Ministering to the Military in Our Midst

“Endure suffering along with me, as a good soldier of Christ Jesus.”

2 Timothy 2:3 NLT

     “Whenever Robert Reiter is asked when he left Viet Nam, he answers, ‘Last night. It will be that way till my soul leaves this old body.' When the survivor cannot leave war’s expectations, values, and losses behind, it becomes the eternal present. This frozen war consciousness is the condition we call post-traumatic stress disorder.”

     – Dr. Edward Tick

Understand that nearly all returning veterans will suffer Combat Stress.  Stress is a mental condition that requires a physical outlet, so many of the symptoms you see are expected and normal and will subside if properly recognized and dealt with (constructive physical exertion).  PTSD is a specific subset of Combat Stress that is a injury and it should be recognized as such.

What is Post Traumatic Stress Disorder (PTSD)? ­

     Post Traumatic Stress Disorder is a specific, formal psychiatric diagnosis with numerous anxiety-related symptoms that can be severe, chronic, and disabling. These symptoms are in response to severe emotional trauma that involved possible death or serious injury to the person or others.

     Post traumatic stress disorder (PTSD) is a normal reaction to an abnormal event. Although it has been called “the signature injury” of Operation Enduring Freedom (Afghanistan) and Operation Iraqi Freedom, it is estimated there are over 400,000 Vietnam War veterans who still suffer from PTSD – undiagnosed and untreated. Consider that for every combat trauma/PTSD sufferer from these and past wars, another 10 people are emotionally and spiritually wounded by the secondary trauma created by the sufferer’s behavior.

What are the symptoms of PTSD?

     During the event, the person typically experiences intense fear and helplessness which could be considered a normal reaction anyone else in a similar situation might have.  What sets PTSD apart from "normal" are the chronic symptoms a persons experiences long after the psychiatrically traumatic event.  These "anxiety" symptoms fall into three categories:    

1. The traumatic event is persistently reexperienced through intrusive thoughts, distressing dreams (nightmares), or flashbacks. The person has intense anxiety during these episodes that may be just as severe as the original event.
2. The person will make efforts to avoid any activity that may "remind" them of the traumatic event.

3. The person will experience persistent symptoms of "arousal" – being more alert – trying to avoid activities that might remind him of the original trauma.  Poor sleep and irritability are associated with this chronic state of arousal.

   

   What causes PTSD?
   
        It is generally accepted that everyone can tolerate only a certain amount of psychological stress (e.g from combat) before becoming at least temporarily overwhelmed and dysfunctional. Most people, however, are able to experience significant stress and recover without developing PTSD.
        Factors that may lead to an increased chance of a person developing PTSD include the intensity of the event, biological factors, and the person’s previous training and exposure to similar trauma.

   

Can PTSD be prevented?

     There is no easy answer to this question. Avoiding alcohol and other substances as a way to "manage" the anxiety symptoms after a traumatic event is clearly recommended. Critical Incident Stress Debriefings were once thought to be universally helpful – but now for at least some, the briefings may be counterproductive. For military personnel, prior training and unit cohesiveness may help individuals better tolerate the psychiatric trauma – but may not totally prevent PTSD long term.

How is PTSD treated?

     PTSD is treated using "talk therapy" or with medications.
Talking therapy includes cognitive therapy (learning how automatic negative thoughts affect your mood), exposure therapy (learning to be less anxious about your memories by talking repeatedly about them), group therapy (sharing your symptoms with others having similar reactions), and family therapy.  Eye Movement Desensitization and Reprocessing (EMDR) is a type of counseling that may help for those with relatively few PTSD symptoms.

     Medications typically used to address anxiety associated with PTSD include the Prozac type drugs (e.g. Prozac, Zoloft, Paxil) which raise serotonin levels in the brain.  Anti psychotic drugs (e.g. Seroquel) are sometimes used if the sleep and flashback symptoms are severe.

