One of the final, major steps in some forms of PTSD recovery is In Vivo Prolonged Exposure Therapy (PET). In this form of treatment, the PTSD survivor returns to the original (or a very similar) trauma site to face his or her fears associated with the trauma location.
To give you a little background in case you are unfamiliar, there are two main components to PET: Imaginal Exposure and In Vivo Exposure. Imaginal Exposure happens first, and it is basically where the PTSD survivor repeatedly revisits a traumatic event/location mentally and verbally to face fears, help process emotions, and practice coping techniques. In Vivo Exposure, the second step, is where the PTSD survivor faces the things he/she has been avoiding in real-life (as long as they are actually safe), such as a place, sound, or item that reminds the survivor of the trauma. PET is completed with the hope that the survivor will confront and overcome feared stimuli in everyday life, and it usually ends successfully.
I’m telling you all of this because, over the course of the last ten days, I completed In Vivo Prolonged Exposure Therapy (and lived to tell the tale!).
I, Kyndall Brown, got on a cruise ship over 2,000 miles from home, stayed on it for eight nights, and conquered about a million different fears while I did it.
Can we just take a second to appreciate how huge that is? It’s a big deal, y’all. You may be rolling your eyes, thinking something along the lines of how difficult vacation must be…but you can just stop right there. I nearly died on a cruise ship in February 2018, and almost every aspect of my life changed after I managed to live through it. I could go into a lot of gruesome details about my time on that ship and afterward that I’ve never shared before, but frankly, I don’t want to tell it. And while I logically understand the cruise ship itself didn’t actually try to kill me, I was actively returning to an almost identical scene of my literal worst nightmares. Just know that stepping onto that cruise ship deck a few days ago was like potentially stepping on an active landmine for me mentally. Erin and I went back and forth about cancelling the trip ten or so times before I stubbornly declared that I would do it or die trying. Facing a cruise ship wasn’t easy, it wasn’t to be taken lightly, and it took more work than you could imagine to get myself ready for it.
Leading up to these moments in my life, I felt a bit like a Titanic survivor saying, “You didn’t get me the first time!” In some moments, I was nothing but excited and hopeful. In others, scared is an understatement…especially when, five days before we left, I found out that my pharmacy wasn’t going to refill my absolutely-necessary-to-keep-my-body-from-starving-itself-for-real medicine until after we were already on the boat (at which point I couldn’t access it). Even though I’ve completed anywhere from one to five therapeutic exercises every single day since January 11th to prepare myself for this vacation experience with the hope that it would turn out okay, I won’t lie: I spent a few minutes having to talk myself out of tears and major anxiety that morning, something I hadn’t had to do since the beginning of March. It felt like a bad omen, a sense of foreboding, a message that the ship was actually going to kill me this time – “Ha-HA, lady! That’s what you get for trying to face ME!” But then I remembered: this is what I’ve been training for like an Olympic athlete of the PTSD event for the past five months. “I am ready for this,” I thought. I called my husband and Mom to tell them about the situation, and they helped me walk through several different scenarios for getting my medicines when I needed them, prior to the trip. I called my doctor. Then I did several rounds of breathing techniques and meditation to keep myself calm throughout the day, and I waited for the doctor and pharmacist to do what they needed to do to get me my dang pills – which they did over the course of the next 24 hours.
Once those pills were safely in my hands, I was as ready as I could possibly be: I’d spent months preparing mentally/physically/with the cruise ship employees to make sure my medical needs were met on board, I dropped in at the local spa for a deep-tissue massage a couple days before the trip to help me relax, we packed our bags on Saturday for every possibly scenario…and that was that. Away we went.
The day we arrived in Seattle and the next morning, as we prepared to board the ship, I was surprised and pleased by how calm I felt. It made me proud to know that all my months of hard therapeutic work had paid off. The only truly difficult moment I had was when the ship came into view the first time: for just a moment, I was overcome by a choking panic, filled with a desire to sob. It was an odd sensation, almost as if the final grief for my past life had come bubbling to the surface like a sea creature in my mind. Instead of running from it, I let myself experience it. I didn’t hide, and I didn’t run – I just let myself hurt in that moment and then began all the things I needed to do to move forward.
Which I did.
Just as I had practiced a thousand times before, I marched through the check-in and security lines (it only took about ten minutes total since we were suite guests, which helped keep me from thinking too much!), and I felt pride as I placed that first foot on the ship’s deck. We went straight to the dining room to discuss my medical dietary restrictions with the chef and maitre’d, we walked the ship thoroughly, and then we conquered my last major expected hurdle: I faced the toilet in our stateroom – the scene of so many nightmares from my past.
Of course, there were a few small, unanticipated triggers throughout the trip:
- The afternoon an old woman rolled past me in a wheelchair after fainting on board – I remember that experience all too well.
- The night we saw beef lasagna and s’mores parfait on the dinner menu – the “final” meal I missed on our last cruise when I had to run to the room to be sick.
- The time I was placing my special meals order for the next day and told the waiter that we were planning to eat off the ship for dinner the next day (Tracy’s Crab Shack in Juneau, my friends, and it was delish!). I felt an automatic, involuntary urge to scream at myself in alarm – even when I knew I was absolutely fine, eating American food in a safe place this time that I had thoroughly researched beforehand.
See, those experiences shaped who I was for awhile – my trauma self. I can’t change them, nor can I forget them entirely; they are burned into my brain forever. But you know what has changed about those memories (with a load of work and effort)? They no longer come with incessant fear, anxiety, and panic attacks.
Each time I faced an unexpected (or expected) reminder of my past experiences, my mind and body also knew how to automatically begin dealing with and managing those instincts. The mind is an amazing thing; you can teach it and train it to be what you want it to be, just like any other muscle in the body. My overly active fight-or-flight tendency learned in a traumatic time could also learn to be calmed and controlled, and the last few days of my life have proved it well.
We had a wonderful trip filled with wonderful moments, from witnessing the majesty of glaciers and the arctic tundra and beautiful snow-capped mountains to viewing the most amazing wildlife. This vacation truly was an experience of a lifetime, made even more monumental because of the personal nature it played in my own life.
But one of the trip’s most poignant moments came as I sat on the Aleutian Ballad (a retired Bering Sea king crab fishing boat). The two captains of the ship had just regaled us with a four-hour demonstration of how to fish for various types of sea creatures, followed by a harrowing tale of how one of them survived two moments that would’ve killed most other people. As he finished and the other captain came forward to speak, he said, “We’ve both lived through experiences like these, and we both shouldn’t be here. But we are. And we’re so lucky for it.”
His words resonated with me more deeply than you can imagine. As I sat there with major tears welling in my eyes, I knew that I could easily say the same thing, every single day of my life.
I shouldn’t be here. But I am. And I’m so lucky for it, friends.
***UPCOMING BLOG POST: a look at living low-FODMAP on a cruise ship! Check back in a few days for all the delish (and not-so-delish) details of our trip…pictures included!***