PTSD and Me

Evidently doctors hate it.  Our ability to self-diagnose and the like, all thanks to WebMD and more has them collectively annoyed.  "I think I have..." is at the top of their list of dislikes.  Do I do this, too?  Yes.  Watch me.  I'm going to right here.

I temper my self-diagnosis lest my doctor reads this.  Let's say I perhaps, I maybe show signs and symptoms.  I might be a candidate for treatment.  When insomnia lies next to me in bed poking me in the ribs just as I start to doze, the nights when I truly can't sleep are when I wonder.  Do I have PTSD?

I've been on vacation for a week.  I don't relax well, something to discuss and review on another day.  My husband and I have talked for the entire duration of my time off how we should go to Emma's Pizza.  We are the couple that always orders a half 16, half 17.  We've done so for years.  The servers know us by what we eat.  There's comfort in this routine.

Except I discovered the Canadian ham and carmelized onions concoction that has my name all over it, so there goes our routine.  In with the new.  It's delicious.

It took us a week to get here, to Emma's.  We made it tonight and shocked the server when we ordered a half five, half 19.  There was a bit of delight in this, the shocking of our server.  We smiled to ourselves as she walked away in amazement, quite the mysterious couple.  Alas.

My husband and I chat.  We look at the other customers.  I tell him why I didn't like the film we watched last night.  We remember what we had scheduled for Thursday.  Then I hear it.  My head jerks towards the big window.  My breath catches and only when I realize what just happened do I release.

A man on a Harley Davidson rides by.  The low rumble was his motorcycle.  I know that now.  Several seconds ago I knew that in some corner of my mind, the intellectual side of me realizing the low rumble was not the precursor announcing an earthquake, the warning many in northern Japan have gotten accustomed to.  Isn't it nice that the earth warns us when an earthquake is about to hit?  To be warned?  So we can prepare?

No.  There's nothing comforting knowing an earthquake is coming.  We can't stop it.  The rumbling, how loud it is or how long it lasts in no way determines how big the quake will be or how badly we will shake.  We sit, clutch the arms of our chairs and wait.

I've also found myself freezing as the walk-up apartment my husband now lives in shakes when our third floor neighbors begin their exercise routine.  Somewhere in the back of my mind I know this is not an earthquake.  My body, however, does not operate with the same speed.  I cringe.  I begin to shake.  I walk through airports with the same discomfort.  The floor of the terminal bounces only slightly with the passing of a jumbo jet and in my mind this is an earthquake.

Surely these symptoms do not reflect comfort with my surroundings.  The man on his Harley tonight did not bring warnings of an earthquake.  My mind, however, did not register safety.  Quite the opposite.  I braced myself for the impending earthquake.

Is this PTSD?  I'm in no position to diagnose but that doesn't stop me from wondering.  Three years of aftershocks, some mild and others severe has my response system on edge.  I'm a taut wire ready to snap or so it feels when I assume I might be facing danger.

I have no practical solution to appease myself, to tell my mind the rumblings in our favorite pizza restaurant will cause me no concern.  Is there a solution?  Will I grow out of this?  Move on?  Get over it?  I don't know.

I live with this ambiguity because I see no other alternative.  So it is.

Mary's Skunk and PTSD

Once upon a time, Mary may indeed have had a little lamb.  I'm sure it was a cute, fluffy thing.  Several months back, the animal belonging to Mary was a skunk.  Which she gave to me, she said, because it matched my outfit and because I reminded her of Liza Minnelli.  Okay.

Mary's skunk was about 50cm long, a cute and fluffy stuffed animal.  I said, "thank you" when she gave it to me because when people give you a skunk, or any other stuffed animal for that matter, it's just polite to express gratitude.

I named the skunk Liza.  Seemed fitting.

