PTSD |

PTSD
Name: Josie Salzman
Posting date: 8/13/07
Husband: returned from Iraq
Hometown: Menomenie, WI
Milblog url: lifeinacrackerbox.blogspot.com

I sit tonight in the kitchen of the Fisher House just staring at the TV while trying to collect my thoughts. The country has been informed that the Army has realized there is a need for more mental health professionals to aid soldiers returning from war with PTSD (Post Traumatic Stress Disorder). They claim to be adding two hundred new employees to help combat the never-ending war that remains in our loved ones' minds. I wish more than anything that tonight I could take a deep breath, relax, and fall asleep with the confidence that our military is taking the proper steps to ensure my family is able to heal from the violence we have encountered.

Unfortunately, that's not an option.

One of the first nights I had with my husband after his injury will forever be burned into my mind. He had been in an excruciating amount of pain the entire evening. It was still early in his hospital stay so the doctors had yet to find a pain cocktail that his body responded to. Just like the evening before, the nurse entered the room and handed J.R. a cup filled to the top with pills. Desperate to make the pain subside for a few hours, J.R. swallowed them in one giant mouthful. An hour later he was drifting off to sleep.

I started making my bed for the night after I was sure he was sleeping. This would be my second night of sleeping in the foldout chair that I would soon learn to hate. I had no more than crawled under the covers when J.R. sat bolt upright in bed. "Get them off me. Get them off me now. The bugs, they're all over me, get them off. They're in the bed. Make them go away."

Unsure of what he was talking about, I jumped out of bed and rushed to calm him down. After a grueling twenty minutes he was able to once again close his eyes. It didn't last. Again his mind took over in his sleep. This time he felt as if someone was in the room and he was under attack. He awoke panicked and sweat-soaked. I sat on his bed and held him in my arms. I promised him that if he just closed his eyes he would be able to sleep and that everything would be fine. I was in the room and I was going nowhere. But everything wasn't fine. No more than an hour after he closed his eyes the terror began. On this night J.R. would relive the entire accident.

"Are you ready? Hey, I'm talking to you. Are you ready to go? We have to get on the road. It's time to head back south." J.R. was mumbling in his sleep.

"J.R. what are you talking about. We aren't going anywhere. Go back to sleep."

We went back and forth for a while before I realized what was going on. He was prepping his truck for convoy and in his mind it was December 19th. His nurse assured me that this was normal, and that I should just keep an eye on him. I listened as he spoke to his men as the convoy went down the road. He mumbled so much I had a hard time understanding. Until they hit the EFP.

"Hey. Hey guys... guys I can't feel my arm. Guys my arm. My arm. My arm is gone. Guys help me! My arm is gone! Help! Help! I need a tourniquet! I'm bleeding out. It's gone. Holy shit my arm is gone!"

By this point J.R. was screaming at the top of his lungs. He was sitting upright in bed. I bolted out the door and yelled for the nurse. Together we muscled J.R. back down on the bed. He was thrashing. At this point more nurses were filling the room. His screams could be heard throughout all of Ward 57. I retreated to my bed and allowed the nurses to help my husband. I pulled my legs up to my chest and tried to ignore my husband's screams.

"Stop stepping on my arm. It hurts. Give me pain killers. You're stepping on my arm. Get off of it. My hand. My hand. My hand is gone! God damn it I told you get off my arm!"

The nurses were calm as they helped him fight through the night terror. They played the roll of the army medics, telling him that he was going to be fine. Helping him fight through the pain. Then all of a sudden came relief. It came in the form of a shot. The medicine entered his body and within minutes the terror was over. He lay in his bed. Calm. I sat on the chair and cried. I cried for my husband, for the pain that he was in. I cried for our dreams that were now garbage. I cried out of exhaustion.

The next morning J.R. remembered nothing. He didn't understand why my eyes were so puffy and I was so tired. That same morning I walked out to the front desk and asked that my husband meet with a mental health specialist and be screened for PTSD. I waited a week and still no doctor came to speak with him. I put in another request for J.R. to be seen by a doctor. One more week and still nothing. My manners were gone. I threw a fit demanding that he be seen by someone from the psych department. They sent a doctor -- in training. We saw him once. ONCE. As if one visit would fix his mind and he could continue living his life in perfect harmony.

