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War involves a wide range of violent and traumatic
experiences
Immediate threat of death, physical injury or
disfigurement,
Witnessing injury and severe pain and distress and/or
death of others (including significant others: buddies)
Involvement in injuring or killing others (both
combatants and civilians)
It may also involve
witnessing or participating in atrocities
undergoing rape
capture or confinement, torture
extreme physical deprivation.
And support as well as combat personnel are affected
Modern Warfare High-tech weaponry; diminished
personal dimension of individual combat between warriors
Taught to kill, not just overcome (warrior standards: touch the enemy; take his weapon; take his horse; bring everyone back safely)
Not a rite of passage, nor attainment of the social definition of a role as those who protect and guard the community (incursion into hunting and camping grounds)
• Guerilla war; insurgency--no uniforms
• the in-war community is involved and also directly in harm’s way
• Surprise: things are not as prior experience indicates—unable to trust one’s own senses
• Commanders are distant rather than in the battles--high-tech communications
• Multiple deployments• Ability to communicate with home
Complex Trauma• serial exposure to a wide variety of
traumatic events• trauma memory encoded,
facts/details taken in, and at the same time the feelings and physical sensations are encoded
• the tiniest event can be so charged with intensity so overwhelming that it literally reprograms the central nervous system.
What happens in the mind/brain/body?
• Flight, Fight, Freeze body-based• HPA Axis: Brakes and accelerator
functions are coordinated and balanced• neural integration: the linkage of
anatomically or functionally differentiated neural regions in the brain into interconnections with body and brain
• Neural systems are changed by experience, repetition (plasticity)
The brain is plastic and self-renewing, capable of rewiring itself
in response to changing circumstances
• The cerebral cortex is the outer covering of the brain, where neurons are located.
• The hippocampus is the long, sausage-shaped organ present on both the left and right sides of the brain.
• At the head of the hippocampus sits the amyglala. • The thalamus acts as a gateway from the outside world
into the brain, and the hypothalamus regulates bodily changes like heart rate and temperature.
• The cingulate gyrus sits just over the corpus callosum, which connects the left and right sides of the brain.
• The frontal cortex, especially the medial prefrontal and orbitofrontal cortex, plays a critical role in the regulation of emotion
Functional areas of the brain are connected by neural pathways– areas deep in the brain, such as the
amydgala, are responsible for appraisal of sensory information alert us to danger based on instinct, learning history (training), and emotional memory.
– Rapid survival decisions are made here in miliseconds with a minimum of information.
– Appraisals can be applied inappropriately without being based on external realities
The more highly evolved cortex is responsible for reasoning, planning
and self-conscious awareness
• Processes information from the lower parts of the brain
• context is added• inhibition of the amygdala• self-soothing and self-regulation: the balanced
and integrated flow of energy and information through the brain originates here
Daniel Siegel, The Mindful Brain
Middle Prefrontal Functions• Bodily Regulation• Attuned Communication• Emotional Balance• Response Flexibility• Empathy• Insight (Self-knowing Awareness)• Fear Modulation• Intuition• Morality
Daniel Siegel, The Mindful Brain
Disconnect from Inner experience
– Inexpressible overwhelming
uncontrollable crazy shameful (weak)
terrifying Alien painful Incomprehensible Kathy Steele, MS
OVERWHELMEDwith inner experience
•Shut Down of emotion, disconnect from sensations, thoughts
• numbing• dysregulation• drugs/alcohol
• disconnect from the rest of the body• isolation
REFERENCES• War and The Soul, Edward Tick• Achilles in Vietnam, Jonathan Shay• On Killing, Dave Grossman• Principles of Trauma Therapy,
John Briere and Catherine Scott• www.johnbriere.com• Traumatic Stress, van der Kolk, McFarlane, and
Weisaeth
• The Mindful Brain, Daniel Siegel• One Veteran Speaks, Robert A. Cagle (special order)