How to Live With Your Partner’s PTSD

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Speaker 1: That’s it. That’s it.

Shannon Palus: Welcome to the Waves. Slates show about gender feminism and what it really means to be triggered. I’m Shannon Palus, a senior editor for Slate and editor of The Waves. Today on my show, I’m talking to Virginia Eubanks. She’s an associate professor of political science at the University at Albany, SUNY, as well as a writer. And this summer, she wrote an essay for the New York Times Magazine that I cannot get out of my head. It’s called his PTSD and my struggle to live with that. It’s a deeply personal piece of writing that illustrates what it’s like to care for someone who’s recovering from trauma.

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Shannon Palus: Trauma and PTSD are words that are thrown around a lot these days. In this episode, Virginia will help us understand what they actually mean. She’s also going to get into why women often suffer from PTSD at a higher rate than men do. And how she got her PTSD diagnosis by caring for her partner, Jason.

Shannon Palus: Before we get into the conversation, I just wanted to set up Virginia’s relationship with Jason, who’s her partner of many, many years, by reading a paragraph to you from her essay. Jason had been a friend for years. I was newly single playing the field, considering my options. I spied him in a crowded room and thought Jason Martin thought it would be fun. And I tipped my cowboy hat, so covered both of our faces and kissed him. Jason resisted my attempts to get him into bed, his slowly unfolding moves, suggesting a longing for durability, for depth. I resisted his resistance, hurting him toward shallow intimacy as like a border collie. And if you think that sounds like the start of a rom com or any story that has a neat and tidy ending. Keep listening.

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Shannon Palus: Virginia, thank you so much for joining us on the Waves.

Speaker 3: So happy to be here. Thanks for the invitation.

Shannon Palus: For listeners who haven’t read your gorgeous New York Times essay. Could you explain a little bit about how Jason got his PTSD diagnosis and how you in turn got yours?

Speaker 3: Jason’s my much beloved partner of Geez, 18 years now, and he was the victim of two really violent attacks in October and December of 2015. The first one, as far as we can tell, was a random beating by a group of guys about a block and a half away from our home. It required six and a half hours of plastic surgery to rebuild his face and skull after that attack. The second attack happened in December, and that was more like a hate crime that someone on the street targeted him for appearing queer. So the guy didn’t manage to get hands on him. He was with Jason, was with friends who helped sort of de-escalate the situation, but he did threatened to kill him and used all kinds of really hateful language that you can imagine what it was. And this is all.

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Speaker 3: The second attack all happened while Jason’s jaw was still wired from his plastic surgery back in October. And so after the second attack, he disassociated and he disappeared. For several days after he came home, we found a psychologist that focused on trauma, and he was diagnosed with what ended up as a pretty severe and chronic case of post-traumatic stress disorder, or PTSD. So he was diagnosed in January of 2016. I was diagnosed with a much milder and now mostly resolved case of PTSD in March of 2021. After five years of caring for him and battling with the health care and the social service system while he worked to heal from those those original attacks, those original traumas.

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Shannon Palus: That’s so devastating.

Speaker 3: In the household. We call it the catastrophe Capital T, Capital C.

Shannon Palus: How did you go about explaining what had happened to other people in your life and explaining that this was not just, you know, a single point in time or a couple of points in time, but actually this ongoing thing that you live with now.

Speaker 3: You know, and in a weird way, it feels like I was just speaking to a good friend of ours a couple of weeks ago who we hadn’t seen in a long time because our social networks got really strained over the course of the last almost seven years of sort of healing and really intense focus on ourselves and our health and and our relationship. And so I was talking to this dear friend of ours who we hadn’t seen in a long time, and he said, you know, like, you’ve actually done this great service to all of your friends because so many of us are sort of out of touch. And the essay sort of explained, you know, what’s been happening since we last talked to you? And I told him it’s kind of a dark joke, but dark humor is one of the superpowers you get with PTSD. I told him like, yeah, it’s like the the most bummer Christmas card ever written.

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Shannon Palus: It also might be surprising to a lot of people to hear that, you know, PTSD is something that you can get walking around on the street from a violent attack. And not just that, but from caregiving. For someone with PTSD, you write an essay about how when you went to look for advice and help, you wound up with a lot of books that said your soldier has come home from war. What is PTSD exactly and how does it affect people who haven’t spent time on the battlefield?

