Of Horses and Zebras

There is a common saying in medicine:

When you hear hoofbeats, think horses, not zebras.

In other words, look for and rule out the common causes of symptoms before you turn to the exotic. That headache is much more likely to be caused from the tension of the day than a malignancy spreading alongside your cortex.

Doctors in training (as well as the layperson who spends too much time on WebMD) are famous for seeing zebra illusions. They hear of these rare and unusual diseases and are convinced that this time, it is the correct diagnosis. For the young doctors, they learn over time that they may see thousands of horses for every one zebra. Their high alert tones down.

But there are problems with the horse philosophy. It is possible to become so focused on believing that every hoofbeat is a horse that you fail to see the zebra in their midst. Famously, until very recently, this often happened with women attack victims. The symptoms mirrored other, more common complaints and they were dismissed before further consideration.

Doctors usually have a systematic way of diagnosing illness. They start with the most common causes of the symptoms at hand, perform tests and ask questions to eliminate some illnesses and include others. Each piece of data is added to the puzzle until the particular horse is named.

Unless it’s a zebra.

The problem with zebras is that once you have seen one, you cannot unsee it. Rationally, you know that just because this hoofbeat was made by a rarity, the next one is still more likely to be the common equine.

You know this. Yet those hoofbeats will never be the same.

Because once they heralded the arrival of a zebra.

We all experience hoofbeats in our relationships, data points of indication. Most of these are benign, evidence of a stressful day or wandering mind, the equivalent of the common tension headache. But sometimes these impressions are an indication of a malignancy within the relationship.

Some people always look for zebras. These are the ones that are always on red alert, searching through emails, calling insistently. They are convinced that the zebra is there, they just have to find it. Some of them go so far as to paint stripes on the common horse. They are as hypochondriac in their marriages as some are with their health.

Others don’t believe in the zebra. They let the sound of hoofbeats wash over them, secure in the knowledge that they come from the harmless pony. They believe that if ever presented with the zebra, that the beast would be so evident as to be impossible to miss. But zebras hide. They blend in with the everyday hoofbeats. You have to watch carefully and look for their distinctive patterns.

Those two approaches, although at odds, originate from the same place.

Fear.

The zebra-spotters are so afraid of the striped one that they are on the hunt. They refuse to be surprised, intent on heading it off before damage is done. Of course, life on the hunt is exhausting when you’re convinced that everything is an attack.

The zebra-blind are also afraid. But instead of going on the offensive, they hide, believing that the zebra cannot find them. But living on the defense is limiting when you’re trying to avoid every potential attack.

There is a place in the middle. A place where hoofbeats are heard. Data is collected. Hypotheses made and tested and either accepted or discarded. A place where the existence of the zebra is acknowledged but not hunted. A place where you trust your ability to spot a zebra among its brethren and you trust that you can survive its approach.

I was once one of the zebra-blind. I trusted that my ex would never introduce zebras into our lives. So I didn’t see them. Of course, it didn’t help that he also knew the powers of disguise, hiding their stripes with plausible stories and Photoshopped documents. When he left, my tears washed the brown paint off the surrounding creatures and I discovered I was living in a world overrun with the striped beasts.

I was trampled.

But alive.

And changed.

Once you’ve seen a zebra, hoofbeats are never the same again.

I hear them.

And I look, without assumptions.

Knowing that they are most likely horses but also realizing that may not be benign.

But also believing that just because I met a zebra once, does not mean that every sound is a sign of impending attack.

When I hear hoofbeats, I think horses, not zebras. But I still look for stripes.

 

 

 

PTSD After Divorce

This is one of those links that I’ve pondered in the past but it has really come to a head in the past few days. First, Paulette posted the following review of my book:

