2nd draft outline:

Seven years ago, when I was first getting into tech, my mental health started getting really bad.

It would strike seemingly out of nowhere, over the smallest things. A critical comment on a code review. A presentation that didn’t get the reception I thought it would. Worrying that a coworker thought I was lazy or disrespectful.

All of a sudden, it would strike. A torrent of self-hating thoughts I couldn’t escape for hours at a time. A sense of imminent danger, that unless I worked the entire evening, I would be fired the next day. A thick hazy cloud descending over my mind, totally freezing my body.

Whatever it was, it took me away from the kind of work I wanted to be doing early on in my career — and it only got more severe with time.

Recently, I was fortunate to come across something that, for the first time in years, really dramatically helped: a friend encouraged me to consider whether I have PTSD. My skepticism soon turned to immense gratitude when I found, for the first time in years, language that accurately described my experiences, and coping tools that actually worked for me.

While I’m grateful to be working for a company that actively encourages its employees to take take time for their mental health, I sometimes find the overall discussion of mental health in the tech world somewhat vague. We might potentially toss ideas around of meditation, mindfulness, yoga, or grounding, but neglect to discuss how caring for your mental health can vary dramatically between a person with bipolar disorder, PTSD, or a general anxiety disorder. I’ve found I’ve had to invent a new set of practices for myself to cope with the unique difficulties that PTSD throws my way at the workplace, with little in the way of guidance or discussion from others.

So, this is the guide I wish I could give myself seven years ago — with no clue about how to navigate my career, or my own mental health. This is a snapshot of what I cope with on a daily basis — and how I cope, recover, and come out better on the other side.

Flashbacks: reliving memories

When my friend suggested that I might have PTSD, one of the reasons I was skeptical at first was because I didn’t experience “proper flashbacks.” Rarely in my life did my vision “cut” to a dramatic re-enactment of a memory playing in my head like you might find in movies.

While that certainly may be the case for some, flashbacks can manifest differently depending on your traumatic history. Pete Walker, a psychotherapist who works extensively with people who suffer from a specific subtype of Complex PTSD writes that flashbacks are more broadly “intensely disturbing regressions [’amygdala hijackings’] to… overwhelming feeling-states” from past traumatic situations (”Complex PTSD”, 145). So, flashbacks might just as much be a return to the feeling of a previous memory, instead of actually vividly reliving it.

Here’s what that’s like for me.

One day, as my coworkers and I were chatting over lunch, someone told me a joke that rubbed me the wrong way. It was nothing rude or offensive, just a bit of a jab.

I responded somewhat intensely back, telling him, “that cuts deep”, in quite a bitter tone of voice. What was going on with me? All at once, I noticed a tingly numbness in my face, shoulders, and legs. My coworkers didn’t seem to think much of anything, but my jaw felt frozen shut. My thinking, too, grew faster and frenetic, analyzing what I can say, what I should say, one hundred simulations of how saying different things might make things worse. My hands and arms, too, slowed and resisted eating any further. At that point, I realized I was in a flashback. I was reverting to a “feeling-state” from my past, and projecting it onto the present.

So, what is happening in situations like these? Bessel Van der Kolk, a psychiatrist specializing in PTSD, conducted an experiment in the 90’s to observe how the brain behaves while experiencing a flashback. With consent, he recorded a script recalling details of patients’ traumatic memories, then replayed it to them while undergoing a brain scan. In “The Body Keeps the Score”, Van der Kolk recalls his surprise examining the results:

So, flashbacks actually have a powerful neurological effect: our sense of emotion becomes heightened, while it’s also profoundly difficult to communicate to others. In a workplace where the work almost entirely reduces to some kind of writing or communication, then, we need to find ways to recover on the spot — even if that means sadly cancelling meetings or taking time out of work.

For me, I find Walker’s 13 Steps for Managing Flashbacks an invaluable resource to come back to whenever I notice a flashback and aren’t sure of what to do next. I almost never follow each step, often just cherry-picking elements from the document that I find relevant. Almost always, these sections stand out:

I’ve come to learn that flashbacks can be devastating, sometimes removing my ability to work for the entire rest of the day, but are always worthwhile to attend to and recover from in the long term. Even a half-hour of flashback-free work is almost always higher quality than the output of four hours of just barely getting by — and besides that, never justifies the mental toll of remaining in a flashback without recovering.

Inner Critic Attacks: attempting perfection

Even more pervasive than flashbacks, persistent self-criticism is likely the single most chronic symptom of PTSD for me. Impacting people with Complex PTSD more frequently than “simple PTSD” (Walker, “Complex PTSD”, 168), the Inner Critic takes a very pointed role of attempting to protect people from their dangerous environment through attempts at perfection.

