The long road to wellness
My mother’s struggle with post-traumatic stress
affected everyone in our family
By Zack Dean
Jacqueline Moore, 53, was a social worker for the Government of Alberta, a job she was forced to leave because of PTSD. (Photo by Victoria Dean)
JACQUELINE Moore’s heart is racing.
Today is her first day back in the office after months away from work. She has put in 10 years as a social worker with the government of Alberta’s Children’s Services and has been away because of post-traumatic stress disorder. She’s nervous about returning because it was a work-related injury, and she and her employer didn’t part ways on good terms.
It’s normal for workers to bring their pets to the office, so Moore’s three-legged black lab, Emerson, is tagging along to help ease the stress of her first day. No one can make her laugh like him, and she considers him her saviour during the healing process.
When she gets to the building, she peeks her head into the waiting room and fakes a smile to the receptionist before heading up stairs to the board room for a meeting. She’s greeted by friendly co-workers she hasn’t seen since her last day in the office.
It’s bittersweet.
“Why am I here?” she mutters to herself as she takes a seat at the giant table. “What am I thinking?”
This place has caused her so much pain over the past year that it feels as if she’s returning to the scene of the crime. Her gut tells her she’s making a mistake.
“Where’s Emerson?”
She hears two dogs fighting behind her. She turns around to find Emerson lying in a pool of blood. His single front leg has been torn off in the attack
“No!” she screams while looking down at her dying dog. “How could I have trusted them again?!”
She wakes up.
Horrific dreams like that have been a common occurrence for my mother since being diagnosed with PTSD a year and a half ago. In reality, she will never return to Children’s Services.
She can’t.
“People think I’m so strong and I don’t see it at all,” she says. “They just see me standing up. They don’t see me rocking back and forth in the corner.”
She can joke about it now, but the recovery process has been a long one.
“I’ve never felt weaker in my life. Never,” she says while reminiscing about the early days of her injury.
It’s weird to hear her talk about herself that way. To me, she’s strong. A total mama bear.
When I was four, my babysitter’s boyfriend thought it would be funny to hold a knife to my throat. The next day, my dad opened the front door to a big angry man with a Rottweiler waiting outside the house. Apparently some woman at our address had chased his son for a few blocks a couple of hours earlier.
‘I knew I didn’t feel right.
Something was kind of funky’
Her protective nature made being a social worker a natural fit. It is also why she was so affected when she got a disturbing text message while cooking Easter dinner in 2016. It was from a teen on her case load who claimed she had been raped and physically abused for two years as a child in a government-paid kinship home – a placement similar to a foster home, where the care-keeper is a relative or close family friend.
What followed is a story that can’t be told for legal reasons, but it ultimately led to Moore being diagnosed with PTSD.
It wasn’t a single event that led to the injury. It was an accumulation of systemic burnout, vicarious trauma and a what she felt was a lack of support from her superiors.
On top of dealing with the rape allegations, Moore had more than 20 other families on her case load. After accompanying the teen to the police detachment to inform them of the rape allegations, she says, she began to feel alienated from her superiors.
Not long after, she had an out-of-body experience during a team building exercise that led to her seeking professional help.
“I remember looking down at the pavement and feeling like my spirit or my personality had left my body,” she recalls. “And I could see myself. And I was thinking, ‘This feels so nice. I’m not doing this anymore. I’m done.’ But it wasn’t right. I knew I didn’t feel right. Something was kind of funky.”
By the end of that week, she had seen a psychologist, who told her to take a three-month leave. It would become indefinite.
Our fridge had “trigger words” on it – aimed at desensitizing her to their connotations – as part of Moore’s exposure therapy. (Photo by Zack Dean)
The psychologist explained her condition with a metaphor: if 10 firefighters are in a burning building that collapses and five of them are trapped under the rubble, unhurt, and the other five escape with serious injuries, it is the five left waiting for help that will be at a higher risk of PTSD, even though they all experienced the same event.