Lisa Arends does an effective job in writing about the aftermath, the fallout, of a life-changing shock, on the abrupt desolation of her marriage. The read is a well done walk through all the PTSD and repeating changes that occur, which is depicted in a letter written to her by her exited husband, the commentary on the letter under the umbrella of the devastating changes she experienced, emotionally, physically and logistically are a walk through the fact that PTSD is not just relegated to victims of war, but to any life encounter that uproots your very existence in a shocking manner. She’s a likeable author, an engaging woman, that you take to and feel for, because she portrays the story, the horror she lived, with veracity and integrity, to allow the facts to unfold on the page even if they point a finger back to her (ie: a text from her spouse to his mother-in-law, Lisa’s mother). Devastation upon devastation unravels and what we hold onto dearly is lost, not just in the relationship but also in the family built around it, fury and otherwise. Arends navigates through this debacle with grace and humility, filled with emotions that are painted with strokes that are sure to offer others in similar situations some reflections and ground; she labels as “Lessons” chapter after chapter, ultimately culminating in what she has learned, valuable life lessons, applicable to anyone. But, this is not just a self-help work, or a read for someone in a similar situation, it’s a compelling story of the frailty and misconceptions we all live with, the thin line of trust & betrayal, confidence and fright, love and rejection, all the things that make the paradoxes of life and keep a balance, hopefully the balance stays in some semblance of equilibrium. In Arends case she tilts off the scale and by the Grace of her very nature, the love of her family, and whatever else strength she draws from she journeys through to meet what is most precious to all of us, connecting and opening to trust (applause to Tiger, no spoilers) despite all temptations not to, and in doing so, learning the ultimate, that love does conquer and cannot be soiled by another’s shadow cast upon our soul.

In the book, I never name PTSD. I only describe the events and my reactions. Yet, here was a third party who deemed that to be an accurate label.

Then, yesterday, a post from Out of the Chrysalis (Does PTSD After Divorce Exist? You Better Believe It)  showed up in my inbox. I totally related to her description of her experience.

And I do believe it. PTSD happens when your mind cannot process the extent of the trauma. It’s like a short circuit in your nervous system, where you have trouble distinguishing between real and perceived threats. We tend to think of PTSD as occurring only in life-threatening situations, but it occur anytime there is an acute or prolonged trauma. Not all divorces lead to PTSD, but if it is sudden or abusive, the trauma can be severe and sudden enough to lead to PTSD-like symptoms.

According to the Mayo Clinic, the following are the symptoms of PTSD:

Symptoms of intrusive memories may include:

  • Flashbacks, or reliving the traumatic event for minutes or even days at a time
  • Upsetting dreams about the traumatic event

Symptoms of avoidance and emotional numbing may include:

  • Trying to avoid thinking or talking about the traumatic event
  • Feeling emotionally numb
  • Avoiding activities you once enjoyed
  • Hopelessness about the future
  • Memory problems
  • Trouble concentrating
  • Difficulty maintaining close relationships

Symptoms of anxiety and increased emotional arousal may include:

  • Irritability or anger
  • Overwhelming guilt or shame
  • Self-destructive behavior, such as drinking too much
  • Trouble sleeping
  • Being easily startled or frightened
  • Hearing or seeing things that aren’t there

From Mayoclinic.com.

After I received the text that ended my marriage, I experienced many of these symptoms. I had the flashbacks and the dreams. I had trouble thinking and remembering. I couldn’t sleep and I frightened easily. But, most of all I trembled constantly, my autonomic nervous system was on high alert, waiting for the next assault.

At first, the triggers were everywhere. Driving along the road that passed by my old house felt like traversing a field with buried landmines. I fully expected an explosion at any moment. I responded as though every mention of his name was literally a threat to my life. At any moment, I could be catapulted back to instant where I received the text. It was as though the phone was always in my hand.

My psychiatrist that I saw that first year stopped short of a full PTSD diagnosis, but she mentioned the disorder and selected medications that are used to treat it. I honestly don’t think I would have made it through without the medications. They allowed me to sleep and eat – two things I could not yet accomplish on my own.

Over time, the triggers decreased. I learned how to sleep and eat without assistance. I stopped the medications and was able to use meditation and exercise to reduce any symptoms. I can still feel the shadows of the trauma when I feel like I’m being abandoned again but, for the most part, my mind and body no longer confuse real and perceived threats.

After my divorce, I learned that most people assumed that depression would be the disorder de jour after a break up. They expected me to be sad and withdrawn. Instead, I was hyperalert,  shaking and always on the lookout for the next blow. It’s important to realize that all divorces are not the same and we all respond differently. There is no ‘right’ way to be after a divorce. The labels can be helpful but even they only tell part of the story. Be gentle and understanding with yourself and others. Seek the help you need and know that it does get better.

I wrote more about PTSD after divorce on The Huffington Post.

Are you struggling to find your center again after divorce? My complete, 12-part coaching course can help you leave the trauma behind and find your way back to happy. Learn more!