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Living with… post-traumatic stress disorder

Neal Aplin recounts how he learned to cope with the aftermath of a traumatic event 
Neal Aplin

In the second of our Living with... series, advanced clinical practitioner Neal Aplin recounts how he learned to cope with the aftermath of a traumatic event

I knew for a few years I had post-traumatic stress disorder (PTSD). I work as a senior healthcare professional and I recognised the signs.

I have experienced periods where I felt down, low in mood and had flashbacks of images and memories.

Speaking about what happened to me brought it all back. Memories and images flooded my mind. Speaking about it was just too painful. Therefore I didnt. I kept it in.

I had not developed the skills I needed to cope with traumatic events

When I was 16, I watched my mum die. I held her hand as she slipped

...

In the second of our Living with... series, advanced clinical practitioner Neal Aplin recounts how he learned to cope with the aftermath of a traumatic event 


Neal Aplin used eye movement desensitisation and reprocessing therapy for post-traumatic stress disorder

I knew for a few years I had post-traumatic stress disorder (PTSD). I work as a senior healthcare professional and I recognised the signs.

I have experienced periods where I felt down, low in mood and had flashbacks of images and memories.

Speaking about what happened to me brought it all back. Memories and images flooded my mind. Speaking about it was just too painful. Therefore I didn’t. I kept it in.

I had not developed the skills I needed to cope with traumatic events 

When I was 16, I watched my mum die. I held her hand as she slipped away. I look back now and think I lacked the life experience and coping mechanisms to deal with it. I pushed on with life, determined not to let my mum’s death define me.

My mum wanted me to succeed and do well at school and encouraged me to do my best. So I did what she wanted – I cracked on with achieving the best I could. 

I volunteered as a medic with the Royal Auxiliary Air Force and I liked the training so much I decided to apply for nurse training. I became a nurse, not really thinking it was because of what happened with my mum, but because I wanted to make a difference. I didn’t want to become old and grey and look back on my life wondering what I had achieved.

Much later, my therapist described me as experiencing post-traumatic growth and on reflection this makes sense. I recognise now I used my mum’s death and what it meant as a springboard.

I later became an advanced clinical practitioner with a good master’s degree. I got married and had children and at times there was pain. I called it my soul wound; a crack or a scar deep in my soul which would never heal. Sometimes it surfaced but I kept it at bay, never speaking about it to my closest friends and barely even my wife.

But the PTSD started getting worse and the episodes more frequent, especially as I started to reach the age of 40, which was the age my mum was when she died. Turning 40 was the spark for my demons. I became increasingly snappy and stressed. I had panic attacks and my memories were triggered.

I was unable to speak about my pain, even when my anxiety worsened

I still didn’t speak to my wife about it. I should have, but I couldn’t. It wasn’t her fault. I hid how I felt from her, but she noticed the changes. Whisky helped with the panic attacks, but I knew it wasn’t a sustainable long-term plan.

Then the irrational thoughts came – and the anger. I practise martial arts and the exercise is superb for my mental health. But I wanted to fight. I was walking home from work, often crying and frustrated and I wanted someone to ‘jump’ me and, rather out of character, I wanted to dance to the song of my angry fists.

I started to spiral, to go to a place in my mind that I hadn’t been before and it scared me. I was genuinely worried I would lose control. I knew I had to do something I hadn’t done before. I had to start talking and I needed help.

I contacted staff support and cried my way through the phone call and thankfully I was seen that day by a psychotherapist. I felt vulnerable. I was talking about the past and the present and how the two were interlinked and it was tough.

No one knew what I had experienced as a teenager

Speaking to anyone was challenging; the memories would come flooding back. I felt like a failure as I couldn’t manage my feelings and keep it together. I felt like a failure as I had to be signed off work. I knew I needed time off but it still made me feel as though I was failing and letting others down.

‘The realisation that I actually do have PTSD, that I will always have PTSD and that it is a part of me was liberating’

Once I started talking, it just all started to come out. And it was not just the therapist I spoke to. I opened up more to my wife and also to friends and family. It surprised them as no one ever asked about my past. People knew my mum had died but I was a closed book. They didn’t know the details.

But when I finally started talking, it felt good, like a weight had been lifted. My therapist advised me to try eye movement desensitisation and reprocessing (EMDR) therapy. I was told that, although it can be intense, it is effective for PTSD. So I agreed.

What is eye movement desensitisation and reprocessing therapy?

Eye movement desensitisation and reprocessing (EMDR) therapy is used to treat the symptoms of trauma. The National Institute of Health and Care Excellence (NICE) recommends its use for people with a diagnosis of post-traumatic stress disorder. During therapy sessions, patients are supported to recall a traumatic event while receiving bilateral stimulation. The aim is to help the brain to process memories of distressing events. 

Stimuli are given in a rhythmic left-right pattern and can be something the patient can hear, see or feel. Bilateral stimulation can involve:

  • Moving the eyes from side to side
  • Tapping movements on different sides of the body
  • Tones heard through one ear then the other while wearing headphones

Source: The Tavistock and Portman NHS Foundation Trust, London

 

Although EMDR has its critics and is perhaps thought to be a ‘pseudoscience’, I deliberately did not look up much detail about it. I didn’t want anything to shape what would happen. I wanted to throw myself into the therapy without any preconceptions on how I should feel or what should occur.

My therapist said some people call it 'magic'. To me it was like time travel. I was 16 again, remembering what had happened: events became vivid, and I saw details that I thought had been lost to time.

The therapy was powerful and intense and it left me drained

To say EMDR is intense is probably an understatement. I found it incredibly intense. Emotional. Hard. Each time it gave me a headache and I felt emotionally and physically drained. But my therapist got me through it.

EMDR without doubt helped me face my PTSD and relieve my psychological stress. And along with talking, meditation and a break from work, I came out from the shadows.

The realisation that I actually do have PTSD, that I will always have PTSD and that it is a part of me was liberating. Rather than feeling down about this, I have an acceptance and a greater understanding of who I am and I can take a proactive approach to managing my PTSD.

EMDR and my psychotherapist helped me with this. But one of the key learning points for me was also the importance of talking. I had kept my feelings and thoughts hidden for so long. Talking with family and friends got it all out in the open, allowing me to explore my thoughts, feelings and better understand my behaviour.

Mental health problems no longer carry a stigma but they can still go unnoticed 

Thankfully I don’t think there is as much stigma surrounding mental health as there was when I was young. There has been much in the media about talking through problems and a wider appreciation and openness about mental health. The recent Britain Get Talking is one example.

When I first spoke to my family about my PTSD, they were surprised. Some members of the family had noted altered behaviours but, because, as my therapist said, I had done a good job of compartmentalising, I was still able to cope and manage until problems hit a crisis point.

It just shows how mental health problems can go under the radar and how people can appear ‘normal’ on the outside, but inside it can be a different story.

So this is me being open and honest about my PTSD with one key message: talk. I hope my story can provide an example to others. For those facing similar emotions, it will be tough to talk, it will make you feel vulnerable, but it does help.


Neal AplinNeal Aplin is an advanced clinical practitioner in care for older people at Great Western Hospitals NHS Foundation Trust, Swindon

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