“Army Strong” Tools For Urban Survival Part 2

March 30, 2007

I’ll continue with my report on the PTSD conference that I attended on Monday. The second speaker of the day was Dr. Bridget Cantrell, the co-author of Down Range - To Iraq and Back. I’m really impressed with the amount of time that Dr. Cantrell dedicates to our Military Members and our Veterans. She truly is passionate about helping our Soldiers and Veteran’s deal with problems that might arise due to PTSD. I admire her energy and dedication.

Here’s a bit about Dr. Cantrell:

Dr. Bridget Cantrell was appointed the 2004 Outstanding Female Non-Veteran for her service to veterans by the Governor’s Veterans Affairs Advisory Committee and the Washington State Department of Veterans Affairs. She has her Doctorate in Clinical Psychology and is a private practitioner. Dr. Cantrell is one of a small number of specially selected and trained mental health providers for the Washington State Department of Veterans Affairs PTSD Program. She is also a provider under the Mental Health Fee Service Program, Puget Sound Veterans Health Care System (Seattle VA Medical Center). Specializing in trauma for several years her primary work now encompasses treating war veterans from all eras and their family members. She also works with those veterans who have been sexually abused while serving in the military. In 2003, she received the Highest Productivity award for the Washington State Department of Veterans Affairs (WDVA) PTSD program. Her extensive work with PTSD has also afforded her the opportunity to provide services for the Crime Victims Compensation Program for the State of Washington. She is also a consultant and expert witness in forensic cases. Her dissertation research entitled “Social Support as a Function of PTSD within Washington State Vietnam Veteran Populations”, was presented to the Washington State Senate Select Committee for Veterans as part of the Governor’s Master Plan for the needs of veterans. Her research included a five-site sample of Vietnam veterans’ bio-psychosocial needs that was used for planning future programs for the King County Veterans Program. Dr. Cantrell’s research findings were formally presented at the European Traumatic Stress Conference, Edinburgh, Scotland. She was also invited to present in Brisbane, Australia at the Brisbane International Traumatic Stress Conference, as well as the International Society of Traumatic Stress Studies meeting, New Orleans, Louisiana. In the Spring of 2004, Dr. Cantrell was requested by the U.S. Army to provide mental health services to the paratroopers of the 173d Airborne Brigade stationed in Vicenza, Italy. While there, she focused upon helping these troops reintegrate with their loved ones and readjust to peacetime conditions after their prolonged combat exposure in Northern Iraq. Information and observations from this time of working with the Iraqi Freedom veterans gave birth to a new workbook course entitled “Turning Your Heart Toward Home”. The book and course is co-authored with veteran writer, Chuck Dean. Dr. Cantrell is a member of the American Psychological Association (APA), Association of Traumatic Stress Specialists (ATSS) and The International Society of Traumatic Stress Studies (ISTSS). She is a Licensed Mental Health Counselor in the State of Washington, a Nationally Board Certified Mental Health Counselor. Presently, she provides mental health services to active duty from all branches of the military, reservists, and Washington State National Guard troops and their families. This work focuses on treating military personnel who have experienced combat exposure or trauma, family deployment stress and readjustment issues after coming home. She helps family members better support themselves and their deployed loved ones. Dr. Cantrell is also involved with veteran advocacy at the Federal and State level to uphold the rights and ensure proper treatment of veterans.

Dr. Cantrell’s lecture concentrated on the treatment of PTSD and what soldiers and families alike could look for. She invited lots of audience participation and several soldiers, just returning from Iraq, shared problems that they were having difficulty dealing with in their lives. Dr. Cantrell was very compassionate and able to offer these soldiers, sound and honest advice.

4 years into the war in Iraq, we’re seeing several stressors that our soldiers are experiencing, when they come home and start reintegrating back into their families. Some of these stressors are:

We’re in the 4th year of the war, with continued deployments.
This war is being fought in an urban setting.
We’re seeing an increased number of wounded survivors compared to other wars.
The war affects not only the soldier but their relationships with children, their spouses and
the communities in many ways.

Dr Cantrell then went on to describe the anatomy of PTSD. These are in no particular order but things that are definite contributors.
1. Intensity of the stressors
2. The exposure and the proximity to danger.
3. The threat of physical injury or death.

The costs of PTSD to the person who is suffering from this disorder, are many. They can include multiple relationships, due to the feeling that they cannot get close to anyone. Multiple jobs due to low frustration or tolerance levels. Increased incidents of domestic violence due to anger issues. Incarcerations due to hypersensitivity to injustice. Drug and alcohol abuse as a way of self-medicating (5 drinks or more per day) and an increase in the number of suicides.

