November 17, 2023: Army Reserve veteran Selina Jackson has years of combat experience…off the battlefield.
Growing up in what she calls a combat zone in upstate New York, Jackson often witnessed brutal fights between her parents that would leave her mother unconscious on the ground. She watched her father, an alcoholic and drug addict, savagely beat her older sister more times than she can remember. The teenage son of her parents’ best friends sexually abused her repeatedly. Her father burned down her house.
And yet, she kept these traumatic, often life-threatening events a secret until the COVID-19 pandemic hit and she found herself stuck at home.
“I physically couldn’t do the things I always did to distract myself,” he said, while working from home, “which for me was horrible, because I thought, ‘Oh my God, I’m here. I’m at home all day alone, working.’ ”.
His PTSD “became overwhelming.” She couldn’t stop the symptoms during the day. “She still carried a great burden of guilt and shame. I didn’t care if she lived or died,” she said.
Jackson was eventually diagnosed with Post-traumatic stress disorder (PTSD), a mental health condition that affects millions of people around the world, twice so many women than men in the general population, and about 13% of young female veterans (vs. 6% of male veterans). Women veterans too They disproportionately experience trauma and adverse childhoods before entering the military, experiences that are compounded by high rates of sexual assault and/or sexual harassment during military service.
Unfortunately, these numbers don’t show the full picture. PTSD often goes undiagnosed. Many patients do not recognize or shy away from telltale signs and symptoms such as flashbacks, guilt, and shame. And the range of symptoms related to PTSD (such as depression, anxiety, withdrawal, substance use disorders, or suicidal thoughts) are also common in other psychiatric conditions. That can lead to misdiagnoses, incorrect treatments, and ongoing challenges.
“For those with PTSD, the world gets smaller and smaller, they start to avoid relationships, work, pleasurable activities, things they used to do,” said Tara Galovski PhD, director of the Division of Health Sciences at Women of the National Center for Veterans Affairs. PTSD and professor of psychology at Boston University School of Medicine.
“But memories come up in different ways, like when people try to fall asleep and can’t because thoughts run through their minds. “They affect concentration, irritability, and the way PTSD sufferers see and think about themselves in the world.”
Without treatment, Galovski said, these symptoms can become chronic and create other types of health problems “in important ways we function.”
Moving through STRIVE
Jackson, now 53 and living in Ohio, credits a program at Ohio State University Wexner Medical Center. called EFFORT (Suicide and Trauma Reduction Initiative) for helping her deal with PTSD and turn her life around.
“I love who I am now,” he said.
STRIVE was founded by clinical psychologist, professor, and retired Air Force veteran Craig J. Bryan, PsyD. The program is research-based and aimed at developing the best strategies to address trauma, gun violence risk reduction, and suicide in adult veterans or the general population. Its origins are rooted in strategies used to treat psychological trauma in soldiers in combat zones.
“The origins of what we now call mass therapy (a compressed format) arise naturally from deployment and being in a combat zone where you don’t have the luxury of going to therapy once a week for an hour for a few months. ”Bryan said.
“Most of the cases I worked on were people who had been blown up, had vehicle rollovers, head injuries, and I had to make quick decisions within a few days about whether that person was going to be okay or needed to leave.” . home.”
The battlefield provided a testing ground for the compressed, accelerated treatment that Bryan brought to the United States, first to the University of Utah and then to Ohio State.
The primary technique used by STRIVE therapists is cognitive processing therapy. First developed as a treatment for victims of sexual assault by researchers at the University of Missouri, the therapy was also adopted and implemented by the VA 16 years ago.
The framework for “CPT suggests that when a traumatic event occurs, it has a large impact on the way people think and, for some, significantly changes their beliefs about why that trauma occurred,” Galovski said. “It also affects their beliefs about themselves and other people, about the world.”
“We use the term ‘stuck points’ a lot,” Bryan said. “This is a belief that prevents natural, spontaneous and integrated recovery processes that help us move forward and overcome an event. Common “stuck points” include things like, “It’s my fault.” “I should have done things differently or worn a different suit.” ‘I should never have trusted that person.’”
With cognitive processing therapy, doctors identify patterns and teach patients to examine their own thoughts from a “more balanced and objective perspective,” Bryan said.
Essentially, therapy helps patients learn to challenge and modify unhelpful beliefs (for example, I was raped because I was wearing a short skirt) and to create new, more realistic understandings around the event (such as, What else was wrong? happening? Have you ever worn a short skirt? Do short skirts cause rape?).
“This more balanced thought process alleviates anxiety, fear, guilt, shame and all the other consequences of PTSD,” Bryan said.
Learn to live fully again
Ohio State’s program is offered in person or via telehealth in 10 daily 1-hour sessions with a therapist. Patients are required to fully participate and complete daily tasks.
One of the reasons STRIVE is effective is that it leaves no room for patients to skip or cancel sessions. “The consistency, every day, having to work at high speeds, was very prescriptive,” Jackson said.
AnnaBelle O. Bryan, STRIVE program director and retired Air Force veteran, said many patients begin to recover between the fourth and sixth session, while others need the full range, and perhaps an additional hour afterward. But she emphasizes that the greatest benefit comes when patients continue to practice and strengthen what they have learned. Currently, STRIVE boasts a recovery rate of around 76%, which Craig Bryan says is similar to what studies have shown; 70% to 80% of patients who complete cognitive processing therapy have significant reduction and improvement in symptoms.
Relapse is common for some people about 6 months after leaving the program, AnnaBelle Bryan said, and usually these attacks are reminders that something happened rather than that something happened. a return to full-blown PTSD episodes.
“If they can get through (these flares) using the skills they learn, then we won’t hear from them,” AnnaBelle Bryan said, noting that 50% of patients fully recover after 2 years. “We track their progress so they can see their progress as it happens, which really helps with recoveries.”
For others who need more help, STRIVE offers 1-hour “booster” sessions. It is important to note that the program is free. Those who participate in it help with the organization’s research and, in return, receive quality therapy.
With a new outlook on life, Jackson plans to leave Ohio and move to upstate New York in the spring. She said STRIVE gave her the opportunity to finally be a better person for herself and everyone else in her life.
“Instead of surviving, I will finally be able to live,” he said.
For more information and resources, individuals, especially veterans, are encouraged to consult the National Center for Post Traumatic Stress Disorder.
You can also learn more about STRIVE, including yours program eligibility.
If you are feeling suicidal, help is available 24/7 by calling 988 (the crisis and suicide lifeline). Veterans and their loved ones can dial 988 and press 1 to reach the Veteran Crisis Lineor text 838255.
STRIVE offers help through a separate program: BCBT EFFORT – to current service members; veterans; first responders (such as law enforcement officers, dispatchers, firefighters, and paramedics) without military backgrounds; and their family members who have symptoms of suicidal thoughts and behaviors.