PTSD from a Veteran

Personal Considerations

• This presentation will contain images, and topics about combat and Post Traumatic Stress Disorder (PTSD).

• I intend to evoke an emotional response.

• If you feel uncomfortable at any time you may leave without comment or question.

Soldiers Around Me…• ‘Joes’ are divorcing• Lots of beer drinking• Risk taking (fights)

and not caring about consequences

• Drug and Alcohol Abuse

• Joblessness• Nightmares and lack

of sleep• Attrition of NCOs

Myself • Driving at night at 30 MPH a trigger

• Easily irritated

• Hyper vigilant- very wearisome

• Startle response

• Merging onto the freeway and driving

• Relationships ended

• Easy to get into a fight

• No memory/concentration

• Strange emotions unexpected

• 4th of July was no fun

2005 Oregon Violent Death Report

In 2005, 19 Oregon Soldiers died in combat in Iraq and Afghanistan.

That same year, 153 Oregon Veterans, of all ages, serving in various wars, committed suicide.

Nationwide, after five years of war in Iraq,

Marine suicides doubled between 2006

and 2007, and Army suicides are at the highest level since records were first kept in 1980.

Reported suicide attempts jumped 500 percent between 2002 and 2007.

2000 to 2006, 1,066 male veterans in Oregon took their lives.

3.7 Suicides a Week

6 years

72 months

288 weeks

1066 Oregon Suicides

A 2003 New England Journal of Medicine Study found that more than 60 percent of those showing symptoms (PTSD) were unlikely to seek help because of fears of stigmatization or loss of career advancement opportunities.

According to the PDRHL

from the Department of

Defense Behavioral Health

Survey 43% of 2000

National Guard

Members had

readjustment issues after returning from the war

zone(s).

I would be seen as weak by my unit members 65%My unit leadership might treat me differently 63%My unit would have less confidence in me 59%My leaders would blame me for the problem 51%It would harm my career 50%

Difficulty getting time off for the problem 55%It is difficult to schedule an appointment 45%

I don’t trust mental health professionals 38%Mental health care doesn’t work 25%

I don’t know where to get help 22%

Red Badge of Courage

Stephen Crane’s book about the Civil War contained themes of masculinity symbolized by war.

Where are the mental wounds?We discount them because they are

• invisible• counter to our notions of masculinity• “secondary”

I don’t rate feeling this way

A Veteran

And what about

when your warrior’s

anger goes home?

What is it like with

his wife and children?

Is it useful then, too?

Cicero

PTSD from Ancient Greece to the Present

• Sophocles, Homer• Nostalgia• Hysteria• Bible’s Job, Joseph, David• Shellshock• Buck fever• Combat fatigue• Battle reaction• Disorderly action of the heart• Soldier’s heart• Homesickness• Irritable heart

WWIICalled combat fatigue and it was a serious problem. In the European Theater, 25 percent of all casualties were serious PTSD cases.

In the Pacific Theater, like Okinawa in 1945, it accounted for over a third of all wounded.

Iraq and Afghanistan

According to a more recent Post-Deployment Health Reassessment 38 percent of regular soldiers, 31 percent of Marines, and 49 percent of National Guard report psychological symptoms.

Those who had served repeated deployments were at extremely high risk of problems and the toll on their family members was great.

What is going on?

The Brain

Phineas Gage On September 13,

1848, Phineas

Gage was

foreman of a work

gang blasting rock

while clearing the

roadbed for a new

rail line.

Conditioning

• Pavlov in 1904• Skinner developed

further into Behavioral engineering

• Rewards and Punishments develop automatic behaviors

“Train Like You Fight”

Methods used to train is an application of conditioning techniques to develop ‘quick shoot’ ability.

The modern soldier trains in full gear, shooting blanks at realistic targets until reflexive fire is obtained.

Train Realistically

This muscular, life sized male upper torso body form is intended specifically for precise marksmanship training. The cavity in its back holds red balloons to resemble vital organs. The body drops when a red balloon is shot.

The Unnatural Act of Killing Another

• It is estimated that in World War II, 75 to 80 percent of riflemen did not fire their weapons at an exposed enemy.

• In previous wars nonfiring rates were similar.

• In Vietnam the nonfiring rate was close to 5 percent

On Killing

I yelled “kill, kill” ‘til I was hoarse. We yelled it as we engaged in bayonet and hand-to-hand combat drills. And then we sang about it as we marched. I had stopped hunting when I was sixteen. I had wounded a squirrel. It looked up at me with its big, soft brown eyes as I put it out of its misery. In 1969 I was drafted and very uncertain about the war. I had nothing against the Viet Cong. But by the end of Basic Training, I was ready to kill them.

-Jack, Vietnam Veteran

Down Range: To Iraq and Back

“To survive and be victorious on the battlefield, our warriors must aggressively seek out the enemy and kill them. This has far reaching spiritual and psychological implications. In order to be “successful” the warrior must not miss a beat in pursuing and eliminating adversaries one after another. When they attack the enemy, they are trained to go one step beyond personal moral boundaries and take the life of another human being. This eventually becomes their personal horror of war- this is one primary aspect that damages the soul. The “killer instinct” that is so energetically thrown around in locker rooms and corporate sales meetings becomes a very real impulse to soldiers in the heat of battle. Without this instinct the warrior is very lucky– or very dead.”