I continued to ask and I continued to receive the same answer: "The psych department is stretched very thin and they can't make it to every patient." It took another week, but finally, a doctor (we'll call him Bob) appeared one morning from the psych department. However Bob came right in the middle of J.R.'s morning therapy session of PT and OT. After explaining to the him that every morning my husband had therapy on the third floor from 9 until 11, he agreed to stop by later in the afternoon. He never did. Instead Bob once again came by the next morning while my husband was at therapy. One more time I gently reminded him that every morning from 9-11 J.R. was unavailable. It finally clicked with him after about a week, and for the first time since his injury, J.R. would be able to speak with a therapist on a regular basis. Or so I thought.

We saw Bob a few times. Then J.R. went outpatient and we could no longer meet with Bob. Once again the war for a therapist began. After a few more weeks of phone calls and digging I landed J.R. an appointment. The appointment was at 11 so we ran from physical therapy up to the doctor's office. We were no more than two minutes late, but the doctor was gone. He told the woman that appeared to be some kind of an assistant that he had left, and to pass the message on to us. Furious, I stormed back home with J.R. After that, I gave up. There were other battles to fight and I was running out of hot air.

We were fine for a few weeks. And then the dreams returned. Constantly waking up in the middle of the night in fear that an IED had exploded outside the window. For weeks he was permanently attached to me at night. And although I usually don't mind to snuggle up at night, it is very different when your husband has the death grip on you while you're trying to sleep. I was exhausted. I no longer had the help of the nurses to care for my husband. His memory was non-existent with the meds he was taking, so it was almost as if I was taking care of a small child. A very stubborn small child with a lot of needs. He couldn't dress himself, could barely feed himself, and still needed help taking a shower. I was so wrapped up in taking care of him that I completely forgot to take care of myself. Then the fights began.

Once again I started asking for a therapist. This time, it only took a week. We saw him twice. Things didn't go so well. After our second and final appointment I returned to our room feeling defeated. Not once had any member of the staff here asked if I was OK. If there was anything that I needed. How I was handling my husband's injury. I was realizing that I was no longer able to handle the stress of taking care of J.R. For months I had been bottling up every concern, every fear, and every frustration inside. I had a break down. Two weeks later family arrived, and I was able to leave and go home for a week of alone time.

Since that week things have been a million times better. J.R. has been able to cut back on his meds, which has made a world of difference. I now see the man I married shining through the drug haze. The fights are less often and less intense. And we are able to realize when a little time apart is needed. It's amazing what taking care of yourself for a while can do for your mental health.

It is also important to remember that even though my husband may be the one that lives with the memory of the explosion, we all live with the memory of the healing process. This war has taken its toll on me as well. And sometimes even I need professional help to deal with our new life.

My whole point to this long-winded story is that two hundred added employees isn't enough. There are over 25,000 soldiers that have been wounded in Iraq. 25,000. Just to help the wounded alone, there are not enough employees.

Now add in the thousands of soldiers returning from war and remember it is not just the soldiers that need help. The families need to be included. There are wives, husbands, mothers, and fathers that deploy with a soldier. It's hard.

I see the army putting a band-aid on our veterans. A fresh coat of paint to cover the walls. A few added employees to make the press happy. But it's time to peel the band-aid off and realize the cut needs stitches in order to heal. This war has been going on for years and the end has yet to be in sight. There will continue to be fatalities and injuries. This is the reality of war.

Comments

[fern]

I'm sad and angry and frustrated about what your husband and you have had to go through. This is total disrespect of the troops - it's the worst possible form of disrespect.

If things don't change for people like you and your husband it's time to pull out of Iraq and Afghanistan totally. We're either willing to make the kind of commitment that we should as a nation or we have no business being there.

And I don't care how one feels about whether we should be there or not. If we're going to be there, we have to do it right and take care of those and we ask to be in harm's way and their families.

There have been many too many terrible stories about the shoddy treatment that the military and VA have been providing. I'm sick of it.

[Maureen]

Dear Josie, It is not how a soldier or his family should be treated. It is not politics but selfishness of our leaders to fail to respond to yours and all returning vets problems. I will vote to help you, but also for years, have been praying for you and your family. Nobody should be so forgotten.

