John Collins sits in his dimly lit living room, violently shaking his right foot after sitting down on his sofa to recount his missions as Mass Communications Specialist First Class in the Navy while serving in Operation Desert Storm and most recently, in Afghanistan. The dark circles that encompass his eyes allude to the terrifying nightmares that he suffers on a frequent basis. The slight tremor in his voice hints at his emotional fragility while speaking of the horrors he saw on the battlefield.
Deb, only wanting to be identified by her first name for confidentiality reasons, could not drive a car or even leave her own home to pick up her children from school because of the seizures she suffered from for years due to growing up as the child of two alcoholic parents and a brutal rape she endured at the age of 18.
Both John and Deb are very different people with completely different life experiences but share one thing in common, Post Traumatic Stress Syndrome. PTSD is a mental condition caused by a traumatic event or series of traumatic events. Clearly, both John and Deb have seen and experienced traumatic events. But PTSD is not just experiencing the trauma. It is re-living the trauma repeatedly in your mind over a long period of time to the point that it can inhibit your life.
The general symptoms of PTSD may include but are not limited to flashbacks, or re-living the traumatic memory in their head like they are actually in that traumatic moment , nightmares, avoidance- such as not speaking or trying to think about the trauma, emotional numbness, a feeling of severe helplessness or hopelessness, memory and concentration problems, or difficulty maintaining close relationships.
Severe anxiety type responses to PTSD may include extreme irritability or anger, an overwhelming sense of guilt, possibly “survivor’s guilt”, overindulgence in alcohol or other self-destructive behaviors, recurrent trouble sleeping, hyper vigilance such as being startled or frightened easily by loud noises or even hallucinations.
Post-traumatic stress disorder symptoms generally appear within the first three months following in the traumatic event but have been known in some cases to show up many years later. Symptoms may become more prevalent in times of stress or only when a sufferer is faced with a reminder of the event. For instance, John cannot let himself be around fireworks because the sound reminds him of 30 mm rockets going off around him while in battle.
At first, John did not think he had any symptoms of PTSD. But shortly before his tour was up in Afghanistan, John started to experience blackouts. Then, upon arriving stateside, the night terrors started. He says he wakes up sometimes and can smell gunfire or hear people speaking in a foreign language.
John’s main job was to document the war as a journalist and photographer. In other words, in his 23 missions, while soldiers ran around with their weapons, he ran around with his camera and says, “When a guy I was with got his face blown off his head, my job was to photograph it.”
It has not yet been determined who all can be affected with PTSD. Those most commonly afflicted with PTSD are those who have experienced extreme traumatic events in their life such as veterans, crime victims, or victims of rape, sexual, or physical abuse.
A recent study published in the Journal of Affective Disorders determined that PTSD is associated to a person’s genetic make-up. However, some clinicians disagree and say that a person’s vulnerability to PTSD depends on the amount of trauma a person is exposed to and the severity of the trauma.
There are several treatments for PTSD .Cognitive therapy or talk therapy, hypnosis, drug therapy and Eye Movement Desensitization and Reprocessing or EMDR are the most common treatments. Some clinicians may even use a combination of therapies or all therapies according to their patient’s needs and responses.
Anna Whalley, Licensed Clinical Social Worker and Administrator of Shelby County Crime Victims Services in Memphis, suggests that it is not necessarily what the trauma might be that a person endures, that it is how a person responds to the trauma. Whalley says, “Not everything is going to work on everyone.” Whalley and the Shelby County Crime Victims Center/Rape Crisis Center see a variety of people affected by traumatic incidents such as those who have been a victim of a crime such as sexual violence, domestic violence, those who may have been a witness to homicide or those friends and family left behind after a homicide. SCCVC also treats those who may have encountered violent crime such as home invasions, armed robbery, and assaults as well as senior crime victims.
The Shelby County Crime victims Center strives to help victims return to their pre-trauma level of functioning by lowering the levels of their post-traumatic responses with talk therapy, relaxation techniques, and EMDR. SCCVC also provides crisis counseling, legal and social services such as accompanying a victim to court, education, and awareness of community resources.