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Speaker 3: Yeah, I think PTSD is so such an interesting place to think about how we relate to each other and what we admit about our culture and what we don’t. And I think one of the really interesting things about PTSD is that we both use the language of PTSD a lot and we also don’t really understand what it is. So we both sort of underestimate the prevalence of the kind of like existential harm or trauma, the kinds of things that that Jason experienced. And we also kind of overuse or misuse the language of PTSD. Right? So when people sort of flippantly say like, oh, you know, like this library book was late and it triggered me, for example, and it’s kind of the way that we can misuse the language of PTSD. And I feel like both of those responses are different kinds, different manifestations of denial.

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Speaker 3: So one of them is dismissal, right? Like just buck up, it can’t be that bad, that kind of underestimation. And the other side of that is false equivalence, which is saying like, oh, you have clinical depression, everyone gets sad, right? That’s false equivalent. So we get a lot of false equivalence around PTSD to. Like you don’t need the absolute worst thing ever in the history of ever to happen to you in order to get PTSD. You don’t have to earn the diagnosis, right? Like, if someone tells me they have PTSD, I believe them. Like, nobody wants PTSD. So if you tell me you have it, I’m going to believe you.

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Speaker 3: But at the same time, we don’t want to say that like all traumas are the same, or that all trauma leads to symptoms of post-traumatic stress or to PTSD, because that’s not it’s just simply untrue. So traumatic exposure and PTSD are different, separate things. Something like 80 plus percent of Americans will deal with a serious trauma at some point in their lives. But only 4% of men and 10% of women in the US will develop PTSD. So personally, I use the clinical definition of PTSD to try to bring some clarity to these kinds of conversations, even though it’s really quite controversial.

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Shannon Palus: Give us the actual clinical the diagnostic criteria. Because they think especially after or should I say, during the pandemic, since it’s still ongoing, you know, it’s very easy to, in a well-meaning way, think I went through something horrific with like lockdowns and, you know, not being able to say hi to my neighbors. And now maybe I feel quote unquote, triggered when people talk about new viral illnesses emerging. But that’s not actually what’s happening, even if you are feeling a little like scared or worried.

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Speaker 3: I find the clinical the diagnostic criteria useful as a place to start. So there has to be sort of three things for a PTSD diagnosis. One is exposure to a traumatic event. And so it has to involve actual or threatened death, serious injury or sexual violence. But the exposure can be either direct or indirect. So that’s the first thing you have to be exposed to a traumatic event defined in that sort of limited way.

Speaker 3: The second thing you need is symptoms of PTSD. And symptoms of PTSD fall into sort of four categories. So intrusion intrusion is kind of unwanted thoughts like nightmares or flashbacks, withdrawal, which is numbing or avoidance of things that might remind you of your trauma. Sometimes psychologists call that constriction a negative cognition. So that means just like memory problems, self-blame, really intense negative emotion, like horror or rage that goes on to disrupt your life, or like strong negative beliefs about yourself or other people or the world. Right. Like everyone in the world is bad. I’m bad. I deserved this.

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Speaker 3: And then the fourth set of symptoms is arousal or reactivity, which is the one that we’re actually often most familiar with. So that sort of jumpy ness, increased startle response, hyper vigilance, that’s what we tend to think of when we think of PTSD as that kind of hyper vigilance and that that jumping us. So you need exposure to the traumatic event and you need symptoms in all of four for all four of those categories. And those symptoms have to disrupt your life and they have to last for at least a month. And that’s actually really important, the persistence thing, because all of these responses are actually like adaptive responses to trauma.

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Speaker 3: The problem is with PTSD is when those responses continue after they sort of make sense. But the way we talk about trauma and PTSD is that we often collapse them into each other. We think they’re the same thing. And I think that’s a really big problem for having good, clear, honest conversations about harm because it fails to sort of recognize how extraordinarily resilient people are in the face of difficult experience. Right. Again, like if more than 80% of us face trauma and only 4% of men and 10% of women end up developing PTSD, then the reality is most of us are pretty resilient when we deal with really difficult things.

