{"id":22557,"date":"2015-11-20T16:55:01","date_gmt":"2015-11-21T00:55:01","guid":{"rendered":"https:\/\/www.fireitupwithcj.com\/dev\/\/?p=22557"},"modified":"2016-06-08T17:28:21","modified_gmt":"2016-06-09T00:28:21","slug":"what-is-ptsd","status":"publish","type":"post","link":"https:\/\/www.fireitupwithcj.com\/dev\/what-is-ptsd\/","title":{"rendered":"What is PTSD?"},"content":{"rendered":"<p>An interview with Joseph Bobrow a clinical psychologist, psychoanalyst, and Zen Master about his newest book \u201cWaking up from War: A Better Way Home for Veterans and Nations\u201d.\u00a0 What are some common issues faced by 3m returning war veterans who served in Iraq and Afghanistan integrating into civilian life?<\/p>\n<p><iframe loading=\"lazy\" width=\"398\" height=\"224\" src=\"https:\/\/www.iheart.com\/widget\/?showId=25229902&#038;episodeId=27440534\" frameborder=\"0\"><\/iframe><\/p>\n<p><em>Except where noted, all quotes are from\u00a0Bobrow, J. (n.d.). Waking up from War: A Better Way Home for Veterans and Nations. Pitchstone Publishing.<\/em><\/p>\n<h1>What is PTSD?<\/h1>\n<p>In \u201cWaking Up from War \u2013 A Better Way Home for Veterans and Nations\u201d, clinical psychologist and author Joseph Bobrow describes what he\u2019s observed after working over a decade with Veterans.\u00a0 Bobrow describes that he has seen two forms of PTSD with elements of each kind of PSTD in \u201cproportions\u201d.<\/p>\n<p>The first form of PTSD represents a cluster of debilitating anxiety symptoms.\u00a0 The roots are with a nervous system <a href=\"https:\/\/en.wikipedia.org\/wiki\/Emotional_dysregulation\">dysregulation<\/a> through a cumulative exposure to war-related trauma. \u00a0Humans are all programmed to feel fear and have the appropriate physiological response which is to either to fight, flee, or freeze.\u00a0 This \u201cfight-or-flight\u201d response is our response to protect us from harm.\u00a0 In PTSD, this reaction is changed, damaged and no longer regulated properly, which means that people who have PTSD may feel stressed or frightened even when there is no danger.<\/p>\n<p>The second form of PTSD includes the emotional stress and burden that is carried by the veterans.\u00a0 It is the moral injuries felt when returned, or the guilt or shame associated with harming others.<\/p>\n<h4>VIDEO: Dr. Bobrow describes PTSD<\/h4>\n<ul>\n<li><strong><a href=\"https:\/\/youtu.be\/KWGPPnpTiBU?t=0m41s\">0:41<\/a><\/strong> What is PTSD?<\/li>\n<li><strong><a href=\"https:\/\/youtu.be\/KWGPPnpTiBU?t=3m08s\">3:08<\/a><\/strong> What are the nuances and different types of PTSD?<\/li>\n<li><strong><a href=\"https:\/\/youtu.be\/KWGPPnpTiBU?t=6m07s\">6:07<\/a><\/strong> What dysregulation happens with PTSD that affects our body, mind, and soul?<\/li>\n<li><strong><a href=\"https:\/\/youtu.be\/KWGPPnpTiBU?t=1m39s\">1:39<\/a><\/strong> What are the symptoms of PTSD?<\/li>\n<li><strong><a href=\"https:\/\/youtu.be\/KWGPPnpTiBU?t=16m32s\">16:32<\/a><\/strong> What are the moral injuries or soul damage that happens with soldiers?<\/li>\n<\/ul>\n<h2>What are physical Symptoms?<\/h2>\n<p>According to May Clinic, the symptoms of PTSD can vary in intensity over time and can start within weeks, months, or years after the originating traumatic event. \u00a0The symptoms can show up when you are stressed, or when there are triggering events that remind you of what you experience in the past.\u00a0 Mayo Clinic groups the symptoms into: intrusive memories, avoidance, negative changes in thinking and mood, or changes in emotional reactions.\u00a0 Here\u2019s the list from Mayo Clinic on symptoms:<\/p>\n<p><strong>Intrusive memories &#8211; <\/strong>Symptoms of intrusive memories may include:<\/p>\n<ul>\n<li>Recurrent, unwanted distressing memories of the traumatic event<\/li>\n<li>Reliving the traumatic event as if it were happening again (flashbacks)<\/li>\n<li>Upsetting dreams about the traumatic event<\/li>\n<li>Severe emotional distress or physical reactions to something that reminds you of the event<strong>\u00a0<\/strong><\/li>\n<\/ul>\n<p><strong>Avoidance(Denial) \u2013Collective denial &#8211;<\/strong>Symptoms of avoidance may include:<\/p>\n<ul>\n<li>Trying to avoid thinking or talking about the traumatic event<\/li>\n<li>Avoiding places, activities or people that remind you of the traumatic