[Lynette]

Until the federal government funds the VA Hospitals and programs on the level that is going to be required over the next twenty years. Until, the government stops gutting the active duty benefit programs, nothing will get better.

[rdholtz]

Josie, there may be more help available right away. If you've been discharged, or if you're within 60 days of discharge, you're eligible for help at the VA's Vet Centers. These are readjustment counseling centers for veterans, and they focus on PTSD and other issues. There are over 200 of them across the country, and they're a tremendous resource in getting help for a variety of problems. They'll also aim you at other resources to help you get the benefits you earned.

I'm a Vietnam vet, and I've been a Vet Center client for over 15 years. I can't say enough good about the one that's helped me. Both the staff and the other clients have been amazing.

To locate one, go to http://www1.va.gov/directory/guide/home.asp, choose Facility Type as Vet Center, and search for the ones nearest you.

You'll be glad you went in.

[Kat Coburn]

My heart goes out to you.

My husband is a Viet Nam era vet who is being ignored by the military in spite of his PTSD (which was originally diagnosed as scitzophrena(sp?))not getting any better.

I wish you better luck than we have had.

[Martha]

Does our Commander-in-Chief have even the smallest inkling of what he has caused our soldiers, our vets, and their famiies?

[Denise]

Josie,

My husband is a sailor whose last assignment was with Marines. We have several friends dealing with PTSD and I know that it's tough going. They are all showing progress now with a combination of cognitive and drug therapies, so keep pushing the VA center and make sure he gets into regular therapy. You'll both be in my prayers.

Denise

[Terri]

About four years ago my husband had surgery to repair a seriously injured shoulder.

Procedurally, no bit deal, but controlling the pain and dealing with the mental trauma caused by the pain wore me right down to nothing

I remember sitting up all night in his hospital room and pushing the button on the morphine dispenser every 20 minutes. It was the only way to keep him down and not ripping open his stitches. Or finding him kneeling in the middle of the floor holding his shoulder and rocking. He doesn't remember any of it. I do.

You have my heart and my thoughts. Keep it up. He may not act like he appreciates it, but he does, down deep. Take care.

[Catzmaw]

Your account should be sent to every one of our Senators and Congressmen. Yesterday we heard Karl Rove saying that President Bush put this country on a war footing. Not so. Our government waves flags and sends to war dedicated people like your husband away from their equally dedicated families, then cuts taxes and tells the people of America to defeat terrorism by going shopping. Even now we hear the refrain "No New Taxes" as if we can afford to run a war without asking for sacrifice from the whole population. And people like you and your husband suffer.

It's time to pay the piper and this government had better get it into its head that the collection should be taken from everyone lest the piper go unpaid. Supporting the troops is easy when it involves slapping a yellow magnet on your car. Let's see some real support in the form of well-funded veterans' facilities and support groups.

[mc]

Josie,
Small steps, hang in there.
mc

[Laurel]

Josie, thank you for sharing your story with us. It is an outrage the way our troops are essentially abandoned when they return home. We will continue writing our legislators, demanding better treatment for our returning vets. We have the greatest admiration and respect for you. Families "serve", too. People tend to forget that. We send you our prayers. Take care and take just one step at a time...

[Dr. Jan Wagman PhD., MFT]

Since moving from Los Angeles to San Diego a year ago I have offered my services as a psychotherapist to the military families in the area (my office is close to Camp Pendleton); and, even though I'm a Tricare provider, very few of the military and their families come for therapy. This has seemed odd to me, as the media keeps reporting there is an overwhelming need for therapists to work with the returning vets.

I don't know if this is true, but a few days ago, another therapist in the area told me that the soldiers are being discouraged from seeking psychological help, especially for PTSD. It appears that the DOD doesn't want the public to perceive that one of the biggest casualties of this war is the soldier's brain. And, the PTSD symptoms? -well, there're the soldier's personal problems, not the responsibility of the military.

In other words, the DOD doesn't want guilt by association.

Unfortunately, the soldiers' mental health has become a political albatross to the spin meisters who insist that the casualties of the war are only those on the battle front.

Regardless, there are 121 of us Tricare therapists in the Camp Pendleton
area willing to help - soldiers, children and their families.

