Healing Combat Trauma

"Just in Time for the Holidays" -- Stress-Reduction Exercises for PTSD

Various stress-reduction or relaxation exercises and techniques are available these days in a number of places, online and otherwise; and at least a few of them make a passing reference to PTSD (though rarely combat trauma). 

Relaxation at first may seem to be an impossible goal for those with combat trauma, because jumpiness and hypervigilance appear to be hallmarks of the experience that also have helped keep troops alive. 

However, the continual wearing-down and weakening of the nervous system over years from adrenaline surges and frequent experiences of "fight or flight" shows just how important it is to develop greater familiarity and experience with relaxation exercises. 

Like riding a bike, it's a much better (and more effective) idea to DO these things than just READ about them -- especially if you want to give yourself a chance to "feel" the effects in your own body, and "test" for yourself whether these techniques really "work."  (And don't forget the caregivers, partners or spouses of those suffering from PTSD: They also carry around a fair amount of stress... )

The emerging field of Mind-Body Medicine (ironic since the idea of mind-body medicine is actually quite old) is full of techniques and tools for stress-reduction and relaxation.  Yoga and meditation, among others, are known for their ability to reduce stress.  But occasionally on the Web there's also a good guide for sufferers about how to relax and renew.  Just such a "technique" guide exists here: The subject is "Relaxation and Relaxation Exercises," and the guide was produced at the Trauma Center, with the funding of the Massachusetts Office for Victim Assistance (MOVA), under a federal Anti-Terrorism Supplemental Grant (ATSG), to aid Victims of and Responders to the 9/11 Terrorist Attacks.  Click here for a link to the guide online.

Also look on the left-hand column of this blog to see a number of resources in the form of books, CDs, and DVDs for stress-reduction and relaxation, including music designed to help people relax and de-stress. A section called "Healing Multimedia" is located about 3/4 of the way down the page (if you think of the blog as a single page, and just cursor down to that), or you could do a search (Cntrl F on most computers, or Apple F on Macs) for "healing multimedia" to find that section of recommended resources. Enjoy!

Learning to Bounce Back: Helpful Hints for Increasing Personal Resilience

"Resilience" or the concept of "increasing personal resilience" is something we're hearing about more and more in connection with PTSD.  For combat veterans and their families, the greater the amount of personal resilience, the more fully they'll be able to "bounce back" from trauma (hence the image of the boomerang, which quickly returns to its source.)

 

According to the dictionary, "resilience" is "The ability to recover quickly from illness, change, or misfortune; buoyancy;" and the intrinisic "property of a material that enables it to resume its original shape or position after being bent, stretched, or compressed; elasticity."

According to the National Center for PTSD, and its PowerPoint presentation on PTSD 101, presented by Fred Gusman, M.S.W. and colleagues, three keys to resilience are the "ABC's" of "awareness" (of one's limits, emotions and resources); "balance") among personal and professional activities [their presentation was to clinical caregivers, so that's explains the inclusion of that sentence]; and "connection" (to one's inner self; to others, and to something "larger" (typically spiritual).) A connection with others, in particular, "breaks the silence of unacknowledged pain; offsets isolation; and increases validation and hope."

 

The short, pithy presentation also offers these

 

Helpful Hints for Personal Resilience:

• Make connections/relationships;
• Avoid seeing crises as insurmountable problems;
• Accept that change is inevitable;
• Set goals and actively move toward them;
• Take decisive actions;
• Look at problems as triggers for personal growth;
• Don’t blow things out of proportion;
• Remember and use past coping, success, strengths. 

-- Source: APA Task Force on Resilience, 2002, quoted in National Center for PTSD’s "PTSD 101," linked here.

Coming Out of the Darkness, One Step at a Time

I was having a conversation recently with one of my favorite veterans (and which veteran is not?!) about how we were going to take a look at his past in a way that wouldn't also cause him some sort of setback, which I wouldn't want (and nor would he).  I'd done a little digging on his behalf, and found a bunch of "the missing link" type information about what happened to his platoon that he served with in Vietnam, during a particularly vicious battle which had left very few of his buddies alive. 