Here’s what that’s like for me.

After recently starting a new role, my supervisor assigned a new, exciting project to me. It felt like an opportunity to prove my value to the company, and so I wanted it to be… well, perfect. At the same time, I was also moving between cities, and spent an entire work day just moving into a new home. While this was thrilling, it also made me exceedingly anxious about what my supervisor might think of me — did they think I was slacking off, just making excuses of myself? What if the project was later than expected? I found myself drawn back to the offices in the evening to complete the project, but the more I worked on it, the harder it became to quit. I saw glaring imperfections on every graphic, on every slide that needed to be perfect. I became obsessed with how my supervisor might be disappointed in me, might regret hiring me, might yell at me for how poor a job I was doing. I wound up staying until 9pm, still incomplete, until some messages from a concerned friend forced me to stop and sleep. Still, the anxiety frayed me of what my supervisor might say until we had a conversation the next day — where they explained how I could produce lower-quality work next time to save time.

So, what is happening in situations like these?

Walker writes, “The inner critic is the superego gone bad. The inner critic is the superego in overdrive desperately trying to win… approval. When perfectionist striving fails… It festers into a virulent inner voice that increasingly manifests self-hate, self-disgust and self-abandonment” (167). So, the Inner Critic often functions as a desperate attempt to gain the support and approval of others through intensely reshaping ourselves.

I used to make the mistake of thinking of the Inner Critic’s perfectionism as a superpower. After all, it was this innate drive that pushed me to make higher quality work than what was expected of me — what was wrong with that? It took me years to learn how following my own Inner Critic’s perfectionism and constant guilt had a directly negative impact on my work. Under the critic’s control, I was hypervigilant, more than ready to deprecate my work, apologize for any possible error I might not have yet detected, or volunteer for more work than I can possibly handle. The Critic was no benefit — it actually fragmented my energy, attention, and my ability to receive feedback and grow.

How do we healthily cope with the Inner Critic, not allowing it to sabotage the lives we want to live?

In his time with PTSD patients, Walker catalogued fourteen distinct kinds of Inner Critics attacks he’s noticed in his patients, including Perfectionism, Self-Hatred, and Toxic Shame. In Walker’s online resource “Shrinking the Inner Critic”, he not only supplies a list of these kinds of attacks, but also “counter-attack” scripts to help counteract the critic’s control. Here are some of what I use the most:

I am still no master at this. I often find myself operating under the Inner Critic to some extent for hours or days on end, only to snap out of it once I gain enough self-awareness to face and disagree with it. Doing so often unleashes intense feelings of guilt, confusion, and self-doubt — but is always worthwhile. In the midst of an industry that so often prizes ambitious visions for the future and extremely efficient work ethics, it’s all too easy to succumb to the idea that we aren’t good enough, aren’t perfect or talented enough, are always falling short. To accept feedback, take healthy risks, and assert boundaries, though, we owe it to ourselves to undo the Inner Critic’s hold on us.

Outer Critic Attacks: projecting danger

Not nearly as well known as its counterpart, but just as destructive, the Outer Critic is the tendency for people with C-PTSD to project fear and anger onto others. Walker writes that while the Outer Critic has the control, “people appear to be too awful and too dangerous to trust” (191). When I first read this part of “Complex PTSD”, I thought I had might as well skip the chapter: I tend to focus on intense self-criticism that only happens internally, so what did this have to do with me?

The more I read, though, the easier it was to tell that I did have an Outer Critic — and just like everything else, it was impacting me both personally and professionally.

Here’s what the Outer Critic is like for me.

Unlike many other PTSD symptoms, my outer critic’s hold on me slowly grew stronger at one company over the course of months. The first incident happened when my supervisor laughed at me during a presentation I delivered early in my position. From that moment on, I felt a distinct danger whenever I was around him — when was he going to laugh at and criticize me next? The previously open and honest raport I had with him in one-on-one’s morphed into desperate attempts to ensure he would never think of me poorly. Later, the company experienced heavy layoffs, and not long afterwards also fired several close colleagues. With the loss of each coworker relationship, I believed more deeply that I needed to be absolutely perfect — otherwise the cruel leadership of the company would axe me next. I stopped being authentically myself to anybody in the company, concerned that somehow, someway, it would become an excuse to let go of me too. When it was finally my last days at the role, and I had little to lose in being honest, everybody I told about my sense of fear, paranoia, and anger was utterly shocked! One person said, “you were the face of the company!” It was jarring to consider just how much of a mask I had been wearing for so long, and how much of an act I was putting on around my colleagues.

