Treatment for PTSD

Treatment for PTSD

The Veteran was taught responsibility at the beginning of Basic Combat Training. Every new recruit quickly learned to take care of things or pay a painful price. Being off active duty with PTSD, the Veteran must take the responsibility to seek help. Not only for his or her own interests, but he or she owe it to the family to ask for help. “A goal of crisis counseling, as you will see, is to help the person in need accept and take responsibility.”[1] The VA is willing to help as many Veterans as it can. “The VA has been a leader in promoting quality care in the United States. The VA’s National Center for PTSD has been a recognized national leader in conducting research and promoting appropriate treatment for veterans suffering from PTSD.”[2] The VA is doing all it can to screen Veterans. Veterans will benefit from early screenings. “… even the most efficient system cannot assist those who do not seek help. The military is taking steps to overcome one of its greatest obstacles in the diagnosis and treatment of PTSD: identifying and breaking down the stigma associated with mental health wounds.”[3] Every human being will need help at some point in life. No one can deal with life alone. One individual cannot fight a war alone, that same principle applies to the mental war veterans must face.

One of the most effective ways to treat PTSD is by focusing on the Veterans thinking process and behavior. “Effective treatments already exist, and these include both cognitive and behavioral…”[4] It is successful because it focuses on the individual’s needs and provides treatment specifically suited for that person. “Cognitive-behavioral therapy (CBT) is one type of counseling. It appears to be the most effective type of counseling for PTSD.”[5] However, Veterans needing help will receive the some sort of therapy that works best for his or her needs. No treatment is effective without the individual’s willingness to get better. Finding a treatment that works for the individual takes time and trust between counselor and counselee. “Cognitive behavioral therapy helps a patient understand the traumatic event they witnessed.”[6] This process has yet to come in pill form and until that happens, patient and caregiver must be committed to the process.

There is no short cut to recovery; it is a long-term endeavor. It will take time. Just how much time will differ with each Veteran. “Therapists typically work with clients on their PTSD over a three-to-six-month period of time.”[7] As the VA makes advances in research and treatment, it must find ways to help the Veteran cope with the demands of living with PTSD. Currently, there are only so many sessions provided for care, but with more research that number could change. “The treatment program is 12 to 16 sessions long, with one-hour sessions conducted weekly until the last several sessions, which maybe conducted biweekly.”[8] With more money invested in the VA by the federal government and other organizations the care provided might change.

One factor to consider when counseling Veterans with post-traumatic stress is that they are not a number or problem needing to be fixed, but rather a person needing help. Once that is established, the counselor is able to start helping, but he or she cannot do all the work. The veteran must participate. The Veteran must commit to the process of finding an effective treatment. Participation is key to recovery. “Effective treatments exist, and these include both cognitive and behavioral, mainly exposure-based treatments.”[9] These treatments will be used until new research is discovered.

For many Veterans returning from war may find it difficult to assimilate back into society. When they are ready, they will reap the benefits of care provided for them in the long process of recovery. For Veterans seeking help, will eventually find a counselor he or she trust and that will significantly increase his or her success of recovery. “… a behavioral method involving clear and concrete goal setting is an initial clinical strategy of choice because of its ease of administration through an interpreter, general effectiveness, and aims toward activities that integrate the person into his or her community.”[10] Part of the recovery process, includes help and support from family and friends. Although the Veteran may perceive a sense of helpless, there is hope for the veteran and the family.

The VA is doing all it can do to make the transition easier for the Veteran. However, it is a slow process. It is extremely difficult for a Veteran to adjust to the demands of war and even tougher road for the family. The difference between an individual who suffers from “chronic combat stress” and those individuals dealing with other types of chronic stress is his or her perspective of the stress experienced. As the Veteran fights his or her battle within, the family must endure with them. “Angry words demoralize and embarrass both the speaker and the listener. Words that belittle, accuse, or nitpick will damage your family relationships.”[11] The entire family, including the Veteran, must learn to adapt. They must learn news way to cope with the changes.

Faith of some sort may be one of the best ways to deal stress. “Religion and spirituality” may benefit those who have experienced stress in combat and those who have experienced trauma in other areas of life. It is a major factor that the US military and the VA guarantees an individual’s First Amendment rights to practice what they believe in whatever faith group/denomination they belong to. “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof …”[12] In order to this freedom, the US military along with The Department of Veterans provide chaplains to help in time of need. Chaplains provide support and opportunities for servicemen and in women in the military and for veterans in the VA.

The federal government is committed to helping Veterans recover by providing necessary factors that contribute to his or her recovery. “Religion and spirituality may provide a framework by which many survivors of trauma construct a meaningful account of their experience and seek solace, and may provide a useful focus for intervention with trauma survivors.”[13] A few years after the birth of this nation, Congress had passed the Bill of Rights that included a number of amendments to protect the liberties of the American experience. “Freedom of religion” is one of the first guarantees of freedom.

