1.
Military Combat: “Basic Training” for Posttraumatic Stress Disorder <ul><li>“ States” that become “Traits”… </li></ul>

2.
A soldier recently returned from Iraq observes… <ul><li>“ During your military training, you are taught to instinctively have some aspects of PTSD…you learn what it takes to survive the battlefield, but you pay the price when you go home.” </li></ul>

3.
Military with PTSD may learn “symptoms” because of the training they receive to engage in combat <ul><li>Taught to eat, sleep, walk, run, perform, and shoot to an instinctive level </li></ul><ul><li>Example: learn to eat faster than other people because you have to be ready to move on </li></ul>

4.
Learned Hyperarousal <ul><li>Learn to quickly go from inactive to active alertness; ready on command from a superior </li></ul><ul><li>Constant state of readiness </li></ul><ul><li>Work to protect others and not let your team “down” </li></ul>

5.
Hyperarousal, Post-Combat <ul><li>Sleep disturbance [trained to sleep lightly for duty and rapid response] </li></ul><ul><li>Anger [needed for combat] </li></ul><ul><li>Concentration problems [black and white reactions versus thoughtful responses] </li></ul><ul><li>Easily startled [need quick reaction to noise and events; turn into direction of threat, not away from it] </li></ul>

6.
Dissociation <ul><li>No remorse for enemy </li></ul><ul><li>Trained to kill </li></ul><ul><li>Trained to withhold emotions, be strong, fight through </li></ul>

7.
Reworking Brain’s Architecture <ul><li>Therapy must address states that have now become traits because of reinforcement in basic training & battlefield </li></ul><ul><li>Depending on individual, may be working with arousal or dissociation, or both [and more] </li></ul>

8.
Transforming Hyperarousal to Relaxed Alertness <ul><li>Hyperarousal is a form of alertness, but not good for body, mind, and emotions. </li></ul><ul><li>Because military are trained for “uber-alertness,” it is also one of the physiological responses that can be addressed… </li></ul><ul><li>And transformed from hyperarousal into “relaxed alertness” [aka: mindfulness]. </li></ul>

9.
Art Therapy Strategies for Relaxed Alertness <ul><li>Start with somatic aspects: locating where it is in the body </li></ul><ul><li>What does it look like, what colors is it, etc </li></ul><ul><li>Any other senses associated with it? Smell, taste, sound? </li></ul><ul><li>How intense, on a scale of 1 to 10? </li></ul>

10.
Art Therapy Strategies for Relaxed Alertness [con’t] <ul><li>Find the individual metaphor that works [and think “military”]; case example: Fighter pilot--create and practice imagery to “fly into calm.” </li></ul><ul><li>Help individual set up sensory triggers for this: making symbols of relaxed alertness; what sights, sounds, or other sensations are reminders of that state? Practice [just in military “basic training”]. </li></ul>

11.
Art Therapy Strategies for Relaxed Alertness [con’t] <ul><li>As simple as it sounds, repetitive, effort-driven art making activities, that are rewarding for the individual, are important at this stage; could be learning to throw a pot on the wheel or other practical art skills. </li></ul><ul><li>Remember-- military personnel are good students. They will “follow orders” to reach an outcome. </li></ul>