How to Change Your PTSD Habits

July 15, 2013

Change Your PTSD HabitsThe caudate nucleus, buried beneath the cerebral cortex, is involved in habit formation.  Evidence from brain imaging studies suggests that new habits may be established during rapid eye movement (REM) sleep, when our most vivid and active dreams occur.  Most body muscles are paralyzed during REM sleep.  For some unknown reason, the eye muscles are not paralyzed, allowing them to serve as a marker of body activity during our dreams.  REM activity per unit time (REM “density”) is greater during dreams with higher levels of overall body activity.

Posttraumatic nightmares disrupt normal dreaming, and thus interfere with the formation of new habits.  Blocking nightmares using dream revision therapy or the anti-hypertensive medication, Prazosin, as described elsewhere in this blog series, should (in theory) free the dreaming mechanism to form new habits.

However, it is not easy to give up old habits that developed during the struggle with PTSD, as one tried, often fruitlessly, to avoid nightmares or flashbacks or both.  Avoidance is a hallmark of PTSD.  Substance abuse is a type of avoidance; social isolation is another type.  Emotional outbursts or meltdowns are habits that serve to isolate the PTSD sufferer from other people.  This blog entry provides guidelines about how to stop old unhealthy habits and form new and better ones after posttraumatic nightmares have been successfully blocked with dream revision or Prazosin.

Charles Duhigg’s best-selling book, The Power of Habit, mentioned in an earlier blog in this series, includes many good suggestions about how to change habits.  Daniel Goleman, author of the worldwide best-seller, Emotional Intelligence, and his wife, Tara Bennett-Goleman, author of Mind Whispering: A New Map to Freedom from Self-Defeating Emotional Habits, provide a five-step process for habit change.

Step 1 is to examine the self-defeating habit.  One way to do this is by keeping a journal about it.  When does the habit occur?  What triggers it?  How does it get started?

Step 2 is to be “mindful” of thoughts, feelings, and actions that occur during the habit.  Mindfulness is a state of mental awareness that can be achieved through quiet contemplation or meditation.  You can learn mindfulness by working with a coach or reading books written by coaches.  The idea of becoming mindful may seem daunting, but anyone can do it.  “Beginner’s mind” (as described by Shunryu Suzuki in Zen Mind, Beginner’s Mind), is a useful concept of true mindfulness.  A sense of expertise in mindfulness may interfere with actual mindfulness, which involves looking at one’s mind without ego or attachment, as a neutral observer or witness.

Step 3 is to consider alternatives to one’s habitual behavior.  This is a bit like revising nightmares.  What good habits might be used to replace a bad habit?

Step 4 is to choose an alternative, just as one might choose a possible dream revision.

Step 5 is to practice, practice, practice every chance you get, until you have mastered the new habit.

Interestingly, getting rid of a bad habit is a lot like getting rid of a bad dream.  This is because a bad dream is like a bad habit.  After learning to revise posttraumatic nightmares, you can use the same techniques to get rid of posttraumatic habits in your waking life.