Most soldiers would rather forget the horrors of war, but for those suffering from post-traumatic stress disorder and behavior problems that can come with it, psychiatrists are beginning to believe it’s better to face their fears head-on with a clinician’s help.

Later this month, a national authority on the affliction will spend four days at the Colorado Mental Health Institute at Pueblo, working with state hospital doctors and others, military caregivers and representatives from Pikes Peak Mental Health.

Edna Foa is a professor at the University of Pennsylvania and the author of a number of studies on treating PTSD. Dr. Matt Goodwin, a CMHIP psychiatrist and a major in the Army Reserve, became aware of Foa’s work during his own tour of duty in Iraq.

An Air Force psychiatrist had taken Foa’s training and drew his interest, Goodwin explained. During his time there, Goodwin said he continued to use traditional methods of dealing with PTSD, but has begun studying Foa’s techniques and expects that the information he and his colleagues obtain this month will help them to provide better care to those war veterans who find themselves patients at the state hospital because of PTSD.

Dr. John DeQuardo, superintendent of the state hospital, pointed out that there already was a large population of military people in the area and more are anticipated.

“This is why we at the state hospital are interested,” he said.

A total of 13 CMHIP clinicians, including psychiatrists, psychologists and a social worker will attend the training. Also invited are representatives from Fort Carson, Peterson Air Force Base, Buckley AFB and Pikes Peak Mental Health.

Attendance is limited and the sessions are filled. Those from agencies outside the hospital will pay for their classes.

Foa’s PTSD work began with rape victims but has been used with war veterans, too.

For combat-related PTSD, it’s not just things like jumping when a car backfires. Goodwin worked with a number of soldiers who elicited a wide variety of symptoms. There were some soldiers who were fine until they heard the lock click on their Humvee and would begin to hyperventilate.

Another soldier couldn’t face going to the chow hall because the smell of barbecue reminded him of the fiery deaths of his buddies attacked by roadside bombs.

For some, the attitudes about psychological problems are a barrier, Goodwin said. Working with soldiers at a fire base south of Baghdad, there was a non-commissioned officer who was increasingly upset about the men he sent out on convoy duty being killed but didn’t want anyone to know he needed help dealing with that.

“That NCO did not want to be seen with me,” he said. Goodwin had to work with him when no one else was around.

Dealing with fear is a constant, and as readers of “Catch-22” recall, not wanting to go into danger can be a sign of sanity.

“There’s a healthy fear,” Goodwin said. That’s something people cope with but they still continue to follow orders. His job was dealing with the uncontrollable fears, the hyperventilation, the nightmares, the avoidance behaviors.

Foa’s work, called “prolonged exposure” first works with patients to find out what the fear triggers are and then, after giving them tools for how to deal with physical reactions to that fear, has them return to face those triggers, eventually overcoming them.

DeQuardo said that while that may seem counterintuitive - to send people back into a situation that caused them to become afraid - it’s been shown that denying those fears doesn’t help cure the PTSD that can re-surface later with serious problems on the job, with families or society.

Goodwin explained that often people can be re-exposed to those fear triggers without putting them in danger, if it’s something simple like just getting into a vehicle or the soldier who avoided the chow hall. He said that some Veterans Administration hospitals are even using virtual reality to accomplish that exposure in a safe environment.

Source: Peurto