Filed under: PTSD
The U.S. military supports the use of service dogs and therapy dogs to help wounded warriors obtain a higher level of independence, well-being, and purpose.
There’s an important distinction between service and therapy dogs. Service dogs are trained to do work or perform specific tasks for those with disabilities (as defined in the Americans with Disabilities Act). The dog becomes a full-time companion for the person it serves. Service dogs also can retrieve objects, turn on lights, or open doors for those with mobility issues. Guide dogs assist visually impaired individuals, and signal dogs alert those who are hearing-impaired.
Therapy dogs offer goal-directed emotional, psychological, and (sometimes) physical support. They’re trained to provide comfort, affection, and unconditional acceptance. They can complement treatment for depression and post-traumatic stress disorder (PTSD) too. A therapy dog usually belongs to its “handler,” who accompanies it on visits to patients. Such dogs also complete special training, but it’s less lengthy than that of service dogs.
The value of animal-assisted interventions (including service and therapy dogs) has become widely accepted. The range of benefits includes positive physical and psychological health effects. Just physically touching a dog can reduce blood pressure, anxiety, stress, and hopelessness. These dogs are helping injured and ill service members at military and veterans’ hospitals across the country.
A special program exists where the roles of dogs in service and therapy come together: Veterans with PTSD train service dogs for veterans with mobility issues. This is a win-win: Both the veteran-trainer and the mobility-impaired veteran benefit from the same dog. Veteran-trainers learn and use positive methods of shaping a dog’s behavior, and as they do so, regain control of their own emotions, focus their attention, improve their social competence, and gain a sense of meaningful purpose.
Adding yoga to your existing pain management plan can help ease pain from injury or illness. An integrative mind-body approach, it often combines meditation and breathing with exercise and stretching. It can be done home, either on your own or with the help of a video, or in a class with an instructor. Yoga and other mind-body practices are recognized by DoD as treatment strategies to help regulate and manage pain-related stress. In addition, yoga and meditation can help relieve symptoms of PTSD. Read the full article for more information...
Sometimes just understanding what’s going on can help the process of recovery. If you’re experiencing post-traumatic stress disorder (PTSD), it might help to have a better idea of how your brain functions and how the various parts are supposed to work. This also can help you understand the treatments used to help “rewire” your brain, so it can work properly again.
PTSD is a mental health condition stemming from traumas—experienced during combat, disasters, or violence—that impact brain functioning. The alarm system in your brain, that normally helps ensure your survival, malfunctions; it becomes triggered too easily. In turn, parts of your brain responsible for thinking and memory stop functioning properly. When this happens, you have difficulty comparing what’s happening now with safe events from the past. Read more...
There’s a promising therapy that uses virtual-reality simulation to help treat service members with post-traumatic stress disorder (PTSD). According to the National Center for PTSD, 10–18% of returning Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) veterans experience PTSD. The good news is that treatments such as virtual-reality exposure therapy (VRET) might help them work through their challenges.
Trained therapists use VRET to re-create stressful events or situations such as combat scenarios in a virtual-reality environment. The patient wears a headset and interactively reacts to possible sights, smells, sounds, and vibrations that have been visually re-created. This makes the experience realistic for the patient as it provides a strong sense of “being there.” Veterans learn to work through emotions such as fear, tension, and anxiety in a safe environment.
Healthcare providers have successfully used virtual-reality simulation as a resilience-training tool too. It helps builds service members’ confidence and coping skills so they feel stronger and ready for what comes next.
Visit the National Center for PTSD to learn more about post-traumatic stress. Here’s what VRET looks like in action.
Mindfulness can help you feel better equipped to handle difficult emotions. It’s a process geared to help you tune in to emotional experiences rather than try to escape from them. It’s easy to be overcome by depression, anxiety, PTSD, addiction, or other mental health problems. And you can make it worse by trying to forget the cause. For example, a service member afflicted with PTSD desperately wants to avoid experiencing certain traumatic events. Ironically, the actual effort to forget can cause him to relive difficult events through dreams, flashbacks, or memories. To illustrate this idea, right now, try NOT to think of weapons. You probably thought about them that much more. Read more here.
