War Experience, Post Combat Trauma - Essay Example

Self-Reflection Assignment Introduction Humans are psychobiologically prepared to cope with multiple types of stressors. However, stress can be phenomenally great for human adaptive ability to cope with. Such stressors are traumatic in clinical sense, and tend to initiate post-traumatic stress disorder (PTSD). PTSD is a neuropsychological anomaly, which significantly affects the pituitary axis of hypothalamus, functioning of endogenous opioid, and the hippocampal size. Survivors of war are confronted by overwhelming events that are gruesome. The number of Americans experiencing PTSD is expected to grow. Recent research indicates that the new generation of Iraq War veterans has 18 % chance of developing PTSD. Interpersonal interactions often reveal the post-trauma behavioral problems of trauma survivors. Post-trauma survivors often manifest feelings of ostracism from rest of society, impaired relationships, social isolation, and alienation, and numb feelings for others. The paper will present a discussion of post combat trauma of a US Marine after experiencing Iraq War. The paper will discuss theories in order to understand how to treat PTSD. How Iraq War Changed My Life The experience of Iraq War ha changed my life. I experienced one of the bloodiest war events at first hand, during my years of service as US Marine in Iraq. I was not only physically injured, but also psychologically affected. I was diagnosed with acute Post-Traumatic Stress Disorder (PTSD), which I had developed almost immediately upon my return home. I had also procured a slight concussion. It was a direct consequence of my war experience. I had previously no idea that the war could instill a permanent scar, which would torment me for the rest of my life. Incessant headaches and nightmares bedevil me, while my limbs seem to be on fire always. I have developed the feeling that I am always at war, although I have returned home safely. I usually have a queer feeling that somebody is after me. Even slightest provocation can arouse intense anxiety in me. The smell of firecrackers or shooting of firearms is sufficient to arouse memories. What I saw during the war will remain deeply embedded in my memory. The happening of what I experienced is as real as if I was still in the battlefield. Sometimes, I have drunk with hope of defusing the nightmares. I even contemplated suicide once. I am still struggling to erase memories of such horrifying events. My short-term memory is failing me, because I cannot even remember my appointments. When I close my eyes, the entire combat scenario becomes so real that special effects of Hollywood depiction cannot even approximate what I experienced at first hand. Furthermore, I have become more antisocial, I just want to live a life of independence. Perhaps, I may spend a quiet and idyllic life in Montana, free from urban disturbances. Meanwhile, I have to learn how to put up with my rage and nightmares. I have fought numerous battles, although the most notable moment came during my travelling together with troops at the outskirts of a village in Baghdad. It was blazingly hot in the afternoon. Our Humvee seat had two rows, which we sat on opposite sides facing each other. I had my M249 automatic rifle come between my legs, which exacerbated my claustrophobia. Overcrowding aggravated the heat intensity, which made the entire unit to sweat profusely. I was drenched in sweat, craving for even the slightest breeze to cool us from intensively hot afternoon heat. Our armored five-vehicle convoy was heading towards to 26 Recon Marines. We were deployed on a special operations mission through enemy territory. Our mission briefings informed us that insurgency had declined in the territory. Following my previous experience, I could not expect much combat. However, anything can occur during war. I would knock myself against my rifle whenever our Humvee hits a rock and pothole. My rifle became heavier as time progressed. The night-vision goggles I wore made the rough dirt road glow soft green. Often, one or two persons could notice something amiss, which was life saving for all of us. I scrutinized everywhere, including my flanks and front. However, I could not notice anything unusual. We cascaded down to a house lying on village outskirts at around 3.00 p.m. Normally, we could rest there by taking shifts, before embarking on patrol day and interacting with local villagers. Even though the villagers were polite, they were a bit edgy. At dusk break, we prepared to leave having satisfactorily scrutinized the area for any sign of insurgent activity. As we deserted the village, we approached a small turn, which was not conspicuous from our vantage point during the previous night. As we moved along, I noticed a young boy along the street with a remote controlled toy car. My eyes met his. The boy seemed harmless at first. After all, this is just an ordinary village boy playing with a toy. The toy car contained some kind of pressure-plated improvised explosive device (IED). The first three vehicles passed the bend safely. Our Humvee was the fourth. Suddenly, the boy directed the toy car, which sped towards the underside of fifth Humvee. The impact between the two caused a blinding flash, then a loud deafening explosion. An orange