I took Liza to one of the preschools in Rikuzentakata where I decided to put it to good use.  To my knowledge, there are no skunks in Japan.  (Correct me if I'm wrong.)  Would the kids know what animal this is?  They did.  Cue my cloak-and-dagger way of introducing the topic of feelings.  Liza would help.

"Do you know what skunks do when they get scared or angry?"
Several hands shoot up and there is general consensus.
"It farts," the kids say, and we alternate between giggling and guffawing.
"Right," I say.  "When a skunk gets scared it farts.  What do you do when you get scared?"  Before anyone can answer, I add, "Do you fart?"
More giggles.
"Nooooo.  We don't fart," one girl says.
"I don't either," I say.  "What do you do then?"
Silence.
Slowly, hands go up.
"I go to my mommy," another girl says.  I nod.
More silence.
"What about when you get angry?  What do you do then?"
A boy says, "I hit.  Especially if it's my brother."  I want to laugh but don't.
This is good.  We're talking about feelings--a topic not usually discussed--today Liza's presence makes this seem normal.
"What about when you're sad?"  I say.  "Do you cry?"
Almost all of the children nod.
"It's okay to cry," I say.  "Did you know that?"  Some heads nod.

In a culture where open displays of emotion are a no-no (especially of raw anger and deep sadness) even talking about how we express our feelings is not the norm.  There are exceptions, certainly.  Exceptions, by definition, are not the norm.  The foreign auntie is allowed to use tools to begin this dialogue.  I don't abuse this position, choosing carefully what to do when, what to talk about with whom.  For children living in an environment where the abnormal is now normal, I stand by my belief they need the vocabulary to talk about feelings.

If we don't talk about the collective trauma experienced by a disaster--any disaster--the simple fact is we internalize.  People of varying skills (some lacking altogether) have come up to Tohoku offering PTSD "counseling" over the past three years.  Aside from the fact few are qualified to counsel, the emphasis on PTSD--in particular, the "P"--is disturbing.

Post-Traumatic Stress Disorder contains the word "post".  As in, "in the past".  As in, "we're not traumatized now."  This is misleading.  It's wrong.  Never mind the qualifications (for now) of those who mean well.  The first fact that needs acknowledging is this:  it's not PTSD if you're still going through trauma.

Focus on the today's trauma.  Focus on the fact life is painful still today.  Let's not rush into telling anyone they're suffering from PTSD when in fact trauma is a part of daily life.  It's not past tense.  It's TSD.  Not PTSD.

Which is why Liza the skunk is necessary.  Not one to superimpose my beliefs on others, here I take exception.  I see no good coming out of maintaining the belief internalizing pain is good or brave.  At the very least, allow the kids to express.

Kick, hit, cry, laugh. 
It's time.

On Resilience, Coping Mechanisms, and Differences of Opinion

To each their own.  Who am I to tell you the way you choose to cope is wrong?  I don't know your pain and your experiences are not mine.  Hard is just hard.  Your "my life is hard" is not a measurable event, and my version of "my life is hard" is just that.  Let's not compare.  Let's not one-up each other.

I spent time with Yuriko over the weekend, one of my favorite women in Tohoku.  She's strong, opinionated and honest.  She personifies "work hard play hard" which isn't a motto many think well of, especially coming from a woman, a wife, and a mother.  That I'm tired of this double-standard argument is not the point.  Not today, at least.  Yuriko told me of how Rio, her six-year old daughter got angry at her (and me) for the deed I meant as a good one which completely backfired.

"She was angry she didn't get to see you when you brought the Halloween candy," Yuriko tells me.
"I'm sorry.  I showed up without calling, I know.  I was on my way somewhere--I don't remember where now--and I saw your light on so I just popped in."
"When I took the candy back to Rio and the other two, Rio got really quiet, gave me one of her I'm-angry-now looks and said, 'You saw Amya-san today?'  So I said I had, and then Rio went off.  I got 'Why didn't she tell me?' and 'Why didn't you call me when she was there?' and then, 'Make sure you tell her I want candy next year, too.'  It was quite the tongue-lashing!"  Yuriko laughs.
"Oh, and then when I asked Rio, 'You wanted to see Amya-san?' she gave me one of these you're-so-dense-mom looks and said, 'Well yeah.  For awhile now.'"
Yuriko and I laugh but I realize my mistake and promise Yuriko I will stop by with more notice next time.