Not everyone is affected the same way by exposure to injury and death. Many who do experience psychological wounds, however, come out stronger as a consequence, and so can you. If you’ve experience a traumatic event or experiences, there can be an upside: It’s called “post-traumatic growth” or PTG. It’s about finding a “new normal” that is even better than how things used to be. PTG can mean better relationships, openness to new possibilities, personal strength, spiritual change, or heightened appreciation of life. In addition (and researchers are still trying to understand why), if you get PTSD, you’re actually more likely to experience PTG. Nobody wants to experience PTSD, but if it happens, you may have an amazing opportunity to come out the other side with some unique strengths.
Walk into the new facility of the National Intrepid Center of Excellence (NICoE) on the campus of Naval Support Activity Bethesda, and one of the first things you will see is a sign commemorating the center’s origins, including the fact that the $65 million facility itself was donated by the Intrepid Fallen Heroes Fund. NICoE is committed to the interdisciplinary diagnosis, treatment, and long-term healing of Warfighters, and educational support for their families, from all branches of service.
Unlike many military environments, the facility is curved, spacious, quiet, and pleasant. Some notable features are the high ceilings, artwork, and state-of-the-art treatment rooms.
Patients at NICoE typically are active-duty service members with mild traumatic brain injuries (mTBI) combined with other psychological health conditions such as post-traumatic stress (PTS), anxiety, and depression. Most have already begun treatment elsewhere, often with many medications. The tranquil environment of NICoE instantly helps put them at ease and often leads to more effective treatment with fewer medications.
Recognizing that traditional therapies can’t heal all wounds, NICoE has rooms dedicated to art therapy, virtual reality, and meditation. Beautiful masks line the entrance to the art therapy room, providing a small glimpse into Warfighters’ individual and unique roads to recovery. The virtual reality room allows Warfighters to face traumatic scenarios at a pace that makes sense, an incredibly lifelike setting full of sound, movement, scents, and images. The spirituality room lets in natural light to a space with a beautiful wood floor surrounded by natural plants and a speaker system that plays sounds of nature.
An interdisciplinary approach, combining traditional and integrative medicine, contributes to NICoE’s 99% satisfaction rate, with more than 600 patients from all different services having completed their four-week program. There is no one-size-fits-all approach to healing, and the interdisciplinary makeup of the clinical team enables patients to pursue various treatment options. Providers can collaborate regularly and have cutting edge equipment at their disposal.
Patients usually bring a non-medical attendant, often a spouse or parent. Children also are welcome at NICoE. A private family room with frosted glass includes a children’s play area, and a playground is located behind the facility.
NICoE also focuses on research to help ensure long-term treatment success. There has been discussion of opening their doors to a wider range of Warfighter patients (treating more conditions) and opening more NICoE satellite centers. Referred to as Intrepid Spirits, such centers are open already at Fort Belvoir and Camp Lejeune. The Intrepid Spirit at Fort Campbell will open this summer, and ground was broken recently for one at Fort Bragg. Other bases that may receive an Intrepid Spirit include Forts Hood, Bliss, and Carson, along with Joint Base Lewis-McCord and Camp Pendleton.
Mindfulness can help you feel better equipped to handle difficult emotions. It’s a process geared to help you tune into emotional experiences rather than try to escape from them. People can feel overcome by depression, anxiety, PTSD, addiction, or other mental health problems, which, ironically, can be exacerbated by trying to forget the cause. For example, a Warfighter afflicted with PTSD often relives difficult events through dreams, flashbacks, or unwanted memories, because he/she desperately wants to avoid experiencing those events. To illustrate this idea, right now, try NOT to think of weapons. You probably thought about them that much more.
Practicing mindfulness mediation means focusing on whatever you are experiencing in the present moment. It can be a structured meditation activity, but because mindfulness is about being present, you can purposefully engage in mindfulness anytime, anywhere. A common meditative approach is to focus on a physical experience such as your breathing, noticing where your attention wanders, and gently guiding it back to your breath; it allows you to experience sadness, anger, fear, and other unpleasant emotions, letting them pass without clinging to the idea of making them go away.”