Whalley says, “What we do here is to help people develop a “new normal.”
Talk therapy can be used as a primary therapy for PTSD or it may be used in conjunction with hypnosis and EMDR. Talk therapy helps a person discuss their problems one-on-one with a therapist who tries to understand the person’s problems and to help the individual change distressing thoughts, feelings, or behaviors.
While talk therapy may work for some PTSD patients on its own, most therapists who use hypnotherapy and EMDR use talk therapy in the beginning as a way of establishing a relationship with their patient before moving forward with more specialized treatment.
Hypnosis is also a form of treatment for sufferers of Post-traumatic Stress Syndrome. The antiquated belief of a magician standing over someone with a pocket watch telling them how sleepy they are and making them cluck like a chicken without remembering could not be any further from the truth. Hypnosis is a legitimate form of therapy. It allows the patient to go into a deep state of relaxation that opens up the subconscious.
Eric Cassius, Licensed Professional Counselor and Certified Hypnotherapist, of Cassius and Associates provides counseling and hypnotherapy to his patients. Cassius views PTSD as a severe anxiety disorder. He believes that trauma, whatever it may be, triggers anxiety. Then, the person gets anxious about the anxiety. In other words, Cassius believes that it is not the trauma that someone is anxious over- that it is the feeling of anxiety that the trauma caused that is the problem.
That is where hypnosis comes in. Hypnosis allows Cassius to get the patient quiet and relaxed through deep breathing. Then, he takes them back to the original traumatic event in their mind. This may be very upsetting for the patient. He believes that the patient made a decision at the time of the trauma how to feel about it or themselves, and what he does with the hypnosis is take them back to that decision and have them step outside themselves and tell the person that made the decision about the trauma to make a new, healthier decision about the event, to feel better about it or more confident in themselves. They literally re-decide the trauma. This is called re-decision therapy in hypnosis. The whole time, the patient goes through the trauma and re-decides the outcome in a safe, calm and relaxed environment and state.
Cassius has seen very beneficial results therapeutically speaking with his patients using hypnotherapy. “I have seen a lot of people that with 5 sessions of hypnosis, they are calmer and are on less meds or no meds at all,” says Cassius.
Cassius does say that PTSD does not ever go away completely, “Anxiety is a part of life,” but that the memories of the event can be toned down dramatically.
Drug therapy is used quite often for PTSD. Antidepressants, anticonvulsants, anxiolytics, beta and alpha blockers, and atypical antipsychotic drugs are all typically used to treat PTSD. While drug therapy may work in some instances, a study from the American Medical Association involving veterans and the treatment of PTSD concluded that the two drugs most widely used for treating veterans with acute PTSD did not reduce the severity of the PTSD for the patient, produce improvement, or, “increase quality of life in patients with chronic SRI- resistant military-related PTSD symptoms.”
Retired Mass Communications Specialist First Class, John Collins refuses to take any drug but prazosin, a drug used to treat high blood pressure, to treat his PTSD related nightmares. In recent years, prazosin has been seen as an effective, non-habit forming way of treating PTSD related nightmares. John refuses to take any drug considered habit-forming because he has seen too many friends from his days in the military develop addictions to narcotics and suffer a myriad of consequences with their addiction.
Collins sought additional therapy through the VA Hospital in Memphis a few months ago but was told it would be a minimum wait of 9 months to see a therapist. Collins is quick to defend the VA on this point and says that there are so many vets with PTSD now that it is almost impossible to keep up. Collins says of vets with PTSD, that, “… you can’t see combat, and come out without feeling the effects.”
Eye Movement Desensitization and Reprocessing or EMDR has been incredibly successful in treating PTSD patients. EMDR was developed by Dr. Francine Shapiro Ph.D. in 1987. Shapiro discovered by chance that moving her eyes from side to side while recalling a traumatic memory appeared to reduce the disturbance of negative thoughts and memories. EMDR was born.
