I barely have an inkling of what it’s like to be a soldier enduring battle field conditions. However, I was a Corporal in the Royal Winnipeg Rifles, Canadian Armed Forces Reserves. I marched, slept in slit trenches while resisting hypothermia, fired machine guns, traveled in APC’s, viewed real war time movies and became a sharpshooter. I’m also a history buff and have read dozens of military novels and watched dozens of wartime movies. I have also assessed and treated dozens of people with PTSD. This is my take on battlefield PTSD.
mind/brain is designed is to react rapidly to potential danger – a stick
in the grass could be a poisonous snake; a shadow moving in the dark
might be an attacking wolf. Adrenaline and
other hormones are pumped into the bloodstream triggering the fight or
flight reaction – increased muscle tension; blood pressure, oxygen
consumption, and blood sugar production. Over time the brain adapts to
battlefield conditions where failing to recognize and react to danger
can lead to instant death.
A. The person has been exposed to a traumatic event in which both of the following were present:
(1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others.
(2) the person's
response involved intense fear, helplessness, or horror. Painfully learned
battle memories are deliberately kept at the edge of consciousness at
all times; day and night. Hair trigger responses are safer in battle.
You are at all times ready to attack, freeze (in flare light), or indelible resulting in the following symptoms.
(1) recurrent and intrusive distressing recollections of the event, including images, thoughts, and/or perceptions.
(2) recurrent distressing dreams of the event.
(3) acting or
feeling as if the traumatic event were recurring (includes a sense of
reliving the experience, illusions, hallucinations, and/or dissociative
flashback episodes, including those that occur on awakening or when
(5) physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
Characteristics as outlined in (C) below are a safer way to be on the battle field. However, upon returning home to the safety of family and friends the mind has difficulty adjusting to a duller more “normal” state of alertness.
C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by at least three of the following:
(1) efforts to avoid thoughts, feelings, and/or conversations associated with the trauma. (Not the time for grief; too distracting.)
(2) efforts to
avoid activities, places, and/or people that arouse recollections of the
trauma. (Recognize danger before being shot at.)
(4) markedly diminished interest or participation in significant activities. (Avoid wasting precious mental energy on non-life preserving activities.)
(5) feeling of detachment or estrangement from others. (Minimize shock and grief when someone dear to you dies.)
(6) restricted range of affect e.g., inability to have loving feelings. (More attempts to limit strong emotions from distracting attention needed to detect and adapt to danger.)
(7) sense of a foreshortened future e.g., does not expect to have a career, marriage, children, or a normal life span. (Attention remains in the present undiluted by fantasy.)
symptoms of increased arousal (not present before the trauma), as
indicated by at least two of the following:
E. Duration of the disturbance (symptoms in criteria B, C, and D) is more than one (1) month.
F. The disturbance causes clinically significant distress and/or impairment in social, occupational, and/or other important areas of functioning.
Acute: Duration of symptoms is less than three (3) months
Canadian Veterans Affairs – on-line booklet - PTSD and War Related Stress – an excellent resource!
U.S. Department of Veteran’s Affairs - PTSD information.
B.C. Partners for Mental Health – PTSD information
What is to