If you have ever “white-knuckled” your way through an amusement park ride (or ridden in a car with a driver you didn’t trust), you may remember thinking, “When will this be over? Please let it be over…” This shows that focusing on how long something lasts can make it feel like an eternity. By engaging in mindfulness, you will feel less threatened by certain emotions, and you will be less likely to engage in problematic forms of escape (such as drinking, drugs, or simply spacing out).
When people experience difficult emotions, they often cope by engaging the language center of the brain, using words internally to wrestle with the experience. But when people have difficulty re-evaluating why they feel the way they do, this leads to a circular internal debate (such as “I shouldn’t feel this way, but I do, but I shouldn’t…”), which can be pointless and can actually cause more distress. Emotions can be dealt with not just through words but also by tapping into their physical elements (noticing how you feel in your body). When people engage in regular mindfulness practice, the parts of their brains tuned into physical sensations are activated while they experience hard emotions. And people who regularly have this part of their brain activated tend to be more emotionally steady.
Unfortunately, it’s difficult to escape unwanted emotions. And more problems will probably pop up as you try to escape. But if you’re willing to face hard emotions, letting them come and go like waves on a beach, then mindfulness practice can help you have a different experience. Tune in to HPRC for more mindfulness resources, and take advantage of the fact that mindfulness is everywhere now, whether part of your martial arts or yoga class or filling the self-help shelves of your local bookstore. Become more mindful, and you can feel better equipped to handle tough emotions; your mind and body will engage them more productively.
PTSD was finally recognized as a medical condition when recent advances in neuroscience showed that the brain no longer works properly after trauma. Your brain has an alarm system to help ensure your survival; it’s useful as long as it works properly. When the alarm system malfunctions because traumatic events pushed it to its limits, the part of the brain responsible for thinking and memory can’t function properly. When this happens, a person with PTSD can’t compare what’s happening now with events in the past when they were safe. However, there are treatments to help “rewire” the brain, so it can work properly again. Learn more about this in “How post-traumatic stress affects your brain”.
Post-Traumatic Stress Disorder (PTSD) can tear apart your sense of what is safe and of what is good.
Part of the diagnosis of PTSD is exposure to a traumatic event: death, serious injury, sexual violence, or the threat of any of these. PTSD symptoms such as intrusive memories, avoidance of situations or feelings, problems in thinking or mood, and feeling overly amped up are common reactions to abnormal circumstances. Think of PTSD symptoms as self-preservation instincts gone haywire. One theory holds that, because you nearly died or experienced something awful or could picture it because it happened to someone close to you, your mind/body tries to sound the alarm bells to keep you safe. But the alarm bells sound at the wrong times and in the wrong ways.
However, PTSD symptoms can come from sources other than fear of bodily harm. They also can arise from inner conflict, when emotions trigger feelings such shame and guilt or when you question fundamental beliefs (such as “the world is basically good”). Witnessing or experiencing betrayal (especially by a leader in a high-stakes situation), within-ranks violence, extreme violence, and incidents involving civilians are some of what can disrupt your world view. It isn’t just an event but the interpretation of an event that causes Warfighters to experience “moral injury.”
If you suffer moral injury as part of PTSD, you start believing you live in an immoral world, or you view yourself as immoral, irredeemable, and defective. If you’re a Warfighter experiencing these feelings, you not only feel lousy, but you are more likely to isolate yourself just when you need others more than ever. Isolation can lead to self-handicapping or self-destructive behaviors.
So how do you save yourself from experiencing moral injury as a part of PTSD? Having a healthy sense of self-esteem can be one of your best protectors. There are no quick fixes. But forgiveness—of others and of yourself—can help you to let go of moral injury. With the help of a psychotherapist, you can begin to wrap your heart and mind around what happened. And pursuing positive interactions, such as getting involved with charitable groups, can give you opportunities to relearn that you are good and the other people in the world are generally good too. Last but not least, connecting with your spirituality—in whatever way is comfortable to you—can help you navigate this difficult journey.