Rio is the girl who, at three years old, told (not asked) her mother to drive by the spot Yuriko's store used to be everyday for a month.  "Rio would put her hands up to the car's window and stare," Yuriko says.  "I have to assume that's how she was processing what happened.  I lost my store but so did she.  That place was just as much hers as it was mine."  This story ends with Rio announcing one day she didn't need Yuriko to drive past the store anymore. "She must have worked it out," Yuriko says.  "I don't understand it," Yuriko tells me, "but something clicked on that day.  She didn't need to see where the store was anymore."  It was on this day that Rio told Yuriko she would protect her mother if another tsunami were to hit.  "I'll beat it up," the three-year old Rio told Yuriko.  This was when I first fell in love with the girl.  I was then and still am today inspired by her resilience.

We cope with trauma and tragedy differently.  Here in Tohoku, a place still very much a disaster zone, there are multiple coping mechanisms:  some drink (sometimes to excess), some shut pain away, some cut themselves, some ignore it, some throw themselves into work to forget, others throw themselves into working towards progress, and a very select few try to work it out by talking it through.

I choose to read.  I need to escape into a world that is at times surreal, unreal, far-fetched, silly, and/or all of the above.  I won't take kindly to people saying this is not a legitimate way for me to process.  Nor can I support others who might think reading to escape is not a viable method of coping--not just for me but for anyone.

What about the other options then?  Rio needed to stare at the plot of land where she had memories.  Many around me drink.  Many who drink don't stop with just a few.  Medical professionals would very likely offer up facts on why drinking-to-forget is not a healthy way to deal with those parts of our lives we struggle through.  I am not one who drinks away my anxiety.  I read instead. It's not my business to be critical of those who choose a different way to cope.  Drink through your pain, deny it, work yourself through it.  I don't agree with the idea of suppressing feelings, drinking to excess, or overworking to forget, but I am constantly reminded of the fact this is not my country.  Who am I to say keeping things bottled up is wrong?  If drinking helps you process is it my place to say you shouldn't?  It's wrong for me, but maybe it's not for you.

I bring this up to say these are ideas I'm trying on.  I'm anything but comfortable with the idea excessive drinking and eating and gambling and the like as a legitimate and healthy way to process grief or trauma or pain.  That said, I'm not fond of those who easily right off my method of coping.  Indeed, I find myself surprised at how defensive I get when what is so important and necessary for me is easily dismissed or criticized.

Tolerance and patience:  the former I'm pretty good at, the latter I'm not.  Today's random musings are brought to you by kids whose resilience and strength I marvel at over and over.  Read away, dear child.  Talk back to your mother, Rio.  I hope it brings you peace.

Parents Who Snap At Their Kids: What Post-disaster Recovery Looks Like Today

I am in no position to diagnose.  With no training in medicine, psychology, or psychiatry it's not up to me to identify who's suffering from what.  What I can say is this:  I don't need a degree to see and understand there's still pain in post-diaster Tohoku.  Two and a half years after Japan's biggest earthquake triggered giant tsunamis, ambiguity and confusion are still the norm.  Leaving the question of why recovery is slow aside, those of us involved in disaster recovery focus on what we can do here and now.

Kazu is drunk.  The more alcohol he consumes the more honest he becomes.  Tonight he let out his pent-up inner most demons.  His main concern, he states over and over, is the kids.

