Page 63 - Total War on PTSD

that negative events can occur at any moment, especially in undefined or ambiguous situations. In treatment, time is spent exploring these belief patterns and helping the Veteran understand why their perspective has shifted due to their trauma. In trauma work, the “overgeneralization” occurs when aspects of the individual’s experience of the traumatic event negatively shift their beliefs of the world and they start to view all environments through that newly formed trauma- based belief system. For example, if a combat Veteran suffers a VBIED (vehicle born improvised explosive device/bomb) attack by a red vehicle, the combat Veteran may be fearful and leery of all red vehicles upon returning home. Because combat Veterans are immersed in an ongoingly dangerous environment for months and sometimes even years at a time, these belief systems become very ingrained. Their vigilance in the community, anticipatory thinking patterns that involve worrying about potentially harmful events occurring in their environment, and their distrust related to the unpredictability of people only perpetuates their isolation and intolerance of being outside of their home. Combat Veterans are often resistant to letting go of this distrust and guarded perspective, as they believe if they are complacent, something bad will happen. As a therapist, they may often view you as naïve to the true evils of the world and will often state that their experiences in the war zone have opened their eyes to the true potential of humans. These beliefs are challenged and actions, including the Veteran’s actions in the combat zone must be viewed in the context they occurred. Reflecting to combat Veterans that they have not taken lives since returning home and that their actions, as well as the actions of their enemies, happened in specific and isolated environments can help with letting go of these generalizations.
No matter what form of trauma treatment the Veteran attends, it will involve elements of exposure to both environments/feared situations and their trauma memories. This exposure is essential to help the combat Veteran learn to sit with their anxiety and not be avoidant of it, as well as help them gain a sense of competency in handling feared situations. Through exposure, the Veteran learns that their memories cannot hurt them, as well as the negative events they were fearing when going out are not actually happening or occurring. Underlying their agitation and anxiety are primary emotions with which they are uncomfortable and that have remained unresolved. By processing their trauma, they learn to sit with these emotions, become tolerant to them, and eventually reintegrate them into their experience. The core to healing PTSD is to help
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