Page 372 - Total War on PTSD

often intrusive, dominating and at times seductive. She became quite overwhelmed while on duty balancing all these factors yet tried to keep up and appear strong and competent. She learned to create distance from the men who were troubling.
Upon return she craved solitude and began instituting strict boundaries so that she didn’t feel invaded or coopted. She became more and more isolated, not wanting to leave her apartment even to go to the market. She felt safer within her familiar walls but that resulted in reclusive behaviors as she was not building friendships and support structures. Her isolation resulted in anxiety and panic attacks when she went about to accomplish daily tasks. She was aware of her own furtive glances at others as well as her hyper- vigilance. She avoided people she knew. Over time she became more and more paranoid as she was feeling threatened even though there were no “rational” threats.
Therapy helped to establish gradual safety in the therapeutic relationship. Slowly she let her guard down and felt relief talking about her day-to-day feelings and concerns. We established a structure so she could begin to move out of her “safe space” and not be so intimidated. We established initial structure by having her find a Veteran to pair-up with to talk to and get together with.
Later, we set a further structure of support by finding a group of Veterans who were meeting with a trained leader. We found a qigong class she could attend regularly. As her nervous system began to relax we slowly discussed aspects of her traumatic experiences. We contained those experiences in the therapy room with strict instructions not to carry anything out the door. As we progressed, she could integrate memories without her nervous system going into flight, flight, freeze reactions.
After a year we could initiate bodywork and began very slowly having Erin breathe gently without initiating memories but rather working with her nervous system to tolerate the breath and my proximity of touch. Later we introduced expressive exercises as she began to tolerate the charge of the breath and sensation. We always stopped at the first sign of struggle. I always titrated the sessions carefully. Over time she could feel and express her outrage, her fear, her sadness, and her grief that included her history of
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