Speaker 3: And it also, on the other hand, sort of dismisses what people are really dealing with when they deal with PTSD, which is not they’re not emotionally upset. They’re not like sad. There’s a difference between sad and clinical depression. There’s a difference between being upset and like being triggered into reliving your trauma as if it is happening again. And that’s what triggers are. They create these moments where you sort of time travel, where you are re-experiencing the trauma as it originally was. So trauma is really awful. Like, I’m not arguing that it’s not meaningful, but it’s it’s really normal. It’s sort of a base condition of most people’s existence. The difference with PTSD is PTSD isn’t a trauma response. It’s because. Disordered.

Shannon Palus: You can be going through a lot of pain that needs a lot of help or even a substantial amount of assistance and not have that official PTSD stamp on you.

Speaker 3: Yeah. And you know, and I also don’t want to turn it into like sort of a capitalist approach to suffering. Right. Which is that like, you need to get the five boxes checked. That means that you’re, like, worthy of earning a diagnosis, which means that hopefully doors open to you for support. That also feels insufficient to me.

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Speaker 3: And the reason that that really matters to me is that I feel like the irony of my story like this, this complication of like whether my trauma was direct or indirect, whether my trauma counts as a caregiver, I think it’s characteristic of like so many caregivers experiences where we’re seen as like necessary but secondary to the people that we’re caring for. So we’re like absolutely crucial to like really important things like raising kids or caring for our elders or helping our loved ones heal or building and sustaining family or community. But that, like our direct experience, gets dismissed and obscured and erased and the harms we face get dismissed and obscured and erased. So, I mean, that’s why I wrote that. One of the reasons that I wrote the essay is I actually think this not that we’re sort of trying to untie is a really important and difficult thought.

Shannon Palus: I want to come back to a statistic that you threw out a few minutes ago, that you write that about 4% of men and 10% of women will develop post-traumatic stress disorder after experiencing a trauma. Why is it so much higher in women than men?

Speaker 3: I think one of the like billion dollar questions of PTSD. So there’s there’s not like a definitive answer to that in the research, but there are some really super persuasive theories. So I get a lot of my understanding from from three books that I just want listeners to sort of know about David Morris’s really fantastic memoir called The Evil Hours. Shelly Jane’s The Unspeakable Mind. She’s a she’s an M.D. and an really early book by Judith Herman from the 1990s called Trauma and Recovery. I’ve sort of cobbled together my understanding of the difference between men’s rates of PTSD and women’s from from those sort of three sources.

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Speaker 3: So my understanding of the theory right now is that there are sort of three things that impact the likelihood of developing PTSD after a traumatic exposure. The first is prevalence, basically, like how often trauma happens. So there are a lot more people and mostly women who experience sexual assault than there are people who experience being in combat service. So in some ways it’s just kind of a numbers game. Women experience more traumatic exposure than men do. So and this is according to the National Crime Victimization Survey. And there’s just way more traumas per year from sexual assault than than military service. And sexual assault is the thing that’s most likely to give women PTSD in military or combat experience is the thing that’s most likely to give men PTSD.

Speaker 3: But the nature of the trauma, what David Morris calls the trauma dose, ends up really mattering as well. So the sort of type and the intense intensity of trauma matters. So, for example, if you lived through an earthquake and there’s an earthquake, your bookcase in your living room falls on you. You’re you’re injured and trapped under the bookcase for two days before anyone finds you.

Speaker 3: Right. That’s a really serious trauma. There’s a there’s a pretty good likelihood that you’ll you might develop PTSD without, you know, like quick treatment and care, but the trauma dose is a lot higher and your likelihood of getting PTSD is a lot higher. If when that bookcase falls on you, it falls on you and your son or your daughter or your partner or your dad or your mom, and you watch them die while you’re waiting for someone to help. Right. So that’s a different kind of a trauma. David Morris would say that it’s a higher dosage trauma and you’re more likely to get PTSD in that kind of a case.

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Speaker 3: And then the third thing that they think is related to whether you’re going to develop PTSD from a traumatic exposure is the response to the trauma. So this comes from Judith Herman, who wrote all the way back in the early nineties that in order to resolve trauma, you have to sort of restore human connection. So you need to be able to share your experience and your experience needs to be acknowledged and the community have to take some kind of action. On it. And this isn’t what happens for most people who try to share experiences with sexual trauma.

