Soldiers and cops: PTSD

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Hi all,

I’m having a philosophic conversation in a class with a peer who has training in psychology and neurology.

S/he says that PTSD is currently being treated as a physical problem rather than a metaphysical problem; medications are ineffective and these people need existential treatment.

I’ve seen a lot of awful things on the ambulance and at crime scenes. It took awhile to learn to disconnect myself from the event. The key, for me, was to consider the elements independently. On arrival, I see people. Then: We have a car accident. We have a homicide. We have a head injury, a broken arm, a victim, a patient. What can I do on this scene? What tools do I have on hand to do my job right now? Afterward, they become people again. I’m not sure if this makes sense. I am sure it kept me sane.

The problem for soldiers and police is the potential for ugly surprises and a constant sense of danger. It is exhausting in all senses to operate at heightened awareness for extended periods. If I had to add that to the mix, I wouldn’t have lasted long. I think whatever treatment we’re providing for our returning soldiers has to take that into consideration.

So my question to you all is: Does what my classmate suggests make sense? I don’t know what existential treatment means. This is not a dig; I really want to understand why current treatments are not working.

Anyone out there have an opinion?

CopyCat

Instant Shine and depression: a returning US Marine's praise for it
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I don’t know what existential treatment is so I guess I can’t really comment.

I don’t know if current treatments work or what their sucesss rate is. I will bet that most people who need to get them do not and if they do probably not enough.

Part of the key is preparation and not just in the sense of good training to do your job. I firmly believe people need to have the appropriate emotional and spiritual background or training in order to process the horror they are going to see and experience, and even then it cannot help but affect you in some ways. But I do believe that if you are prepared emotionally and spiritually then the repercussions are lessened.

I am NOT saying that people who suffer PTSD are emotionally or spiritually immature or anything is wrong with them in either realm. But rather what they have been through in both realms did not prepare them for or give them them means to process what they were going to experience in such a way as to avoid true debilitating PTSD.

Now is there any real way to prepare yourself to watching people die terribly. No. Are you going to go through a process afterwards dealing with it. Yes - everyone will. But I think some people’s emotional and spiritual backgrounds enable them to through the inital decompression process, process what they have experienced and not suffer from PTSD or at least the severe forms of it.

Just my two cents …

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man, this is a serious thread, I was hoping for something intersting like people were putting Cops on soldiers to make them fight faster and harder. (that’s cops as in copulins)

or that cops helpped relieve PTSD.

having a former coworker who had PTSD and Gulfwar syndrome, both are not a good conditions, and are very real.

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Copycat - I don’t know alot about PTSD, but from what I do know I agree that a purely physical treatment (drugs) would really only be a stopgap solution. The drugs can distance the user from the event, but as soon as the drugs aren’t there the sufferer is left with the exact same problem - being able to understand and cope with what they saw.

I think in some extreme cases both medication and some form of metaphysical/pyschological treatment would be required.

Just a suggestion if you or someone you know IS having this problem at the moment - do a google search for Bad Buddhist Radio and listen to his podcasts. NOTE: This guy is NOT RELIGIOUS the podcast is actually a practical and very PRAGMATIC view of how to practice buddhist philosophy in your life - Give it a try, don’t let the buddhist thing scare you away - It is a life philosophy (metaphysical) and I could see it really helping someone who is having trouble getting over a traumatic event.

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Hi Bosshank,

How do you define an appropriate spiritual background/training?

Are you suggesting that an atheist or agnostic would be more prone to problems because of their belief - or lack of it?

Cat

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Woofie,

Doh! Perhaps I should have thought about that subject line a bit!

I wonder if Instant Shine would help?

Cat

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I haven’t seen anything close to what soldiers do, but I can imagine what it’s like to be scared 24/7. I haven’t been in that situation, and won’t pretend I have, but I do know what it is lke to have stressor around you nearly all day. I still tense up a bit when anyone runs up my stairs. Drugs, or any other substance will defintely not help, IMO.

