You can still get your PTSD under control. Believe it.
By Mary Tendall and Jan Fishler
In past articles, we have stated the usefulness of therapy as a path to healing war trauma. While it is possible to function with many of the symptoms of PTSD (post-traumatic stress disorder) without formal therapy, it is nearly impossible to heal trauma without the aid of a trained therapist to help resolve longstanding issues via tools such as cognitive/ behavioral work, talk therapy, breath work, visualization, or EMDR (eye movement, desensitization, and reprocessing). Because many Vietnam veterans are at a stage in life where they are reflecting on the past and looking toward the future, a common perception is that they fear there is not enough time to do the things they want to do – in essence, that it is “too late.”
Because many Vietnam veterans are at a stage in life where they are reflecting on the past and looking toward the future, a common perception is that they fear there is not enough time to do the things they want to do – in essence, that it is “too late.”
Ironically, many Vietnam veterans who have coped with troubling PTSD-related symptoms for years are just now beginning to ask for help with symptoms such as anger and isolation. While dogs and grandchildren might have served well as safe emotional outlets, there is the growing realization that an emotional connection with other loved ones is equally important. Although the ability to start new in a profession or begin a family is an improbable solution, it is never too late to change the quality of one’s life.
This article focuses on changes that have been made by three veterans seen by Mary in her practice. Upon entering therapy, all of these men believed that change was impossible. Once hopeless, they have succeeded in altering the course of their lives, and offer a picture of courage to anyone who is ready to take a walk on the therapeutic path.
At the age of 66, Rob* has been in treatment for his combat-related symptoms of PTSD for less than a year. He didn’t realize that he had been coping with PTSD for more than 30 years until he attended a stand-down to find out about VA medical benefits and talked to the local veterans’ representative. He was shocked when the representative showed him a checklist of symptoms resulting from a combat experience. All of them applied to him. His wife was thrilled to see that list.
Problems related to PTSD
- Anger, irritability and rage.
- Feeling nervous.
- Difficulty trusting others.
- Feeling guilt over acts committed or witnessed, the failure to prevent certain events, or merely having survived while others did not.
- Hyper-alertness and startle reactions Feeling grief or sadness.
- Having thoughts and memories that will not go away.
- Isolation and alienation from others.
- Loss of interest in pleasurable activities.
- Low tolerance to stress.
- Problems with authority.
- Problems feeling good about oneself.
- Substance abuse.
- Trouble sleeping.
“I knew it!” she declared upon finally receiving validation for concerns she had held for years. When Rob was referred to the Vet Center to be authorized for treatment, he still didn’t believe he would qualify as someone with PTSD.
“I wasn’t one of those guys,” Rob said. He had a long-term marriage, had successfully supported his family, and was now about to retire, but he was very curious about the checklist that described him so well. Following is Rob’s version of the story.
First, my therapist gave me an education about what PTSD is, and she told me to read some of the VietNow articles.
“I was skeptical about the whole thing, but I soon realized that my family was all for me getting some help, even if I didn’t think I needed it. First, my therapist gave me an education about what PTSD is, and she told me to read some of the VietNow articles. My wife and I read them, and that opened up discussions we have never been able to have before. That was when I realized that the described symptoms were mine, and they had really had an impact on my family. I had no idea that was the case.
Then came the guilt. My kids are grown, and what can I do now? I can’t just change at this point. So, months into therapy, I now realize what has been going on with my anger, isolation, and emotional numbness. I have ways of working on that, because I can now recognize what is happening in my body when I am triggered. It has really helped, and my wife says she notices a difference.
My nightmares are gone, and that is a real blessing. I never thought it was possible to get rid of them.
My nightmares are gone, and that is a real blessing. I never thought it was possible to get rid of them. My therapist said it would be easy, and it was, but I never believed it until I realized that they were absolutely gone. They used to keep me awake several nights a week. There is a lot of work I still have to do, and my family notices changes more than I do, but I have to say that my life is better and it sure as hell is good to know what has been going on all these years. I never thought I’d be saying any of this, but if it helps someone else, I am glad to do it.”
Because of the severity of his combat experience and the extent of his symptoms, Charles, now 58, made many poor choices when he returned from Vietnam. Hs use of drugs and alcohol escalated, his marriage broke up, he lost track of his son, and he was unable to keep a job. As Charles says, “I quit most of them before I was fired.”
When he realized that many of his problems were caused by his experiences in Vietnam, he adopted a what-do-I-have-to-lose attitude, and entered treatment extremely motivated to make changes.
