Monday, November 15, 2021

Boundaries and PTSD

Hi this is Virginia with the Soldier's Guide to PTSD. I want to talk to you today about boundaries.

Healthy boundaries are the ultimate form of self-respect because they say to the world, I just deserve to be honored, respected, and valued. Boundaries denote confidence. 

Since confidence is one of the casualties of PTSD, we likely have to relearn (or maybe learn for the first time) how to make a healthy, reasonable boundary, how to maintain it, and what to do if someone chooses to ignore it. 

Making healthy boundaries seems like it should be easy and intuitive, but it's not. So let's start.

1. Healthy boundaries make healthy relationships

There is no such thing as a healthy relationship without boundaries, whether it's a marriage, a friend, a colleague, or the relationship that you have with your kids. Healthy boundaries say I deserve to be honored respected and valued and this is important for any healthy interpersonal relationship.

2. People do not know our boundaries unless we state them clearly and succinctly

In a perfect world, people should know how to act, but this is not a thing. Some people think that offensive comments are okay some people don't understand that unsolicited touching is creepy. Let's not waste time getting mad about what "should" be. Instead, let's remember that half the people we meet are below average and common sense is not common. Boundaries are not intuitive. Therefore, we must State our boundaries clearly and concisely, out loud, to other people.

3. Reasonable people respect reasonable boundaries

The inherent problem with this is that not all people are reasonable. Sad news of the day. The world is full of psychopaths and assholes. 

4. It's our boundary and their choice

We create healthy boundaries, and then we have absolutely no control over other people or how they act. When we state or healthy boundaries, out loud, clearly and concisely, other people then choose whether they want to respect our boundaries or not.

This is hard to hear, so I'm saying this with a lot of love and empathy: when people choose to ignore our reasonable boundaries, they are saying in no uncertain terms, loud and clear, I do not respect you and I do not want a relationship with you that is not on my terms. No exceptions.

Boundaries are vital to relapse prevention for PTSD. You can read more about boundaries in The Soldier's Guide to PTSD.

Monday, November 1, 2021

A Word on Confidentiality


Hi this is Virginia with the Soldiers Guide to PTSD. I want to take a minute to talk to you about confidentiality in therapy and mental health treatment. 

Before talking with any individual therapist about our war experience, it might be smart to have a candid conversation about the limits of confidentiality. This is especially true if you have something sensitive you need to disclose. 

I recommend that you ask:

  • Who will have access to clinical notes, 
  • What our therapists have to report to our chain of command or to our health insurance, and 
  • the level of detail in the therapist's notes, written in our medical records
Additionally, I encourage asking for a copy of our medical records and reading them. 

Any mental health therapist should be open and transparent about this. In my clinical training, we were taught to address this during the first session and review HIPAA

The relationship that you have with your therapist is important for your full recovery from PTSD or moral injury. And trust matters.