welcome my name is natasha sherman and i am your host and my guest today is dr jenna to desk oh she is a doctor of clinical psychology and although she works with a variety of segments of the population today we're going to talk about one of the areas that are important to her and that's her work with veterans and p t s d and veterans families welcome thank you so much for having me i'm delighted to have you here and i think what happens is we get very focused on the news so you know we have the opioid epidemic and then that kind of we hear a lot of you know every day and then we tune out and  it's no longer sexy news and i think sometimes that's what's happened with p t s d another veteran with p t s d and i know it has a huge impact on the veterans themselves who given their service and their families and society at large so i wanted to talk about that so maybe you could just start about why you work with this particular population so i work with this population because when i was completing my graduate studies at weidner i began to work in the community mental health system and everywhere i looked the kids in the community had their recent no way of avoiding trauma right in your face all the time and so i began and i cultivated my early years of my professional career treating children and doing a lot of advocacy in and out of court for kids who had experienced trauma and then i want to mention that p t s d is not just in the veteran population yeah yeah it is experience in demick and another interesting tidbit is even if you don't meet the diagnostic criteria for it doesn't mean you have been impacted by trauma trauma can lead to p t s d it can also lead to depression and lead to psychosis or all manner of other not so wonderful possibilities right  so after working with kids and then started working doing some consulting with amnesty international which led to a lot of work in the cambodian community and seeing the impact of the horrific trauma within that community really kind of woke me up and from that point the universe dropped in my lap the opportunity to go and work at the v a medical center in wilmington and that well yeah so let's talk a little bit like let's jump right to it in terms of what is it that we should be watching for in our families or extended families as symptoms that something is really wrong and we can't just dismiss it as yeah you know they experienced x to y and z what should we be watching for that's a huge question with a very complex answer so i'm not going to do it justice but what i can say is the first thing to be aware of is avoidance the hallmark of traumatic stress is  avoidance of things that remind you of the stress that originally occurred talking about it and so on and usually that avoidance leads to people having  you know nightmares and you know flashbacks and nightmares are your brain's way of trying to get all of these you know elements of the original traumatic event or events back together so that you have you know an integrated in a whole and healthy brain the difficulty is that for most folks when those things occur it's really unpleasant you push it away of course and so and i'm going to jump around because we're going to do like little sound bite so then you know again there's stigma attached to mental illness there's the whole thing about you know families being loving and caring but at some point if you haven't had the experience there is this underlying sometimes attitude of just get over it you know it's enough it's ten years or whatever it is not recognizing that p t s d has actually changed the physicality of the brain that this is not something that you can get over just by wishing it  so what's the impact on the families like what that should they be doing for themselves so the first thing is to find ways to take care of one's self and each other but one's self you have to water the seeds in yourself first so you have a core up of goodies to so what would that look like that would look like things like you know if you're struggling with trying to figure out like how do i talk to my loved one and how do we structure our home go see a therapist go see somebody who has an expertise in helping out and you know then you lay it all out on the table and you figure out what works as best as it can for every individual i think that's very significant is seeking someone out who is an expert you can see how it on yourself to be an expert or to figure it out and  so yes so you need a second brain yes absolutely and maybe even a third and a fourth maybe but at least you need to yes yeah yeah and so then there are different methodologies that come into play when you're working with veterans and i want to talk about one of the things that you like to specialize in is mindfulness and so one of the things  you know ties into the whole thing talking about the opioid epidemic show our veterans easily prescribed opioids so there was a period of time in history particularly within the v a system where i would say that was more rather than less true some of that has to do with the fact that pharmaceutical companies would come in with data and say look you know pain is the vital symptom that any pain is is unacceptable and so the idea and the thinking back then was we just alleviate as much we push that pain away as much as we possibly can and we're going to give you these medications to do it and we make a lot of money while we do and oh by the way thank you very much we get to make some scratch so you know yeah that was a really bad idea because life always has pain life always has suffering and pain is never just pain anyway the physical body only accounts for like maybe a third of the experience of pain you know then you have to start thinking about things like thoughts and the with the mind and the body connect and how  that experience i mean there's so many variables but basically the idea of being you know you you lay out with the family what might be possible and when it comes to opioids mindfulness treatment has been something that is shown to diminish people's reliance on those kinds of medications  and i can say from my own personal experience with my veterans i've i've taught over fifteen hundred veterans mind house in the context of formal codified mindfulness programs like based stress reduction which is sort of the gold standard and then a whole bunch of other fancy stuff i developed over the years for them so let's talk about that because some people don't even know what mindfulness is or it's some oh yeah you know you just pay attention or you