So, what’s happening in situations like these? Why do I and many others with C-PTSD find it so easy to totally distrust in everybody around us?

The sad answer is, it’s likely because we’ve had our own trust in others deeply broken in the past. Pete Walker writes of the case where a neglectful parent-child relationship is the core of the patient’s trauma:

So, people with C-PTSD create an outer critic in response to being in genuinely dangerous social environments, where people’s actions might very well hurt or trigger us. We might gain an Outer Critic, too, because of how inevitably disappointing it seems to genuinely connect and trust others.

Just like flashbacks and inner critic attacks, though, we owe it to ourselves to recognize the shape of our own outer critic and learn to recover from it. When we engage the world through the outer critic’s eyes, we rob ourselves of the support, mentorship, and joy that comes from authentically connecting with colleagues and even supervisors at the workplace.

This is also essential to also protect our own friends and coworkers. Just like we need to protect ourselves from the inner critic, we have a responsibility to avoid others being hurt by our own distrust and paranoia of others, which can so easily manifest in anger, resentment, isolation, or even passive aggression. I certainly know from my own journey, I have cut ties with many coworkers, formally or informally, while under the Outer Critic’s gaze.

So, then, how do we temper our Outer Critic?

Like the Inner Critic, Walker writes that we can engage and contradict our critical thoughts of others. “To shrink the outer critic,” he writes, involves “invoking positive thoughts and images of others to help erode the critic’s intimacy-spoiling habit of picking them apart. One helpful thought substitution exercise is to list five recollections of positive interactions with a given friend.” (208) When we give critical feedback, we can also steer clear of excessive anger by listing 5 positive points of feedback for every 1 point of critical feedback (209).

Personally, I find giving people small opportunities to demonstrate their trustworthiness is an invaluable practice. This might be something rather small, like allowing a boss to know something I’m uncertain about, rather than pretending that I have it already figured out.

Tech workers contending with an Outer Critic are placed in an interesting position. While we all need to undo the Outer Critic’s relationship-ruining judgements and projections to grow, we are also placed in a highly individualist culture that prizes charismatic, successful CEO’s — even when they work their staff to the bone, yell at colleagues, or use intimidation tactics. In this way, healing is somewhat countercultural: rejecting the myth of individual excellence, and learning to value instead trust, cooperation, and teamwork. To gain the support of others, to grow, and to make an impact at work, we owe it to ourselves to undo the Outer Critic.

Dissociation: rejecting reality

While flashbacks are a kind of forced encounter with the past, and inner or outer critic attacks push to avoid past traumas from happening again, dissociation is, in the case of my brain, one final trick up its sleeve when everything else has not worked. The trick, of course, is to escape reality entirely.

Dr. Valerie Sinason, a psychotherapist with 30 years’ experience working with traumatized clients, describes dissociation as “a mental state in which people feel disconnected from their sense of self, experience or history as a defence against stress” (”The Truth about Trauma and Dissociation”, 70-71), or as a kind of trick of the mind, so that any individual distressed beyond fathomable means of coping with stress “can run into another part of their mind” (41).

Here’s what that’s like for me.

Interning as a junior software engineer, my code reviews would receive upwards of a hundred comments from colleagues. In my own lack of self-understanding, I would steadily became more agitated. My inner critic would yell at me about receiving any feedback at all, leading to frenzied attempts to erase the comments by quickly changing the code and pushing the new version to everybody to approve and affirm — only to discover through more comments or automated tests that I had introduced even more problems. As comments piled up, ten, twenty, fifty, one hundred in total, the internal sense of anxiety, panic and dread continued to ratchet up until… I felt nothing. Suddenly, I was surrounded by a haze. My hands would not move, nor my legs, nor my mouth. I was stuck, staring at the screen of comments steadily coming in, each one releasing an automatic email, but unable to do anything about it. Yet at the same time, I was not in that room. I was imagining my coworkers yelling at me, assaulting me, firing me. And it was like that for hours on end. (Interestingly enough, this was the inciting incident behind me seeking therapy.)

So, what is happening here?

Bessel Van see Kolk conducted a study on traumatized people to learn more about how they perceived their sense of self and bodily awareness. Contracting a group of both healthy students and traumatized adults, he set both groups under a brain scan and asked both to focus on nothing. While the students’ brains lit up in several areas, indicating a connection to one’s emotions and bodily sensations, the traumatized patients’ brains were almost eerily absent of any activation. Van der Kolk concluded that “these patients had learned to shut down the brain areas that transmit the visceral feelings and emotions that accompany and define terror. Yet in everyday life, those same brain areas are responsible for registering the entire range of emotions and sensations that form the foundation of our self-awareness, our sense of who we are.” (121-122/440) Van der Kolk’s patients with PTSD had adapted, learning to shut down neurologically to temper how uncomfortable and intolerable the constant distress of trauma can be.

