Understanding Combat Related Post Traumatic Stress Disorder

211 Pages·2012·8.79 MB·English

by  Walter F. McDermott

Understanding Combat
Related Post Traumatic
Stress Disorder
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Understanding Combat
Related Post Traumatic
Stress Disorder
W F. M D
ALTER C ERMOTT
McFarland & Company, Inc., Publishers
Jefferson, North Carolina, and London
LIBRARYOFCONGRESSCATALOGUING-IN-PUBLICATIONDATA
McDermott, Walter F., ¡946–
Understanding combat related post traumatic
stress disorder / Walter F. McDermott.
p. cm.
Includes bibliographical references and index.
ISBN 978-0-7864-6946-8
softcover : acid free paper
¡. Post-traumatic stress disorder. 2. Post-traumatic stress
disorder—Treatment. 3. Soldiers—Mental health—United
States. 4. Veterans—Mental health—United States. 5. Combat—
Psychological aspects. 6. Psychology, Military. 7. Soldiers—United
States—Biography. 8. Veterans—United States—Biography. 9. Post-
traumatic stress disorder—Patients—United States—Biography. I. Title.
RC552.P67M383 2012 616.85'21—dc23 2012008064
BRITISHLIBRARYCATALOGUINGDATAAREAVAILABLE
© 2012 Walter F. McDermott. All rights reserved
No part of this book may be reproduced or transmitted in any form
or by any means, electronic or mechanical, including photocopying
or recording, or by any information storage and retrieval system,
without permission in writing from the publisher.
Front cover image © 2012 Shutterstock
Manufactured in the United States of America
McFarland & Company, Inc., Publishers
Box 6¡¡, Je›erson, North Carolina 28640
www.mcfarlandpub.com
To the tens of thousands of Americans
who died fighting in the Vietnam War,
especially to those men who died alone.
You will never be forgotten.
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T C
ABLE OF ONTENTS
Preface 1
1.Introduction 3
2.History of Combat Disorders 7
3.Symptoms and Diagnosis of PTSD 10
4.Post Trauma PTSD Rates 12
5.Family Difficulties 16
6.The Veteran’s Spouse 19
7.Psychotherapy 24
8.Cognitive Psychotherapy 33
9.Shattered Assumptions 39
10.Fear and Anxiety 48
11.Psychological Treatments of Fear 56
12.Memory Difficulties 67
13.Nightmares and Flashbacks 74
14.Social Avoidance 83
15.Guilt 94
16.Anger and Violence 105
17.Depression and Suicidal Thoughts 114
18.Low Self-Esteem 134
19.Substance Abuse 141
20.Medications 144
vii
viii Table of Contents
21.Experimental Treatments 152
22.Chronic Pain and PTSD 155
23.Mild Traumatic Brain Injury and PTSD 172
24.Special Combat Veteran Populations 179
Resources for the Combat Veteran 187
Notes 189
Bibliography 193
Index 199
P
REFACE
This book is about the invisible wounds of war: Post Traumatic Stress
Disorder (PTSD). In a semi-memoir format, it provides an explanation of
the historical development of PTSD, its myriad symptomsand the scien-
tifically verified psychological and medical treatments for the disorder. In
the United States and Great Britain alone there are hundreds of thousands
of war veterans suffering PTSD symptoms. Our current Mideast wars are
generating thousands of new PTSD cases. Because it is a psychological
hidden wound, veterans afflicted with PTSD may find it difficult to under-
stand the troubling symptoms of their disorder. Combat veterans and their
families can learn to better understand PTSD by reading this book.
I wrote this book from a unique perspective: I am a Vietnam combat
veteran and clinical psychologist who has treated combat PTSD veterans
for more than 28 years. I served in an artillery battery assigned to the 9th
Infantry Division in Vietnam’s Mekong Delta from 1969 to 1970. For most
of my psychological career I worked as a staff psychologist at the Jack-
sonville, Florida, VA Outpatient Clinic’s Mental Health Unit. This com-
bination of experiences enables me to analyze PTSD symptoms from a
personal perspective as well as a professional one.
Combining the basic tenets of cognitive psychotherapy and my own
military experience, I developed and refined many unique therapeutic
ideas and insights. These innovative therapeutic concepts are described in
detail and in plain language. For example, the reader will learn that the
Bible’s fourth commandment is usually mistranslated, an awareness of
which can help some combat PTSD veterans ease pathological guilt over
killing the enemy. An early chapter addresses those unsung victims of com-
bat stress, the spouses of PTSD veterans. It helps them comprehend this
alien combat disorder by detailing its similarities to the negative psycho-
logical aftereffects of a sadly more familiar trauma: rape. The book also
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