Page 58 - Total War on PTSD

zone and continue to be reactive to it when they return home. At the beginning of treatment, I almost always ensure that the Veteran understands the role of combat triggers in their response to their environment and try to help them recognize how these subtle and now benign experiences are no longer danger indicators.
Many individuals do not understand how physically ingrained PTSD is for the individual who is experiencing it. The combat Veteran cannot simply “forget about their experience” or “let it go” and it will take considerable work and processing for them to reduce their symptoms over time. Re-experiencing symptoms can occur day or night and often feel like they have a life of their own, haunting the individual who has been through traumatic experiences. The combat Veteran struggles to cope with both their internal and external world upon returning from a combat zone. Beyond the fight or flight symptoms mentioned above, combat Veterans can experience nightmares, flashbacks, intrusive memories, and even dissociation when emotions or triggers become too intense to handle. Combat Veterans will often have nightmares about their most traumatic experiences. When these occur, because the body believes it is actually in that traumatic experience, the Veteran will experience fight/flight symptoms in their sleep. This can lead to them yelling out in their sleep, thrashing around in their beds, and even punching or swinging at people who share their beds, as they act out their dreams without awareness. Veterans will often wake up with their heart racing and feel frightened, disoriented, and soaked in sweat.
It is also not unusual for the combat Veteran to experience nausea and bed wetting with these fight/flight symptoms as well. When they awaken, due to the anxiety level the dream created, they will often get up and check their homes to ensure they are secure and even “clear the house” at times due to safety concerns. During the daytime, combat Veterans may have what seems almost like “short video clips” or pictures running through their mind uncontrollably of traumatic events. To those around them, their family and friends may notice the combat Veteran often stares off or seems inattentive when these images are occurring. When triggers are intense or unexpected, they can cause flashbacks, where the combat Veteran actually loses orientation to the environment and believes they are back in the traumatic event...they smell it, feel it, experience it...they are there for seconds to minutes or even longer in some instances. In extreme cases,
58 of 1063