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13155532 veterans-and-ptsd


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13155532 veterans-and-ptsd

  1. 1. Veterans and PTSD
  2. 2. Personal Considerations‡ This presentation will contain images, and topics about combat and Post Traumatic Stress Disorder (PTSD). I intend to invoke an emotional response.‡ If you feel uncomfortable at any time you may leave without comment or question.
  3. 3. ‡ Joes are divorcingSoldiers Around Me͙ ‡ 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 triggerMyself ‡ 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.Suicides among Oregon service membersand veterans over the past five years showsthat more Oregon veterans died at theirown hands than at the hands of theirenemies in war zones Officials calculate the deaths at a rate of roughly 20.2 per 100,000 soldiers -- which is higher than the adjusted civilian rate for the first time since the Yearly increases in suicides have Vietnam War been recorded since 2004, when there were 64 -- only about half the number now. And theyve occurred despite increased training, prevention programs and psychiatric staff
  7. 7. The numbers kept by the service branches dontshow the whole picture of war-related suicidesbecause they dont include deaths after peoplehave left the military. The Department of VeteransAffairs tracks those numbers and says there were144 suicides among the nearly 500,000 servicemembers who left the military from 2002-2005after fighting in at least one of the two ongoingwars. The true incidence of suicide among military veterans is not known, according to a report last year by the Congressional Research 6 years Service. Based on numbers from the Centers 72 months for Disease Control and Prevention, the VA estimates that 18 veterans a day -- or 6,500 a 288 weeks year -- take their lives, but that number 1066 Oregon Suicides includes vets from all previous wars. 3.7 Suicides a Week
  8. 8. A 2003 New England Journalof Medicine Study found that15 percent to 17 percent ofIraq and Afghanistan veteranswere suffering from PTSD,and more than 60 percent ofthose showing symptomswere unlikely to seek helpbecause of fears ofstigmatization or loss ofcareer advancementopportunities.
  9. 9. According to the PDRHL fromthe Department of DefenseBehavioral Health Survey43% of 2000 NationalGuard Members hadreadjustment issues afterreturning from the war zone(s).Nationally, the overall rateof PTSD has been describedas being at least 30%.
  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 don͛t trust mental health professionals 38%Mental health care doesn͛t work 25%I don͛t know where to get help 22%
  11. 11. Red Badge of Stephen Crane͛s book about the Civil War contained themes Courage of masculinity symbolized by war. Where are the mental wounds? Do we discount them because they are ‡ invisible ‡ counter to our notions of masculinity ‡ ͞secondary͟
  12. 12. PTSD from Ancient Greece to the Present ‡ Nostalgia ‡ Hysteria ‡ Shellshock ‡ Buck fever ‡ Combat fatigue ‡ Battle reaction ‡ Disorderly action of the heart ‡ Soldier͛s heart ‡ Homesickness ‡ Irritable heart
  13. 13. And what about whenyour warrior͛s angergoes home? What isit like with his wifeand children? Is ituseful then, too? Cicero
  14. 14. Back then, PTSD was calledcombat fatigue, and it was aserious problem. In theEuropean Theater, 25 WWIIpercent of all casualtieswere serious PTSD cases. Inthe Pacific Theater, the ratevaried widely, depending onthe campaign. In some ofthe most intense fighting,like Okinawa in 1945, itaccounted for over a third ofall wounded.
  15. 15. Iraq and According to a more recent Post-Deployment HealthAfghanistan 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.
  16. 16. What is going on?
  17. 17. The Brain
  18. 18. On September 13, 1848,Phineas Gage Phineas Gage was foreman of a work gang blasting rock while clearing the roadbed for a new rail line. After a hole was drilled into a body of rock, one of Gages duties was to fill the hole with gunpowder, add a fuse and sand, and then pack the charge down with a large tamping iron.
  19. 19. In total, how many times has Mark McGwire swung a Baseball Bat? He labored through the 2000 season with a bad right knee, missing virtually all of the second half. He had surgery to correct patella tendinitis. One season with a bad knee G AB R H 2B 3B HR RBI SB BA OBP SLG changed his swing enough toCareer 1874 6187 1167 1626 252 6 583 1414 12 .263 .394 .588 cause him to retire.
  20. 20. Conditioning ‡ Pavlov in 1904 ‡ Skinner developed further into Behavioral Engineering ‡ Rewards and Punishments develop automatic behaviors
  21. 21. ͞Train Like You Fight͟ Methods used to train is an application of conditioning techniques to develop ͚quick shoot͛ ability. The modern soldier trains in full gear, shooting blanks at realistic targets until reflexive fire is obtained.
  22. 22. 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.