“In your mom’s case,” says Moore’s husband, Chris, “it was a systemic helplessness because the system around her trapped her.”
Chris has been my mom’s most reliable source of support. No one spent more time with her talking things over, and sometimes it was a challenge to find the right way to go about it, he says.
“Sometimes there’s a helplessness, because you can’t feel what they’re feeling. You can’t figure out what synaptic connections are happening in their brain or what thoughts and processes are happening because you can’t understand. You’re not in it. It’s a very frightening thing to see in someone.”
When a person with PTSD is triggered, their fight or flight response kicks in. The brain gets short circuited and the part that deals with processing and rationalization shuts off. What’s left working is the part that processes emotion. The disorder is physiological but presents with emotional symptoms.
For my mother, dark thoughts can be sparked at random. For example, setting up a tarp while camping, the possibility of using the rope for hanging crossed her mind. Not necessarily on herself, but the thought was something she had never experienced before. Another time, I showed her a picture I had taken of an anti-suicide bridge barrier. I didn’t know it at the time but looking at it made her anxious.
When she first took time off work, we didn’t know how serious the situation was. Hearing that a social worker is taking a stress leave is hardly out of the ordinary. The job leaves its mark on workers, and we just assumed it was her turn.
“We thought it was temporary,” Chris says. “It seemed serious, but we obviously didn’t know it was going to be much bigger and more deep-rooted. Like a cut versus a scar.”
At first, the family was glad to have her home, my sister, Victoria Dean, says.
“The house was always clean and there would be snacks waiting when we got home. Like a stay-at-home mom.”
What we didn’t know was that she was cleaning the house because she couldn’t sleep. Her brain was on overdrive. When she did sleep, she was often plagued with nightmare images of injured children. So she’d get up and start doing housework in the middle of the night because her mind was racing.
Even when I was brought into the loop, I didn’t really understand it. I had to see the PTSD in action.
We are the type of family that has no problem letting each other know what we think. So when my mom was acting irrational, there were times when I’d have trouble empathizing.
‘It seemed serious, but we obviously didn’t know it was
going to be much bigger and more deep-rooted’
When I ask her how I made the recovery process more difficult, she says: “When you get antagonistic about things, and you don’t know when I don’t have the brain power to argue with you about stuff – There would be times when it would be like, ‘Does he not just understand that I can’t do this anymore?’”
I believe it. Arguing is part of the foundation of our dysfunctional friendship. That, and her dark sense of humour. I enjoy her company even when we’re fighting because she’s a worthy adversary. I know there were times when I purposely took it too far. I wanted to win.
Always being sympathetic was a challenge for me because the PTSD was a constant presence in our house. It seemed like we were always talking about the treatment or the court cases, or her former co-workers.
There was a lot of drama in her life, and finding balance between giving her what she needed and focusing on my own life wasn’t easy.
“There were times when it felt like we had to neglect everything else and focus solely on how she was doing,” Victoria recalls. “Obviously that’s not a bad thing because we want to be there for our mom. But, at the same time, there are only so many times that we can be at Level 10 and match the level she’s needing us to give her that sympathy.”
My brother, Jeff Dean, doesn’t live at home, and aspects of our home life tended to catch him off-guard.
“Mom and I used to always talk about the mystery things,” he says. “The dark stories, like two English kids who kidnapped a three-year-old when they were eight and they killed her. Mom and I used to talk about all that stuff. Now it’s like, ‘Lets talk about Disney.’”
He’s exaggerating, but only a little. He recalls trying to discuss a documentary with her and Chris, about JonBenét Ramsey, the little girl who was found murdered in her home in Boulder, Colo., on Boxing Day 1996.
“Mom was telling us about how she had an episode while watching the show. And then, when Chris was explaining the show to me, she had another one at the dinner table.”
An episode involved tucking her chin into her body and covering her face with her hands. She wouldn’t cry; she’d just shut down.