 He was away from the field at the time, recuperating at a naval hospital in the U.S., and his finding out casually about the entire wiping out of his company of Marines has been the single hardest episode of his life.  What with one thing and another, I'd managed to find out much of the information he wanted to know, but was loath to share it with him, lest it cause him any more horror than it already had.  So I wanted to proceed gingerly with him, not just set him on the slippery banana peel of reflection, as it were, and give him a push.  Vietnam had already been plenty hard for him to process, and its explosive tentacles reached all the way into his present.

We discussed the methods back and forth for a while, of what would be comfortable to share with him, and what the pace could be, and then I asked him, was there anything "good" for himself that he could be doing, so that the material might be absorbed in as successful a way as possible? Was there any special place he could go to, music he could listen to, anything therapeutic he knew to do for himself, while he tried to take in bits and pieces of information about the most troubling time in his life, that has plagued him for the 40 years since it happened.  This is what he wrote back in response:

So, what I need is a very sunny mildly cool day, no monsoon weather or rice-paddy heat; a quiet place in the woods (back forty) with my three dogs; and a print off of the material to read, meditate on, cry, scream, cuss, and read some more; AND my cell phone with your number on speed dial.  That arm and hand reaching down to pull me up out of the darkness. 

 

You know when you save someone’s life, you own that life, until they save yours.  So if you save me, you own me…

(Can you tell why I just adore him?!)  But it did also put me in mind of one other "therapeutic" item we haven't talked about much on the blog yet, but which I know about from my previous writing life.  There's a former cancer nurse named Valerie Cooksley, who's written a number of books for Prentice Hall and others on aromatherapy, but from the scientific end of things, not the frou-frou end.  For a while she was a consultant to Tacoma General Hospital, among others, and their ICU, and she developed some essential oil blends (her term) or "potions" (mine), that have therapeutic aspects.  The ones I'm remembering, because they were directed to the dying and their families, were blends that attempted to enhance people's ability to both grieve the past, and to let it go.  Somehow I can't help thinking that essential oil blends like that would be of some potential value here, too.

It would be hard to quickly go into why and how medicinal aromatherapy works -- it has greater credibilty in Europe, where Cooksley's trainers were trained -- but the concept, in a nutshell, is that essential oils have properties that can modulate people's emotional states, and they're very effective "drug delivery" models, because they quickly cross the "blood-brain barrier" through the nose, directly into the brain's mood receptor sites. I've probably just botched the science by trying to explain it in two sentences and get back to the point, but that's the gist of things, and Cooksley knows what she's talking about.

If you're a fan of the Bible, you also remember essential oils in use with the "We Three Kings of Orient Are" types, who allegedly came to visit Jesus.  "Anointing people with oil" is a practice that dates back at least to Biblical times.  "Gold, frankincense and myrrh" were the three gifts the Wise Men brought (why do they sound like Mobsters, at this remove? Too much "Sopranos") -- and of those, two were rare, costly essential oils.

Just to be very clear on this, I by no means think that dabbing or sniffing a few essential oils is going to be a cure for PTSD.  However, as a pleasant adjunct to what you're already doing, or a lovely relax-i-fier that can be put into use at any time?  Great stuff, and a nice addition to life, in the way that a massage is, or great sex -- not curative in itself, but a nice and pleasant and stress-reducing aspect to life, that's wise to incorporate into your life as much as possible.

Herewith some lovely blends of Cooksley's, along with her notes as to why those particular choices.  Although she's focusing on "death and dying," expand the definition of that as you read these blends to include situations that would also bring up horrifically charged emotions around that topic, such as revisiting combat trauma, and those who were dead and dying there, plus the resultant grief, shame, guilt and confusion that typically surround these episodes.  (This may explain why my "lavender sleep pillows" for returning combat vets and their families, made from a Cooksley recipe, and blogged about here, were consistently such a big hit.)  The last two she mentions are the two I would particularly want to focus on.  You'd have to "read the directions" elsewhere on how to use essential oils (externally, obviously), but sometimes even a drop touched to the underside of your nose, at the point where it meets your upper lip, or waved underneath on a tissue, can give you an immediate "read" on whether the remedy might have some value for you. 