event<strong>\u00a0<\/strong><\/li>\n<\/ul>\n<p><strong>Negative changes in thinking and mood <\/strong>Symptoms of negative changes in thinking and mood may include:<\/p>\n<ul>\n<li>Negative feelings about yourself or other people<\/li>\n<li>Inability to experience positive emotions<\/li>\n<li>Feeling emotionally numb<\/li>\n<li>Lack of interest in activities you once enjoyed<\/li>\n<li>Hopelessness about the future<\/li>\n<li>Memory problems, including not remembering important aspects of the traumatic event<\/li>\n<li>Difficulty maintaining close relationships<strong>\u00a0<\/strong><\/li>\n<\/ul>\n<p><strong>Changes in emotional reactions: <\/strong>Symptoms of changes in emotional reactions (also called arousal symptoms) may include:<\/p>\n<ul>\n<li>Irritability, angry outbursts or aggressive behavior<\/li>\n<li>Always being on guard for danger<\/li>\n<li>Overwhelming guilt or shame<\/li>\n<li>Self-destructive behavior, such as drinking too much or driving too fast<\/li>\n<li>Trouble concentrating<\/li>\n<li>Trouble sleeping<\/li>\n<li>Being easily startled or frightened<\/li>\n<\/ul>\n<h5>Source: <strong>Post-traumatic stress disorder (PTSD) (Symptoms):\u00a0<\/strong><a href=\"http:\/\/www.mayoclinic.org\/diseases-conditions\/post-traumatic-stress-disorder\/basics\/symptoms\/con-20022540\">http:\/\/www.mayoclinic.org\/diseases-conditions\/post-traumatic-stress-disorder\/basics\/symptoms\/con-20022540<\/a><\/h5>\n<h2>What are the emotional effects returning Veterans feel?<\/h2>\n<p>While the physical symptoms may be easier to observe, there are symptoms that effect us emotionally and are less easy to detect.\u00a0 Bobrow explains that the most entrenched, profound, and treatment-resistant problems are those related to a loss of purpose, and meaning. Soldiers go off to war in the act of service, but return to see their battle victories get erased over time and the war continue. \u00a0Bobrow shares his observations from a group discussion with veterans:<\/p>\n<blockquote><p>\u201c Veterans do not want all that they and their loved ones have gone through, all they have lost, to have been in vain.\u00a0 They want it to mean something.\u00a0 In one veterans\u2019 small group the theme became, \u201cWhat do we got to show for it?\u201d .\u00a0 The inner conflict was so profound that even broaching the topic made some of the participants test and defensive, as though others were blaming them just b bringing it up.\u00a0 Today, we see this dynamic emerging in many Iraq war veterans.\u00a0 As the country they found to save falls apart, many are experiencing a resurgence of emotional pain linked with a sense of meaningless.\u00a0 Feeling like it was all for nothings is a terrible blow.\u00a0 When we factor in the element of betryal- a \u00a0leader, a government, or healthcare system- we have a potent mix.\u00a0 Add the emotional and \u00a0moral reverberations of having killed, and having witnessed death and grave injury, or having acted in a way that is at odds with one\u2019s sense of right and wrong and the mix is turbocharged. Shame, guilt, and self-loathing stroke the fires\u201d. P33<\/p><\/blockquote>\n<p>Bobrow describes this as PTspD, where \u201csp\u201d refer to the spiritual register.\u00a0 The injury happens not on the physical level, but Bobrow describes the \u201cD\u201d (Disorder) in more detail.\u00a0 He has observed the <em>disabling<\/em> of our capability for reflecting and processing trauma; <em>dispirited<\/em>, the evaporation of basic aliveness; <em>disbelief,<\/em> as in the crises of faith that are generated when one\u2019s entire assumptive world, including our religious beliefs, which affects one\u2019s sense of meaning; <em>disrespected<\/em>, despair, a loss of hope, an sense of being helpless to remedy the situation, and <em>disaster<\/em>, with the existential angst.<\/p>\n<h2>How does it affect the person returning from war?<\/h2>\n<p>Joseph Bobrow explains that in previous wars, the whole country was at war. This is quite different for the three million people who went away to Iraq and Afghanistan war.\u00a0 These soldiers went to fight in countries torn apart from war, and then had the surreal experience of returning back home where everything seemed just as they left it.<\/p>\n<p>No longer in uniform, these veterans integrate back into society. Perhaps, returning back to get a college degree indistinguishable from other students in a class room.