Time, a whole lot of love, and acceptance of what happened is required I think. I don’t really know, but the first step, IMO, isn’t just finding out how to resolve this, but also find alternative methods of getting things done that doesn’t involve our countrymen being shot at all day long. Is there no way to fight this problem at the source? PTSD is a product of humans – war in its various forms. (National level, neighborhood gangs, etc..)

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My country’s army send the soldiers to a small island in Greece for some time before they get home. There they can transition into the normal world.
I do think every traumatic event takes a certain amount of healing time and I have learned that is it stress without the opportunity to heal that breaks people down. I think it is possible to heal after killing someone, but it takes time and patience. Being a soldier for years and years may not be something that can be done while functioning in today’s society. Maybe policemen also need some time every now and then to unwind and destress. Perhaps we are also wrong in sending 18yo boys to kill and die. One time there was a series of pictures of all the boys who died and some of them looked so young and vulnerable that I would feel unethical about dating. We would not normally expect a teenage boy to have work with a ton of responsibility or expect him to marry and support a family in this day and age. Perhaps it would be better if soldiers sent to was were at least 21 or so. I also agree about preparing them for the horrors they may face. Perhaps something that is between martial arts and spirituality, like Tai Chi, could be suitable. I have noticed Tai Chi helps with all sorts of healing, physical and emotional.

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Years ago, post-traumatic stress disorder (PTSD) was usually called shell shock or combat fatigue and was studied primarily in connection with military veterans. Today much has changed. You don’t have to be a soldier to be diagnosed with PTSD. You only have to be a survivor of some traumatic event.

The event could be anything from a war to a rape attempt to a car accident. A fact sheet from the National Center for PTSD, in the United States, puts it this way: “To be diagnosed with PTSD, an individual must have been exposed to a traumatic event.” And this event “must involve some type of actual or threatened PHYSICAL injury or assault.”

PTSD has turned out to be a very common disorder. A random survey of 1,245 American adolescents showed that 23% had been the victims of physical or sexual assaults, as well as witnesses of violence against others. One out of five of the exposed adolescents developed PTSD. This suggests that approximately 1.07 million U.S. teenagers currently suffer from PTSD.

Don’t hold back from encouraging the sufferer. If you have a loved one dealing with the horrible memory of some traumatic event, understand that he or she is not overreacting or deliberately being difficult. Because of emotional numbness, anxiety, or anger, he or she may not be able to respond as you would wish to the efforts you are making to be supportive.

But don’t give up!

The sufferer needs to recognize and avoid unwise coping strategies that cause further harm. These include use of illicit drugs and overindulgence in alcoholic beverages. Although alcohol and drugs may give promise of temporary relief, they soon make matters worse. They usually contribute to social isolation, rejection of the people who want to help, workaholism, uncontrolled anger, uncontrolled or overcontrolled eating, or other self-destructive behavior.

Physical wounds are often the first to heal, but people suffering from PTSD can be wounded in many ways in body, mind, and spirit.

There are different legs of PTSD that you can treat…the anxiety associated with it, the nightmares or sleeping well, and of course lots of talking to a compassionate counselor who understand what it means to live with PTSD

Here are some symptoms…

Flashbacks—feelings that the trauma is happening again

Bad dreams and nightmares

A tendency to be very startled by loud noises or by someone unexpectedly coming up to them from behind

A shaky feeling and sweatiness

A pounding heart or trouble breathing

A feeling of upset when reminded of the trauma by something seen, heard, felt, smelled, or tasted

Anxiety or fear—the feeling of being in danger again

Trouble controlling emotions because reminders lead to sudden anxiety, anger, or upset

Difficulty concentrating or thinking clearly

Difficulty falling or staying asleep

Agitation and a constant state of being on the lookout for danger

An emotional shutdown or emotional numbness

Trouble having loving feelings or feeling any strong emotions

The feeling that surroundings are strange or unreal

Loss of interest in things that were previously enjoyable

Hope some of this helps!!!

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There has been a lot of success using EFT with PTSD.

