Combat PTSD. There is hope!
Active service can be considered as an extremely stressful event of exceptional nature, which can (and in many cases does) lead to general distress almost in everyone. Unlike other kinds of stressful situations that we encounter in out lives, active service can lead to a trauma with the long-term consequences. Some consequences can be very serious.
War stress factors have a lot of various forms, and most often they may include following:
- a fear of death, injury, pain or disability,
- pictures of comrades’ death and a need to kill another person,
- factors of combat condition (lack of time, high rate, unexpectedness, uncertainty)
- deprivation (lack of sleep, meals and liquid)
- unusual environmental conditions (unfamiliar terrain, heat, sun exposure, etc.).
According to researches, the veterans of Afghanistan war suffer from combat PTSD of varied severity. The trauma that war veterans re-experience may be manifested in various ways.
80% – repeated nightmares. In the first 2-4 years after the war, the nightmares disturb almost all combatants with particularly severe effects in those, who had brain contusion. These dreams are characterized by the feeling of helplessness and loneliness in conditions of potentially lethal damage. During the nightmares people make involuntary movements of varying intensity.
70% – psychological distress (stress, associated with the strong negative emotions and is destructive to health). Different events of a peaceful life cause unpleasant associations, for example: flying helicopter reminds of military operation, camera flashes remind of shots, etc.
50% – memories of the war (feeling of sadness after the major loss with acute emotional pain and recurrent memories of the trauma).
Types of adjustment in veterans:
- Active-defense type: an adequate assessment of the combat PTSD severity or its neglect. Neurotic disorders can be shown. A part of combatants are ready for examination and outpatient treatment.
- Passive-defensive type: withdrawal, acceptance of illness, depression, hopelessness. Mental discomfort is expressed in somatic complaints.
- Destructive type: the loss of social ties, internal tension, explosive behavior and conflicts. In search of relief patients use alcohol and drugs, breaking the law and committing a suicide.
Six major problems in participants of the Vietnam War:
- the feeling of guilt,
- abandonment / betrayal,
- the loss experience,
- the loss of meaning in life,
- the fear of death.
Typical development of post-traumatic stress disorder in war veterans has 5 phases:
- the initial impact (psychological traumatic experience);
- resistance / denial (people are not able and do not want to understand what has happened);
- acceptance / repression (a psyche accepts the fact of a trauma, but a man tries to suppress such thoughts);
- decompensation (worsening of a pre-existing condition; a consciousness is trying to transform the trauma into a life experience to move on) – the presence of this phase is a feature of combat PTSD;
- overcoming of trauma and recovery.
In cases of chronic combat PTSD (longer than 6 months) people get stuck between the 2nd and 3rd phases. In an attempt to “reach agreement with the trauma” they change their understanding of self perception and the outside world. These particular processes lead to the personality disorder. Attempts to avoid the unpleasant experiences of repeated psychological trauma lead to pathological outcomes of combat PTSD.
Delayed psychotic reactions in veterans depend on three factors:
- the pre-war personality characteristics and ability to adapt to a new situation;
- reactions to the life-threatening situation;
- the level of personal integrity recovery.
Human responses to the trauma also depend on biological characteristics of the body (primarily on the state of nervous and endocrine body systems).
The following types of therapy have proven to be very useful for the combat PTSD treatment:
- gestalt therapy,
- family therapy,
- neurolinguistic programming,
- guided affective imagery (catathymic image experience),
- eye movement desensitization and reprocessing.