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Sunday, December 19, 2010

A Pill to Prevent PTSD

I have to laugh when I read this kind of stuff. Are they gonna give a pill after every firefight and every IED? After every time a pedophile molests a kid whom he or she has picked because the parents won't know or won't believe? After every time a battered wife is battered?
This morning, I was thinking about the brain-based survival skills that are activated by danger. We all have them. They are built into us. Attention to threat, the ability to rapidly adapt to whatever is going on (i.e. numbing) and the capacity to pour on the adrenaline to move before thought and do whatever it takes to survive don't reside in the forebrain where we think, use words, use logic, plan. These abilities are built into what they called the reptile brain when I was in high school biology, a part of the brain that doesn't speak English, and can't tell time, so it can't tell something is over. It is also a better safe than sorry system, so it keeps reminding the survivor that the world is not safe.
And they are going to disable this with a pill? Don't they think this system is what has kept the human race alive?
If you jump at a cat, you see the same system in action. Move, adapt, live!
There's a book about meditation, Don't Just Do Something, Sit There. People with PTSD don't need a pill, they need training in techniques that allow them to choose when to be numb (it can have certain advantages when dealing with bureaucracy) and when to feel, when to let hyperalertness take over and when to be calm, when to remember and when to step away from the memories. Meditation is one way to learn how to do this. So is yoga. Somatic therapies developed by Pat Ogden and Babette Rothschild also work. So do the exercises taught in Dialectical Behavioral Therapy developed by Marsha Linehan.
They also need to process what happened to them, moving the non-verbal memories which keep activating symptoms into the forebrain by using words, writing or talking about what happened. It hurts, but then they have already lived through the pain of the actual events.
Avoidance perpetuates PTSD.
Is this pill a form of avoidance? Who knows? I don't, and they don't, but I just can't imagine soldiers taking a pill after every firefight. Would they lose their edge? Who will volunteer to find that out or are we just going to blindly do it like they are now doing with sending soldiers back who have PTSD, on drugs that are un-tested in randomized clinical combat trials?

Tuesday, December 14, 2010

Does it ever change?

I found this Time Magazine article while trying to find information on the VA Hospital in Rutland Heights, Massachusetts, where I grew up and my dad was chief surgeon. We moved there after the time of the article, and probably they wanted my Dad because he had been a thoracic surgeon in WWII in Europe so he was a good surgeon and a vet, too.
What I find so surprising is that this article was written after the big one, the good war. Apparently the greatest generation was not the greatest generation when they got home. I think they probably had to fight to get good treatment just as Vietnam vets and OIF/OEF vets are having to do.
Most VA's these days have excellent medical care, but they are overwhelmed because during the previous administration, the VA budget was cut. This was an unfortunate but not unexpected result of a war begun by people who had never been to war. They had never seen the physical damage war does to people, so they failed to plan for the wounded. And like most foolish war planners through out history, they thought the war would be over in a few months.
They also believed the right-wing propaganda that real men are not bothered by war and PTSD is a left wing conspiracy against our troops, so they started attacking the diagnosis.
The actual left-or-right-wing conspiracy against our troops took place during the Vietnam War when DSM II came out (1968) and dropped all mention of post-traumatic reactions from the list of available diagnoses.
At the bottom of the article if you look closely there is a footnote that says:
"Veterans' Hospitals are of three types: general, neuropsychiatric, tuberculosis. More than half the patients are neuropsychiatric cases."

Saturday, December 11, 2010

Facebook Page and Holiday helps

I started a Facebook page, Patience H C Mason, Author, which is the business kind of page so it comes with a discussion board (the link to the title of this post) to make it easier for people to ask questions and find help. I have three discussions started including two begun with two different articles I wrote on the holiday season, PTSD and Holidays and one called "Can't you just be normal for one day?"
These are also available at if you want to print them out. This time of year is hard on veterans and other trauma survivors so I am hoping these will be of help to some of you.
Anyone is welcome to friend me on Facebook, but if you do, please add a note to your friend request saying how I may know you, or what the connection is...
Meanwhile, Happy Holidays!

Wednesday, December 8, 2010

Women Veterans

Two things have happened recently that got me started on thinking about women veterans. One, I saw Lioness the film, which totally blew me away. Second, I got an email from a VA therapist working with OIF/OEF veterans asking me to rewrite Why Is Mommy Like She Is? for the new women veterans, which I have done. You can order it at my website.
Today Anonymous posted on one of my posts, Do you have anything for women veterans? My reply to her is let me know what you need and I will try to write it.
Some thoughts:
War changes people.
We, as women, are supposed to take care of other people's emotional and physical needs. Even today, in a household where both people work, the wife still does most of the housework and child care after work, while the guy watches TV. Is this fair? No. Is it right? NO. Is it common? Yes.
I'm not sure how quickly this expectation is laid on our women veterans when they get home: the housework and the parenting. From my own experience when Bob got home from Vietnam, I suspect it is hard to get back into giving a sh*t about laundry and dishwashing... and even the kids... your husband...
No matter how much you may want to be the same, war has changed you, and it will take time, and sometimes therapy, to let go of some of the pain and altered priorities and become who you prefer to be. One of the things war will do for you is to get you thinking about how you were and if you want to be that person...
When Bob went to Vietnam, he smoked. When he got home, he'd been living in a tent and sometimes sleeping in the helicopter for a year, so he'd just flick his butts on the floor. I laughed. He was raised by a much better housekeeper than me, so he would apologize and say he'd been living in this tent, and they all did it. He got so he didn't do it after he'd been back about a month.
At that time, I don't think I was even aware enough to realize he had been living in a separate reality in which all the priorities were different, but I hated housework so I thought it was really funny... I think that was good for our marriage, because if I had taken it personally and felt insulted or any of a million other common thoughtless reactions ("Don't you have any manners," to a WWII combat vet who hadn't eaten at a table for YEARS.), I think our problems would have been greater.
Things happen in war that change a person's priorities.
Another thing that was pretty evident, looking back, was that Bob's physiology and emotional life were changed by the experience. These were the normal results of his brain trying to keep him alive: hyperalertness demonstrated by an utter inablilty to sleep and leaping up over and over in the night, emotional numbing which caused me to feel unloved because I had no idea that in war you have to put away your emotions to rapidly adapt to what is going on around you so you can do your job, despite bullets, rockets, IED's or whatever. He began to drink to get to sleep, another common way of dealing with the changes war creates in the brain.
At the time, most psychiatrists were telling veterans who said war had changed them, that they were wrong, but now we know it does change you, your brain chemistry, your reaction times, etc.
I think this would be harder to accept for a woman because we are supposed to be feeling, emoting, caring people, so If you feel like you don't give a sh*t, be aware that it is a normal protective device of your brain, not some kind of moral defect. It is evidence that you lived through something that killed others, so it is a good thing. It can become a bad thing over time, but right after you come home, give yourself a break and don't expect yourself to be the same.
War changes people. If you understand the changes, it makes them easier to accept. If you don't like them, you can work on unlearning what you have learned under the hammer of war. My "Veterans Day and I'm mad" post has a very detailed explanation of the changes, if you would like to read that.
Meanwhile, whatever happened to you, whatever you did or didn't do, you deserve to recover.
My email is on my profile, so please email me with any questions you have or topics you would like covered.