Speaker 3: Right. So the response there is often to sort of belittle, to excuse, to dismiss, to blame the victim. So the theory is that women these three things have one, larger numbers of traumatic exposures to higher trauma dosage per exposure, and three, less recognition of the experience after it happens so that there are something like two and a half times more likely to develop PTSD after a traumatic exposure than men.

Shannon Palus: And it also seems like for caregiving, you know, if we don’t even recognize caregiving is really a job, if you’re caring for someone with PTSD, it it must be awfully hard to get people to recognize that like, oh, yes, this can be traumatic and have have an effect on the caregiver as well.

Speaker 3: I can say from my own experience that I’ve only been what I would think of as like full blown trigger three times in the last seven years. And for me, triggered means like that I experienced a kind of cognitive disorder, a disorder ring that where I, I maybe lost some cognition I made up may have lost the memory. I might have lost some time. Right? That the sort of emotional or physical threat was significant enough that my body acted to protect me in the moment and that I wasn’t fully in like in charge of the way I was dealing with my own experience.

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Speaker 3: So two of those moments where I was triggered was in arguments with my partner with Jason. So I want to be really clear that Jason was never physically violent with me and is the kindest person I know in the whole world, but was having an incredibly difficult time and not always fully himself.

Speaker 3: And the last one was around medical billing. I had had had such an incredibly difficult time navigating us through the health care system, which failed us in lots of ways, but certainly always got our billing information through through the unemployment and the disability systems, through just trying to find mental health practitioners. It was incredibly difficult trying to get into behavioral health crisis center, which again we were turned away from. So all of these moments where I came up against bureaucratic hurdles to getting Jason the care that he needed, those felt very much like they were life threatening too, to Jason and that I was responsible for his life.

Speaker 3: In a situation where I was operating way outside my capacity, I reacted by going into sort of full blown physical trauma reaction, right? So I hyperventilated. I cried so hard. One of my eyelids turned inside out. Right. I lost time. Right. Really difficult stuff like that. So this is, it’s it’s it’s quantitatively and qualitatively different from being reminded of being beaten to death in the street.

Speaker 3: But one of the reasons I wrote the essay is I really wanted us to struggle with like, how different is that and how are those differences gendered and how do we erase and ignore the the real harm that can happen to both people who are struggling and people who are caring for people who are struggling when we fail as a society to support them adequately.

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Shannon Palus: We are going to take a break here. But if you want to hear more of my conversation with Virginia, check out our Waves Plus segment. We dig into what Virginia hopes people take away from her piece and whether the pandemic was a, quote, unquote, traumatic event. You got a lot of unsolicited advice in response to the essay. What are some of the tips that people gave you?

Speaker 3: It was really it was really striking the kinds of response we got to the New York Times essay. So I do want to say that most of the responses were really extraordinary, really gratifying, like people who like praise the quality of the writing or said that they felt really seen, which meant a lot to me or simply wanted to wish us well, which meant a lot to both of us.

Speaker 3: But there was a lot of unsolicited advice and sort of like two categories. One was medical advice, the other was relationship advice. And I do want to say that like lots of people who live with chronic illness or other disabilities have written a lot about why you might want to reconsider giving people unsolicited medical advice. So I just want to offer listeners that there’s some great stuff, for example, on the website The Mighty about on this topic.

Speaker 3: But just speaking from my own experience, right, I found unsolicited medical advice, I’d say frustrating at best and at worst really quite patronizing. And this is true even for folks who have had experience with PTSD themselves and have found sort of something that that they feel really evangelical about that really worked for them. And like, if you found the perfect treatment and like your PTSD, like greatly improved or even vanished immediately, like, amazing, I’m so, so happy for you. But that’s not what most people experience. Like most of us best find some kind of clued together combination of therapies. Like for Jason, it was sensory, motor and EMDR and talk therapy. For me it was like cognitive behavioral and massage and hiking. And we just like put our heads down and we just grind through the years of healing because a lot of it is about patients and time.