Amygdala

• Connection with lots of areas of the brain

• Emotional stamping of events

• Increases reflexive reactions

• Signals sent ‘upward’ are checked by prefrontal cortex.

Visual

Amygdala

?

Almost all service members returning from the war zone will experience some of these behaviors and reactions. It’s vital that you remember that having these reactions does NOT automatically mean you have PTSD. It would be abnormal if you didn’t experience some of these feelings and behaviors following what you have been through in the war zone.

It isn’t an Either/Or… it is a spectrum

Signs & Symptoms of PTSD• Flashbacks, or reliving

the traumatic event for minutes or even days at a time

• Shame or guilt • Upsetting dreams about

the traumatic event • Trying to avoid thinking

or talking about the traumatic event

• Feeling emotionally numb

• Irritability or anger • Poor relationships

• Self-destructive behavior, such as drinking too much

• Hopelessness about the future

• Trouble sleeping • Memory problems • Trouble concentrating • Being easily startled or

frightened • Not enjoying activities

you once enjoyed • Hearing or seeing things

that aren't there

Anxiety

• The mind stays on vigilant, ever on alert.

• This keeps emotions and the body aroused.

• Chronic or severe arousal changes the nervous system.

• Smaller threats than usual sound the alarm.

• Takes longer to return to resting state.

• Physical symptoms• Emotional fatigue• Mental fatigue• Spiritual fatigue

• Exaggerated stress response

• Avoidance is hallmark

Dissociation

• Perceived detachment of the mind from emotional states or even the body.

• Dreamlike state or unreal place.

• Poor memory of specific event

• DID, Fugue• Fragmented• State-dependent

memories

• Traumatic memories are walled off

• Dissociated material is highly emotional and relatively non verbal

• Triggers can be the sense, body movement, dates, stressful events, strong emotions, cognitive patterns, behaviors, out of the blue, and combination.

What is Dysfunctional?

• Impaired in function;

especially of a bodily

system or organ (of a trait

or condition) failing to

serve an adjustive purpose.

• If a person is behaving in

ways counter-productive

to their own well-being

B Buddies VS Withdrawal

A Accountability VS Controlling

T Targeted VS Inappropriate Aggression

T Tactical Awareness VS Hyper-vigilance

L Lethally Armed VS Locked and Loaded

E Emotional Control VS Detachment

M Mission Operational Security VS Secretiveness

I Individual Responsibility VS Guilt

N Non-defensive Driving (combat) VS Aggressive Driving

D Discipline and Ordering VS Conflict

Many Treatment Options

• Medication• Psychotherapy• Exposure Therapy• Cognitive Behavioral

Therapy (CBT)• Eye Movement

Desensitization & Reprocessing (EMDR)

• Memory Work• Art Therapy• Thought Field Therapy• Healing Rituals• Group Therapy• And More…

www.strategypage.com

Call of Duty 4

U.S. Army medical researchers have noted that

soldiers that play violent video games, are better

able to handle the stress of combat. More

elaborate (virtual reality) combat simulations are

now being used to treat combat veterans who

are suffering from severe stress reactions from

combat (PTSD, post-traumatic stress disorder).

Pathologizing

It is important that therapists who work with veterans be educated in the warrior tradition and its rituals in order to recognize and help veterans identify with [the use of] warrior traits. Ignoring these traits is harmful to the veteran, for then the inner warrior remains invisible. Pathologizing the traits is also harmful, for then the vet is further wounded by reductionist interpretations that may minimize their importance to him… or empty them of their spiritual potency.

-Edward Tick, Ph.D.War and the Soul

Strengths of our warrior tradition

What is a HERO?

I am an American Soldier.I am a Warrior and a member of a team. I

serve the people of the United States, and live the Army Values.

I will always place the mission first.

I will never accept defeat.I will never quit.I will never leave a fallen

comrade.I am disciplined, physically and mentally

tough, trained and proficient in my warrior tasks and drills.

I always maintain my arms, my equipment and myself.

I am an expert and I am a professional.I stand ready to deploy, engage, and

destroy, the enemies of the United States of America in close combat.

I am a guardian of freedom and the American way of life.

I am an American Soldier.

You might feel you can go it alone, but….

Post Traumatic Stress Disorder (PTSD) is not only an

individual problem but also a

family and

community

problem.

Family Members

• Provide opportunities to talk• Don’t be afraid to ask about

the war• Accept your limitations• Offer attention, interest, and

care• Educate yourself• Find available resources• Be supportive with

expectation that readjustment will occur

• Do not pressure to talk• Do not stop them from talking• Try not to make judgmental

statements• Avoid telling what one

‘should’ do• Watch for clichés or easy

answers (war is hell)• Avoid giving advice without

fully listening• Don’t rush things

MyHeroesAtHome.com

Community

• Join the local VFW or American Legion

• Battle Buddy• Create a book club• Mosaic.com• Welcome home every

vet you see• Join Vets4Vets.com• Volunteer, even though

you don’t feel like it

Quick Rundown

• Training has given you faster reflexes for combat actions• Experiences give emotional shaping to memory• It is normal to have mixed feelings about wartime experience• Having some symptoms does NOT automatically mean you have

PTSD• Only a clinician can diagnose you with PTSD• PTSD is not permanent and many treatments are available• There are MANY resources available for treatment• If left untreated it will negatively impact everyone around you• Healing is found via community

warriormyth.blogspot.com

Thank You

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