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Loving the Warrior Home: How to Help in the Healing of PTSD Alan Basham, M.A. Eastern Washington University What is Post-Traumatic Stress Disorder? Disorder: Something is not right with how the person perceives and functions in the civilian world; distress, upset, not at peace within Stress: An experience of a life-threatening event or protracted threatening environment Traumatic: The person is psychologically injured by the experience Post: Symptoms become evident after the threatening experience has ended Post-Traumatic Stress Disorder is the normal reaction of a normal person to a devastatingly abnormal experience. The Body’s Response to Threat • Arousal is mediated by the limbic system • Autonomic nervous system (ANS) balance – Sympathetic branch (SNS): get ready for action! – Parasympathetic branch (PNS): rest & relax • In threat situation, amygdala & hypothalamus (in limbic system) activate SNS and release corticotropin-releasing hormone (CRH) • Adrenal glands release epinephrine & norepinephrine to mobilize for fight or flight Physiological Threat Response (continued) • CRH also activates pituitary gland to release ACTH, and causes adrenal glands to release cortisol, which halts the alarm reaction & production of epinephrine & norepinephrine • Body returns to homeostasis after threat….. • In PTSD, something goes wrong with this hyperarousal axis: adrenal glands do not release enough cortisol to halt the alarm reaction What is PTSD like? • Memories & fight/flight reaction remain strong • Traumatic event continues to invade the present, resulting in continued hyper-vigilance • Perception that the threat is over and that the victim has survived is missing • Threat level remains high (perceptually) even when threat itself is history • Dissociation, alienation, acting out, & selfmedication are used to relieve suffering Why does the problem persist? Hippocampus and amygdala (limbic system) are central to memory storage – Recording, filing, remembering traumatic events – Hippocampus gives time/space context to events; logs traumatic event as being in the past – Amygdala aids in the processing of highly charged emotional memories, both during & while remembering the traumatic event Protracted threat blocks processing of threat Treatment of PTSD “We didn’t know what PTSD was exactly or how to treat it. Now we do. Unfortunately, we experimented on Vietnam veterans for 40 years before we discovered what works.” Trauma-Focused Cognitive Behavioral Therapy (TFCBT) Prolonged Exposure (PE) How can I help? Learn about PTSD. Don’t pry or push, but be ready to listen. Never minimize or rationalize away the experience. Confront unkind behavior…..gently. Name isolating behavior…..& invite closeness. Honor the warriors, but don’t idolize them. Understand and accept the military mindset: task oriented, no nonsense, minimal emotion. Let your warrior lead in the healing. Normalize her/his reactions. Reconnect them with nature and thus with self. Provide family and community support. Bring them home spiritually, not just physically. What can I do to stand down? • • • • • Learn about PTSD. Identify your own current fight or flight behavior. Learn to be self-aware about unnecessary vigilance. Tell yourself the truth about the “invisible wound.” Hold yourself accountable for inappropriate behavior and attitudes. • Reconnect with nature and thus with self. • Tell your story to family members and friends whom you can trust. • Take off the war paint, and let others help you do it. If you need help (and many of us have), consider a brief course of treatment with Cognitive Processing Therapy or Prolonged Exposure Therapy to make sense of it all. Landmarks on the Road Home Baby Doll….A gift of nature to help me heal A long trek in the mountains…. “What are you doing out here all by yourself?” “You will always be lethal, but you’re not dangerous.” Grieving at The Wall…. Surrounded by love. Accepting responsibility for my choices Taking off the “War Paint” Honor the Wild Man, then put him back into the inner place. Transforming the Knife Making peace by telling my story Recommended Readings Philpott, D., & Hill, J. (2009). The wounded warrior handbook: A resource guide for returning veterans. Lanham, MD: Government Institutes. Rothschild, B. (2000). The body remembers: The psychophysiology of trauma and trauma treatment. New York: W. W. Norton. Schiraldi, G.R. (2009). The post-traumatic stress disorder sourcebook: A guide to healing, recovery, and growth (2nd ed.). New York: McGraw-Hill. Tick, E. (2005). War and the soul: Healing our nation’s veterans from post-traumatic stress disorder. Wheaton, IL: Quest Books.