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Speaker 3: So this kind of desire that I saw in the advice we were getting this sort of almost this fixation on a silver bullet, solutions to me at least could feel really dispiriting like and even a little dismissive because like, trust me, Jason, I have heard every possible single bullet for PTSD you can think of, but it’s rare that people actually know our context well enough to, like, offer meaningful advice.

Speaker 3: And and I think that’s really important, right? People don’t understand that, like treatments that are common in major cities just aren’t available in places where like where I live, you know, I’ve been trying to find a somatic experiencing practitioner for like four years. And the closest one I found is 90 miles away. And I just don’t have the time or money to drive 180 miles a week for a 50 minute appointment. I just don’t. And so it’s enormously frustrating to have people be like, Oh, have you heard of X like X works? Because basically we’re being told that we’re doing it wrong when we’re just doing our best to get through this really difficult experience with the resources that that we have. And I mean, I think that’s important, too.

Speaker 3: When I say resources, there’s a class dimension to the advice, too, right? So like people with adequate financial resources rarely seem to sort of like understand that money can be a significant barrier, particularly to trying alternative therapies. But like, if the thing that you’re suggesting to us isn’t available to people on Medicaid, like we can’t try it. And it’s really, really horrible to have somebody say like, Oh, there’s this thing that can cure your PTSD in three appointments, but you can’t have it. So. Right. Just to offer to listeners things like you can say, may I offer advice based on my own experience? And then be okay if somebody says no or like I read about x x whatever or trans transcranial magnetic stimulation. Can I send you information and be okay if I say no? Because we may have already looked at that and looked at that. We may have already moved on.

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Speaker 3: So I got a lot of relationship advice and most of it was people sort of giving me permission to leave the relationship. And I found this also fairly dismissive and a little patronizing. What’s interesting, I think, is a lot of it was framed as a kind of professional, middle class white, like, go get your feminism right. Like, don’t take care of that man. Like, go out and, you know, write your next book or whatever, which doesn’t like acknowledge that I was writing my next book while I was, while I was caring for Jason. But I just don’t think that there’s anything like emancipatory about rejecting the opportunity to care for people you love. Like, that’s not to me, that’s not feminism. Rejecting care is not feminism.

Speaker 3: I do think it’s feminist analysis to like recognize that poor and working class women, particularly migrants, particularly women of color, bear an unequal responsibility for care and. We’re neither respected nor remunerated sufficiently for, like the vast social and economic wealth that we create by doing that labor that I do think is a kind of practicing of feminism to really grapple with care infrastructure.

Speaker 3: But really, I do think one of the key feminist challenges of our age, particularly in the age of the pandemic, is really grappling with the care infrastructure that supports everything else in our society, like whether it’s professional paid care or unpaid family care care. Workers deserve institutions that support them. They deserve resources for providing adequate care to the folks that they love or their clients. And you know what we deserve money to? Nothing happens without care. There’s no work without care. There’s no community without care. There’s no culture without a without care. And we really do genuinely have to grapple with that. And if the like if the pandemic doesn’t wake us up to that, I don’t I don’t know what will.

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Shannon Palus: Just opt out of being a caregiver is not a very like heartening message for feminism. It’s very like almost girlboss like just become a billionaire entrepreneur who, like, doesn’t have ties to anyone.

Speaker 3: I mean, but that that’s not to say that we shouldn’t address the fact that like that women and queer folks and people who are marginalized by race and class really end up bearing more than their fair share of the responsibility for caring for others. And that is like sort of absolutely, I think, crucial for us us to wrestle with. But the solution is not then just like don’t do it right. Like it’s that’s the solution is that’s not the solution.

Speaker 1: Yeah.

Shannon Palus: Thank you so much for coming on the show and sharing all of this. I think you’ve given our listeners a lot to think about, and I hope that anyone who hasn’t already read your New York Times essay goes and does so now. We’ll link to it in the show notes.

Speaker 3: All right. Well, thank you so much for having me. I really appreciate the conversation.

Shannon Palus: All right. That’s our show this week. The Waves is produced by Shannon Roth. Shannon Paulus. That’s me is our editorial director. Alicia montgomery is vice president of Audio. We would love to hear from you. Email us at the Waves at slate.com. The waves will be back next week. Different hosts, different topic, same time and place.