\u00a0 Soldiers feel both alienated and isolated when they return. This <a href=\"http:\/\/www.nytimes.com\/2015\/09\/20\/us\/marine-battalion-veterans-scarred-by-suicides-turn-to-one-another-for-help.html?_r=0\">NY Times article<\/a> covers the story of a solider returning after service and his experience after six of his friends in the battalion commit suicide<\/p>\n<p>While soldiers attempt to get help from PTSD, often their needs are not met or understood by the medical community and society at large resulting in a sense of ethical betrayal and loss.<\/p>\n<blockquote><p>\u201cWe will help our country, even, if necessary giving our lives.\u00a0 If we return, we expect to receive the care and services we have earned\u201d. P 33<\/p><\/blockquote>\n<h4>Video Answers<\/h4>\n<p>Click on timestamps to hear answer<\/p>\n<ul>\n<li><strong><a href=\"https:\/\/youtu.be\/KWGPPnpTiBU?t=17m57s\">17:57<\/a><\/strong> Why veterans feel so isolated when they come back form service?<\/li>\n<li><strong><a href=\"https:\/\/youtu.be\/KWGPPnpTiBU?t=22m24s\">22:24<\/a><\/strong> How do we address invisible injuries, like TBI, that happen with shoulders?(mood, memory)<\/li>\n<\/ul>\n<h2>Veteran Voices<\/h2>\n<p>Here are a sample of veteran voices that Joesph Bobrow gathered over the course of his retreats with veterans. Here is how they expressed to their family of \u201cWhat did deployment feel like?\u201d<\/p>\n<blockquote><p>\u201c I feel isolated and lonely, even though I had my comrades with me. It was a void, being away from my family.<\/p>\n<p>I felt agonized, as if my heart had been ripped out of my chest. Sad. When I got to see my kids on Skype, I was happy and proud.<\/p>\n<p>I felt this was my last go-around, my last dance on this planet.<\/p>\n<p>I felt like I was betraying my children for my country.<\/p>\n<p>I was afraid that when I said goodbye to my kids, I wouldn\u2019t see them again.<\/p>\n<p>I felt un-included because I missed my son\u2019s first words, first steps, first everything. I was stuck in limbo, and my family went on with their life without me.<\/p>\n<p>I hated that my wife didn\u2019t get more support\u201d p131<\/p>\n<p>The book also includes what veterans want to say to their families:<\/p>\n<p>\u201c It\u2019s hard to take off my uniform; I\u2019m sorry.<\/p>\n<p>I feel responsible for what I put you through.<\/p>\n<p>When you and mom waved goodbye to me, I put you both away. When I returned home, I didn\u2019t know how to come back.<\/p>\n<p>I\u2019m sorry that I can\u2019t be there with you all for the 45<sup>th<\/sup> of July. It\u2019s because in my mind the bombs and missiles are still going off.<\/p>\n<p>I didn\u2019t write or call as much as I wanted to, but I was trying to protect you.<\/p>\n<p>I did everything I had to, including some crazy stuff, to come back to you.<\/p>\n<p>I so enjoyed putting together that birthday package for you. It pulled me out for that moment.<\/p>\n<p>When I read your letter it made me cry: \u201cDad, what happened to you?\u201d you wrote.\u00a0 \u201cWhen you left you were so much fun.\u00a0 But when you got back, I didn\u2019t know who you were.<\/p>\n<p>The faded picture in my vest gave me strength. Sorry, I didn\u2019t call; I didn\u2019t know how to explain the pain.<\/p>\n<p>When I was away, I was scared for you.\u00a0 I hope I never have to go back.\u201c p133<\/p><\/blockquote>\n<h2>Effects on PTSD on Families<\/h2>\n<p>Bobrow explains that repeated war trauma unravels connections with families , their peers, and their communities.\u00a0 A saying within military families is \u201c When a service member deploys, the whole family deploys\u201d.<\/p>\n<blockquote><p>\u201cUnless we wake up and see, hear, and recognize the story of our veterans, and their families, children, and caregivers as our story, we will surely repeat those past errors, with similar or more grievous costs\u201d p 32.<\/p><\/blockquote>\n<h4>VIDEO: Dr. Bobrow describes PTSD<\/h4>\n<ul>\n<li><strong><a href=\"https:\/\/youtu.be\/KWGPPnpTiBU?t=25m51s\">25:51<\/a><\/strong> Lyrics from a song created by soldiers to heal.<\/li>\n<li><strong><a href=\"https:\/\/youtu.be\/KWGPPnpTiBU?t=28m55s\">28:55<\/a><\/strong> Why service affects the whole family?