Using Meditation and CBT to Treat Combat Veterans with PTSD

The human mind is a brilliant and complex organ capable of amazing things. However, once traumatized, a person's brain becomes susceptible to several biological changes in critical locations. Through the feats of modern-day science, the process of neuroimaging has allowed us to see what Post Traumatic Stress Disorder (PTSD) can do to the chemical processes that occur in our brain. These neurochemical changes can be found in the amygdala, the hippocampus, and the prefrontal cortex. The amygdala is the brain's natural alarm system that will alert us in times of fear or high stress and uncertainty. The prefrontal cortex will help calm the brain down after realizing that what is in front is not to be feared. It provides logical reasoning to presented situations. These two parts need to work in unison for a proper flight-or-fight response of the human body. Lastly, the trauma would not be reoccurring unless the experience latched onto us somehow, which is where the hippocampus comes in. The brain's memory center is responsible for storing memories and past experiences and bringing them around once the center is activated. 

In the field of psychotherapy, you may have seen many instances of trauma shutting down or discarding memories or even bringing in false facts to fill the memory picture. Once the hippocampus is affected, the memory pathway also becomes damaged. As practitioners and advocates of mental health, it is essential to always keep in mind how traumatic experiences can alter brain function and have a profound psychological impact, different for each individual. It is important to be up to date with all professional and successful practices that may pave the road to recovery for caring for patients with these disorders.  

PTSD Therapy

PTSD was only recognized as a diagnosable condition in 1980 when mental health was still not given much importance. Even though symptoms were evident, combat veterans from the Vietnam war or the civil war were given treatment under different names of the illness, such as "battle exhaustion" or "soldier's fatigue." With the advent of heavy artillery and machines introduced into war zones giving way to bloodbath - the psychological weight has become heavier to carry. Numerous comorbidities have also been found in veterans who have PTSD, such as depression. Hence, while treating individuals with such backgrounds, it is necessary to consider their environment, socioeconomic status, and physical health factors. 

Over the years, many paths have been taken to discover the efficacy of numerous psychotherapies and treatments. As mental health professionals, we must be up to date with modern and forthcoming research on different therapy methods. In this article, we will discuss two methods. One that has been in play for quite a while now has been deemed most effective, i.e. cognitive-behavioral therapy (CBT), while the other may seem unconventional but can do wonders if taken seriously i.e. meditation.

Cognitive Behavioural Therapy (CBT)

Aaron Beck, known as the father of cognitive therapy, discovered the contribution of emotions and feelings towards healing from depression or anxiety. Back when therapy included techniques that stemmed from research on behaviorism - like punishments and rewards for condition one's behavior, cognitive therapy offered a fresher and newer approach. The basis for CBT is to understand how thinking a certain way can give birth to negative thoughts that may influence a person's behavior. Unlike its predecessors, it is not invasive but more gentle. CBT is a talking therapy that is built on trust between the therapist and patient. As a therapist (or mental health professional), it is up to you to build a rapport with your patient, giving them a safe and structured space to voice out all their feelings, memories, and emotions. 

Jordan B. Peterson, a clinical psychologist, wrote in his book "12 Rules for Life" that as someone who is listening to people and their lives all day long, it is vital to make sure that you have completely understood what your patient has told you before you give them your reply. "Conversation requires listening, not just talking," he writes. It guides towards better and more open communication. 

How does CBT work?

There is minimum risk in CBT, although it may be painful for your patients as they come face to face with their negative feelings. This is why a slow pace and structured schedule can make a significant difference in their healing. There are specific steps for CBT you need to follow for better efficacy:

1. Make your patients identify troubling conditions in their lives. Help them see the behavioral patterns that emerge in such situations.
2. After identifying the triggers, ask your patients to express how they feel about the emotions and thoughts that accompany these feelings. They will need to keep track of these thoughts, which can easily be achieved by keeping a journal.
3. Help your patients to pay attention to negative retaliations or behaviors that can occur from being triggered. They need to recognize destructive behaviors and group them as unfavorable.
4. Encourage your patients to view their situations objectively and devise ways to reshape their negative thoughts.

The last step does not come easily, but with practice and extensive knowledge, you can provide your patients with positive thought patterns and help them learn behaviors that may bring them out of stress spirals or overthinking, leading to anxiety attacks. Current research has deemed CBT effective for treating people with PTSD. However, it is essential to motivate the patient to accept this treatment method and stick to it. 

Meditation

In the old traditional ways of healing simmered down from the practices of Buddhism, meditation sits at the throne of achieving spirituality. The meditative process includes shutting out the outside world to focus on your inner thoughts and feelings, leading to mindfulness. Modern research has shown mindfulness to help ease stress levels and center the mind and body. Meditation is the act of becoming one with mind and body and training your consciousness to tackle different situations. It has also been shown to incite higher brain activity in the prefrontal cortex and the amygdala, brain centers involved in the fight-or-flight response. Even though it has not been found to completely rid people of their trauma, it has provided them with the proper tools they need to face specific triggering scenarios in their everyday life. Hence, this practice should be considered complementary to PTSD therapy rather than the main course of action.

Most recently, meditative practices have joined the league of psychotherapeutic techniques of CBT in dealing with depression, anxiety, and even PTSD in veterans. For people that have suffered loss and trauma in combat, the world may start feeling like an unsafe and unforgivable place, with diminishing empathy. Under the foundership of Dan Libby, Ph.D., a clinical psychologist, the Veterans Yoga Project has been deemed successful in providing healing to their patients through meditation and yoga. 

Mindfulness Meditation

Many different types of meditations may work for each separate individual. However, to achieve mindfulness, you need to be present at the moment and be conscious of your surroundings. For people with advanced levels of traumas dwelling in their past, focusing on the present can cushion the comorbidities of anxiety and depression that accompany PTSD. Mindfulness meditation can take away all the extra attention from negative thoughts and feelings. Hence, it is used in adjunction with CBT. 

The most important thing to remember here is that meditation does not shut out your mind to thoughts. Whatever negative thoughts may wander into the mind need to be dealt with care and patience. It is synonymous with facing your biggest fears. If done right, a person can control their emotional and physical reactions to things that may upset them.

What works:

As a therapist or mental health professional, your patient needs to trust your involvement in their shared trauma, backed up by your trust in meditation, while familiar with the entire process and techniques. In short, what patients are looking for is someone who understands the connections between trauma and meditation. They need someone that will guide them on this somewhat spiritual journey. Meditation requires expelling all the negative energy around you, which is why you may need to remind and motivate your patients to trust the process just like you do.

Lastly, here is some advice for all mental health professionals: Taking on the complex human mind is no small feat; it requires deep and thorough knowledge, the will to helping other people heal, and sincerity. Keeping in touch with the latest research and newly found psychotherapeutic practices will help you branch out your practice and enlarge the circle of people you can hope to help. Coming to seek out professional help is never easy, so patients and their care need to be your utmost priority.