Drs. Sharon Richie-Melvan and Diane Vines have written a book about this very subject called Angel Walk: Nurses at War in Iraq and Afghanistan. Dr. Sharon is both a nurse and retired Lieutenant Colonel from the Army while Dr. Diane is a professor of nursing at the University of Portland and the first civilian nurse White House Fellow. However, these distinguished women humbly share stories and interviews from those nurses who have served on the battlefield from Vietnam to Iraq and Afghanistan.  These stories give civilians and families of military personnel an understanding of the experience that most veterans avoid sharing directly with those who have not served. Many Veterans don’t share these stories because they don’t want to traumatize others or believe that anyone who hasn’t served could understand what they’ve been through. Drs. Sharon and Diane sensitively present their accounts, and then follow with ways we can support and assist our service men and women in their readjustment after deployment.

The second section of the book is rich with resources and hopeful accounts of of ways that people can recover from the stress of war and reintegrate back into life successfully. The authors caution that it takes time and both veterans and their families need to have realistic expectations. The authors also address Military Sexual Trauma that occurs for one in seven women who have served and do a nice job of removing the stigma of seeking support for overcoming such traumas. Many military personnel worry that seeking help from the VA will go on their records and impact their careers. While the VA is doing better about acknowledging that you do not have to have mental health problems to develop post-traumatic stress, the authors note other places soldiers can seek support outside government systems if they want.

If you or someone you care about is struggling with post-traumatic stress and readjustment back to civilian life, read this book. It will help you understand what they are going through and how to be sensitive to their needs. Once I began reading it, I could not put it down. Highly recommended!

Thanks to all our Battlefield Angels who risked their lives to save ours.

Photo Credit Department of the Army

For Veteran’s day, I was asked to rerun this post about a veteran with whom I had the privilege of working in April, 2011.

A few weeks ago, I had the honor of working with a courageous Iraq war combat veteran who sustained a traumatic brain injury (TBI) in the war and suffered severe flashbacks.

He asked if Rapid Resolution Therapy (RRT) would work for him, given the TBI. While I told him I was not sure how the TBI would impact things, I was sure we could clear the impact of the trauma. I reassured him that he’d already completed the hard part by surviving the war. He laughed and agreed that meeting with me could not be any worse than what he’d already experienced in combat.

When the soldier arrived at my office, he had a service dog with him, which led me to think he had a visual impairment. So, I offered to fill out the paperwork for him as he verbally gave me his answers. The soldier laughed and said,

“I can see just fine. My service dog accompanies me because my flashbacks have been so bad. When I have a flashback, my dog walks in a circle around me clearing the area to protect me and other people. Then, he licks my face and helps me wake up and come back to the present time and place.”

Wow. I was totally impressed with this soldier and his dog. He told me he’d not been allowed to drive due to the flashbacks, and hated depending on his wife to take him places. He could not be around his children when they were playing due to his low tolerance for loud noises and “screaming” sounds since the war. Here this guy dedicates his life to fighting for our freedom, and now post-traumatic stress had imprisoned him. I was totally dedicated to this mission to fight for his freedom now.

We cleared the emotional impact of his traumatic memories in just under 2 hours. Though the TBI caused him to have some delay in his speech and thought process at times, he had a wonderful sense of humor and a keen intellect. His favorite part of RRT was the “goat and the snowflake” story (see this post for an explanation).

Upon hearing this story and playing the “pants” game to help him stay present, the soldier quickly realized that the horrific images were just images now. Similarly, the emotional intensity he had been feeling cleared as his deeper mind “got it” that those events had been completed and no longer were in existence. We only had to discuss one event in detail, and he was able to apply the same concepts to the other traumatic events he had experienced. I watched in amazement as he smiled and said, “Yes, there is no IED exploding. It no longer exists. My commanding officer is okay now and is not pinned under that truck. I am not getting shot at this moment. There are no piles of beheaded bodies that I have to clean up anymore. Those guys left their bodies and they are at peace now.”

