Much has been said and written about PTSD since Viet Nam and the conflicts in the Middle East. I think there needs to be some clarification on this matter. Many professionals serving First Responders at home use the term “Critical Incident Stress”, and have developed Debriefing protocols that have proven effective in addressing those who have been involved or who have witnessed single traumatic events. Neither this syndrome nor its protocols should be confused with Post-Traumatic Stress or the Disorder that describes its symptomatology.
PTSD results from prolonged exposure to traumatic stress or to the posibility of such occurances. PTSD developes from being involved in unexpected firefights, or it may come from a such routines as driving in supply convoys through territories where there is a potential of ground attack or roadside IED bombs. The traumatic stress is constant in both cases, and without after-action help, the stress carries over even when threats are no longer present. EVERYONE WHO HAS BEEN IN COMBAT or in the theater where such stress is likely, has PTSD. It is just a matter of the degree in which its effects are evident to the soldier and/or to his/her observers.
The symptoms of PTSD are listed in every tome on the subject: startle reactions, nightmares, irritability, avoidance of stressful situations, addictions, etc. What I want to address here is the etiology of PTSD. Those who have experienced combat know well that if one is overcome by emotion in a fight, one will get killed. Soldiers quickly learn to deal with threats of the moment by suppressing feelings so one can respond instantaneously. When one returns to safety, spontaneous vomiting, or other delayed involuntary emotional reactions to what had occured are then commonly experienced. Often there are day or night dreams that relive or exaggerate the frightful event(s). The point is that the combattant learns to suppress his/her emotions over a period of time, which extends beyond the period of threat. Abreation or retelling the traumatic experience(s) begins the process of connecting one’s feelings with an event, and this process takes time (and sometime treatment) – even months or years. This breaks the practice (or “racket”) of keeping emotions appropriate to the stressful occasions of life in the UNCONSCIOUS MIND where they can control us, transposing them instead into the CONSCIOUS MIND where one can control the emotions and the related behaviors! It is common to hear a combat veteran, years after his trauma, respond to a former buddy at a unit reunion, “Damn you for making me remember !” But such is the very beginning of a healthy process for the one suffering from PTSD.
The family is the threshold for returning to society for the returning combat veteran. Many of the symptoms of PTSD have a negative, even frightening, effect on members of the family. One glaring sign of PTSD is when the returning soldier confronts problems or disliked responsibilities in the home or marriage, he/she retreats to the barracks, ship, or hanger to find buddies (which I call “the 2nd Family”) with whom previous bonding has been experienced, in avoidance of solving problems at home or in the family. When confronting potentially destructive symptoms of PTSD by the returnee’s loved ones, the spouse or parent needs to seek professional advice, rather relying on patience that may reach its limits with negative results.
PTSD is a normal reaction to the abnormal experience of combat or the continuous threat of trauma. Deployment experiences change every person involved – both those at home and those abroad. The Servicemember may have a difficult time accepting therapeutic help, thinking it is a sign of weakness – in his or her own eyes, or in the eyes of others or of one’s superiors. However, war is an overwhelming experience, and adjustment in the process of returning home and to society may require the understanding help of a trained outsider for adjustments to be made by both the veteran and his host family members. Such may expedite a fitting welcome to a normal life in close relationships and in peaceful surroundings.