Post Traumatic Stress DisorderMilitary PTSD

I watched a TV program this week which featured Ross Kemp (that bloke off East Enders) exploring soldier’s experiences of Post Traumatic Stress Disorder.

The program was first shown on Sky on 12th November 2012 – but is still painfully relevant.

Ross talked to three ex-servicemen who had experienced traumatic events during the Falklands War thirty years ago. Some were never diagnosed, but all had suffered appallingly for decades following their experiences. Ross made the point that current statistics indicate that something like 6% of service personnel are affected by trauma and that 180,00 troops have served in Iraq and Afghanistan in the past decade. The inevitable conclusion is that there are going to be devastating unintended consequences of these wars over the next twenty years amongst those who return to civilian life still fighting their own personal battles – irrespective of whether they are formally diagnosed or not.

Common Misconceptions

What alarmed me about this program was not the suffering or the magnitude of the problem. In my work, I receive referrals for clients who suffer the effects of military PTSD and am well aware of the damage it causes. What shocked me was the degree of misunderstanding about the condition which still prevails even amongst those who are clearly doing their best to help.

Although the program did show how some people had recovered, there was clearly a suggestion in the first part of the program that “PTSD is a lifelong condition”. That ongoing long-term support is always required. One soldier who was doing well had received therapy over a period of four years.

Walter Busuttil (Director of Medical Services at Combat Stress) drew the analogy between PTSD and “a fuse blowing in the brain”. I have had clients who greatly value the help they have received from Combat Stress, and specifically from Walter Busuttil. But I think this is an inaccurate and damaging metaphor. No one repairs a blown fuse – but the effects of even the most severe PTSD can usually be overcome by using the right approach.

The More You FEEL, The More You HEAL

Perhaps the most depressing statement was made by someone within TRIM (The army’s Trauma Risk Management unit) who proclaimed to a group: “Remember, the more you FEEL, The more you HEAL”. This statement is in direct contradiction to my training and my experience. And more to the point, it is contrary to the intuition of most sufferers of PTSD. They instinctively feel that they do not want to talk about their experiences, much less emote about them for fear of making their condition much worse. I suspect that this myth is one of the main reasons that so many soldiers do not even ask for help. Couple this with the implicit suggestion that there really is no cure, or that you might need four years of therapy and ongoing support – and you get the situation where sufferers expect little more than and are prepared to accept continuous misery for thirty years or more. They actually believe there is no other option.

But Surely Talking Helps?

It is true that sufferers of PTSD sometimes switch off their emotions entirely in order to protect their sanity. It is also true that a return to health is likely to include a re-activation of emotions. But to suggest that the route to health lies in encouraging the client to get emotional is a misconception that lies at the heart of much so called therapy.

The most effective methods for detraumatising sufferers of PTSD, involve reducing emotional arousal rather than raising it. Yes, the images and feelings associated with the traumatic experience certainly need to be processed, (put into a narrative context) and therefore need to be accessed. But a skilled therapist knows how to do this without the soldier needing to even describe the actual events. And they are careful to only do this while the soldier is in a state of deep relaxation.

Reasons for Hope

I know, because I have studied it, used it and seen the results first hand, that the human givens approach can help people overcome the debilitating effects of trauma quickly, effectively and permanently. But this approach has only been around for ten or fifteen years. It took CBT (Cognitive Behavioural Therapy) at least forty years to become fully accepted.

Professor Simon Wessely is Professor of Psychological Medicine at the Institute of Psychiatry, King’s College London and Head of its department of psychological medicine, Vice Dean for Academic Psychiatry and an advisor on PTSD to the MOD. I once asked him what he would need to know about a new approach to military PTSD in order for it to hold his attention – he answered “A properly conducted, peer reviewed Randomised Control Trial”.

Until such a trial is funded, conducted and the results published in a respected peer reviewed journal, I and my colleagues have to accept that we are pioneers. We do what we can wherever we can – sometimes in opposition to the established order. I sincerely look forward to a time when Ross Kemp and the people he has access to, know and accept that there are serious alternatives to thirty years of pain and suffering. I look forward to the time when they know that it does not take many sessions, cost much money or require more pain before the gain, that the idea that “The more you feel the more you heal” is a myth akin to the blood letting which doctors routinely prescribed not so many years ago.

I guess I am an optimist – you have to be an optimist when life’s events cast you in the role of a pioneer. One positive note from the program was the observation that things had already improved in the 100 years since the First World War – after all, we used to shoot sufferers of Shell Shock (PTSD) on the spot.

If you are suffering from trauma (regardless of whether you have a formal diagnosis) and you have an MOD number, you can now get free help from a national charity: “PTSD Resolution” – see http://www.ptsdresolution.org. Contact them directly, or contact us at in8 to find out more.