meditate or something so let's talk about mindfulness as you are talking about him so as i am defining it i'm simply talking about something that is a quality of attention and in this quality of attention you're paying attention on purpose to what's happening moment by moment by moment by moment that's really all it is and we bring certain kind of quality so i'm going to interrupt you here interim going to play devil's advocate and then ok we're paying attention moment by moment so what yes so what but when ever you invite your self to pay attention to one thing what generally happens is the mind wanders and wanders pretty fast so in mindfulness practices for instance we usually start either with paying attention to the body or paying attention to the breath as it is felt directly in the body right so if i'm sitting here and i know my eyes are closed and i'm noticing my breath is coming in my breath is going out and suddenly i'm kind of having the awareness of the smell of cheeseburgers and would really like a cheeseburger for lunch and i haven't had cheeseburgers in a while but you know cheeseburgers aren't so good for you but when i get out in the bush is out here the minute i realize it i can go oh i'm doing that cheeseburger thing i do and with kindness or at least with the intention of kindness begin to bring myself back to the thing i was sitting with in the first place this is i interject something  here i love this conversation so i like that with kindness and i remember i lived in a yoga center in india and my teacher saying you know when a child runs into the street you don't beat it you're just taken by the hand and you bring it back and you don't judge it whatever they don't know better so i get all of that but you know again on a very practical level so what here's the so what every time you wander and every time you return it's like doing one repetition with the weight when you do a repetition with the weight you build architecture when you wander and return your brain changes  ok and what is the purpose why are we trying to make this brain change when you experience a traumatic event your brain instantly shifts and you begin to see the world in a different way and that leads to your brain being physically different so a person who's who's experienced a trauma that's not processed or integrated if you stick their head in an m r i machine you're going to see some differences in the image dilla which is your fight or flight organ it's the one going danger will robinson your hippocampus which is responsible for things like encoding emotional information ok so when you have one traumatic event changes all this mindfulness builds it back ok and this is what i really want to get to so your brain does literally change literal and so the whole fight or flight thing is not something we want to continue being in that mode because that causes stress and that causes all the other stuff that is associated with stress so we do not want to live in a middle of mode all the time yeah and it's hard to convince people who've been living there for a long time that it's ok to come back out because they really do folks develop this belief that i have to be hyper vigilant i have to look at every single thing i have to be on my game at all times or bad things will happen because that's been the experience to ask somebody to come back from that and drop into the moment they're in is real tough yeah and you know again perception trumps reality so it's like when your mind is change and you have this trauma and you're trying to avoid the trauma so where ever it is your mind do that tunnel with no cheese at the end of it your mind is going down is not usually going to be a good one so if you can bring it back to the moment this moment yeah it's seeing that no clear and present danger right so it allows you to be present as opposed to being in all the what ifs and you know and the interesting thing i think is it becomes not just about sort of turning the volume down on the mic delish shouting that bad things will happen there's all this other connectivity that occurs trauma folks who've experienced trauma often try to live a life in the land of the mind sometimes pretty much everything from here down is like i don't know what's going on down here i don't want to know it's got on down here you know so for people to be able to connect with their actual body and feel into the actual safety in any given moment no matter what the mind is telling you requires some change in a part of the br is if i were to kind of like stick my hands in like this and go like that it's right in there and it has connectedness from here all the way down every that the fact that you can feel the soles of your feet right now is because of your insula so allowing and cultivating that architecture is a way that people can also come home particularly you  trauma what is that military sexual trauma is when people are harassed or assaulted sexually or on the basis of sexuality in the military it is men and women men and women so the current statistics all quote for you and then i'll tell you what i suspect the real statistics are the current statistics are one out of every four women who have given service in the military has experienced military sexual trauma and one out of every eight men now that's what the the statistics are but i have all i can count on one hand the women i have met who have served in the armed forces who have not and then transcribe sexual trauma i'm talking what's the range what's the spectrum  everything from i'm not sure i understand your question when you say these statistics they've experienced some kind of sexual trauma right so what what i'll give you an example yeah for a while there women coming back from iraq for instance were having these huge issues with their urinary tract health and with kidney infections because when they were in in theater they would stop drinking water around three in the afternoon because they did not want to have to go to the loo treen at night because they were being attacked and raped that's what i'm talking about but their fellow soldiers yes it's awful it's awful and and  we see these commercials you know be the best that you could be whatever else and you know it's like one has to kind of question and talk to other people because it's not a superstition kind of join and you'll be everything will be wonderful so then what about the men what does that look like for the men it's generally excuse me a superior officer and there is usually some threat like a lot of threat you know you're going to