It's also fair to say that anyone I've ever made essential oil blends for, after Cooksley's recipes, has become a fan for life: they're "delish," and this is just lovely high-touch, low-tech stuff.  Women tend to be bigger fans than men -- they're six times as able to "notice" the scents themselves, though this isn't necessary for the scents to do their work -- but both sexes have been able to see the value, once they've tried a few of these for themselves.

“Serenity Blend”: Lavender 15 drops, Bergamot 6 drops, Mandarin 3 drops.

“Anti-depression”:  For depression or grief; useful for back or hand massage. 

Lavender 9 drops, Ylang-ylang 9 drops, Basil 2 drops, Geranium 2 drops, Bergamot 2 drops.

“Joyful Hope”:  Anti-depressant blend.  Uplifting and purifying, to encourage a healing and caring environment.  Orange 4 parts, Ylang-ylang 2 parts, Bergamot 1 part, and Lemon, 1 part.

“Grief and Bereavement”:  For dying patients and their families.  Lavender 4 parts, Marjoram 1 part, Hyssop 1 part.

“Ceremonial Oil”: A nurturing, peaceful blend, to be used with terminal patients.  Helps with feelings of fear, encourages faith.  Grounding hand or foot massage, solar plexus, or used to anoint head.  Lavender 10 drops, Ylang-ylang 8 drops, Sandalwood 4 drops, Frankincense 2 drops.

Another book on the suitably "grand and broad" topic of Aromatherapy and Healing the Spirit, mentions this blend for helping soothe "sudden psychological trauma" -- perhaps, in this case, as it is revisited in memory:

Lavender 3 drops, Frankincense 2 drops, Spikenard 1 drop.

And there's also an item that has a long therapeutic history in Complementary and Alternative Medicine, a blend of Bach flower essences called "Rescue Remedy," available, like essential oils, both online from Amazon.com and places like Whole Foods, Wild Oats, and other natural grocery stores.  Rescue Remedy is a low-tech, non-drug remedy for calming nerves that has an enthusiastic following among a diverse group of CAM adherents, including veterinarians. (I highly doubt even the skeptics suggest that animals are susceptible to the Placebo Response ;-).

 

I wonder if we can add one of these to the list of what my friend will be taking into the woods with him, when he wants to try processing his trauma from the past, in manageable bits and pieces; I hope so.

 

I'd actually like to see him outfitted with many of these items, some soothing, restful music, and Thomas Day Oates, Jr.'s spectacularly-soothing DVD, "Pacific Light," which we blogged about earlier, here.  Maybe he'll need a little red wagon, too -- to carry all that stuff into his healing space into the "back forty" of the woods, with the dogs running along beside him, hoping for the best.

 

In a perfect world -- ahh, I can dream, can't I? -- veterans healthcare options for PTSD would include scented oil massages with just the essential oils necessary for helping speed healing, or take the edges off the particularly hard memories.  As no less an authority on health than Hippocrates, the father of Western medicine, once said:

 

"The way to health is to have an aromatic bath, and scented massage every day...healing is a matter of time, but is sometimes also a matter of opportunity." -- Hippocrates, father of Western Medicine (460-377 BCE)

 

Here's hoping that my adored veteran buddy gets his healing, and his opportunity...

Shaking Off the Blues: Two New Books Help Veterans and Others Get "Unstuck"

A well-regarded psychiatrist who thinks there are other-than-pharmaceutical antidotes to biochemical depression?  Rank heresy!  Oops, actually we meant -- how very refreshing indeed. 

A soulful journalist who's lived and worked in war-torn countries, and knows what it's like to be a survivor -- who then turns her attention to helping veterans and their families come home from war and rebuild the pieces of their often-shattered psyches? Again, a wonderful suggestion.