I remember for the longest time I might have had it after losing quite a few friends on 9/11

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Copycat, what your friend suggests makes perfect sense to me. She means existential psychotherapy, and in my opinion that would definitely be the best thing for soldiers, cops, emergency personnel… anyone who sees violence as a regular part of their job. That sort of environment can cause rumination on the meaninglessness of life, e.g. “why does it matter if I do all the right things in life when there are people out there who do this?” etc, which in turn can foster nihilistic thoughts.

Existential therapy - Wikipedia, the free encyclopedia

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PTSD is not physical or metaphysical. It is psychological and should be treated as such. There is an NLP pattern that is absolutley golden for this. Unfortunately, an awful lot of people who call themselves NLP practitioners these days don’t know what the hell they’re doing. It is certainly NOT something to be treated with drugs. Ever.

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Warren, what’s NLP?

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Neuro-linguistic programming - Wikipedia, the free encyclopedia

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SteveO, regrets that this comes so close to the anniversary of 9/11.

Before I saw your post on EFT I was asking myself how I would treat a case of PTSD if left to my own devices.

First is to recognize that time does not heal all wounds, sometimes it cements them into place. We set a broken bone as soon as possible. I believe the same principle should apply to the “break” that comes from a profound non-physical trauma.

I would not expect a traditional psychological therapy to do much for most suffering from PTSD syndrome.

So, I would teach the person the basics of EFT to give them a sense of self-determination is applying a technique that supports emotional regrowth that passes the trauma. YEAH! – I think that’s a great insight, SteveO.

But I would also immediately begin a direct physical intervention in two ways:

  • acupuncture: balance the yin-yang and the arousal systems, especially for those who’ve been under “high alert” stress for extended periods of time; reset the adrenals
  • ROLFing: high stress causes us to build a suit of “micro-armor” using muscle tension and myofascial tissue which rolfing dismantles; every flashback or re-visualization reinforces the armor. The longer the armor sits in place, the more defined and self-perpetuating: even after all danger has passed the physical posture and sensations of fear can be triggered by the armor – flashbacks and sequellae, which then further reinforce the armor.
    The acupuncture should take a few days, perhaps weeks … the rolfing, one session a week for ten weeks. I’d add one more thing into the mix to help support the whole package: an hour of yoga three times a week … doesn’t really matter which style as long as the techniques are long on breathing and breath quality as well as stretching and core strength.

For the most acute or persistent cases I’d also prescribe hypnotherapy (from the Erickson school) with a brief therapy intervention focus.

Of course, I’m not a doctor and the above is not medical advice. I was fantasizing that I’d become a Doogie Hauser meets Dr. House meets … uh, nevermind.

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Because we are individuals and the reason why someone has PTSD - the trauma behind it - there is not a cookie cutter answer of what works best.

It is obvious than some type of therapeutic help is needed, usually a form of integrative psychotherapy.

Depending on the individual need occasionally medications can be used, but this is very individualized. Anti-depressants may be helpful because of the chemical balances caused within the system from PTSD. Great emotional trauma does not effect the emotions only it is tied into the chemical structure of our bodies as well. Look at the fight or flight reaction where great amounts of chemicals are released into our systems.

I believe in full integrative therapies…
MarkL is correct when he speaks about other therapies like acupuncture or ROLFing - these kinds of touch therapies are effective for several different reasons.

Even using essential oils for calming and relaxing purposes can work. Though that may not be effective for someone who is in the throws of extreme PTSD…but could work for them later.

Deep breathing practices are essential for anyone suffering trauma or anxiety. It is known that if you practice a form of deep breathing you can slow the heart rate down and start to relax…

Bio-feedback is incredible for PTSD - again breathing and relaxing. There is a bio feedback machine that is on the market today that any untrained person can use without a license - that IS NOT what I am talking about.
If you use bio feedback please make sure you get the referrel from your physician or therapist.

The point that I would make with PTSD is that you need to treat the whole body.

I think the more we learn about the mind and our bodies we continue to see how integrated they are. The old school standard practicioners just want to apply quick fixes to most everything. Those with more open minds know the body and mind are a whole and not separate functions.

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Oh! Full marks, schell, I don’t believe I missed biofeedback training, tsk!

