I just came back from giving a talk to a local group of vets and their counselors. Not going to say exactly where for confidentiality reasons, but I really love giving vets my perspective on PTSD, because it is so different from the medical model with its random collection of weird symptoms and the current 8 week cures. One of the counselors said, and I agree completely, "These new therapists say they are going to cure these guys in 8 weeks. It is insulting. No one would tell the mother of someone killed in Iraq or Afghanistan that they were going to cure their grief in 8 weeks!"
Combat PTSD involves HUGE amounts of grief over friends, ideals, beliefs, and body parts lost. How do you cure that in 8 weeks?
Cognitive Behavioral Therapy of PTSD has a short track record and does not "cure" everyone, but only a percentage. The follow-up studies do not cover a lifetime. PTSD comes back with further trauma because it is a set of survival skills built into your brain, which are activated by war and other traumas. There is nothing a therapist can do to keep you from suffering further traumatic events. Life happens. Shit happens.
The CBT therapies were not developed using combat vets. I think they work on some people. But people need to find out what works for them, not what works for the therapist.
Of course it is easier to apply a manualized therapy and pretend that's it, but for our vets often that isn't it. They simply stop talking and looking for help.
This recently happened to a friend. He finally went to see someone at the VA about his depression, and this woman told him, "I just don't allow myself to become depressed." Well if he could do that, he wouldn't need her help. He felt insulted. Needless to say, he won't be going back.
At one VA I gave a talk at, they told me that the CBT therapist don't let them swear in group. How do you talk about war, real war, ugly, bloody, horrible experiences if you can't swear. It is like these therapists are so full of themselves they have absolutely no comprehension of what vets have been through. I wish they would read Recovering From The War, or some of the recent vet memoirs, and wake the fuck up!
One thing I love to see is a bunch of vets start to nod and sit up and look interested and hopeful as I explain how hyperalertness (attention to threat and the ability to move faster than thought) are built into the reptile brain. So is the ability to rapidly adapt to whatever is going on so you can be in control, which means you become numb so you can do whatever you need to survive and keep others alive.
The talk I gave, The War at Home, goes through each PTSD symptom, giving the vets an idea of what it did for them during the war, what it may be doing to them now, and how that may affect the family. Most of them have never heard anything like what I say before.
I love doing it.