Page 52 - Total War on PTSD

always are the deciding factors in the Veteran’s actions and behaviors. To be aggressive and angry in the combat zone are viewed by peers as much more favorable attributes than being emotional or breaking down, which are viewed as weak or “combat ineffective.” When a combat Veteran comes into treatment, it is important to give them a space that is judgement free and where their actions can be viewed contextually. In treatment, we discuss the natural progression of aggression over the course of deployment, suppression of the fear that stalks the Veteran and is replaced by numbing, and the necessity of these adaptive behaviors to survive horrific and overwhelming circumstances.
Combat Veterans can go beyond what situations dictate as far as aggression and the harming of others. They are often deeply ashamed by their actions and question their values and morals that would allow them to act in such a cold and seemingly sociopathic manner. These individuals are typically not sociopaths. I have repeatedly seen this phenomenon in God-fearing men who, in general, have very good values. Whether it is the group mentality, mid-brain/animalistic functioning in dangerous situations, the low level of chemical shock they experience related to repeated trauma exposure, dissociative symptoms, or simply vengeful behavior, there has to be some normalcy to a phenomenon that occurs in greater frequency over the course of deployments, particularly in individuals who have had multiple deployments. Commonly, a combat Veteran will have to be in treatment a long time and have a great deal of trust and rapport with an individual before they disclose these incidents to a clinician. Over the years I have come to truly believe that there is nothing a person can do that is not human on some level. It is imperative to always provide a supportive, judge free zone for the combat Veteran. No one will condemn them more than they condemn themselves. For individuals who do cross the line of necessity with aggression, forgiveness and the belief they can be forgiven will be essential for their healing. I often refer individuals to our chaplaincy services for adjunct counseling if they are spiritually conflicted over their combat experience.
The traumatic events combat Veterans have survived will replay through intrusive memories, flashbacks, nightmares, and physical reactiveness to reminders of their trauma in their current environment. When combat Veterans present for treatment, they discuss their distress over not being able to lessen these symptoms or get them to stop. The treatment of these symptoms is
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