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Patricia – you have something valuable to say, and you don’t think anyone’s listening. I know someone who suffered childhood trauma, with untreated PTSD leading to a personality disorder and an exhausting lifetime spent escaping intrusive memories. Her drug of choice is cannabis, which I don’t think is coincidental given its effects on memory. The thing about pharmacological treatment of disorders is that, regardless of symptom relief, people rarely end up feeling like, “This is just what I need and want, long term.” Not to mention side effects, dependence and cost. Also, PTSD is about a lot more than intrusive memories. But maybe I misunderstood.
In both childhood and adult PTSD it appears that a sense of loss of control over one’s own safety and the failure to respond functionally by others to whom safety has been entrusted are key factors. When it’s forbidden or psychologically too toxic to attribute blame for traumatic events externally, where it almost always belongs, then blame gets internalized and adds to the “psychology of helplessness”. (“I was responsible for the safety of myself and others, I failed, so I can’t feel safe.”)
One therapeutic approach that can be useful is narrative reframing. By increasingly representing the traumatic experiences and their context symbolically, realistically, and cognitively, they may become distanced from more affective and felt representations which are tied to limbic system responses (like hypervigilance, fight-or-flight, etc.) symptomatic of PTSD, and distanced from the psychology of self blame and helplessness.
But what would therapeutically useful and realistic reframing look like for an Iraqi vet? What would help regain a sense of ability to control safety in his environment, a sense that the witnessed carnage and threats to her life didn’t result from personal failure or deficits, that his environment needn’t always be unsafe?
Maybe narrative elements that simply honor the truth: that she was placed in traumatic situations due not to her failure, but to a failure of her country to act truthfully, rationally and morally; often without the resources needed to protect herself; that he didn’t fail himself or his buddies, but that his leaders failed him; that they coped adaptively, honorably and the best they could in a pathological environment created by disturbed and untrustworthy leaders.
What may have most value therapeutically isn’t likely to be offered at VA centers. The reframing needed by vets won’t likely fit with the national lie that will attempt to salvage justification for the needless and senseless carnage in terms of a righteous “war on terror”.