Dr. Jan Wagman PhD., MFT

[Joy Chism]

SaveOneSoldier.Org would like to ask that you consider a reciprocal link between your site and ours. We’d appreciate any help the blog community could give us with spreading the word about our efforts. Please contact our Webmaster using the Contact area of the SaveOneSoldier.Org website so we can be sure to link back to your site.

SaveOneSoldier.Org exists to bring attention to the struggles facing American soldiers returning from battle in Iraq and Afghanistan who are suffering from PTSD (Post Traumatic Stress Disorder). In particular our site addresses the story of a young Army Ranger, Tommy Murphy, who currently faces up to 50 years in a military prison for (non-violent) infractions he stands accused of committing on U.S. soil while in the middle of a PTSD-related psychotic episode. Please visit our site to read more about Tommy Murphy and about our military’s current handling of soldiers with PTSD.

Our banner image can be found at http://www.saveonesoldier.org/sosorgbanner.jpg and can be hot linked back to http://www.saveonesoldier.org.

Thanks for your support,

SaveOneSoldier.Org

[Patrick]

I hope all of America sees how the military has been used by politicians, to stifle dissent, and even common sense.

We must never allow this to happen again.

I am willing to pay more taxes, if thats what it takes, to pay our service people more, and to give them better mental and physical care.

America should ask why taxes were cut on the top %5 of the wealthy these past 5 years.

And we should never again let ruthless politicians use fear (9/11) to start a war that does not make America safe.

If peopel have to die top keep America safe, so be it. But that is not the case with Iraq. As Cheney said in 1994, "how many American lives is Sadaam worth? Not many."

Where are all the people cheered for this war? Where are all the church groups, the Young Republicans, why arent they volunteering to help our troops as they come home?

Why aren't we all pressuring the Bush administration to cancel tax cuts for the rich, and spend the money on veterans?

This is revolting, that our guys get sent into harms way under false pretenses, then when they get home the same cowards who sent them refuse to provide the services they need.

[Blackie]

This is why people should not be so gung-ho to go to war.

[retired army wife]

I immediately went to prayer for you and your husband. I don't want to downplay your situation at all but you must be proactive in your efforts to receive counseling/ treatment. The VA is not going to come to you, you must go to them. My husband and I are both vets. So far, I haven't accessed VA care, but my husband has and I can say he's received A+ treatment, but he took it to them. He accepted rehab training and is now a school teacher. He is an oddity in the VA system. My husband was the first rehabed/retrained vet that his VA counselor had ever had. This should not be. The benefits/treatment is there but you must press on for it. It's astonishing how many vets reject rehab training.The VA is not solely to blame for this situation, vets have to apply and accept treatment and training when it's offered. I pray that you will not give up.

[Jessica]

It saddens me to think of all the families across the country that are going through the same trouble as your family. I know that my loved one still has trouble sleeping, he always feels as though there is someone watching over him, trying to hold him down in bed. He has been through the “diagnosis” process and they came up with “Manic-depressive” something or other. These issues were not present to him before his deployment overseas and I think that the government is putting a band-aid on a bullet wound. Until they realize the depth of what is going on with our soldiers they cannot begin to heal them. I feel for you and your family and pray that you get the help you so desperately deserve.

[Mary Werling]

Josie, Reading your story brought tears to my tears but some of the posts made me mad. The doctor who offered his services at Camp Pendleton and the old army wife that said that you had to keep working at the VA to get them to do what they should be doing to begin with. I wish there were some way to post your story to the internet and have it spread allover may make people open their eyes to what is going on. You and your family are in my prayers.

[Carrie]

Josie,
Reading what you have been through made me cry. I can not express in words how sorry I am for what you and your family have experienced. It hardly seems fair that your husband gave so much for us and has received so little in return.

So many of us take for granted what we have. We are safe in our own worlds, while those fighting for our safety are dying and suffering life altering injuries.

It is so sad that our government has so little respect for the men and women that protect our way of life. It is unacceptable that there are not enough trained employees to help soldiers with PTSD. Soldiers give up so much when they go to war and it is horrible that they do not get back what they give.

I am happy to hear that you see glimmers of the man you married returning. Its sad that he was lost to begin with.

My prayers are with you and the thousands of other families who are experiencing the affects of a loved one who has returned from war, changed and emotionally battered.