flame came rolling towards our vehicle and dislodged me from my seat upwards between the Humvee and blast hole. The impact of the explosion was so severe that I lost consciousness for some time. When I regained my consciousness, I was seeing red because blood oozed from my eyes. Our corpsman saved my life because he pulled me from the burning vehicle. It was a near-death experience. Deafening sounds of mortar rounds, sniper fire, and then the cracking of AK-47s rented the air. We were under attack by insurgents. The fifth Humvee, approximately 20 feet behind us, was severely damaged, with its front end turned upside down. The back half of our Humvee was gone, with some parts being discovered later some hundred feet away. None of my fellow Marines in the fifth Humvee survived. Some of my colleagues died in the gun battle. However, the Marines managed to quell the insurgents. Once I regained my consciousness, I noticed that our platoon leader lay in a deep crater having his legs ripped apart. The team’s corpsman tied tourniquets to distorted legs of our platoon leader, while the ground around us darker with smoke and dust. It was evident that the platoon leader was in great agony, because he was requesting our corpsman to kill him. It was a horrifying experience. Cognitive Behavioral Psychology in PTSD Response According to Ruzek, et al. (2008), cognitive-behavioral approach can be more useful in preventing PTSD development. This can only be possible if the model appropriately considers the context of trauma and needs of the individual. The development of PTSD paves way for development of other disorders, including depression and substance abuse. The cognitive-behavioral therapy modulates maladaptive behaviors and cognitive processes, in order to mitigate human suffering. The model assumes that clinical problems, including PTSD, substance abuse, and depression, are responses that are learned. The adaptive and functional aspects of behavior are underlined, rather than psychopathology disease model. The post combat veterans are assisted to acquire novel behavioral models that are highly adaptive, which helps to alleviate their trauma (National Collaborating Centre for Mental Health 2005). The functional analysis of maladaptive behaviors that the veteran seeks to change helps the cognitive-behavioral therapy provider to understand the conditions that conjure up particular thoughts or behaviors, and the subsequent repercussions and behavior maintenance. The provider teaches the help-seeker new behavior, and encourages him or her to apply the new skills. Psycho educating the affected individuals concerning how behavioral problems are delineated by behavioral theories is an important aspect of cognitive-behavioral methodology (Ruzek, et al. 2008). Three months of exposure to cognitive-behavioral therapy tends to be more effective in minimizing PTSD rates five months after traumatic event. Patients diagnosed with PTSD five months after traumatic event tend to exhibit considerable decline in PTSD symptoms, having undergone 3-month exposure (Naval Center for Combat & Operational Stress Control 2012). Doyle and Peterson (2005) argued that the success of deployment cycle is determined by successful re-entry and reintegration into society. According to Grinage (2003), setraline and paroxetine are effective drugs in treating acute PTSD symptoms. The drugs rely on the efficiency of selective serotonin reuptake inhibitors in treating PTSD symptoms. According to Walser, et al. (2004), trauma survivors with psychiatric, in addition to physical needs, may not be easily identified by medical professionals. The cognitive-behavioral approach treats post-combat trauma as maladaptive behavior, rather than aspect of mental disorder. These problems are viewed as beneficial coping mechanisms for difficult situations, although may cause the individual to procure additional problems. The technique avoids pathologization of pervasive stress reactions, which is in harmony with traditional approaches to disaster mental health. The analysis classifies response ways and decisions into specific objectives, which help to alleviate feelings of helplessness and simplifying the task of managing problems. These objectives are short-term and realistic. This enables the survivors to wield control over the circumstance and attain success in coping individually (Monson & Friedman 2006). Psychodynamic Technique of Responding to PTSD PTSD patients tend to have aberrant psychological mechanism for coping with overwhelming events. According to Friedman (2000), not all adverse outcomes are traumatic. Only those that fulfill the Diagnostic and Statistical Manual (DSM)-IV “A1” standards are classified as traumatic. Highly agonizing stressors, including rejection, serious disease, failure, or even divorce do not meet “A1” criteria of DSM-IV. This is based on the premise that many people are able to cope with ordinary stressors, although traumatic stressors may overwhelm their adaptive capabilities. Adshead (2000) observed that continuous fear or shame response from the primary PTSD aspects. These reactions can be effectively treated by psychotherapy. This may also enhance efficacy of pharmacological therapy. According to Kaiser, et al. (2005), psychopharmacological therapy tends to more effective in alleviating