Monty, my initial thoughts are based on my experience with my docs since there is no cure to this beast.
@Anthony is a therapist so his insight would be better on how he approaches things and what he likes from patients.
For me, therapy isn't so much where you go to get fixed but a place to have someone else, trained with this, give you a different perspective on what you're dealing with so you can look at things differently and process some of the hard roadblocks. You can also work on coping skills and identify triggers with their help. You need to trust in your therapist and feel they are truly engaged in your struggles. They need to be hard at times and push you. So at therapy you need to be fully confident of your therapist to be more open with them. The more specific and comprehensive you can be about each issue you want to address, the better. Bring them a primary issue for each session that you want to address or talk about, sometimes just talking about something can be helpful. Treat therapy like a sports practice or a time-out where you work on your game or make an adjustment before you go back out there into the real world. Baby steps. Nothing comes quickly.
It is interesting that you are better at work and feel more in control there as that was the complete opposite for me. Maybe you feel more at ease to let the beast loose at home, rage freely since it is your house? I would be very conscious of secondary PTSD if you have family there with you, especially children. We tend to give those we love the most our best and OUR WORST (take them for granted at times). Don't let the beast be an excuse to bully others. But they also need to be given a voice or some awareness of what you're dealing with, you can't shut them out fully. And they need to be somewhat supportive but not victims. The bottomline, is to focus on you first always, you can't help others if you don't help yourself. So you can't be totally selfish and you can't improve well in a situation where there is no support or attempt from a significant other. PTSD is particularly cruel on staying in relationships, so the odds are against you. That mean you can't be upset if it doesn't survive. Your survival is the goal. That may cost something if there is no effort on the other side and you need to understand this and give them honest opportunities. You'll know if they're not up to it.
I'm glad you seem better at work since that is a place that can give you some structure to start the climb back to some routines. Since I really don't know much about your particulars, I can't speculate on what you can do. Attending Group therapy is powerful addition to individual therapy, as long as it is a good group. that may take trial and error. Warriors have been doing this some sort of group therapy since they first started coming back from combat. It is one place you can find the camaraderie we missed from the military. Make sure you give it an honest effort.
Finally, I recently came across this article about therapy and thought it was interesting. I haven't fully processed it yet so not sure what I think about it but I like the positive approach and finding strengths. Acknowledge what it is, a permanent combat injury, and move on dealing with how we are gonna live with it and get back up when it knocks us down again. [I don't; agree with the 10% number at all--especially for combat vets, that comes from a different overall count] . Also, I'm not "avoiding" driving, I'm just gonna avoid rush hour, most stressful driving, because I don't wanna ruin my day on purpose if I can plan otherwise. I call that planning around a known trigger not avoiding it. If I need to buck up and drive in rush hour than I can do it but I prep for it well. Hope something in all that mess helps.
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PR Web:
Connecticut Professor Researches Better Treatments for Vets with PTSD
PR Web: Connecticut Professor Researches Better Treatments for Vets with PTSD
Jan. 14, 2015
Preliminary results indicate that experimental RESET therapy is highly effective in treating PTSD in comparison with established cognitive behavioral methods.
Windham, CT (PRWEB) January 14, 2015 - Dr. Kristi Salters-Pedneault is the co-investigator in a large scale study that seeks to test the efficacy of RESET, an experimental acceptance-based therapy for PTSD.
“I’m not a veteran, I’ve never served our country. But it feels good to have a set of skills that I know I can use to support veterans,” she said. As a professor of psychology at Eastern Connecticut State University, she researches more effective treatments for veterans suffering from Post-Traumatic Stress Disorder (PTSD). Preliminary results indicate that RESET is highly effective in comparison with established cognitive behavioral methods.
“[RESET] teaches soldiers to be more accepting of symptoms they might have, particularly intrusive thoughts. They’re taught how to have the thoughts without trying to push them away and to recognize those thoughts as just thoughts. They’re not something to fix. It doesn’t mean you are crazy. It’s a natural response and these are just thoughts that can’t hurt you,” she said.
The study is partially funded by the Department of Defense and by the National Center for PTSD.
“I love working with the veterans. It is very meaningful and rewarding work. I’m really grateful I get to continue that,” said Dr. Salters-Pedneault.
The study involves 1,500 veteran volunteers from Fort Drum in New York. The goal is to help veterans deal with intrusive thoughts, one of the most disruptive symptoms of PTSD.
“Thoughts of combat leap into their heads out of the blue,” explained Dr. Salters-Pedneault.
It is difficult to predict who will develop PTSD symptoms. Even after a highly traumatic experience like combat, only about 10% develop PTSD. There are certain risk factors, including previous traumatic experiences.
“I think that’s important. It suggests that cumulative trauma does not have a protective effect. People might say ‘wow, you’ve been through things like this before so you will be stronger.’ But we have evidence of the opposite,” she said. Many veterans try to avoid being exposed to things that cause them to experience PTSD symptoms, a tactic called emotional avoidance.
“The classic example in veterans is that they avoid driving, especially if they did convoy work. That’s because when driving you are at significant risk of IED (improvised explosive device) explosions. In Iraq, trash bags on the side of the road could be a bomb. So they’ll avoid driving because trash on the road produces a huge fear response. If you drive under safe conditions over and over you can extinguish that fear,” she said. Emotional avoidance actually hurts in the long run. Avoiding triggering stimuli can cause symptoms to become worse over time. RESET therapy is focused on acceptance, which can help overcome emotional avoidance.
“If you are exposed to something you are afraid of over and over you will get over that fear,” Dr. Salters-Pedneault explained.
For family members of veterans with PTSD, Dr. Salters-Pedneault believes the most helpful thing they can do is fight the stigma around the condition.
“Make it very clear that they are in support of the person seeking treatment, that it’s okay for them to ask for help, that it’s courageous to ask for help in that context. Really encourage the veteran to seek treatment early, before there are downstream consequences.”
Kristalyn “Kristi” Salters-Pedneault, PhD is an assistant professor of psychology at Eastern Connecticut State University. She is a member of the Connecticut State Universities chapter of the American Association of University Professors. AAUP is devoted to ensuring higher education’s contribution to the common good, defending academic freedom, and promoting high standards in education. For more on CSU-AAUP visit their blog.