"They're just too well behaved," he says.  "They don't ask for things, they don't say, 'Daddy can we go to so and so,' because they know what will happen if they do."
My job tonight is to listen and prod.  "What do you mean?"
"Well, it's primarily the adults who are the problem.  We snap at the kids.  We're all tense.  We've got short fuses.  We're tired, I know I'm tired, and when we get this way we take it out on the kids.  It's not right but we do it anyway."  He sips his drink.  How many has he had?  I've lost count.
"So, the kids, because they know we'll get pissy, they don't act out.  They're the ones trying to make sure the parents, that's us, don't have a reason to get angry.  Or, maybe I should say angrier."
We're silent for awhile.  When he speaks again Kazu runs his hand over his buzz-cut hair.  "I did it, too," he says.  "I snapped at Yuuki."
I think of Yuuki, Kazu's son, a boy who has I swear grown at least 20 cm in the two plus years I've known him.  "What happened?" I ask.
"It was dumb.  It's true I was mad.  Yuuki wouldn't stop playing those video games," and Kazu mimics Yuuki's fingers pressing buttons on a remote control device.  "I hate those things," he says.  "I had told Yuuki to go to bed.  He didn't, of course."  Kazu laughs but it's an uncomfortable laugh.  "So I yelled at him.  Normally, I would have said something about taking him up to his room and helping him get to bed, but that night I snapped and told him to get to bed.  We're all like that, us parents.  We're all stressed."

It's neither fair nor accurate to say all parents in Tohoku snap at their kids out of post-disaster anxiety.  Do some?  Yes.  Do many?  Perhaps.  Probably.  The take away tonight from Kazu's alcohol-induced honesty is that he is tired, and that many parents around him are, too.   Why wouldn't he be?  Earlier in the day, another one of my brothers from Tohoku told me how the spirit of gaman, usually a beautiful combination of strength, determination, and perseverance has turned into apathy.  "People are giving up," he tells me.  "Not in the 'I'm suicidal' way, but they're all tired of waiting.  Change and improvement, it's so slow.  It's taking so long.  Too long."  He's now talking to himself more than me, and because I don't have the words to fix what's wrong I stay silent.

In some communities rebuilding has been going on for a good year.  Prefabricated homes and stores and businesses have long since been available.  It's the newly rebuilt homes and stores and businesses that are marking how well reconstruction is going.  In cities like Rikuzentakata where nothing can be rebuilt in what was downtown, the city is far behind its neighbors.  The lack of speed in visible progress turns into disaster-fatigue which then turns into snapping parents.  Or so Kazu says.

Clearly I don't have the solution.  I listen.  I let them vent. I nod my head when they need agreement and shake it in disgust when they need an additional soul to commiserate with them.  I left Kazu wondering just how useful his venting was for him.  I tell myself I listened, and hope that was enough.

Tales from Rikuzentakata: "That's All I Did."

No spin.  No embellishing.  This is a story without preservatives.  Made with all natural ingredients, it comes straight from the front lines of disaster-stricken Rikuzentakata. 

Teiichi Sato is a man who looks like he chops down trees in his spare time.  Barrel-chested, salt-and-pepper hair flying in all directions, he's quick to tear up and quick to recover.  He's one of the victims-turned-survivors from the tsunami that wiped away the City of Rikuzentakata, his store and home included. 

Mr. Sato will be the first to admit his mind did not belong to him for a month after the tsunami took away everything he owned.  "I wasn't myself.  I didn't know what to do.  My mind?  It was white.  Like that screen on television, black and white static.  I had nothing."  Today, he is the proud owner of his seed store selling literally seeds and seedlings.  How anyone can stay in business selling only seeds, competing with the giant box-stores selling the same seeds for less--this is a mystery to me.  I don't ask questions.  His income, he tells me is "Less than what most people make around here" but this doesn't seem to bother him.  Personifying stubbornness, a fierce will to live, and commitment to survival, the hostility he showed to his customers two summers ago when he was working through this PTSD is all but a memory.