“So she ended up leaving. She was upstairs for about an hour, and then she came back downstairs but couldn’t sit in the same seat anymore.”
Of all the therapy Moore received, eye movement desensitization and reprocessing was the most controversial in our home.
“I still don’t know how I feel about it,” Victoria says.
The way it works is that a psychologist moves his or her finger from side to side and the patient follows with their eyes after thinking about a traumatic experience. It simulates the REM stage of sleep, when memories are processed. The goal is to reprogram the memory of the experience and remove the emotional attachment to it.
Moore did EMDR once a week for eight months before being admitted into WCB’s traumatic psychological injury program at Edmonton’s Millard Health Centre.
“There is no way I would have gotten as far as I did without EMDR,” she says. “Not even close.”
I was skeptical of EMDR at the beginning. My mother may have been making progress but, from the outside looking in, she appeared to be taking two steps back for every one forward. She seemed emotionally drained and depressed. Victoria and I would come home on days she had an EMDR session and know we weren’t going to see her for the rest of the night.
Moore with Emerson. She spent a lot of time with the dog and with horses as part of her long healing process. (Victoria Dean)
“There were times when I’d come home and sleep from 4 p.m. until the next day,” she says.
Although EMDR is relatively new and it is still being studied, it is definitely better than doing nothing and may be an improvement on supportive listening, Scientific American reports. But it’s not as effective as exposure therapy.
My introduction to my mother’s exposure therapy was coming home to see three small pieces of paper on the fridge: “Government of Alberta.” “Foster Care.” “Child Welfare.”
Holding them up were magnets with self-help slogans: “Don’t Quit.” “Enjoy Today.” “Actually, I can.”
She couldn’t look at them without crying. So the goal was to desensitize her to the words. She’d make fun of herself, likely because she was embarrassed. But the process served its purpose.
When Moore was with her Worker’s Compensation Board occupational therapist, she was told simply to look at a standard form that people have to sign saying they will disclose any information related to a child being harmed.
“I freaked right out completely,” she recalls. “I was looking at it and she looked at me and said, ‘What’s going on?’ And I said, ‘You can go ahead and say someone is going to do something, but no one is going to do anything!’ And they were like, ‘Holy crap.’”
Another therapy involved wearing a Fitbit to monitor her heart rate, and a beaded bracelet around her wrist.
“If I felt a flashback coming,” she recalls, “I’d have to roll the beads and go through them one at a time with my finger. Because it slows your brain down.”
Moore didn’t have many flashbacks but the worst one occurred in March. She was driving down the Yellowhead Highway in Edmonton, when her mind took her back to an RCMP office, answering questions about a serious case.
‘I’d have to roll the beads and go through them one at a time with my finger.
Because it slows your brain down’
“I just remember a swoosh took over my brain,” she says. “It was really fast. But what I realized is, as I was driving, all of a sudden I was yelling, ‘I was trying! I was trying!’”
There are three steps to any healing process: Injury, treatment and recovery. My mom did a lot to help herself during the recovery stage, and was never prescribed medication. Instead, she did daily yoga, meditation, and animal therapy. She spent a lot of time with Emerson and horses.
Nineteen months after going on medical leave, she is almost 100 per cent recovered and is working on a bachelor of social work at MacEwan University. The program seems a strange choice, but it makes sense. Helping people is what she’s good at.
She’s working towards a master’s degree, and hopes to eventually develop her own program of ecotherapy, helping people through outdoor activities in nature.
“I know it works,” she says. “This experience is not going to be for nothing.”
Moore says that, for the first time in a long time, she’s optimistic about her future, but she is also being concerned for her idealistic young classmates. She wonders if they know what they’re signing up for.
“I thought I was a person who had a very solid understanding of mental health issues,” she says. “Now, when I see a paramedic, or a police officer, or a peace officer, or someone who is in Corrections, or who is in one of these high-risk positions, I have way more respect for them.
“And I wonder: ‘I hope you know the risk you’re at having chosen this.”