<\/li>\n<\/ul>\n<h3>Effects on children<\/h3>\n<p>War often means separation from parents and children feeling the loss of protection or safety.\u00a0 This is compounded by multiple separations caused by being called out to duty several times.\u00a0 The spouse that stays at home is often stressed and overwhelmed.\u00a0 Wives of soldiers sent to war, suffer at higher rates with 18% higher rate of depression.\u00a0 Children of deployed parents suffer more emotional issues especially when separations are long or when the parent at home is struggling.<\/p>\n<h3>Effects on spouses<\/h3>\n<p>As part of Bobrow\u2019s family retreats, he\u2019s talked to the spouses left at home and he shares their experiences of scary and shameful feelings.\u00a0 Some were terrified that their loved one would not return home or would come home irreparable damaged.\u00a0 Some felt a sense of utter helplessness.\u00a0 Others fantasized about new love interests or had affairs.<\/p>\n<h3>spouses Voices \u2013 What did deploayment fee like<\/h3>\n<p>Here are a sample of veteran voices that Joesph Bobrow gathered over the course of his retreats with veterans. Families shared their feelings on \u201cWhat did deployment feel like?\u201d<\/p>\n<blockquote><p>\u201c I kept asking, \u201cWhy am I always the one who has to be strong?<\/p>\n<p>While he was gone, our daughter almost died. I had to go to the ICU and had to go through all that alone. I was angry that he wasn\u2019t there.<\/p>\n<p>I found myself looking at the kids and thinking \u201cWait, stop!\u201d They were growing up so fast and I didn\u2019t want him to miss it.<\/p>\n<p>I had to keep really busy to make it through.<\/p>\n<p>I was product of him, but scared of having to be mother, father, and everything all together.<\/p>\n<p>I felt a little guilty, because I did get to witness all those moments, but, since I was there, I was also the one who got balmed. That was hard.<\/p>\n<p>I would sometimes laugh at moments when I wished he was there.\u00a0 Like when I blew up the lawnmower.<\/p>\n<p>When you were away, I cried every night.<\/p>\n<p>The longer you were away, the longer my agony.<\/p>\n<p>Every time the phone rang I was frightened.\u201d P 131, 133<\/p><\/blockquote>\n<h2>Who can get PTSD<\/h2>\n<p>According to the National Institute of Mental health, PTSD is something that anyone can get any age. Generally speaking, PTSD is something that someone gets after seeing or living through a dangerous event. Joseph Bobrow noted that anyone who serves when at war can get PTSD, whether it\u2019s the firefighters that were called during 911, the mental health professionals serving veterans, or the health providers who work with returning veterans.<\/p>\n<p>War veterans, as well as survivors of physical and sexual assault, abuse, accidents, disasters, and many other serious events can get PTSD.\u00a0 Some people may get PSTD after a friend or family member experiences danger or is harmed or when there is a sudden, unexpected death of a loved one.<\/p>\n<p><strong>VIDEO: <a href=\"https:\/\/youtu.be\/KWGPPnpTiBU?t=1m48s\">1:48<\/a><\/strong> Who can be affected by PTSD? Is it only veterans?<\/p>\n<h2>Treatment of PTSD<\/h2>\n<p>Treatment can be a long road,here\u2019s a passage that Bobrow shares from a patient:<\/p>\n<blockquote><p>\u201c I\u2019ve started going backwards again. All the emotions and nightmares are coming back. I ahd stopped drinking and now I\u2019m drinking again, trying to hide it.\u00a0 I can\u2019t sleep at night. It\u2019s hard to find yourself again, bacuse you\u2019re never going to be the same person. I am trying to figure out how to forgive myself for everything I did over there, and it\u2019s hard to figure out. I\u2019m messed up. I\u2019m fired of just taking pills\u201d. P 198<\/p><\/blockquote>\n<p>Bobrow shares his thoughts on current approaches to PTSD:<\/p>\n<blockquote><p>\u00a0\u201cThe strategies utilized are commonly one-dimensional , symptom-driven, one size fits-all, and despite the rhetoric about \u201cgold standard\u201d are unproven.\u00a0 Programs like Comprehensive Solider fitness that costs hundreds of millions of taxpayer dollars are re-upped without reliable evidence. Planner and leaders can\u2019t, don\u2019t and won\u2019t stop to think about what vets really need and want.