Religion and Spirituality

The First Amendment provides certain rights for each person to practice what they believe. As long as that belief does not cause harm of others. Some sort of book is at the center of most major religions. For the Christian, the Holy Bible provides inspiration and help for those in need. It is a source of hope for many who read it. It is valuable to counselors as they provide care for those in need. “The terms “religious” and “spiritual” are both used in the clinical literature to refer to beliefs and practices to which individuals may turn for support following a traumatic event.”[14] According to the VA, they support an individual’s right to have some sort of religious practice. They encourage veterans in their decision to look to a spiritual or religious practice as a viable aspect of one’s recovery.

There are many options for a veteran to inquire about and is highly encouraged to take advantage of the available sources and individuals to help them deal with PTSD. “U.S. military personnel have several options when seeking help for mental health problems, including U.S. military chaplains, mental health practitioners embedded in operational units, counseling offered in community service programs, mental health services provided by Military Treatment Facilities (MTFs) within both specialty mental health and primary care settings.”[15] The VA provides not only medical care that would include doctors of medicine and even psychiatrists, but also offers services for mental health, chaplains, and any other organizations to help the individual. “There is a large body of anecdotal literature documenting the propensity of individuals to seek religious/spiritual comfort following a traumatic event.”[16]

The terrorist attacks of September 11, 2001 provide a recent instance of this phenomenon. “Although feelings need to be recognized and acknowledged, they are basically a product of your thinking, and they can be controlled.”[17] (Romans 12:2) Hunt “If you dwell on negative thoughts, you can turn almost anything, even good circumstances, into stress.”[18] (Philippians 4:8-9) Hunt notes, “Stress can increase your ability to endure. However, excessive pressure can break you. God, knowing you intimately, does not allow pressure beyond what you can bear. But your response is critical.”[19] Help is available to help Veterans, but ultimately it is up to the individual to seek it our. “Every crisis will carry a challenging choice. You can choose to persevere and be changed (because of love for God and for others), or you can choose to seek a way of escape.”[20] Biblically, God has demonstrated that He is able to change an individual by focusing on their heart. However, veterans must allow for it to be changed. Much of the military life requires an individual to use his or her intellect to survive on the battlefield, but recovery will require more from the heart and less on the mental processes.

Scripture Can Help

Eyrich and Hines propose, “…how indispensable Scripture is to the counseling process.”

Here is the list:

  • The Word of God is illuminating – Psalm 119:105; 130; 133; 2 Peter 1:19; 1 John 2:8.
  • The Word of God is inspired – Nehemiah 9:13; Acts 1:15; Romans 1:2; 1 Corinthians 4:35; Galatians 1:11; 1 Thessalonians 2:13; 2 Timothy 3:16; 1 Peter 1:10–12; 2 Peter 1:2–21.
  • The Word of God is instructive – Psalm 119:24, 169; Romans 15:4.
  • The Word of God is powerful – Jeremiah 23:29; Ephesians 6:17; 2 Timothy 2:8; Hebrews 4:12.
  • The Word of God is revelation – Exodus 24:4; Jeremiah 30:2; 45:1–2; Habakkuk 2:2; John 20:30; Revelation 22:18.
  • The Word of God is reliable – 1 Kings 8:56; Psalm 19:9; 105:19; Proverbs 22:19; Luke 24:44.
  • The Word of God is a safeguard – Psalm 17:4; 119:9, 11; Proverbs 3:5–6.
  • The Word of God is truth – Matthew 15:1–3; Mark 7:7–13; John 5:46–47; Acts 18:28; 28:23.
  • The Word of God is true – Psalm 33:4; 119:43, 151; Proverbs 22:20; John 17:7; Colossians 1:3–6; 2 Timothy 3:15; Revelation 19:9, 21:5.
  • The Word of God is trustworthy – Psalm 19:7; 111:7; 119:138; Revelation 22:6.[21]

Prevention

Dattilio and Freeman stated, “A goal in crisis intervention is to actively help the patient to respond to the specific negativistic perceptions or beliefs that contributed to the crisis. … This involves several steps:

  • identifying and labeling the negative emotion
  • identifying thoughts or events that triggered this feeling
  • identifying automatic thoughts that are maintaining this emotional state
  • having the patient recognize the central importance of this perception or belief
  • collecting evidence that is inconsistent with this belief
  • identifying the most persuasive evidence against the belief or perception
  • developing an alternative, more adaptive, conceptualization of the triggering event
  • assisting patients to see how their mood would shift if they were to accept this alternative viewpoint
  • developing a behavioral plan for using this information to cope with the situation.[22]

The simplest reminders can make the biggest impact. “When you first begin to experience shallow, rapid breathing … produces classic symptoms of a panic attack … as a warning signal. Using the following techniques can stop these symptoms:

  • Take slow deep, deep breaths and hold the air in your lungs for a number of seconds. Then slowly release the air.
  • Place the open end of a paper bag around your nose and mouth. Breathe normally into the bag, being sure to breathe in the same air being expelled.
  • Place a blanket or sheet totally over your head. Doing so will increase the amount of carbon dioxide being taken into your lungs and ward off the frightening symptoms produced by too little carbon dioxide in your blood.[23]

In order for true healing to take place, the Veteran must trust his or her heart. “For the sort of change to take place that is pleasing to God and has the power to truly change a person there must be a change of heart.”[24] It may be safe to say that the Veteran leaves one battle zone on active duty and to another as he or she becomes a Veteran. Exposure to war creates traumatic stress, but constant worry creates stress: either way it is still stress.

