Making peace after trauma comes with knowing the different types

Making peace after trauma comes with knowing the different types
by Kathie Costos
Wounded Times Blog
April 21, 2013

It does not just happen. It does not take time to heal all wounds. It takes a lot of work but what has happened after men and women are out of combat zones proves what does not work. "Resilience" during combat is one thing but expecting it to work on preventing PTSD is a deadly notion.

I was reading this article about "Mindfullness"

"New study from University of Michigan, VA Ann Arbor Healthcare System shows group mindfulness activities have positive effect on PTSD symptoms."

First, it is not new in the world of psychiatry but it may be new to University of Michigan. Part of PTSD is the loss of ability to calm down. The function of the human body has been compromised by the constant stress of combat, multiple traumas topped off with the treat of them happening again. In other words, the body learned how to survive on "alert" and it needs to learn how to calm down again. 

It claims that,

"After eight weeks of treatment, 73 percent of patients in the mindfulness group displayed meaningful improvement compared to 33 percent in the treatment-as-usual groups."

Sounds great but any help can make people feel better when it comes to PTSD because as soon as they start talking about it, it stops getting worse. What this study does not address is the longterm.

There are three components to healing. One is the mind and that requires a trauma specialist to respond right after "it" hits the "fan" and then the event is not allowed to take over. This does not have to be a "professional" but can be done with someone trained to respond the right way. Someone who will not dismiss or minimize what the serviceman or woman is experiencing. Someone who is trained to stay away from the wrong choice of words. I've actually heard people try to "fix" someone by saying "God only gives us what we can handle." That ends up enforcing what they already think. People walk away from trauma either believing they are one lucky SOB or they just got nailed by God. God either saved them or did it to them. If they believe God did it to them, then bingo, they just heard they were right and God gave it to them. I have also heard well trained crisis responders do it to perfection. They listened right, saying very little and with compassion. They focused on the person they were helping. Not taking phone calls, checking their watch or looking around the room as if they had something better to do.

If that doesn't happen then you need to have a mental health professional but even that is an issue if they are not trauma specialists. Otherwise they get it wrong too. Psychiatrists and psychologist come with the same issues. If they are not experts on what trauma does, they get it wrong. If they are not specialists there is also the issue of many not believing PTSD is real even though brain scans have shown the changes in the brain. Some of them know so little all they offer is medication as if "they have a pill for that" is the answer to everything. Medication numbs. It does not heal. There is also the issue of many medications coming with a warning they could increase suicidal thoughts being prescribed. The right ones can work to calm things down enough so the other part of treatment can start to work.

The body is the second part that needs to be treated. Everything is being drained by flashbacks, nightmares following a year of being constantly on edge. The body has to relearn soothing and calming down. There are many ways to get there. Yoga, meditation, martial arts, writing, swimming, walking and playing a musical instrument help with that as long as they can train themselves to focus on what they are doing and not the negative thing that happened to them. If they start to think of the events they survived, they need to push it out and think of what they are doing.

The other, and I think the most important part of healing, is spiritual. Forgiving. Knowing they are forgiven for whatever they feel they need to be forgiven for and forgiving whomever they have to forgive. That is not up to anyone to judge or dismiss. It is the only way they being to make peace with what happened. With combat and a close cousin law enforcement, it is not just surviving the event. Often it is participating in it with the use of weapons.

Yesterday I had a conversation with a friend about being confused over something I said about this. It is a good time to clarify. There are different causes of PTSD but all are being diagnosed and treated the same way. They treat someone surviving a hurricane (one time event) the same way they treat a rape victim even though a hurricane always comes with a warning but rape does not. The threat of something happening again or not is part of what has to happen in therapy. Something that happens in a natural disaster is not man made. Rape is. It is done to the person by another person's actions. Worrying about it happening again is part of what PTSD does. Then the human issue of forgiving comes into it. Forgiving their attacker while seeking justice is tricky. It requires a lot of work to do that but once it is done, life gets better not carrying that burden on top of everything else.

Abuse is another one especially when you live with the person. For me it was my Dad, a violent alcoholic until I was 13. Then my ex-husband tried to kill me. Huge difference between what nature does and what people do.

They treat someone with PTSD after a car accident the same way as the other three even though the threat to them is the repeated every time they get into a vehicle. Again it is the human factor of someone causing the trauma or worse, when they caused it.

Firefighters are another different group. They put their lives on the line everyday and when they are not rushing to a fire, they are waiting for it. They don't know when the next alarm bell will ring. The friend I talked to yesterday is involved with firefighters. He told me that some of them are armed when we were talking about how cops and military folks use weapons. (That is something we can explore later as I learn more about that aspect.) For the average firefighter, again, there is a huge difference between the type of PTSD they get hit with because of the nature of the trauma, the threat to their lives and concern for facing it all over again. There is survivor guilt when they couldn't save someone or when one of their friends die in the line of duty.

We are all talking about the bombs in Boston last week and people seeking things no one should have to see because other humans decided to do it and others decided to help afterwards. They will have a lot to deal with on a whole different level. It is close to what firefighters/first responders face on a daily basis. Lives on the line and seeing things no one should have to see but they know someone has to do it.

Then you have police officers and the troops. Cops know the risk every time they clock in but they get to go home at the end of their shift. The troops don't while they are deployed into combat zones. The troops get to go back to the states away from combat, but cops have to get up and do it all over again everyday. (Getting how complicated all this is yet?) Both groups have to use force and become part of the event itself. The nature of the trauma is much different for them from the other groups and they have to be treated differently.

Then you also have the secondary stressor. I had a DEA agent years ago contact me because he was worried about losing his security clearance. He was a combat veteran and had been through a lot working on both jobs yet it was not until his younger brother was killed in Iraq that it hit him like a ton of bricks. What he discovered was he was pushing past mild PTSD and not addressing it. He was not ready when he was hit by the event that was the thing to wake up sleeping PTSD.

That is something that is happening right now after the bombings in Boston. People will react differently when they go out in public and need help right now. The victims will need a different kind of help. For the responders, they will need help too. Yet if they are treated the same way, then they will need a lot more help then they would have if they are treated properly right now.

There are experts who are not experts in trauma, but there are experts in trauma that I learned from over all these years. They are out there and those are the people who should be running the studies like the one you just read about. They are the ones who should be listened to if we are ever going to get any of this right. If we keep listening to the ones doing the talking most of the last 40 years, the ones getting the attention and funding, then we are all screwed.

They say take care of all parts of the survivors of trauma with their minds, bodies and spirits and then you have healing. Otherwise we have the history of PTSD being repeated.