\u00a0 Here, too , the press of trauma and our maladaptive reaction on the one hand and concealed self-interest coated with unctuous honorific talk on the other seem to rule the day.\u201d Page31<\/p><\/blockquote>\n<p>After experimenting and trying many methods, here\u2019s what Bobrow shares his thoughts on the most effective treatments plans are those that involve:<\/p>\n<ul>\n<li><u>More than just veterans<\/u>. It \u00a0is critical to involve family members not just the veteran alone.\u00a0 This enables veterans to share their true experiences with their partners, other family ememebers, and colleagues.<\/li>\n<li><u>Calming practices<\/u>: Practices that build regulation such as quigong, yoga, and meditation help veterans when they encounter feeling \u00a0of remorse, sadness, memories of traumatic vets, and dreams, practices. (Note: Check out <a href=\"https:\/\/www.youtube.com\/watch?v=B4hhMm8qsCs\">EFT<\/a> too).<\/li>\n<li><u>Discussion among Communities<\/u>: Group work where people share their stories, sitting with one another in safety, listening deeply and respectfully without judgment, or trying to fix anything. Bobrow explains that this kind of dialogue helps heal war trauma and preventing future destruction by allowing soldiers to express their fears without feeling ambushed, or being left with their guard down.<\/li>\n<\/ul>\n<h4>VIDEO: Dr. Bobrow shares treatment plans<\/h4>\n<ul>\n<li><strong><a href=\"https:\/\/youtu.be\/KWGPPnpTiBU?t=5m0s\">5:00<\/a><\/strong> What techniques have worked with PTSD?<\/li>\n<li><strong><a href=\"https:\/\/youtu.be\/KWGPPnpTiBU?t=33m27s\">33:27<\/a><\/strong> How can transformation happen?<\/li>\n<li><strong><a href=\"https:\/\/youtu.be\/KWGPPnpTiBU?t=38m56s\">38:56<\/a><\/strong> Why have retreats worked in helping PTSD?<\/li>\n<li><strong><a href=\"https:\/\/youtu.be\/KWGPPnpTiBU?t=43m22s\">43:22<\/a><\/strong> Why current medical treatments and solutions are not enough?<\/li>\n<li><strong><a href=\"https:\/\/youtu.be\/KWGPPnpTiBU?t=47m00s\">47:00<\/a><\/strong> What is the stigma associated with PTSD?<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>An interview with Joseph Bobrow a clinical psychologist, psychoanalyst, and Zen Master about his newest book \u201cWaking up from War: A Better Way Home for Veterans and Nations\u201d.\u00a0 What are some common issues faced by 3m returning war veterans who served in Iraq and Afghanistan integrating into civilian life? Except where noted, all quotes are<\/p>\n","protected":false},"author":1,"featured_media":22559,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[458,63],"tags":[],"yst_prominent_words":[595,586,6876,6869,6874,6866,6872,6864,6870,6863,6865,1633,6873,5894,6867,594,6871,6875,6868,4532],"class_list":["post-22557","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-emotional-intelligence-and-psychology","category-wellness"],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"https:\/\/www.fireitupwithcj.com\/dev\/wp-content\/uploads\/2015\/11\/bigstock-PTSD-Magnifying-Glass-on-Old-74995405-compressed-1.jpg","jetpack-related-posts":[],"_links":{"self":[{"href":"https:\/\/www.fireitupwithcj.com\/dev\/wp-json\/wp\/v2\/posts\/22557","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.fireitupwithcj.com\/dev\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.fireitupwithcj.com\/dev\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.fireitupwithcj.com\/dev\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.fireitupwithcj.com\/dev\/wp-json\/wp\/v2\/comments?post=22557"}],"version-history":[{"count":3,"href":"https:\/\/www.fireitupwithcj.com\/dev\/wp-json\/wp\/v2\/posts\/22557\/revisions"}],"predecessor-version":[{"id":22896,"href":"https:\/\/www.fireitupwithcj.com\/dev\/wp-json\/wp\/v2\/posts\/22557\/revisions\/22896"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.fireitupwithcj.com\/dev\/wp-json\/wp\/v2\/media\/22559"}],"wp:attachment":[{"href":"https:\/\/www.fireitupwithcj.com\/dev\/wp-json\/wp\/v2\/media?parent=22557"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.fireitupwithcj.com\/dev\/wp-json\/wp\/v2\/categories?post=22557"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.fireitupwithcj.com\/dev\/wp-json\/wp\/v2\/tags?post=22557"},{"taxonomy":"yst_prominent_words","embeddable":true,"href":"https:\/\/www.fireitupwithcj.com\/dev\/wp-json\/wp\/v2\/yst_prominent_words?post=22557"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}