How to Rid Your Life of Worry:

  • Desire to be free of all that chokes out the will of God. (Psalm 40:8; Psalm 51:4; Mark 8:34–36; Philippians 2:13; Mark 4:19)
  • Recognize God’s presence in your life. (Colossians 3:4; Romans 8:38–39; Philippians 4:19; Isaiah 41:10; Psalm 18:2)
  • Eliminate the worry producing can’ts, should’s, must’s and have to’s. (Psalm 13:2)
  • See your worry producing situations as opportunities for character building (Philippians 1:6)
  • Cultivate contentment with prayer. (Luke 18:1; Philippians 4:11–13)
  • Thank God for … (Psalm 34:18)
  • Nourish your body with the right physical activities. (Psalm 127:2)
  • Nurture your mind with spiritual music(Psalm 28:7)
  • Commit to doing the following every day for the next four weeks:
  • Focus on living in the present—not in the past or future. (James 4:13–15)
  • Emulate the godly example of people you know. (Proverbs 13:20)
  • Ask God to direct you in performing at least one unexpected act of kindness.(Matthew 7:12)
  • Believe His promise—you have the peace of God surrounding you and the God of peace within you.(John 14:27; Matthew 6:34; Jeremiah 17:7–8).[25]

[1] H. Norman Wright. The New Guide to Crisis & Trauma Counseling (Kindle Locations 197-198). Kindle Edition.

[2] Terri Tanielian, Lisa H. Jaycox, Terry L. Schell, Grant N. Marshall, M. Audrey Burnam, Christine Eibner, Benjamin R. Karney, Lisa S. Meredith, Jeanne S. Ringel and Mary E. Vaiana. Invisible Wounds of War: Summary and Recommendations for Addressing Psychological and Cognitive Injuries. (Santa Monica, CA: RAND) Corporation, 2008): 4. http://www.rand.org/pubs/monographs/MG720z

[3] McGrane, Madeline. “Post-Traumatic Stress Disorder in the Military: The Need for Legislative Improvement of Mental Health Care for Veterans of Operation Iraqi Freedom and Operation Enduring Freedom.” Journal of Law & Health 24, no. 1 (2011):, 205.

[4] Nicholas Tarrier. “The Cognitive and Behavioral Treatment of Ptsd, What Is Known and What Is Known to Be Unknown: How Not to Fall into the Practice Gap.” Clinical Psychology: Science & Practice 17, no. 2 (2010): 140.

[5] Jessica Hamblen, Treatment of PTSD, NAT’L CTR. FOR PTSD, 1, http://www.ptsd.va.gov/public/pages/treatment-ptsd.asp

[6] McGrane. “Post-Traumatic Stress Disorder in the Military”,183-215.

[7] Monica Descamps, et al. “A Cognitive-Behavioral Treatment Program for Posttraumatic Stress Disorder in Persons with Severe Mental Illness.” American Journal Of Psychiatric Rehabilitation 7, no. 2 (May 2004): 119.

[8] Ibid., 120.

[9] Tarrier. “The Cognitive and Behavioral Treatment.” 134.

[10] Tarrier. “The Cognitive and Behavioral Treatment.” 138.

[11] Payleitner, Jay K. 52 Things Kids Need from a Dad: What Fathers Can Do to Make a Lifelong Difference. (Kindle Edition): 107.

            [12] U.S. National Archives & Records Administration. Amendment I. (College Park: MD, 1791). http://www.archives.gov/exhibits/charters/bill_of_rights_transcript.htmla

[13] The Working Group VA/DOD. 50.

[14] Ibid., 50.

[15] Tanielian, Invisible Wounds of War, 22.

            [16] The Working Group VA/DoD, 172.

[17] June Hunt, Biblical Counseling Keys on Stress Management: Beating Burnout Before It Beats You (Dallas, TX: Hope For The Heart, 2008), 3.

[18] Ibid., 2.

[19] Ibid., 2.

[20] Ibid., 4.

[21] Howard Eyrich and William Hines. Curing the Heart: A Model for Biblical Counseling. (Ross-shire, UK: Christian Focus, 2002): 40-41.

[22] Dattilio and Freeman. Cognitive-Behavioral Strategies 2-53.

            [23] Hunt, J. Biblical Counseling Keys on Fear: No Longer Afraid. (Dallas, TX: Hope For The Heart, 2008): 4.

[24] Eyrich, Curing the Heart: 45.

            [25] Hunt, J. Biblical Counseling Keys on Worry: The Joy Stealer. Dallas, TX: Hope For The Heart, 2008.

 

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