  23. 23. 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
  24. 24. I yelled ͞kill, kill͟ ͚til I was hoarse. We yelledit as we engaged in bayonet and hand-to-hand combat drills. And then we sang aboutit as we marched. I had stopped huntingwhen I was sixteen. I had wounded a squirrel.It looked up at me with its big, soft browneyes as I put it out of its misery. In 1969 I wasdrafted and very uncertain about the war. Ihad nothing against the Viet Cong. But by theend of Basic Training, I was ready to kill them. -Jack, Vietnam Veteran On Killing
  25. 25. ͞To survive and be victorious on the battlefield, ourwarriors must aggressively seek out the enemy and killthem. This has far reaching spiritual and psychologicalimplications. In order to be ͞successful͟ the warrior mustnot miss a beat in pursuing and eliminating adversaries oneafter another. When they attack the enemy, they aretrained to go one step beyond personal moral boundariesand take the life of another human being. This eventuallybecomes their personal horror of war- this is one primaryaspect that damages the soul. The ͞killer instinct͟ that isso energetically thrown around in locker rooms andcorporate sales meetings becomes a very real impulse tosoldiers in the heat of battle. Without this instinct thewarrior is very luckyʹ or very dead.͟ Down Range: To Iraq and Back
  26. 26. Almost all service members returning fromthe war zone will experience some of thesebehaviors and reactions. It͛s vital that youremember that having these reactions doesNOT automatically mean you have PTSD. Itwould be abnormal if you didn͛t experiencesome of these feelings and behaviors followingwhat you have been through in the war zone.
  27. 27. Amygdala‡ Connection with lots of areas of the brain‡ Emotional stamping of events‡ Increases reflexive reactions‡ Signals sent ͚upward͛ are checked by prefrontal cortex.
  28. 28. Signs & Symptoms of PTSD‡ Flashbacks, or reliving the ‡ Self-destructive behavior, traumatic event for such as drinking too much minutes or even days at a ‡ Hopelessness about the time future‡ Shame or guilt ‡ Trouble sleeping‡ Upsetting dreams about ‡ Memory problems the traumatic event ‡ Trouble concentrating‡ Trying to avoid thinking or ‡ Being easily startled or talking about the frightened traumatic event ‡ Not enjoying activities‡ Feeling emotionally numb you once enjoyed‡ Irritability or anger ‡ Hearing or seeing things‡ Poor relationships that arent there
  29. 29. 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.
  30. 30. 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 sense, event body movement, dates,‡ DID, Fugue stressful events, strong‡ Fragmented emotions, cognitive patterns, behaviors, out‡ State-dependent of the blue, and memories combination.
  31. 31. B Buddies VS WithdrawalA Accountability VS ControllingT Targeted VS Inappropriate AggressionT Tactical Awareness VS Hyper-vigilanceL Lethally Armed VS Locked and LoadedE Emotional Control VS DetachmentM Mission Operational Security VS SecretivenessI Individual Responsibility VS GuiltN Non-defensive Driving (combat) VS Aggressive DrivingD Disclipine and Ordering VS Conflict
  32. 32. You are likely to feel okaythe first few months afterreturning home from war Many cases of PTSD do not become dysfunctional until years later Ignoring it does not make it go away
  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. ‡ MedicationMany 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 More͙
  35. 35. Call of Duty 4U.S. Army medical researchers have noted thatsoldiers that play violent video games, are betterable to handle the stress of combat. Moreelaborate (virtual reality) combat simulations arenow being used to treat combat veterans whoare suffering from severe stress reactions fromcombat (PTSD, post-traumatic stress disorder).
  36. 36. What is a HERO ?
  37. 37. PathologizingIt is important that therapists who work with veteransbe educated in the warrior tradition and its rituals inorder to recognize and help veterans identify with [theuse of] warrior traits. Ignoring these traits is harmfulto the veteran, for then the inner warrior remainsinvisible. Pathologizing the traits is also harmful, forthen the vet is further wounded by reductionistinterpretations that may minimize their importanceto him͙ or empty them of their spiritual potency. -Edward Tick, Ph.D. War and the Soul
  38. 38. 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.
  39. 39. Family Members‡ Provide opportunities to ‡ Do not pressure to talk talk ‡ Do not stop them from‡ Don͛t be afraid to ask about talking the war ‡ Try not to make judgmental‡ Accept your limitations statements‡ Offer attention, interest, ‡ Avoid telling what one and care ͚should͛ 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 ‡ Don͛t rush things
  40. 40. You might feel you can go it alone, but͙. Post Traumatic Stress Disorder (PTSD) is not only an individual problem but also a family and community problem.
  41. 41. Community ‡ Join the local VFW or American Legion ‡ Make regular phone calls to other ͚buddies͛ ‡ Be a resource for fellow vets ‡ Create a book club ‡ ‡ Welcome home every vet you see ‡ Join Vets for Vets ‡ Volunteer, even though you don͛t feel like it
  42. 42. 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
  43. 43. Hotlines
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  46. 46. Thank You