Outcomes / Prognosis

     The prognosis for individuals diagnosed as having PTSD is variable. Unfortunately for some, PTSD can become a chronic, life long condition.

     Without treatment, PTSD sufferers’ problems escalate and lead to secondary trauma issues for themselves and their families. PTSD does not stop with the sufferer. Their symptoms and the responses to them intersect all of their personal relationships. If untreated, shock waves from a traumatic event impact the entire individual and can fracture horizontal relationships (spouses, children, grandchildren, other family members, friends, co-workers, and even supervisors) and result in separations, divorce, and even job loss.

Practical Tips for Supporting One With PTSD

     Attempt to be non judgmental  Don’t expect the individual to be "cured" overnight.  Watch for morbid conditions.
     Learn about PTSD. Check out the many excellent references listed at the end of this chapter.       The last one (from military.com) is a good way to stay current concerning this illness.

________________________________________________________________________________

Severe

Mild

The Spectrum of Combat Trauma/PTSD

Reintegration

Issues

Combat/Operational

Stress Reactions

Adjustment

Disorders

Acute Stress

Disorder

Posttraumatic

Stress Disorder

PTSD Symptoms

Emotional

    * Shock

    * Anger

    * Depression

    * Panic

    * Helplessness
    * Despair/Hopelessness

Physical

    * Vacant Stare

    * Excessive sweating

    * Rapid heart rate/breathing

    * Chills

    * Vomiting

Cognitive

    * Confusion in thinking

    * Trouble making decisions

    * Memory dysfunction

    * Alertness (high/low)

Behavioral

    * Eating changes

    * Withdrawal

    * Poor Hygiene

    * Sleeping(Too much/little)

    * Various Addictions

Effect of Secondary Trauma

Fractured Relationships

Family/

Friends

Supervisors

Co-workers

Community

GOD

More tragically, the sufferer’s relationship with God may be fractured. And although the PTSD sufferer does not suffer alone, they will often believe that they must deal with their pain alone. Even people of faith can suffer guilt, remorse, and anger at God about the event and become unable to pray or receive peace. They may isolate themselves from their family and friends as well as their faith community. When military members don’t or can’t tell their stories the trauma never goes away. Neither do the symptoms. Their lives are not what God promises. Their families never truly know them. They cannot receive forgiveness.

Why Should Your Church Be Involved?

“Carry each other's burdens, and in this way you will fulfill the law of Christ” Gal 6:2 (NIV)

The effect of combat trauma on the military member and his or her family is a deep wound of the soul. It is a wound which no amount of pharmacology, behavioral therapy, psychological counseling or other human intervention can truly heal apart from the divine intervention of the Lord.

Spiritual Symptoms of Combat Trauma

    * Feeling abandoned by God

    * Finding it hard to pray

    * No yearning for righteousness

    * No spirit of thankfulness

    * No sense of hope

A wounded soul requires intervention in an environment that only a church can provide. Churches are all about community and relationships. They provide the compassion, acceptance, and understanding for fostering a relationship with our Lord Jesus Christ. They recognize that God is the healer. They use prayer as a foundational strategy. Churches can teach combat trauma sufferers to pray for themselves and lift them up with intercessionary prayer. Pastors and lay pastoral counselors can dialogue with the combat trauma sufferer and encourage them to dialogue with professionally trained trauma counselors and medical professionals when necessary and available.

References

Healing the Soul  PC-based, interactive, self-guided self-assessment of relationships, finances, work, personal concerns, recreation and hobbies, spirituality, and intellectual matters. 

National Alliance of Mental Illness

National Center for Posttraumatic Stress Disorder

Posttraumatic stress disorder

Family Doctor Review Article

Primary Care Treatment of PTSD

Current News Concerning PTSD in Military

NBC Interview by Brian Williams - "Soldier helps others leave war behind" -    http://www.msnbc.msn.com/id/7924753

"When the War Never Ends" by Jocelyn Green http://www.christianitytoday.com/ct/2009/july/14.48.html