Okay, let's begin our answer.
There are two parts to what we have to discuss in my answer to you. The first is what your obligation is to yourself. The second is what your obligation is to your mother.
There is of course no legal obligation in the US for children to their parents. There is a moral obligation but that depends on your religious and ethical system. The Biblical responsibility is to help as long as your life is not jeopardized. I believe it can be summed up, as well as most moral systems' view, very briefly like this: you know how on planes they tell you, In case of sudden loss of cabin pressure, put on your mask first and then put on the mask of those next to you who need your help.
So the fist obligation is to yourself. If you can move away from Hawaii to the mainland, that would be the best option. And I urge you to do this if at all possible. Why? Because you are tied by not just loyalty but by emotions carried over from a childhood of abuse. Those are feelings that can suffocate a person. And to add
to that, you have generations of this type of misuse of family loyalties as an inheritance. You need to create some distance, start your own therapy, and create your life.
All of the above is true even if you stay in Hawaii. If you can move to a different island than she is in, second best. If you have to stay on the same island, okay. You still need to apply the principle of distance, therapy, and creating your life.
She is not as helpless as you believe. She will adapt to her environment. So, you have to prepare her that she needs to leave and find her own living arrangement. You may have to move also because she may not be willing to take steps to do anything until she is forced to. So, you may need to look for your own new living arrangement and let her stay there or find her own way. She needs to apply for state health insurance. Here's the website: http://www.med-quest.us/
You need to have your support system in place. Your friends need to know of your plan and that it's going to be tough for you. I'd like you to also begin therapy again. I would like you to interview psychologists who have a more humanistic focus and is experienced in PTSD work.Here is the web address for Psychology Today's therapist directory. You can sort by zip codes and when you see someone who seems like they might be helpful (they show you a photo of the therapist!) look at the listing and see if they list humanistic therapy and PTSD in their orientations and specialties.
The idea here isn't that these types of therapy are magic. It's that I want you to find a therapist who will form a strong therapeutic alliance with you and will help you look at the sources of your emotions and the effects of the trauma. This work in therapy will help you prepare for your independence if you haven't been able to achieve that before you start.
Now, I want to give you a tool to use for when the depression is overwhelming or there is anxiety panic. Here are instructions on a therapeutic protocol called Progressive Muscle Relaxation (PMR). It's really quite easy to do almost anywhere. My patients suffering from depression or anxiety, when I teach them PMR at first are amazed how simple it is and that it is a psychological protocol. It was first used in the 1920s! Since then, of course, it has been refined and many studies have been done showing its effectiveness. You will practice PMR at first when you don't wake up with an attack so that you will be familiar with it. I want you to practice the PMR at least 5-6 times before an attack or feeling acute anxiety. Why? Because when you're in the throes of anxiety, you will only remember to do something you are very familiar with it. So practicing 5-6 times is really a minimum. And this is good also for just general anxiety without panic attacks and for feeling as though you are in a dark hole of depression as well.
I want to stress the importance of breathing as well. Part of the physiology of what is happening to you in a panic attack is that your breathing is getting shallower. This reduces the oxygen in your blood to your brain. That increases the anxiety reaction, which strengthens the attack and you are in a vicious cycle! Not good. So breathing is the primary tool. I have found in my practice that learning breathing techniques can be helpful. But some of my patients are not interested in learning more than one thing at the beginning, so I have found that just reminding you to BREATHE deeply at the same time you are doing PMR is almost as good. If you are willing to take a yoga class for seniors and learn breathing techniques, that's the best. But, breathing deeply with your PMR will help.
So, we're ready for learning PMR. I want you to print my instructions below my signature and have a copy in each of the rooms of your home where you may be when you have an attack. And again, you need to practice this easy technique at least 5-6 times as soon as you can. It needs to become as natural to you as breathing. Ah, remember breathing?
- After finding a quiet place and several free minutes to practice progressive muscle relaxation, sit or lie down and make yourself comfortable.
- Begin by tensing all the muscles in your face. Make a tight grimace, close your eyes as tightly as possible, clench your teeth, even move your ears up if you can. Hold this for the count of eight as you inhale.
- Now exhale and relax completely. Let your face go completely lax, as though you were sleeping. Feel the tension seep from your facial muscles, and enjoy the feeling.
- Next, completely tense your neck and shoulders, again inhaling and counting to eight. Then exhale and relax.
- Continue down your body, repeating the procedure with the following muscle groups:
- entire right arm
- right forearm and hand (making a fist)
- right hand
- entire left arm
- left forearm and hand (again, making a fist)
- left hand
- entire right leg
- lower right leg and foot
- right foot
- entire left leg
- lower left leg and foot
- left foot
- for the shortened version, which includes just four main muscle groups:
- neck, shoulders and arms
- abdomen and chest
- buttocks, legs and feet
Quickly focusing on each group one after the other, with practice you can relax your body like ‘liquid relaxation’ poured on your head and it flowed down and completely covered you. You can use progressive muscle relaxation to quickly de-stress any time.
What You Need:
- A comfortable place.
- Some privacy.
- A few minutes.