have terrible horrible bad things happen to you i mean you know put in for article fifteen just crazy stuff but it's also because they're threatening them to have sex with them yes ok yes or they're attacked i had several male veterans who've had give up know and i'll tell you why there's i will say it with my dying breath there is a meaning in this kind of suffering and it's a gift to hold people and be able to help them figure out that meaning for them and how their healing path could we do with a little less suffering you know why yes i personally i think a little less suffering would be nice i think the thing that gets to me is and again you know it's a thought then that i have to let it go but you can't dwell there it's just this idea of we seem to have learned nothing i mean you know children are being molested that adultery being molested you know the church covered up tons of molestations and it's not just the church that you go into other organizations now we're talking about the military what is wrong with  what seems to be wrong with us i think is grasping we have this attitude this belief that we are king and or queen over all the domain and we somehow therefore own we take ownership of reaching out and getting more reaching out and getting more and reaching out and getting more makes us great capitalists but not such great human beings and the reality is one to shift that belief a little bit you can start realizing that in each and every moment you're already there there is all the more is right here tara brock talks about being a bird with two wings you put all of that crap ola i like to call it jackassery if you will in one hand because it's there it doesn't go away but in the midst of the jackassery there's also the fact that right now my teeth don't hurt right now i had food today we overlook this stuff and one doesn't outweigh the other is being able to see both with equity yeah yeah it will be equity part is the challenge yeah i is you know on the other hand and i get that reaction for more but i think part of it ties into that and this is where we go back to mindfulness is that we keep thinking that what is going to fill this is out there and go and so and we're not taught to think differently in this culture salute so you know again and advertisement in society and everything else you know just  tied in also at least my interpretation is it's being with what's inside saeed so it's if you could just be present like you say in this moment nobody's threatening our lives right we you know we're not starving and and then we don't even have to look at it in relationship to suffering it's like oh my god here i am on this journey of life and kind of embracing it but we're not trained to look inward where everything exists and where all that kind of real gold is yeah no i agree one hundred percent i think that there's this there's this idea that  somehow if we keep reaching outside of ourselves we will find the answer i as a psychologist i think of myself as a sure and i call myself a mental health  because my intention is to help folks to walk their journey and to help them carry a little of the load you know until it's a little bit more about that about which piece well when you talk about you know their journey so we're not you know part of the journey is wanting to reach for that and being part of a society that encourages us to reach for that so it's for me it's like when you're talking about their journey well partly you know as someone suffering from p t s d of any sort wants to escape a so it's like ok let's bring you back let's bring you back let's get you to a place where you can see that you're actually safe and i can be safe and can stop being vigilant but then how do you you know so that's part of the journey but the end game what's the end game is like the end game is whatever you resist persist and that means that if you are trying really hard not to feel the feelings that are arising in your body and in your mind they will most definitely come back louder and more of noxious lee in all requires again a second brain you need a second brain to do this work with you because you need someone to bear witness if you can begin to allow yourself to sit with even the stuff that's awful you have a hope and it doesn't mean there's a saying feeding yourself to the lions i tell my patients look sit with this discomfort for as long as you are able to stay friendly with it noticing when it starts to get of ugly right and when you get up to that edge you notice where that edge is and if you need to open yourself back up to something else but there's a there's a process of approaching and then leaning back and then and being in charge of your safety absent being willing to do that and i think you know we're almost out of time but one of the things i really think is you know all we're longing for all of us at the heart of it is connection being  shieling loved and cared about and then what we don't notice is that there are people we can reach out to and so even if it's not someone in your personal life there are professionals there are absolutely there are groups it's really making people realise that there is something out there that can alter this for you yeah and to keep reaching for it there is absolutely hope there is healing there is growth there is taking all of this crap digging it into the soil and then seeing the amazing things that can come next you don't have to do it by yourself and in fact you shouldn't do it right yourself right i think your hands pick i don't think you can maybe  in i don't i don't know everything and we're not here to be by ourselves so listen you are there is this wonderful thing called into your being the mirror neurons in the back of my brain communicate with the mirror neurons in the back of your brain we or just now beginning to understand the physics into your being and how it is that we connect with each other how it is that when a kid in california has a car accident the mother in hawaii  know yes and you know we are at the end of our time but i love ending on that note and i just wanted to reaffirm that the fact that the brain has changed doesn't mean it will stay that way forever that it can be rewired and that there is hope absolutely thank you so much for being here and thank you for the record i have enjoyed it all thank you so much and i express my deepest gratitude and appreciation to all of the veterans who have welcomed me into their lives and their hearts to to be of service yeah thank you my name is natasha sherman thank you for joining us