persistency of particular intrusive symptoms related to PTSD. Van Etten and Taylor (1998) argued that psychological therapies tend to be more effective in treating PTSD than drug therapies, although both have greater effectiveness than control conditions. Pharmacotherapies tend to have greater dropout rates than psychological therapies. The psychodynamic approach involves institutionalization of trust, attaining justification for accessing meticulously secured traumatic resources, and safety. Trauma forms the core of the therapy. The traumatic resource is explored intensively, with numbing symptoms being the titrant of intrusive remembrances. The provider assists the patient to break away from trauma and reestablish link with family, friends, and society as a whole (Friedman 2000). Iribarren, Prolo, Neagos, and Chiappelli (2005) observed that psychological debriefing is usually provided almost immediately after traumatic events. Such measures are aimed at preventing the prospect of developing adverse psychological stress. The help-seeker undergoes emotional dispensation through normalization, catharsis, and girding up for future consequences. Exposure psychotherapy tends to more effective in responding to PTSD. Nevertheless, the approach does not indicate substantial influence on adverse symptomatology of PTSD, such as deteriorating social relations, avoidance, or rage. A general psychiatric service can be effective in treating trauma survivors with persistent or acute PTSD. Collie, Backos, Malchiodi, and Spiegel (2006) suggested that art therapy has greater potential for treating difficult-to-treat symptoms, including emotional insensitivity and avoidance, while considering the root causes of the symptoms. Iribarren, et al. (2005) observed that there is inadequate empirical research corroborating the argument that psychological debriefing methodology effectively impedes psychopathology. Cognitive-behavioral therapy, and desensitization and reprocessing of eye movements tend to be more effective in responding to PTSD. Psychotherapeutic techniques, including psychodynamic and humanistic interventions are scantly supported by research. Conclusion To sum up, war experience can instill immense psychological burden beyond human adaptive capacity. Following fresh war veterans returning home from Iraq War, incidences of post-traumatic stress disorder are expected to escalate. Medical professionals would need to be keen in recognizing the psychological needs of trauma survivors. A person may develop PTSD if the stress is traumatic. Cognitive behavioral approach can be more effective in treating PTSD, if it takes into consideration the context of trauma and special needs of the post-war combatants. Psychodynamic methodology involves helping the individual to break away from trauma and reestablish links with family, friends, and society as a whole. Reference List Adshead, G. (2000). Psychological therapies for post-traumatic stress disorder. British Journal of Psychiatry , 177, 144-148. Collie, K., Backos, A., Malchiodi, C., & Spiegel, D. (2006). Art Therapy for Combat-Related PTSD: Recommendations for Research and Practice. Journal of the American Art Therapy Association , 23 (4), 157-164. Doyle, M. E., & Peterson, K. A. (2005). Re-entry and re-integration: Returning home after combat. Psychiatric Quarterly , 76 (4), pp. 361-370. Friedman, M. A. (2000). Post-Traumatic Stress Disorder. Retrieved June 25, 2012, from American College of Neuropsychopharmacology (ACNP): http://www.acnp.org/g4/GN401000111/CH109.html Grinage, B. D. (2003). American Family Physician. Diagnosis and Management of Post-traumatic Stress Disorder , 68 (12), pp. 2401-2409. Iribarren, J., Prolo, P., Neagos, N., & Chiappelli, F. (2005). Post-Traumatic Stress Disorder: Evidence-Based Research for the Third Millennium. Evidence Based Complement Alternative Medicine , 2 (4), 503-512. Kaiser, D., Dunne, M., Malchiodi, C., Feen, H., Howie, P., Cutcher, D., et al. (2005). Call for art therapy research on treatment of PTSD. Art Therapy_PTSD , pp. 1-8. Monson, C. M., & Friedman, M. J. ( 2006). Chapter One: Back to the future of understanding trauma: Implications for cognitive-behavioral therapies for trauma. In V. C. Follette, & J. I. Ruzek, Cognitive-behavioral therapies for trauma (pp. 1-16). New York; London: The Guilford Press. National Collaborating Centre for Mental Health. (2005). Post-traumatic stress disorder: The management of PTSD in adults and children in primary and secondary care. National Clinical Practice Guideline Number 26 , pp. 1-167. Naval Center for Combat & Operational Stress Control. (2012). A research publication for providers. Combat & Operational Stress Research Quartely , 4 (1), 1-8. Ruzek, J. I., Walser, R. D., Naugle, A. E., Litz, B., Mennin, D. S., Polusny, M. A., et al. (2008). Cognitive-Behavioral Psychology: Implications for disaster and terrorism response. Comprehensive View , 23 (5), 397-410. Van Etten, M. L., & Taylor, S. (1998). Comparative efficacy of treatments for post-traumatic stress disorder: A meta-analysis. Clinical Psychology and Psychotherapy , 5, 126-144. Walser, R. D., Ruzek, J. I., Naugle, A. E., Padesky, C., Ronell, D. M., & Ruggiero, K. (2004). Disaster and terrorism: Cognitive-behavioral interventions. Original Research , 19 (1), 54-63. Read More