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Monday, July 27, 2009

After trauma comes a teachable moment

After trauma comes a teachable moment

by
Chaplain Kathie

When we talk about PTSD and our troops along with our veterans, we do a great injustice if we do not use every teachable moment possible to help them heal.

Despite a recent study about intervention and crisis response, there is a great deal of more evidence the right crisis intervention works to help people recover from traumatic events. The key word is the "right" intervention.

Trained responders, unless having experiences of their own recovering from traumatic events, will only learn what they are told. If it isn't personal to them, they will walk away with a heavy binder of information and notes, but not much more than that. If the instructor is not fully knowledgeable, that load of education is not worth much than a "load" and they will not respond in the right way. In some cases, they may end up needing some crisis intervention for themselves as well. If the training is right, then they are able to go out in the field helping people recover instead of doing more damage.

It's the same condition in the military. We've read article after article on military Chaplains more interested in proselytizing than helping soldiers overcome what they were just exposed to. When this happens, teachable moments are lost. PTSD is allowed to take hold and may be fed by the wrong response from the very people the troops turn to for help. Once this happens, it is extremely difficult for them to trust someone else enough to seek help from.
Fort Bliss Expects To Handle More PTSD Cases With Influx Of Soldiers
Dena Richardson/KFOX News Reporter
Posted: 7:37 pm MDT July 26, 2009
Updated: 9:24 pm MDT July 26, 2009

EL PASO, Texas -- Plans are under way to handle more cases of post-traumatic stress disorder with the influx of soldiers, according to Fort Bliss officials.

About 20,000 troops are stationed at Fort Bliss currently. But following realignment, there will be nearly 35,000 soldiers, and that could mean more PTSD cases to treat.
read more here and watch video
Fort Bliss Expects To Handle More PTSD Cases

With the troops comes a "tougher than" attitude telling them they are supposed to be strong enough to take whatever comes their way. This complicates the will to seek help from anyone. When they find the will to acknowledge the need, part of them is still in hero mode, denial as well as a sense of obligation to the rest of the men in their units. For the time they take to seek help, they think about how much they need to be with their units instead of focusing on the "one among them" instead of the military family as a whole. They want quick answers and quick recovery to get back to their units.



Should the person they turn to offer a long, drawn out response, they will not be hearing anything they need to hear because their brain is screaming "just get to the point" so they can get out of there. With PTSD, there is a very long list of issues they are facing and the responder needs to focus on their most pressing issue at the time. They can do this if they listen first and then respond to the issue the one seeking help foremost in their mind.

Veterans also carry that "tougher than" attitude within them. It's very hard to get any of them to seek help and they won't unless they know PTSD is not because there was anything defective in them but part of the emotional chain they carry within them. They confuse courage as being emotionally barren while it was because they had compassion in the first place, they found the courage to act on it and risk their lives for the sake of others.

Many years ago, I almost blew the chance to help a veteran heal. I was new at all of this and was more interested in giving the veteran everything I knew all at once. I saw his disgust in his face. I stopped talking and started to listen. His issue was not anything that I had addressed shoving the answers at him. He was more concerned with losing God. Once I actually heard him, I was able to focus on his most pressing issue at the time and then help him to understand what PTSD was. Had I not stopped talking, he would have just walked away and there would have been a teachable moment lost.

Experts know that as soon as PTSD is addressed, it stops getting worse, but what they don't talk about is the right way to address it. Sometimes we can do more damage if we add the frustration of not being heard to the one seeking help. Another way we blow it is when we do not warn them that when they begin to face PTSD, they usually get this emotional rush flooding out of them. This is terrifying to them and they think it's getting worse instead of knowing that it is good to cry. It's an emotional release of what they have been carrying around as a human. If they don't see it coming, recovery can go into reverse. Another teachable moment lost.

The second we respond to someone after trauma we are given part of the "golden hour" responsible for the rest of their lives. PTSD progresses into a full assault against them for every moment left un-addressed. While we have veterans as old as WWII veterans seeking help for the first time, they have shown us that it is not too late to help them heal but the damage done to their lives cannot be reversed. There are years worth of pain they carried and in turn inflicted on their families. This is something else we don't talk about. Distant, detached husbands and fathers end up causing a lot of bitterness in the family. Relationships come under attack because of the lack of knowledge and help. Some go beyond the point of no return but some relationships can be restored with forgiveness fused with understanding. This only comes after knowledge is delivered and acted upon. If no one addresses the family issues these veterans come with, then many of the psychological steps taken can be reversed should the family be left out of all of it.

Resentment will feed PTSD symptoms. The wrong response from family members will feed it. If the family is included in the recovery they will be able to have the tools to adjust and cope appropriately as well as forgive. Again, teachable moments lost as uninformed family members react out of hurt instead of being part of the healing.

We will see an increase in PTSD cases as outreach efforts reach the older veterans and the newer veterans gain understanding enough to seek help. The problem is there are just not enough people to go around and even less are trained the right way. It seems that everyone is looking for a quick answer, grabbing at every new program that comes out. Bloggers shoot out the latest press release about programs being offered as the new "answer to all solution," but there is not one program that will ever work for all. Should a veteran seek the wrong program because it worked for someone else they know but does not work for them, they will give up on help. If they understand that each individual responds differently, they will keep looking for the one that will work for them with confidence there is an answer somewhere for them.

As I try to put out as much information as possible on this blog, it has been disheartening that so much has been left out of the conversation concerning the moments we lost by not doing what needs to be done. Too many have already been frustrated away from help because of the lack of appropriate help at the VA and service organizations. There are not enough professionals to go around and even less providing what needs to be known. There was a time when I could get a veteran to understand what PTSD was and then send them for the diagnosis and treatment they needed but those days ended years ago as the influx came in like a tsunami.

I cannot treat them or diagnose them and most of the other advocates online cannot either. Providing information and understanding is their only job but it does little good if there is no one to send them to so they can act on what they have just learned. Unfortunately, we keep losing moments when we could be helping them heal because there is just a lack of people to send them to. It will be this way for a long time with ever increasing numbers unless everyone dealing with PTSD is trained appropriately to respond the right way as soon as possible.

We will see more veterans taking their own lives, more families destroyed, increasing numbers of homeless veterans, drug and alcohol abuse, domestic violence and veterans in jail unless we take all of this as seriously as the military comes up with plans to send them into combat. We can treat them as soon as they are hurt or leave it to fester and infect the rest of their lives. The choice is our's to make but they and the rest of the country will pay the price in the long run. We will have only ourselve's to blame if we do not learn from what we've already known.

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