His history of multiple relationships, several arrests due to fighting, and his inability to keep a job, left him feeling angry and hopeless. He thought it was best if he came down with a life-threatening disease in order to “end it all without anyone feeling guilty.” Twelve years ago, when a physical ailment affected the quality of his life, Charles talked to a veterans’ representative about getting benefits. Like Rob, Charles was shocked by the list of symptoms on the PTSD checklist. When he realized that many of his problems were caused by his experiences in Vietnam, he adopted a what-do-I-have-to-lose attitude, and entered treatment extremely motivated to make changes.
Today, Charles is happily married to a supportive and humorous woman. He owns a small parcel of land several miles from town, and is proud to say that he negotiated the purchase without a “blow up.” He maintains a close relationship with his previously estranged son, who often brings his three children to visit. Charles is beginning to get to know and socialize with his neighbors, and is able to communicate without feeling a sense of total distrust. He is still plagued by road rage, but has managed to solve that issue by leaving the driving to his wife.
Sadly, he has been unable to locate the daughter he hasn’t seen since she was an infant, and that continues to trouble him. But with that exception, Charles says that his life is better now than it ever was before or after Vietnam. He looks forward to the future, and has many plans for the improvement of his land, which he would like to leave to his grandsons some day.
Mick is another veteran who opted for treatment that resulted in a positive outcome. Today, at 62, he is active as an AA sponsor, is very happily married to “a wonderful woman,” has many friends, and has renewed his relationship with his son. He owns a small ranch with sheep, rabbits, cats, and a guard llama, and describes his current situation as “a peaceful, spiritual life.” Mick attributes the quality of life he has achieved to the many years he spent in treatment working on combat-related issues.
Mick returned to his home state of California at the peak of the anti-war movement. In his words, “I was exhausted mentally and physically, and very disillusioned. I had thought I would just go back to work and do life: go to school, get married, have kids, and get a job.”
Then the PTSD really kicked in, and I was fearful all the time.
Unfortunately, Mick experienced many obstacles in manifesting that dream: he was unable to get work, he was addicted to the drugs he had been taking while on the blasting crew in Vietnam, he used alcohol excessively, and he perceived every civilian as “selfish and out of touch with what was really going on.” He was unable to concentrate on school, and dropped out after a month. He looked at his family as strangers, and he had several failed relationships. After about two years, because of his reactivity and substance use, he left his wife and son.
In 1990, Mick finally realized that he was out of control, and he quit drinking and using drugs. “Then the PTSD really kicked in, and I was fearful all the time,” Mick says. “I left my second marriage of 11 months, and moved to the foothills to work with my brother. I got into a PTSD program that was sponsored by the Vet Center there, even though I was shaky and didn’t trust anyone, including myself. I really felt that I was going to hurt someone or myself.”
CHOICE AND TREATMENT
Like Rob, Charles, and Mick, every veteran must choose a path that is perceived as reasonable and possible. That may mean seeking help for substance use, or getting involved in a meaningful activity such as service to other veterans, church work, community service, or perfecting a hobby. It may also mean choosing to receive guidance in decreasing and/or eliminating the symptoms that have greatly impacted the quality of life in the past 40-plus years. No one is meant to go through this type of healing journey alone.
Readjustment Counseling Services
- Individual counseling.
- Group counseling.
- Marital and family counseling.
- Medical referrals.
- Assistance in applying for VA benefits.
- Employment counseling, guidance, and referral.
- Alcohol/drug assessment.
- Information and referral to community resources.
- Sexual trauma referral services.
- Community education.
A variety of treatment and lifestyle modalities were used to help Rob, Charles, and Mick create positive change. During individual treatment, relaxation tools such as deep breathing and safe imagery were taught. In addition, trauma-release regimes – including EMDR, somatic experiencing, and cognitive and behavioral reprocessing – were employed. For two of the men, a veterans’ support group proved very helpful, but the third chose not to attend group sessions. Church involvement played a positive role for one of them, while the other two found great peace in their connections to nature and their land.
In order to reprogram the old “combat mode” pathways, all three veterans learned to work continually at interrupting their old triggered reactivity, and replaced it with healthy action and thinking. Their individual work on this apart from the treatment sessions put them in charge of their healing and kept it as an ongoing process.
*Names and some situations in this article have been changed. Some photos may include models who have no real-life relationship to the story or any PTSD issues.
Mary Tendall, MA LMFT, has worked for over 20 years with combat veterans and their families, as a licensed psychotherapist, specializing in combat-related PTSD. She has consulted for the Gulf War Resource Center, National Public Radio, and Newsweek. She continues to work with combat veterans and their families, and is affiliated with several national non-profits whose goal is to help veterans, such as VietNow, Soldier’s Heart, Train Down, and America’s Heroes First. She can be reached by e-mail at firstname.lastname@example.org.
Jan Fishler is an author, writing coach, and creator/presenter of a series of writing workshops. Her memoir, Searching for Jane, Finding Myself, is available on Amazon. You can learn more about her at janfishler.com. She is married to a Vietnam veteran.