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NPR the other day published a great interview with none other than James S. Gordon, M.D., author of the new book called "Unstuck: Your Guide to the Seven-Stage Journey Out of Depression." Depression is an important topic, because many people who are risk for suicide have depression as an underlying state.  According to one psychiatry textbook for medical students, "A majority (60% to 80%) of people who commit suicide carry a diagnosis of depression."   

If you remember, we've talked about Dr. Gordon on this blog before.  He has an impressive, very talented background academically (Harvard College, Harvard Medical School), and is the founder of the Center for Mind-Body Medicine in Washington, D.C., as well as a frequent lecturer at the Smithsonian, and the former chairman of the White House Commission on Complementary and Alternative Medicine, also known as "CAM."  (We've blogged about CAM, also known somewhat misinformedly as natural medicine, and its opportunities for treating PTSD here on the blog, at length here; and also about the varieties of mind-body medicinethat might show some promise for treating combat trauma and PTSD, here.)

To listen to the NPR interview, or to read the accompany material on getting unstuck -- in Dr. Gordon's words -- click here.  To read Dr. Gordon's bio -- click here.  To read our previous posts about his work on "Healing the Wounds of War," click here; on "Healing the Troops," click here; and on his and the Center for Mind-Body Medicine's annual conference, planned for October 25-29th in Minneapolis, Minnesota this year, click here.  The topic of this year's conference is the highly-appropriate "Integrating Mind-Body Medicine into Clinical Practice, Medical Education & Trauma Healing."  As Dr. Gordon's website says, "We're teaching thousands to heal the world's millions." Indeed -- and what a noble task that is; and how very, very vital.

If I had ONE RECOMMENDATIONfor the Pentagon, the DOD, the VA, the various branches of the military (Army, Air Force, Navy, Marines, National Guard) that frequently comb this site, looking for answers to the questions they have -- it's that they would get to know Dr. Gordon's work, and send representatives to this conference in late October, 2008.  Check into mind-body medicine, with a credible expert, and somehow who's already worked with, and proven his work with, the war-torn and traumatized (troops and civilians) here and abroad.  Broaden the outlook on how to treat PTSD and combat trauma, by returning people to themselves, and helping them to learn to manage their own stress in creative and supportive ways.

Dr. Gordon says his book, Unstuck, goes into many of the same principles that his trauma work does. I can't wait to start reading my copy, which his office promises to send.

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In the meantime, I hope Dr. Gordon gets to cross paths professionally with Minnesotan Britta Reque-Dragicevic. I have read her book-- devoured it in one sitting is the more accurate description -- and think it has lots of potential to comfort, support and nurture returning veterans and their families in putting the pieces of the puzzle back together.  (One thing I love about both Dr. Gordon and Britta Reque-Dragicevic -- they both "get" it.  They've had a personal experience with what they're talking about; it's not just academic.  And they're both driven to help others heal from their suffering -- the not exactly unspoken single purpose of this blog: there's synchronicity.)

Reque-Dragicevic has written a completely soulful manual on getting unstuck herself, and with her profound understanding of the needs of trauma survivors, as a longtime journalist in post-war Saravejo and Bosnia, I sense a little (**magical?!**) professional matchmaking going on that would only serve to increase the amount of healing and overcoming in the world, especially among trauma survivors and veterans with PTSD.  If you want to read more about Reque-Dragicevic's marvelous book, Close to Home: A Soldier's Guide to Returning from War, click here.  Her book is endorsed and recommended by Dr. Edward Tick, among others.  At a mere $10 as a download on the Web, you really can't go wrong.  (We'll be quoting from Reque-Dragicevic's book on this blog in the future, with her permission, because it's wonderful stuff and she really "gets" it. Veterans and their families need to experience this.)

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If you have $10 to spare, or as a gift for someone else, buy Britta Reque-Dragecivic's book.  It's a download, and you can have it in your hands within minutes, from anywhere in the world, and start the healing process today.  If you have about $18 and shipping, buy Dr. Gordon's book, and start the healing pro