"I wanted to get this story out from inside me.  That I rebuilt this store, if you can call it that....that I rebuilt it from scraps of debris that I found all over town.  That I rebuilt my store to show that even someone normal like me can start over.  That even someone like me who lost everything can still live.  I wanted to get this story out but it was too painful to write it in Japanese."
I nod as I listen.
"So I wrote it in English.  And then Chinese."  Here he drops the bomb.  "But I don't speak, read, or write English or Chinese."  He laughs.  "So, I looked up words in the dictionary one after the other, and then started putting together not knowing at all whether my English was correct.  Then I heard of an English teacher who was holding classes here in town once a month and I asked for help.  He and I worked through my manuscript, polishing it so it was presentable.  And then I published it.  It's not high prose, but it's readable."  He says this as if it's no big deal at all to write a book in two languages he doesn't understand.  He did the same thing with the Chinese document.  "Dictionaries are really helpful," he says, nonchalantly.  "Get a native speaker to check your work, and" he claps his hands together, "just like that, you've gotten out what was pent up inside.  That's really all I did."

That is most definitely not all he did.  It never occurred to me here is where I would found the one person I know in my life who wrote a book about a terrible and painful experience in two languages he neither comprehended nor ever used.  The result is a short book revealing grief and hope in ways only he can retell and capture.  I won't spoil it for you.  Don't buy it if you're not interested.  If you are, however, here is a true, first-hand account of a victim who turned himself into a survivor out of sheer will.  Read and weep as many have. 

Please contact me at amya@city.rikuzentakata.iwate.jp if you are interested in purchasing a copy.  Each book costs 1500 yen.  You will need to pay via bank transfer.  I will provide you with details.
It's worth it.  Take my word for it.

Flashback

None of us could have anticipated the events of that night.  Our outing was meant to be a fun, casual dinner.  The five of us were at a local ramen shop in Rikuzentakata.  The two girls, my adopted daughters whom I love like my own, and mom and dad all sit around the table negotiating how many bowls to order.

"It's a big bowl," mom says to the girls.  "I don't think you can finish it."
"Yes we can," younger sister protests.  "Yeah.  Mama, please?"  Older sister chimes in.
"You never do," dad objects.  "You'll have to finish what they don't eat," mom says to dad.
"Again?"  We all laugh.
"Can we have gyoza, too?"  The younger one is determined to eat tonight.
"Do you have any appointments tomorrow, Amya-san?"  I'm taken back my mom's question.
"Appointments?  Why?"
"The gyoza here is really garlicky," dad says.
"Oh."  I think for a minute.  I do have meetings tomorrow.  How garlicky are they?
"I'll just have one," I reply, not one to pass up good gyoza.

We order, continuing to chat.  When the bowls arrive I am shocked at the size.  This is possibly the biggest bowl of ramen I've ever seen.
"Woooow," I say, looking down at what's in front of me.  Turning to the girls, "You're really going to eat all that?"  "No," dad says as the girls say, "Yes!"  We laugh again.

Silent except for the slurping, none of us notice grandpa sitting at the bar.  Suddenly, there's a buzz.  The chefs come out from the kitchen, moving quickly.  One of the servers is standing near grandpa, calling out to him.  Grandpa is slumped over.

"What's going on?" The older girl starts to get up.
"Sit," mom says.
"Be right back," and dad jumps up heading towards grandpa and the small crowd.

Fast forward three minutes, we piece together what's happening. Grandpa is unresponsive.  A chef is spooning sugar into grandpa's mouth.  "Diabetic shock," mom says to me.  I nod.  Soon we hear an ambulance.  Mom and I exchange looks.  I see mom looking at the girls sitting on either side of me.  I look down at them, first left and then right.  The younger one is in tears, trying hard not to show how upset she is.  The older one is pale.  It's the first time I've seen someone this white in a long time.

