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Veterans And Ptsd


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This is a version of presenation that I give for free around the state of Oregon. My intent is to change the way the military and veterans talk about combat stress injurie and PTSD, to make it more of an open topic. Currently we hear the term and we 'tune out' and don't seek the help so many of us need. Understanding what is happening in the brain and soul, with respect to our uniform and our warrior ethos, has helped many soldiers/marines begin treatment. I am always reworking this to make the message better. I try to relate to the audience and use my credentials as infantry instructor and combat vet to that effect.

Veterans And Ptsd

  1. 1. PTSD from a Veteran
  2. 2. 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.
  3. 3. • ‘Joes’ are divorcing Soldiers Around Me… • 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
  4. 4. • Driving at night at 30 MPH a trigger Myself • 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
  5. 5. 2005 Oregon Violent Death Report
  6. 6. 2000 to 2006, 1,066 male veterans in Oregon took their lives. 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.
  7. 7. 6 years 72 months 288 weeks 1066 Oregon Suicides 3.7 Suicides a Week
  8. 8. 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.
  9. 9. 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).
  10. 10. 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%
  11. 11. Red Badge of Stephen Crane’s book about the Civil War contained themes Courage of masculinity symbolized by war. Where are the mental wounds? We discount them because they are • invisible • counter to our notions of masculinity • “secondary”
  12. 12. I don’t rate feeling this way
  13. 13. A Veteran
  14. 14. 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
  15. 15. 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
  16. 16. Called combat fatigue and it was a serious problem. WWII 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
  17. 17. Iraq and According to a more recent Post-Deployment Health Afghanistan 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.
  18. 18. What is going on?
  19. 19. The Brain
  20. 20. 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.
  21. 21. Conditioning • Pavlov in 1904 • Skinner developed further into Behavioral engineering • Rewards and Punishments develop automatic behaviors
  22. 22. “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.
  23. 23. 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.
  24. 24. 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
  25. 25. 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 On Killing
  26. 26. “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.” Down Range: To Iraq and Back
  27. 27. Amygdala • Connection with lots of areas of the brain • Emotional stamping of events • Increases reflexive reactions • Signals sent ‘upward’ are checked by prefrontal cortex.
  28. 28. Amygdala
  29. 29. 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
  30. 30. Signs & Symptoms of PTSD • Flashbacks, or reliving the • Self-destructive traumatic event for behavior, such as drinking minutes or even days at a too much time • Hopelessness about the • Shame or guilt future • Upsetting dreams about • Trouble sleeping the traumatic event • Memory problems • Trying to avoid thinking or • Trouble concentrating talking about the • Being easily startled or traumatic event frightened • Feeling emotionally numb • Not enjoying activities • Irritability or anger you once enjoyed • Poor relationships • Hearing or seeing things that aren't there
  31. 31. Anxiety • The mind stays on • Physical symptoms vigilant, ever on alert. • Emotional fatigue • This keeps emotions and the body aroused. • Mental fatigue • Chronic or severe arousal • Spiritual fatigue changes the nervous system. • Smaller threats than usual • Exaggerated stress sound the alarm. response • Takes longer to return to • Avoidance is hallmark resting state.
  32. 32. Dissociation • Perceived detachment of • Traumatic memories are the mind from emotional walled off states or even the body. • Dissociated material is • Dreamlike state or unreal highly emotional and place. relatively non verbal • Poor memory of specific • Triggers can be the event sense, body • DID, Fugue movement, dates, stressf • Fragmented ul events, strong emotions, cognitive • State-dependent patterns, behaviors, out memories of the blue, and combination.
  33. 33. 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
  34. 34. B Buddies VS Withdrawal A Accountability VS Controlling Inappropriate T Targeted VS Aggression T Tactical Awareness VS Hyper-vigilance L Lethally Armed VS Locked and Loaded E Emotional Control VS Detachment Mission Operational M Security VS Secretiveness I Individual Responsibility VS Guilt Non-defensive Driving N (combat) VS Aggressive Driving D Discipline and Ordering VS Conflict
  35. 35. • Medication Many Treatment • Psychotherapy Options • Exposure Therapy • Cognitive Behavioral Therapy (CBT) • Eye Movement Desensitization & Reprocessing (EMDR) • Memory Work • Art Therapy • Thought Field Therapy • Healing Rituals • Group Therapy • And More…
  36. 36. 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).
  37. 37. 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
  38. 38. Strengths of our warrior tradition
  39. 39. What is a HERO ?
  40. 40. 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.
  41. 41. 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.
  42. 42. Family Members • Provide opportunities to • Do not pressure to talk talk • Do not stop them from • Don’t be afraid to ask about talking the war • Try not to make judgmental • Accept your limitations statements • Offer • Avoid telling what one attention, interest, and care ‘should’ do • Educate yourself • Watch for clichés or easy • Find available resources answers (war is hell) • Be supportive with • Avoid giving advice without expectation that fully listening readjustment will occur • Don’t rush things
  43. 43.
  44. 44. Community • Join the local VFW or American Legion • Battle Buddy • Create a book club • • Welcome home every vet you see • Join • Volunteer, even though you don’t feel like it
  45. 45. 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
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  47. 47. Thank You
  48. 48. Hotlines