing fine.”

Each day, he would wake up, go downstairs to his wife’s room, bathe her, replace the diaper she now needed, put her into a sun dress, braid her hair, have breakfast with her and then read his newspapers and books as he sat beside her.

I didn’t get it. Why was he doing this with a woman who couldn’t even recognize him? “This poor man must be eaten up with guilt,” I thought.

I suggested, presumptuously, that Mr. Cohen’s guilt would not help his wife. The old man looked at me with an amused sparkle in his eyes and shook his head at my stupidity.

“You really don’t understand, do you? This is where I want to be. Maybe someday you will understand.”

It’s been thirty five years since my visit with Mr. Cohen and I think I do finally understand. Instead of guilt, he felt joy in the presence of someone he had loved and been loved by for sixty years.

It is difficult to change from a human doing to a human being, but as I observed first hand from people who died having it all, but who felt as if they had nothing and others who had very little, but felt they had it all, it’s probably something worth the effort.