EMDR clinician, Cynthia A. Warren, Master of Science and Licensed Professional Counselor, practices counseling and EMDR at Cassius and Associates. Warren develops a clinical relationship with her EMDR patients initially with talk therapy. After discovering whatever the traumatic event may have been suffered, she has the patient fill out a form in a session which asks what the primary event or issue is, what the overall picture of the event is, What negative beliefs they have about the event or themselves concerning the event, a positive thought they would like to think about themselves or the event now, a scale from 1 to 7 of how the positive belief feels to them now, what emotions they feel concerning the event or themselves now, and finally, on a scale from 1 to 10, 0 being no disturbance and 10 being the greatest disturbance, how they would rate their disturbance level now.
The following session is when the EMDR therapy will begin. Warren attaches a machine with ear phones that produce sounds back and forth from ear to ear that creates the side-to-side stimulus for each side of the brain. Then, Warren gets her patients to a state of deep relaxation through breathing techniques and finding a safe place in their minds. Next, she goes through the worksheet that she and her patient filled out previously. After each question, the patient stops and processes, then goes to the next question. After going through the questionnaire, Warren does more relaxation techniques with the patient to restore calm due to the emotional nature of re-living the trauma.
Warren finds that while children and a select few may only require one session of EMDR therapy, on average, she says it takes 3 to 4 sessions to significantly decrease the levels of disturbance surrounding the event or negative feeling about themselves due to the trauma.
Warren says of EMDR therapy that it is not anything dramatic, “It’s subtle.” Warren recalls a patient telling her after completing EMDR that, “I can think about it. I know about it. It feels like the memory is further away.”
Basically EMDR is a combination of re-living the traumatic memory with a physical stimulant that re-organizes where the memory is stored in your brain, thus making the memory less traumatic while instilling a new and positive belief about the event.
While EMDR and hypnosis may seem strange, Warren says in her experience with PTSD patients that, “they are willing to try anything to get some relief.”
That was certainly the belief of rape victim, Deb, who also grew up the child of alcoholics. She had even been misdiagnosed with epilepsy at age 20. Deb’s anxiety over her rape and tumultuous upbringing led her body to, “manifest it (PTSD) as seizures, a stroke, migraines, and an inability to communicate verbally”.
Deb was unable for almost 20 years to drive on a consistent basis, was unable to pick her children up from school and was on constant medication - 4 medications at once during the height of her struggles. She was completely homebound for 3 years and considered filing for disability.
Finally, Deb tried EMDR therapy and talk therapy at the urging of a friend. The therapies were so successful that today she is med-free, drives every day, and feels like she can, “function again.”
One thing that all of those who have suffered with PTSD or clinicians who treat it seem to agree on is that the sooner someone who thinks they may have PTSD gets help, the better.
PTSD can have devastating effects. Those who go untreated may experience severe depression, physical manifestations, or even attempt suicide.
Major Sander Snowden is a Company Commander who led 190 reserve unit Marines in his tour in Afghanistan. Snowden says that while deployed, the marines have each other. They function as their own support system.
Upon arriving stateside, Snowden says that with reservists, they deploy for a year and then they come home and are immediately sent back to civilian life where everyone, including friends and family are very supportive. There is about a 4-month period high, where people are patting them on the back for their efforts in fighting for their country and they have a little money in their pocket. But, things do not always stay that way. Snowden says, “After that 4 months, a Marine will experience depression because the find that they spent all their money, have no job, and no one is there to pat him on the back anymore.”
Snowden has lost several of the men he commanded to suicide since coming back to the U.S. in April of 2011.
Snowden says he tells his men that it is very important to check up on each other and his unit has weekly “welfare calls,” where the Marines each call the same three friends every week to check in. But even that Snowden says doesn’t stop the suicides. “If they want to do it- they are going to do it.”
There is a hotline that is completely anonymous and free for military personnel to contact at militaryonesource.com.
Snowden encourages anyone suffering with PTSD, not just military to seek help, “Don’t ever try to handle it by yourself. It is bigger than you. You are not alone. Other people have been there.”
Collins agrees. He says to fellow veterans and anyone suffering with PTSD to, “Go get help. It only gets worse. “