Three days after our session, I gave him a follow-up call. He said, “I feel great. I have not had any flashbacks, even when my kids were screaming or I heard a loud noise. I have been driving again. I am able to imagine being on the beach watching the cranes when I feel stress and it immediately calms me. I am free again.”  Then, three weeks after our session, his psychologist from the VA called to find out what we did because he couldn’t believe how much this better this soldier was doing.

I thanked this brave soldier for his service and we celebrated his return to freedom! You do not have to be imprisoned by trauma or your past. There is a way to return to freedom and reclaim your life.

Courtney Armstrong is a Licensed Professional Counselor as well as a Master Practitioner and Associate Trainer in Rapid Resolution Therapy. She has a private counseling practice in Chattanooga, TN where she specializes in treating trauma, anxiety, and grief. To contact Courtney, click here. To learn more about Rapid Resolution Therapy, click here.

A RAND Corporation study has shown that nearly 20% of troops returning from Iraq and Afghanistan experience post-traumatic stress disorder (PTSD) or depression upon their return home. Even older veterans, like those who served in Vietnam, can experience a resurgence of PTSD when they retire and have more time to reflect on the past. So what are symptoms of PTSD and how can we assist our veterans in overcoming it and enjoying life again?

PTSD can occur after someone has witnessed or been involved in an event that was life threatening or was an extremely disturbing event out of the realm of normal human experience. Symptoms include reexperiencing the event in the form of nightmares or flashbacks; feeling easily startled, anxious, or irritable and on edge most days; avoidance of anything that reminds you of the event; and/or feeling numb and detached from things.

Fortunately there are better treatments available for PTSD than there were 20 years ago, and the majority of these treatments can bring relief in as few as one to ten sessions. Treatments usually involve training you in effective ways to calm your emotions and bodily responses, reprocessing the traumatic memory (or memories) so they do not replay or haunt you, and creating new meaning in your life in spite of the trauma.

I use a method called Rapid Resolution Therapy® that has been very effective in clearing PTSD. RRT differs from other methods in that the person does not have to relive the painful emotions associated with the event in order to clear it. In addition, this approach seems to shorten the time needed in therapy with many of my clients reporting complete relief from PTSD symptoms within 1-6 sessions.

Other treatments for PTSD include Cognitive Processing Therapy, Prolonged Exposure Therapy, and Eye Movement Desensitization and Reprocessing. SSRI antidepressants like Paxil, Zoloft, or Lexapro have also been shown to reduce symptoms, but work best if the person is also involved in trauma-focused therapy of some sort.

Many Vets don’t seek treatment for PTSD because there is still a stigma attached to going to a “shrink” and frankly, they don’t want to discuss what happened. I understand- the horror many Vets have witnessed and experienced is beyond human imagination. Some Vets are also haunted by the missions they had to carry out that harmed or killed others in order to protect democracy. They often do not feel a therapist could understand or be able to relate to these experiences, unless the therapist has also had experience in combat. However, what is most important is that you find a therapist who has the capacity to understand what the experience was like for YOU, knows how to assist you in reprocessing the memory, and collaborates with you to access your resilience and reconnect with life.

PTSD is treatable. Sometimes symptoms clear on their own, but the earlier you seek treatment, the better. If symptoms go on for a year or longer, the less likely they will subside without treatment. For more information on combat related PTSD, visit the National Center for PTSD. Click here for more information about Rapid Resolution Therapy®.

Courtney Armstrong, LPC, is a licensed professional counselor and nationally known speaker on trauma and grief. She is the author of Transforming Traumatic Grief: Six Steps to Move from Grief to Peace After Sudden or Violent Death of a Loved One.

For example, I love the 9-11 Day of Service idea in which people are committing to one small way they can give back to others this week. Firefighters in New York and other cities have organized 5k runs and motorcycle rides to honor first responders.  The movie “Thank you, New York” is being released that documents the phenomenal work of the New York Says Thank You Foundation. This foundation started in 2003 at the suggestion of a 5-year old boy “to transform the 9/11 anniversary into a positive, hands-on platform for national volunteer service.”

