Page 376 - Total War on PTSD

Veteran to safely delve into the recesses of their mind and re-experience personal trauma, there needs to be a strong sense of safety in an environment that is stable, consistent, and regulated. Traumatic material captures the extreme vulnerability once felt and arouses physiological sensations once endured that are set off in the present. Traveling the traumatic minefield necessitates caution. Defenses must be softened and the parameters of the relationship established. Then deeper material will be able to unfold organically, in a safe environment.
With Veterans the protocol may change slightly as case management needs to be emphasized and in place right from the beginning. If there has been drug addiction to pain killers or extensive use of sleep medications or alcoholism then those acting out behaviors need to be translated into healthier habits so therapy can take hold. Recovery programs are suggested in parallel with therapy; possibly a new medication regime will be helpful. Likely a dysregulated lifestyle has taken hold, possibly sleeping too much (a sign of depression), high anxiety that defeats proper meals or routines. Instituting stable structures are critical: exercise, walks in nature, yoga or stretching, light classes like qigong or Tai Chi promote calming and arouse the parasympathetic side of the ANS.
Historic hardships can often manifest in current unhealthy behaviors. Therapy will create insights and understanding into those behaviors rather than the Veteran enduring unhealthy behaviors repeated over and over. As the reality ego is strengthened and one’s functional aptitude has increased, life can become more adaptive, and activation can be established in a variety of spheres. A secure stage is set in the middle phase of treatment for an unfolding of a deeper level of feeling and subjective experience. The Veteran is able to feel more and may have more access to experiences, as defenses have been dismantled; and is more able to recognize character style when it reasserts itself.
More anxiety, panic attacks, or depression may emerge from a Veteran’s mental and emotional recesses that are harbingers of the emergence of historic feelings and traumatic material. With Veterans, historic family heirlooms can also interact with current PTSD and all have to be included and worked. There may also be debilitating depression that
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