Shannon Palus: Thank you so much for being a sleep last member. And since you’re a member, you get this bonus segment. And this week, Virginia and I are going to talk a little bit more about her piece and the pandemic. So to start among our listeners, I’m sure there will be people who are living with PTSD or who have loved ones are friends of PTSD. Virginia What do you hope these people take away from this conversation?

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Speaker 3: One of the things that was really important that I wanted people to take away from the essay, like in terms of my my audience, is that I really wanted to write this sort of impetus for the essay really came out of my own experience, like looking for anything to read about being a PTSD caregiver and really only finding a handful of self-help books that really only had like pretty toxic sexist advice in them. So really feeling like XY, like I was drowning and I didn’t have any help. So I really wanted to write for people like me who were sort of caring for somebody that they loved, but feeling really, really out of their depth. And I wanted other caregivers to know that navigating PTSD is just so much harder than we expected.

Speaker 3: Even though I wanted to also give people hope that that, you know, that healing is possible, but it takes a really long time and like whatever they decide to do in the face of that challenge is okay. I just wanted people to hear that if you decide to stay like it’s okay. If you decide to leave, it’s okay. Like, if you change your mind. That’s all right. If you decide not to decide right now, it’s okay. Like, it’s all okay because none of the choices you have are perfect or even really very good. And we’re all just doing our best.

Speaker 3: So I wanted there to be hope in the essay, and I wanted people to take that hope away. But I wanted it to be, like, realistic hope. I definitely struggled with some of the some of the writing that particularly this this happens in caregiving memoirs sometimes where sort of at the end of the book wraps up with this like. And then everything was wonderful. Like, we were deeply in love, more deeply than ever before. And we’re having sex in, like, a hotel room in Greece. And like, I would, I just remember reading a specific memoir and kind of throwing it across the room because it was just so out of my comprehension that that could even be a destination for us.

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Speaker 3: And Jason and I are deeply in love and deeply, deeply family to each other. But we’re still not sure, seven years in what’s going to happen with our romantic relationship. And I wanted people to know, like, it’s okay that it’s hard. And for the people who decide to stay. I think my biggest advice, my best advice is like find the things you won’t give up and then don’t give them up. So for me, that was sleep and writing.

Speaker 3: So I moved out of the bed that Jason and I share after the attacks, and I haven’t moved back yet. That’s cause like really big issues for us around intimacy, particularly physical intimacy, and it’s something that, like, we’re just starting to address in therapy now seven, sort of seven years into this. But I can’t imagine, having spent the last seven years having my sleep interrupted every single night by Jason’s nightmares and insomnia and still functioning as a caregiver and as a breadwinner and as a person who’s just like living a life of my own. And so I also worked really hard to kind of strike that balance, that difficult balance between caregiving and meeting my own needs, prioritizing my own needs.

Speaker 3: So, I mean, just days after the first attack, I left Jason in the care of his dad, and I went back to a writing residency, and then I came back home for the surgery and then I went back after the surgery. So I guess I just want people to know that it’s going to take a lot longer than you think. And you’ve really just got to kind of live your life in the meantime. And that’s a really it’s a really hard balance to strike, but I think it’s really important.

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Shannon Palus: I really like that answer, and I think that’s going to be really helpful for a lot of people to hear.

Speaker 3: Yeah, I hope so. And I mean, and I think that so many of us are grappling with some degree of this because of the pandemic and what the great majority of us have had to do to care for family members and to manage, you know, manage a household and manage trying to make money in very difficult situations.

Speaker 3: Right. And try to maintain some sense of community when people are losing their minds. Right. Like it’s been a really tough couple of years and that’s something I also wanted people to take out of the essay. There’s like one what I think of as like a very pandemic line in the essay, which is when I’m talking about when we get rejected by the mental hospital. And one of the things I say about that experience is it’s what we call in the household, like we call the attacks, the catastrophe, and then we call this moment the reckoning. And the reckoning is the moment where we realized that we were still thinking that we were gonna get back to normal at some point, and that we kept measuring, like, how close to back to normal? We were like at six weeks we were like, we’re halfway there, which seems insanely denial and optimistic to me now, of course.