Engaging in events like this empower us and counter the helplessness that trauma and sudden loss bring. However, some people may do better with private gatherings with close friends or even moments of reflection in solitude. Whatever your friends or loved ones tell you they need to do that day to get through, honor their request. The ways people grieve are as differentiated as our fingerprints. Below are some other tips.

Tips for dealing with anniversaries of traumatic events or deaths

• Stay present: As much as possible, stay in the present moment and do not relive the event. Your emotional brain confuses what is imagined with what is real, so if you watch replays of the event on television, or replay it in your mind, your nervous system can respond as if the event is happening all over again.

• Finish the story in a new place: If you feel it would be healing to review the event, do so in the presence of a caring, understanding friend and try finishing the story at a new place, a place in which you or your loved one is no longer suffering.

• “Do watcha wanna”: Plan something you would naturally want to do to honor yourself or your loved one on that day. You do not need to attend memorial services or other events if they are not helpful to you. It is okay to ask for privacy or to do something fun or distracting. For example, I read an article in which siblings of two men who died in the WTC attacks are going bowling and attending a baseball game on 9-11 because these are activities they enjoyed with their brothers.

• Reach out to friends: If you are friends with someone who was impacted by a trauma or death, know that they appreciate their friends calling to say “Hello,” or offering to accompany them to the cemetery or other events on anniversaries, no matter how long ago the death occurred. If you are the griever, know that your friends probably want to support you, but aren’t sure what to say. They are also relieved if you call them and let them know what would help you feel better on that day.

• Make living stories: Whether it was 9-11 or some other trauma or loss, the story of how they died is not the story of who they are. Define the deceased by their living stories and know that you will always have a connection to them. If you are supporting a friend through a loss, it is okay to talk about the deceased and use the deceased’s name when you refer to them. Hearing the name of our loved ones and their stories is comforting.

• Envision connection: Do something that gives you the feeling of being connected to your deceased loved one in a positive way. You may do so by telling stories as noted above, but it’s also fine to talk to them, write them a letter, or feel their presence with you. You always have access to them. They are not lost. They are not gone. They’ve just changed form.

Many people tell me they feel like they have to face the reality that they will never be the same and grieve the loss of their former selves. But, I do not think you have “lost” your former self. Instead, I think the impact of these devastating events casts a shadow that is blocking your ability to connect with the world the way you used to. The work I do with people clears that shadow so they can reconnect to the light that is always there within them and actually connect with the world in a deeper, richer way than they did before.

Click this link to hear a radio interview Courtney did with Michele Rosenthal (of HealMyPTSD.com) discussing how to recover the lost self. We’ve been getting great feedback from listeners of this show and think you will find it encouraging and uplifting.

The series began on June 1st with Ruth Buczynski Ph. D. interviewing Peter Levine who developed the Somatic Experiencing approach to treating trauma. Matthew Friedman, MD was featured this past Wednesday and did a wonderful talk on psychological first aid in the aftermath of traumatic events and the neurobiology of resilience. Over the next several weeks, you will also hear from the following experts:

- Allan Schore, Ph. D.: Affect Regulation and Mind-Brain-Body Healing of Trauma

- Pat Ogden, Ph. D. Body-Mind-Spirit Integration: Sensorimotor Psychotherapy for Treating Trauma

- Mary Jo Barrett, MSW: Rethinking PTSD: A Blueprint for Treating Complex Trauma

- Stephen W. Porges, Ph. D. : The Polyvagal Theory for Treating Trauma

I’ll be commenting on the material from the teleseminars in future posts, but wanted to get an announcement out about it so you can sign up before it is too late! So far, I’ve been very impressed with what I’ve heard.  Also- you do not have to be a therapist to sign up for the series. It is open to physicians, nurses, clergy, and the general public- all that is required is an interest in helping heal people from trauma.

To sign up for the course, click this link: http://www.nicabm.com/treating-trauma/