Thank you, Josie. Thank you for supporting your soldier. Thank you for weathering the life-altering events that you have experienced for me and the rest of the country. I wish the best for you and I will continue to pray for your husband and your family. Your story has forever touched my heart.

With Profound Respect and Gratitude,

Carrie

[chris]

The Aftermath of War

We found a wounded veteran,

And held him in our hearts.

We've seen the bravest soldier,

Break down and fall apart.

Yet we love our heroes,

Like no other has before.

We're the wives of combat veterans,

In the Aftermath of War.

We had to learn the hard way,

When coping with PTSD,

That their war is never over,

And freedom is never free.

We bandage up their broken hearts,

The best we can each day.

We see the scars upon their souls,

That never go away.

Knowing we can't heal the wounds,

That cut their very core.

We're just trudging through the trenches,

In the Aftermath of War.

We've seen them lose their faith in God,

And in the human race,

As they try to hide the anguish,

That's still written on their face.

We've witnessed all the symptoms,

That they're not willing to admit.

We've dodged the screaming bullets,

And been crawling in the shit.

We've felt the anger, guilt and blame,

Of these men that we adore.

As we stumble on the battlefield,

In the Aftermath of War.

Each day we share the horrors,

Of a pain they can't forget,

And we feel we lived through combat,

Because we love a vet.

But we are all survivors,

And we're learning how to cope.

Hanging on with all our might,

Just holding onto hope.

And our soldier's heart will cry out,

That they couldn't love us more.

Because we're sitting in their foxhole,

In the Aftermath of War.

By Chris Woolnough

[chris]

Reading about your experiences is heartbreaking. Sadly, you are not alone, we found no help from the VA, or when we finally did, it was traumatizing. Bad help is worse than no help at all. I hope you will come and visit us in the aftermath of war coping with ptsd too. Witnessing a loved one whose physical integrity has been threatened is a traumatic stressor as well. Now that I have ptsd of my own, I don't believe it's a mental disorder. I believe the autonomic nervous system (fight or flight response) is permanently damaged/injured by overwhelming stress. What you survived would be markedly distressing to anyone!
Research shows that getting help early increases the chances of recovery from trauma. I think treating a normal reaction to trauma as if it were evidence of mental illness does a lot of harm to survivors in the aftermath of war. Plus, you cannot fix or repair an autonomic nervous system injury with logic alone. (biofeedback/neurofeedback teaches people how to retrain that autonomic nervous system reaction.)
If you look at the circumstances of what causes the berserk state, it is clear to see how the lack of care from the people in charge, is contributing to the agony of ptsd we suffer from.
The first stages of the onset is referred to as going ‘berserk’ and whilst this has been adopted into the general language, it is a Norse word, which is believed to refer to going into battle ‘bare shirt’ (or without armor). All the Berserker feels he needs is a weapon, and anything else gets in the way. Homer refers to a berserk state: “In his ecstasy of power, he is mad for battle… pure frenzy fills him” Iliad 9:288ff In traumatized battle veterans, there seems to be a pattern of specific conditions that seem to trigger the berserk state that precedes the onset of CPTSD. The National Vietnam Veterans Readjustment Study has identified four of these conditions, which contribute to CPTSD. These are exposure to combat, exposure to abusive violence, deprivation and loss of meaning and control. The berserk state seems to have a survival basis – when facing certain death, a soldier clearly has nothing to lose and everything to gain by ‘losing it’ and turning on the enemy in a wild frenzy. That rush of adrenaline can, sometimes, save your life
read a the rest of a study of combat trauma here.
http://groups.msn.com/AftermathofwarcopingwithPTSDtoo/awpsycopaths.msnw?action=get_message&mview=0&ID_Message=30231&LastModified=4675665182881452630
In the aftermath of war, I was exposed to combat, literally fighting for my life, and my veterans life, our rights to fair treatment, etc. (the VA had given him valuim for his ptsd, it's on a list of things to avoid because it has side effects like suicide and homicide. Not only did he try to end his own life, but mine as well.) There is the exposure to abusive violence. Loss of meaning and control when no real help was available to us to help relieve our suffering, and the betrayal of what's right caused us more harm. Deprivation, on so many levels, deprived of treatment, support, the rights my husband fought, and bled, and in his own words died for.
And the family members too, go berserk. Or as I say, wind up with ptsd of their own when their autonomic nervous systems are so overwhelmed by the trauma of it all. The VA contributes to our suffering and misery by denying the affects of trauma. Sad. Money saved, lives ruined, in the aftermath of war. Already dead, a study of CPTSD " This can give a feeling to the soldier that his superiors do not understand the situation, particularly if the orders seem senseless, and this can add to the feeling of betrayal – being sent into likely death for no reason, or because of a misunderstanding by superiors. The rage resulting from surviving this is a very real, major contributor to CPTSD, and it cannot be underestimated.