Speaker 3: But like we thought the same thing at six months, we thought the same thing at three years. And like the what happened when we got rejected by the Behavioral Health Crisis Center was this moment where we kind of looked at each other and we were like, Oh, there’s no back to normal. Like, We’re not going back to normal. We can still go to a great place. Like we can still heal from this and get better and find a life that is fulfilling and extraordinary. But we’re not getting back to the normal that existed before the attacks. And I think there is a lesson for that, for the sort of the bigger the bigger picture of what we’re all dealing with in the wake of the pandemic.

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Shannon Palus: So was the pandemic a traumatic event, in your view?

Speaker 3: Yeah, yeah, yeah, yeah. So there’s so much there’s a lot of controversy about this, right? BETHELL Vander Kolk says we can’t talk about the pandemic as trauma. It doesn’t meet the clinical definition. Lots of people talk about it, talk about the pandemic colloquially as a trauma. Personally, I think it really matters who you are in the pandemic, right? If you are unhoused in the pandemic, like, yeah, I’d say there probably you experienced a life like an existential horror that was like clinically a trauma, right? If you lost your job and couldn’t get access to unemployment and like loss and potentially we’re going to we’re going to lose housing, right? Yeah. Like I’d say, you probably had what would clinically count as a as a trauma.

Speaker 3: Right. And then I think it gets a little bit more challenging when you talk about the sort of interpersonal and the cultural experiences of the pandemic. I think for all of us, to some degree, we experienced. We experienced trauma sort of broadly a broadly defined which might not meet that clinical definition that you require for a PTSD diagnosis. But just to say that, like your trauma doesn’t qualify, isn’t a qualifying event for a PTSD diagnosis, doesn’t mean your trauma doesn’t matter? This is the thing about trauma is to a certain degree, you just have to trust that that is somebody’s subjective experience.

Speaker 3: And I think finding this way to talk about the reality of like the deep suffering and harm that like political decisions and cultural decisions and ways that we are with each other interpersonally. Right. That those harms matter, even if they’re not like clinically significant for a case of PTSD, doesn’t you know, it doesn’t matter. We have to address the kind of traumatic reactions that people are having, even if it doesn’t qualify folks as PTSD.

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Speaker 3: You know, if I really come down to it, I struggle with this a lot writing the essay, which is like, what’s the big picture solution, right? Like, how do we fix it? Like I say very clearly, I think PTSD is hard. There’s not nearly enough support for people who are experiencing PTSD and for people who are caregiving for people with PTSD. I took a lot of inspiration from programs like the VA has a program of comprehensive assistant to family caregivers that provides family caregivers for wounded veterans with like money and training and support. But the sheer scale of PTSD and the fact that most of it’s not military means that like this kind of military based after the fact response like is necessary, but it’s not sufficient to actually address the reality of PTSD.

Speaker 3: And really the only solution I see after really grappling with this for like close to three years is to go upstream. Like, the only way we really fix PTSD is to stop creating so many traumatic exposures that then can lead to PTSD. So like David Morris, for example, would say like the single most impactful way to prevent PTSD is to stop campus rape. I’d add from our experience that a key way to lower PTSD rates is to like address and interrupt community violence before it happens.

Speaker 3: And so like all of this trauma stuff sort of folds in on itself, right? To a certain degree. Living through the pandemic, if we choose to let it drive us apart, can create the environment in which more traumatic exposure happens. And then because of the kind of traumatic exposure, because of the ways we respond to it, that trauma can turn into PTSD. Right. Or we can choose to organize our society and our relationships to each other in ways that mean that we really prioritize caring for each other, whether that’s interpersonally or in terms of care infrastructure or in terms of the way we build social infrastructures that support people when really bad things happen.

Shannon Palus: PTSD is really like a public health issue, far from something that you could just quote unquote fix by opting out of a lifestyle or opting out of caring for someone or just taking more deep breaths. It’s it’s really this systemic, big picture issue.

Speaker 3: I absolutely think that’s true. Yeah.

Speaker 1: Well.

Shannon Palus: Thank you again for being a Slate Post member. We would love to hear from you. Email us your Post segment. Ideas and opinions at the Waves at Slate.com.