"It's alright," mom says to the girls.  The older one nods, trying to be brave.  I sense the younger one on my left quickly wiping her tears.  I touch her head and say, "Do you want to sit on my lap?"  She nods.  I pick her up, move myself in front of the television we've all been ignoring, and turn my back towards grandpa.  "You sit on Amya-san's lap, too," mom says to the older one.  I move younger sister onto my left knee, and pull older sister onto my right.  She's shaking.
"It's alright.  Everything is going to be okay," I say and turn them more towards the television, talking about the AKB girls we see.

The ambulance arrives, puts grandpa on a stretcher and quickly leaves.  The girls try to sneak glances towards the paramedics, but I bring their attention to the television screen each time.

Once the restaurant is quiet again, we all sit around the table.  The girls are no longer hungry.  Mom says in a very soft voice, "I know it's scary for you to see ambulances.  It reminds you of daddy being away with the fire brigade, right?"  They nod.  Dad is a volunteer firefighter, and was out for days following the tsunami, looking for survivors, recovering bodies.  The girls don't fully understand what dad was doing, but were worried sick.  Emergency vehicles now scare them.

How an unexpected incident can turn an otherwise happy outing into a traumatic experience is a stark reminder of the power of memories.  In this case, the fear over a father's safety in the aftermath of a tragic and terrible disaster ruined not only our night out, but served as a trigger bringing back buried pain.

I hope for those in Tohoku we are all able to find a realistic and robust mental health plan that allows for lasting healing.  In the mean time, I will keep hugging these girls.  Mom and dad, too.

What's on TV in Tohoku

Having relied on my computer-guru husband for all things electronic for the past twenty years, I've evidently become quite the techno-dud. Case in point:  I can't get my television to work.  Now that I'm back in Ofunato and have a television at my disposal, I'm watching.  I call it research.  Getting caught up on local news is an important part of my information gathering.  I'm more surprised than not by what I'm seeing.

Two things strike me immediately.  First, the commercials are anything like what I've seen on television in Tokyo (when I actually have access to TV).  In the past thirty minutes, the commercials have shown the following:  a cemetery plot in a nature park (twice), a new apartment complex inland, a vegetable-delivery service (twice), a pharmaceutical company ad, and a car dealership.  There are the requisite coffee commercials, sports drinks, cosmetics, and ramen ads interspersed among the more locally relevant services being provided.  The former list is unique to Tohoku, or so I'm guessing.  Cemeteries for those who are no longer here, an apartment inland far away from the coast, fresh vegetables unlike those under suspicion, new or used cars for those whose were washed away.  These commercials are airing a year after the tsunami?

I have yet to see a commercial in Tokyo advertising a cemetery.  Or a we'll-make-sure-your-vegetables-are-safe promotion, targeting the fear of--dare I assume--radiation in locally grown produce?

Then there are the news programs highlighting areas hit by last year's tsunami.  The news is, for the most part, not uplifting.  The focus is on how much any given town was destroyed, how slow-going the recovery is, mayoral meetings discussing who can assist whom, damaged buildings and hospitals, the continued need for medical expertise (actually mentioning PTSD).

It's been over a year since the tsunami hit destroying city after city, town after town.  Surely there's a feel-good story out there.  I'm baffled by why there isn't more focus on these.  If depression is an ongoing concern here, then why continue to focus on the negative?

Then I heard it.  "It will be almost a year since the great disaster."  What?  They're airing a tear-jerker story from several months ago?  Are the reporters on strike?  Did the editors play the wrong clip?  What's going on?

This is followed by Richard Gere hugging a kid as he drinks a bottle of Orangina.  That's followed by an ad for the new show "Let's Make Tohoku Happy" starting April 7th.  So there is good news.  I'm baffled all over again as to why the focus on the negative, all while images of Richard Gere run through my brain.

Television content in Tohoku is not what I expected.  I decide to continue my "research" and vow to keep monitoring the news and commercials to see what those around me are watching.  Perhaps someone here can help me make sense of the negativity and commercials unlike those in Tokyo.