Many soldiers do not survive the berserk state, and are killed in the process of an ‘I don’t care if I live or die’ charge into almost certainly lethal situations. Those that do survive, though, will be irreparably changed and a high percentage will be violent. The symptoms of CPTSD are far-reaching, intrusive, terrifying and almost impossible for non-sufferer to comprehend: difficulty falling or staying asleep, irritability and angry outbursts, difficulty concentrating, recurring nightmares at night, hallucinations and flashbacks ‘reliving the experience’ in waking hours, exaggerated startle response (jumping and hitting out at the slightest thing), hyper-vigilance (checking two or three times that things are as they appear to be, not trusting what you see), physiological reaction to a reminder of the trauma (at the sound of a car backfiring, hitting the floor like a reflex). (the author made a mistake here, this is an example of an exaggerated startle response, evidence of autonomic nervous system sensitivity and arousal) Suffers often do not expect to live long lives, or to have successful careers or marriages, they lose interest in things that they previously enjoyed, and make massive efforts to avoid anything that arouses memories of the traumatic circumstances.

Memory takes over control of the mind with CPTSD, with flashbacks coming at any time, and these are no normal memories. With flashbacks, the sufferer relives the traumatic moments, and terror, grief and rage may merge together. Once this happens, the sufferer has no authority to stop it, or make it go away and only with specific psychological techniques can the sufferer be given any control. As long as flashbacks are happening, the consciousness focuses on it, and reality tends to be less real than the past event. Emotional numbing is one of the few ways of detaching from the utter, inescapable, constant terror. Clearly, these symptoms are a massive intrusion into someone's life, and impact not only the sufferer but also their loved ones, who have to learn to live with a person they suddenly do not know. A man who may have previously been emotionally strong, organized, in control and would never dream of hitting a woman, can be suddenly transformed into a jumpy, hostile, crying, terrified man who is constantly on edge, and not sleeping or eating, with massively violent outbursts towards anyone close to him. Many sufferers have been misdiagnosed as having schizophrenia because they remain in an emotionally deadened, socially withdrawn state for a long period. Sufferers may change physically, as many find it impossible to eat properly and lose large amounts of weight. Wives, close friends and families of sufferers have a huge burden to bear when faced with such massive changes, and often need counseling themselves to deal with the change in their relationship. It is not difficult to see why marriages often break under the strain, and as counselor I would be aware that there may be relationship issues that could be causing extra stress to the client. Forty percent of Vietnam combat vets reported carrying out a violent act at least three times in the previous year, 49% of Vietnam CPTSD sufferers had been arrested or in jail at least once, and 39% reported alcohol abuse, and 40% of Vietnam vets were divorced at least once (National Vietnam Veterans Readjustment Study - 1990). This shows what a comprehensively devastating effect this disorder has on the lives of so many ex soldiers around the world. It is almost impossible to give a true and accurate percentage of suicides in Veterans but many report that they think daily of suicide, and report that they have lost twice as many friends to suicide than to the actual war in which they fought. (J Shay – Achilles in Vietnam). Combat PTSD has been described as feeling ‘already dead.’ Many Vietnam vets who have survived, have said “I died in Vietnam,” and can provide such a total loss of all emotion as to make the sufferer genuinely and completely fearless for his own safety during the berserk phase, and utterly emotionally numb after it.
Is there any escape from the rigors of CPTSD? Once the soldier has entered the berserk state, he will never return to being the man he was before that point. The loss of ‘innocence’ is something that cannot ever be regained, and some research shows that actual physiological changes take place within the brain. However, it has been proven that the sooner counseling is received, the better the chances of return to some kind of normality. Sufferers that have a solid network of family and friends make a much more consistent recovery than those that do not have this support.
Once the sufferer can start to talk about the events around the trauma, and has a safe, trustworthy environment to do this, then healing will begin. If he is sure he will not be judged, blamed, or traumatize the listener, then the safety will enable some catharsis. However, to be trustworthy in the case of CPTSD clients, the listener must be able to feel some of the terror, grief and rage that the victim did. Empathy in this stage is critical. Many veterans have said that no one ever really listens to what they have to say. The sufferer also has to try to escape from a perpetual ‘present.’ For many in combat, it is too painful to think of the past, of home, of happy events, and too hopeful to think of a future where they may return there – most soldiers look forward to the next decent meal, the next smoke, the next break, and never look further ahead than that. Escaping from a shrunken time horizon is an enormous feat for the sufferer. A key factor in being able to move on from the trauma is the ability to see the enemy as a worthy adversary. Ironically, the Forces work on their troops to see the enemy as evil and dehumanized because it is well known that soldiers cannot kill an enemy who is seen as human, hence words like ‘Hun’ and ‘Nip’ arise. However, in order to recover from CPTSD, honor must be restored to the enemy, or the sufferer's self respect will never fully heal. If the sufferer can look back and see that the individual he fought and killed put up a decent fight and was a true fighter, this can help the healing process. Recovery is possible to a degree. There will always be regressions at life-changing points, such as parenthood, retirement, and the outbreak of another war. Most never recover fully but can go on to lead fulfilling lives with the right help, support and some medication. Ultimately, though, prevention of this terrible disorder must be the ideal.
Julie Shiels 2004