Dr. Cantrell stressed that when the soldiers return home from the warzone, it is very important for them to continue to be a “team player” with their spouse or significant other. To let their spouse know if they’re struggling with things and to work together as a team to seek help and overcome the problems they’re experiencing. For the spouses in attendance, Dr. Cantrell stressed the importance of knowing how to be a partner to their spouse, to be in-tune to their body language and supportive to them, in order to recognize what might be going on with them. She also stressed the importance of being encouraging and understanding and to help ground them back to reality.

There are certain things that can increase the likelihood of PTSD. Those are:

1. Exposure to a traumatic event
2. Persistent re-experiencing of the event.
3. Persistently engaging in avoidance of stimuli that are associated with the trauma, or triggers.
4. Persistent symptoms of arousal,; such as anger, sleep disturbances, hypervigelance and increased startle responses.
5. The duration of the symptoms last for a month or more and cause significant clinical distress.
6. Acute type of PTSD is a duration that is noted for 3 months or more.

PTDS, left untreated can affect a person in all facets of their life. This includes in the workplace, educational settings, in their family, in relationships with friends and in social settings.

Certain behaviors are indicative of PTSD. These behaviors can include:

1. Unable to follow through with tasks.
2. Focus on safety/overprotectiveness, or control of situations.
3. The need for a weapon (ritual)
4. Intrusive thoughts, flashbacks or reenactment.
5. Views others as doing stupid things, such as authority figures.
6. Anger and rage (the wire)
7. Numbing out and disassociation. Isolation.
8. Thrill seeking behaviors.

Some fear based responses that may be seen are:

1. Road rage- extreme anger
2. Workaholic
3. Avoids relationships (fear of loss)
4. Hypersensitive to physical contact
5. Drug and alcohol abuse (5 or more drinks per day)
6. Over-eating (comfort foods)
7. Suicidal or homicidal thoughts (easy way out)

There are some physical effects that can be very noticable when a person is re-experiencing a traumatic event. These include:

Physical and Central Nervous System Responses
Increased heartrate
Increased blood sugar
Muscle tension
Migrane Headaches
Shortness of Breath
Nausea or intestinal problems
Pressured speech

Hyper-Arousal Results
Unpredictable responses
Hypersensitivity to environmental stimuli
Increased frustration level
Memory Problems
Sleep Disorders

PTSD can affect not only the returning soldier, but the spouse and family as well, who can experience secondary PTSD. The spouse has taken on new roles while their soldier was deployed. Due to the increased availability of communication with their spouses in the warzones, they experience vicarious war trauma as well. The spouses develop new connections while they’re soldier is deployed. Their worry and anticipation can lead to high expectations for when their soldier returns, added to the constant concern of more deployments.

There are many challenges facing the soldier when he or she returns home. They may miss life in the warzone, the closeness they felt with their buddies. They may feel numb with a lack of desire for intimacy. Their children have changed, and grown and they’ve missed developmental changes in their children while they were deployed. The roles in the household have evolved and in some cases reversed. Their spouse has developed new support networks and they may feel that their spouse doesn’t “need” them as much as before. They may feel disconnected and don’t want to talk about that feeling due to shame or anger. Their outlook on life may have changed. They may experience difficulty with guilt, trust and spiritual issues. They feel as if their entire assumptive world has changed.

Dr. Cantrell shared some of the barriers to treatment for returning soldiers. Some of these barriers can be:

1. They have a misunderstanding of what PTSD is and think they are going crazy.
2. The stigmas attached to seeking psychiatric help: These stigmas may be that they feel they will be looked upon as weak by their peers, or that it can cause them to not get promoted or that they will be labeled as crazy, or that they will be rejected by potential employers.
3. They are unaware of the services/benefits available to military members and veterans.

If left untreated PTSD can cause severe and persistent problems for a person. These may include sleep disorders, nightmares, anxiety, extreme anger, irritability or startle responses, depression, apathy, unwanted and distressing memories and thoughts.

The most important thing is to seek help! Doing so allows the person suffering from PTSD to reconnect with their world. You need to abandon expectations and reestablish roles, egotiate with your spouse, make time for your relationships, think of the consequences of not getting help, makewise choices and live for today.

The effects of PTSD are very treatable if help is sought. There are many Veteran’s groups and organizaitions out there today that can help in the location of resources. Military bases are aware of the problems that can arise and services have been established and put into place for the soldiers returning from the war zone. Don’t be afraid to use the resources available to you. Seek the help you need.

I would highly recommend reading Dr. Cantrell’s book Down Range — To Iraq and Back, both for the returning soldier as well as for their spouse. There is a lot of very valuable information that will make the entire process of re-integration into society, and back into your personal relationship much easier. To learn more about Dr. Cantrell and the services and programs she offers, please visit her website, Hearts Toward Home International


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