BTW, I know there are simple bio-metric monitors that are relatively inexpensive (e.g. The Stresseraser) and don’t require formal training or license. There is also a machine (J&J I-330) that I’ve been looking at for a while … on my wishlist, so to speak, that runs about $3500 plus sensors.

I’m curious to know whether you think there are good quality biofeedback systems available to the public, and what limits you see in using them without a specialist on hand…

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Popular Science has an article in the Medicine section of the September 2008 edition discussing how D-cycloserine (DCS) is showing promise in it’s ability to help veterans recover faster from PTSD. Here’s the link to the article, and the full text is listed below: To Hell and Back Again | Popular Science

To Hell and Back Again

A drug tested in virtual war may help soldiers recover from traumatic stress-- and could conquer everyday anxiety.

By Eric Hagerman

Plenty of medications help people deal with fear, but the most effective one may be a humble antibiotic. Scientists testing a new treatment for veterans with post-traumatic stress disorder (PTSD) say the key to faster recovery might be a 50-year-old tuberculosis drug called D-cycloserine, or DCS.

As part of a five-year Emory University study funded by the National Institute of Mental Health, veterans with PTSD take the drug or a placebo, don a virtual-reality helmet, and re-create their worst nightmares: rumbling down the road to Falluja, feeling the vibration beneath the seat, hearing the rat-a-tat of gunfire just before a bomb explodes. A therapist guides them safely through the traumatic memory. The study is double-blind, so neither the researchers nor the patients know what’s in the pills, but one group is showing an improvement in symptoms sooner than they normally would.

How does it work? DCS affects the amygdala, the brain’s emotional center that governs fear. The drug doesn’t stamp out bad memories but, rather, lets the patient reshape their reaction to them. “If it gets to the point that they’re bored telling it, that’s excellent,” says lead psychiatrist Barbara Rothbaum.

Studies have already shown that DCS can speed recovery from obsessive-
compulsive disorder and phobias, such as a fear of heights. The drug’s psychiatric potential is so promising that the Atlanta biotech firm Tikvah Therapeutics recently licensed the rights to sell the drug as an aid to treat anxiety.

That’s good news for veterans, since nearly 20 percent of them have symptoms of PTSD, yet less than half of these seek treatment. “If you can get treatment to be just as effective in, say, half the number of sessions, that’s very cool,” Rothbaum says. Cooler still is that for millions of Americans who rely on daily doses of drugs that only mask the symptoms, DCS may let them conquer their fears once and for all.

1 Comment

08/12/08 at 12:02 pm
As a psychologist from the EU, currently doing postgrad research at a top (sic!) UK institution, I often find myself returning to the same question I used to wonder about as an undergraduate: Why does the American public not revolt to the fact that pharmaceutical and insurance (interchangeable terms?) companies blatantly dictate the sort of treatment which is ‘evidenced’ to efficiently help solve a patient’s/ client’s issues?

And, at the end of the day, how wise is it to depend on the most complex of research (or the most complex products psychopharmacology has to offer) to come up with ‘something’ to address ‘issues’, or ‘nosological entities’ (use the term you like best -‘themes’ feels somehow more accurate to me) that are indeed quite simple, as well as integral to our human existence? It’s a philosophical, anthropological, as well as political an issue at its core, and somewhat cliché; I know. But that simply doesn’t make it less important.

Mental health services simply cannot always count on the shortest, most economical solution to deliver treatment. It’s not in the interest of the people who need the services, and I bet it’s not in the insurance-payers’ interest either, once it’s them who will eventually have to bear the burden (and I only mean the financial one, here) these decisions bring; because, people will return for more m.h. services, either due to too-short interventions, or in the absence of a therapy that brings substantial change from within, rather than acting as a pill-popping counter.

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How does a biofeedback machine work?

Intriguing!

For the record, I do not have PTSD. It was brought up in another forum I post to and I was interested in what you all would think of that person’s thoughts on treatment. I don’t know much about treatment options. I do know that returning soldiers aren’t getting treatment often enough, as evidenced by the increase in suicides.

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Tacitus mentioned a nifty-sounding mini-biofeedback machine awhile back. I really wish I could locate that post.