It’s important to note: dissociation isn’t universally bad. In many ways, Sinason notes, we’re all constantly on a spectrum of dissociation, choosing to pay attention to some of our emotional experience, and ignoring others. Even at its most extreme, sometimes dissociation can be a tool to stay resolute and calm even while traumatizing things are happening around us.

However, it does come at a cost. When I dissociate, I often lose track of time, bodily sensation, and location. I might be able to work, but most often I feel absolutely stuck within an unmoving body, thoughts spinning faster and faster with no means of expressing them. Dissociation is a tool, but for me, it’s an expensive one with many side-effects, and a tool that often my brain forcefully pushes onto me.

For me, exiting dissociation looks a little different with every episode. Depending on the context, recovering from dissociation can look like grounding and reconnecting with my present experience — if only a little bit. Following Van der Kolk’s encouragement to “notice the physical sensations beneath the emotions” (132?/440) is often helpful as a principle: not only naming the feelings, which can help, but noticing, in the smallest of ways, how they are manifesting in the body. Keeping very focussed on this is essential for me: in dissociation, my brain refuses to allow almost anything into my consciousness. So, working with it, feeling only a finger or a shoulder at a time, is often my entry point back to reality. Even making a “safe” contact with some element of my internal reality

Other days, changing my environment is most helpful. Moving from one space to another at all can be helpful, if only to a different meeting room, but by far the most helpful spaces are both public and anonymous: cafes, libraries, and parks. Experiencing space where I can witness other humans living their lives, and knowing that I am relatively safe among them, helps to convince my brain that the world isn’t all that bad after all. (And, if physically moving isn’t at all an option, even friendly Discord servers or live-streamers have created a similar effect, tricking my brain into thinking I’m “somewhere else.”)

Finally, learning to lean on a support network has been crucial. There have been timeless moments where I’ve been absolutely stuck: both unable to move, and unable to make any contact with my internal experience. In those moments, contacting confidantes at work, or friends willing to support me, about my experiences have been a lifesaver, almost magically re-establishing my ability to move and feel things through again.

Dissociation is deadening. As our present experience overwhelms us and appears unnavigable, our consciousness decides to unmoor from physical embodied reality. Unchecked, this can leave us lost in a cloud for hours on end, unable to move or clearly think. In my experience, though, by finding some small “entry point” back into reality, we can ground, face reality again, and learn to exist amidst hardship again.

Wrapping up

Having any form of trauma-based mental illness, including C-PTSD in my case, certainly makes life more difficult. Whether it’s mild or extreme, on a daily basis I have to recover from flashbacks, de-fang my critic’s attacks, and, more rarely, ground to avoid dissociation.

The picture I’m painting, perhaps, is a bit of a grim one. Does all this mean that anyone with C-PTSD like myself will inevitably struggle through their career, just barely scraping by with the time left over from coping?

To some extent, yes: C-PTSD in particular is known to be a lifelong mental illness. So, at no point in my career will I be entirely free from these symptoms randomly flaring up and disrupting whatever I had planned.

Yet, there’s a silver lining to all of this: by coping with these symptoms well, myself and other people with PTSD can recover. We gain the skills to manage flashbacks, remain mindful in the face of the inner or outer critic, and assure ourselves that the world is actually safer than our dissociated mind believes it to be (Walker, 68).

In the next article in this series, I’ll write about the everyday practices I take into the workplace to remote long-term recovery, and how C-PTSD even leads to thriving in life. (Link here when completed.)

What I Liked

• Personal. The piece could have slanted towards the intellectual and detached, but remained human
• practical. Resources, steps, and new ideas are provided
• Grounded. Tactile sensory details are provided, and truisms, tropes, and opting out of the visceral realities of CPTSD is avoided.

What I Didn’t Like

• Wordy. This is pretty long, and even with the benefit of the structure, sags under the weight of its own ideas. Feels like it’s proving true 5 different things at the same time.
• Overly dependent on quotes. You’re your own author. You should back up what you’re saying, yes. But you don’t need to literally fly the quotes by us every time you make a point, especially speaking from personal experience. Bring up quotes when the reader is ready to take in a new voice.
• Uncertainty regarding voice, audience. Is paul from 7 years ago the audience? Are we the audience? Are traumatized people the audience?