Managing Traumatic Stress and Combat PTSD Through The R-E-C-O-V-E-R Approach*
PTSD: TOO MUCH OF NATURE'S ONCE-HELPFUL THING
Too Much Of A Once-Helpful Thing: The ability to "react" without "thinking" can save your life. But the process of neural imprinting also has its drawbacks. As a result of neural imprinting, the brain and central nervous system may become habituated to responding in a certain way - sort of like a "default" response in your computer. The brain may choose this imprinted response habitually (over and over), whether or not that response is really appropriate to the actual situation at hand. This is the reason that soldiers who have returned from war may respond to stressors in the home in much the same way that they reacted in the combat theater. Their reactions have become both imprinted and habituated. The brain is naturally very efficient, so when it comes to the survival of the body, it wastes no unnecessary effort "reinventing the wheel" In fact, it may lose alot of its ability to be inventive (creative), altogether, if experience has taught that there is one, best way to survive. Because the brain has experienced that a particular pattern of response was effective in the past, it continues to order the same response over… and over… and over. (This is where we get the phrase "one track mind"! )
Have you ever known a loved one or family member who just seems to "react" (or over -react) to things in the same way, time and again, no matter what the issue is? Is it always anger? Is it always rage? Is it always going on the offensive, or the contrary, behaving as a victim? How many times have you said to this person: "Can't you see this from my perspective?", or "Can't you exercise some control over your behavior?" and they seem never able to do so. Do they appear to you as though they simply don't WANT to do so? Well, you may be surprised to know that there are neuro-biological reasons for this.
Usually, traumatic stress reactions fall into one of 3 major patterns. The brain will choose which pattern, or combination of patterns, has worked well in the past, when life and death were REALLY on the line. Since the brain has learned that the chosen pattern or patterns worked well in surviving the most serious of life's problems, it adopts the same pattern(s) to deal with virtually ALL of life's problems. This is where the PTSD survivor loses access to their creativity - in other words, the person stops creating new and better solutions to new problems. Instead, the person "defaults to applying old solutions to new problems, whatever they are." This can be pretty disastrous when the old solution, formulated during hand to hand combat, or a life threatening attack, still gets used even in a casual conversation with a husband, wife, or children.
The body's neuro-biological responses typically fall into 3 major categories
A) A "fight" reaction, in which the person engages with the stressor aggressively;
B) A "flight" reaction, in which the person evades the stressor but remains mobilized; or
C) A "freeze" reaction in which (l) the person becomes physically or emotionally immobilized, or (2) the person finds it impossible to leave their situation, or (3) duty or personal responsibility prevents the person from leaving a situation, or (4) the person stages a withdrawal or "retreat" from the stressor.
In a later article, we will talk about two major behavioral pathways involved in these responses, which we call "Locked and Loaded", or "Hunkered In The Bunker."
Regardless of which response pattern is chosen, it is the fact that the response becomes repetitive that makes PTSD so difficult to live with for families and spouses. When a person's brain takes the kinds of solutions that worked in combat, and uses them to also respond to virtually ANY kind of stress at home, it quickly becomes obvious that one solution is not appropriate for all problems or stressors. The stressors that were experienced in combat may have involved life or death situations, while the stressors in the home might involve something as minor as the kids dropping their socks or leaving their toys on the floor. But for the PTSD-affected person, all things may get treated as if they were life-threatening ! The result is that the behavior looks extreme, overly reactive and "over the top", whether it involves extreme agitation and aggression, or extreme withdrawal.
Most families assume that a loved one, especially someone who has been trained to deal competently with life-or-death situations, ought to have their behavior well under control . They have no idea that the veteran with PTSD is , in fact, not consciously in control of this behavior. The vet doesn't know this himself/herself… it all feels perfectly natural. But in fact, it is the limbic brain that is making the choice for the veteran, long before there is an opportunity to "think about" or "choose" a more appropriate response. The same holds true for the habituated, "instantaneous" reactions of people who are traumatized in situations other than combat.
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