You know what?

optimum arousal zone of the Modulation Model

http://www.sensorimotorpsychotherapy.org/articles.html

This is where I believe ptsd occurs, when a person is past that point of no return. This is where the risk and resiliency factors of ptsd come into play as well. It's what I call "adding insult to injury", until the system of self preservation is so overwhelmed, a permanent injury to the autonomic nervous systems fight or flight response occurs.
Naturally, when a person experiences physical symptoms of ptsd, they remember the last time they were in that much danger, so they react accordingly. This neurobiological response to fear ensures our survival.
Maybe scientists are misinterpreting the results of autonomic nervous system reactivity as a psychological response to trauma induced stimuli

"Hyperarousal involves "excessive sympathetic branch activity [which] can lead to increased energy-consuming processes, manifested as increases in heart rate and respiration and as a "pounding" sensation in the head" (Siegel, 1999, p. 254). Over the long term, such hyperarousal may disrupt cognitive and affective processing as the individual becomes overwhelmed and disorganized by the accelerated pace and amplitude of thoughts and emotions, which may be accompanied by intrusive memories. As Van der Kolk, Van der Hart, et al. (1996) state, "This hyperarousal creates a vicious cycle: state-dependent memory retrieval causes increased access to traumatic memories and involuntary intrusions of the trauma, which lead in turn to even more arousal" (Van der Kolk, Van der Hart, et al., 1996, p. 305). Such state-dependent memories may increase clients' tendency to "interpret current stimuli as reminders of the trauma" (p. 305), perpetuating the pattern of hyperarousal. Van der Kolk points out that high arousal is easily triggered in traumatized persons, causing them to " ... be unable to trust their bodily sensations to warn them against impending threat, and cease to alert them to take appropriate action" (p. 421), thereby disrupting effective defensive responses.
read the rest at
http://www.sensorimotorpsychotherapy.org/articles.html

People with ptsd only FEEL crazy, for having a NORMAL response to trauma. The lack of care is contributing to the problems we face in the aftermath of war.
Please stop by and read "Survival of the fittest, a letter of acceptance" and my tribute to veterans called thank you soldier. (in our poetry corner) Those who have survived it know the ultimate cost of war. And I didn't care if I lived or died when I charged into battle to fight the system. People with ptsd aren't crazy, war is insane! Big healing hugs and all my love, Chris

http://groups.msn.com/AftermathofwarcopingwithPTSDtoo/awpsycopaths.msnw

[Tooth-Grinding]

I am so sorry to hear of your experiences in Iraq and your resulting PTSD. I know many people who suffer from PTSD (one of who was in New York during 9/11) and I pray for all of you who have suffered from it. God bless.

[Moncler Doudoune]

I like the writing structure of your blog and it does a pretty decent job of presenting the material.