We've all heard this analogy when describing a flawed approach..."trying to put a square peg into a round hole", right? It couldn't be more true when we refer to our current mental health approach with combat veterans. As recent as yesterday, we read that combat troop ailments are creating a medical backlog in the already strained system. To make matters worse, I will suggest today that what we are doing is totally inadequate and that the fundamental approach of treatment is flawed!
In a previous post, we dove into the timing and release of bodily chemicals that bring about the feelings and sensations related to “adrenaline poisoning” or PTSD. You could assign them names like; terror, anxiety, and hypervigilance. However you name them, these are the signature presentations in many of our combat-exposed warriors. At the core of this chemical cascade, is the hormone and neurotransmitter called epinephrine (more commonly referred to as adrenaline). We know that adrenaline produces major changes in the physiology of our bodies; namely:
- Increased heart rate
- Constriction of blood vessels
- Boosts in energy
- Heighted senses, particularly smell and hearing.
An Ever-Widening Gap
I believe it’s important to keep the neuroscience of combat stress top of mind. Important, as it reminds us that the behaviors we see in many of our returning warriors are reactions and not premeditated responses to stressful situations. I like to keep this fact top of mind also because 99% of the population does not understand what it’s like to serve in the military. Even more difficult to understand, is how it feels to be in a combat zone. But above all else, I like to emphasize a unique change to our body, that comes from overexposure to adrenaline, and that is the changes that occurs in the regions of our brain called the amygdala. These changes actually increase the size and sensitivity of this part of our brain. It makes us more alert and causes us to react faster. While these reactions helped to keep our fighting forces alive when they were “down range”, they clearly stand out in peacetime situations as behaviors that “don't fit in.”
These behaviors are also what grab the bulk of the headlines we read in the news. Most reports focus on the behaviors associated with violence, anger, and rage. The current politically correct speak is “it makes it difficult to integrate into society.” This type of reporting may help drive ratings or sell newspapers, but it only adds to the ever widening gap between society and the “true 1 percenters” – combat vets! This “gap” exists for many reasons, but we compound it with an unsatisfactory level of mental health care for our combat-stressed service members. Sometimes, it seems like there is no hope.
But that’s why I write this blog—to educate, to inform, and to offer a different perspective. So today I would like to share with you further evidence that points to the amygdala as the chief culprit of why our warriors “act the way they do;” especially when they are triggered. I would also like to suggest a change to the current treatment paragdim used on our wounded warriors. Who knows…maybe I’ll get the attention of a medical or mental health care professional to at least consider my point of view?
The Devil Inside
In his book, The Emotional Brain, Dr Joseph LeDoux informs us that the amygdala is the place where our “emotional memories” are stored. Remember this is the same place that sends signals to create the changes in our heart and circulation to prepare us to fight or flee. With these facts in mind, it’s easier to understand the behaviors exhibited by a warrior that gets “triggered” by a reminder of something they sensed in combat. The forces at work on them are now reminding them (in chemical and electrical messages) of the need to take action. Additionally, the words and pictures of the emotional memories associated with specific combat trauma amplify the effects of adrenaline. In this state, our warriors are on full alert and reacting in a manner that kept them alive on the battlefield. Notice we don’t say deciding here, as a decision is a choice in multiple courses of action. This is a reaction and there is no other choice but to counterattack!
When we step back and think about these facts, it begins to become very clear that our emotional states create our behaviors. Ask any psychology major and they will tell you that as a species, we move toward pleasure and away from pain. Emotions are housed in a part of the brain referred to as the “limbic system” where emotion, behavior, and long-term memories are housed. So if our emotions are very strong, they cause us to take specific actions. Remember the last time someone cut you off in traffic? Or do you remember the the last time you watched a very sad movie? If you’re emotions are triggered, there is usually a responding behavior the comes next. To put it this way, when we look at PTSD as an equation, we would express it this way:
Emotional State = Your Behavior
So from a common sense approach, it would appear the solution to change the behavior in our wounded warriors, we should address the emotional states caused by combat, right?
Well, we don’t!
In the second part of this blog series, I will dive deeper into our current treatment choices and point out where we are need to focus our efforts. I will also shed light on some very positive results I am personally generating in my coaching practice.
It's not too late to make a change and a difference in our effectiveness when dealing with the stresses of combat. However, common sense is seldom common in practice. I'd like to encourage as much comment and discussion around this topic, so I hope I’ve sparked your interest in this opener…
till my next installment…