Cognitive Processing Therapy

This week,Rick began a new 12 week program through the VA called "Cognitive Processing Therapy". This is a fairly new program,which has seen  considerable success.While it does not get rid of PTSD,since it's something one has for life,it helps the soldier come to terms with the illness,with the circumstances that created it,and helps them control it.

Our first session,with Rick's counselor,Ken, was mostly Ken discussing PTSD and what causes it. I must admit that I thought I knew what I needed to know,after seven years of living with it. However,I learned many new things,such as the fact that when a trauma happens that triggers PTSD,it causes the brain to fire certain neurons at the same time,which become "stuck" together. The emotional part of the brain overrides the rational,which is the most primitive part of the brain-therefore triggering the "flight or fight"response. In Rick's case, there are certain things that trigger him-helicopters,hearing gunfire,crowds,etc. He knows that he is safe,he is not in Iraq,but the brain reacts the way it did when he had to be constantly on alert over there.  Sometimes it involves a flashback,sometimes not. Usually his flashbacks have him standing stock still,and staring off into space,albeit for just a few seconds. He doesn't even realize it happens until after it's done.

Ken also discussed the program itself,which involves homework,an impact statement,stuck points,and a trauma statement. Ken gave an example of a Vietnam veteran who felt that he had killed his friend. Ken asked him if he had personally taken his life. The gentlemen said no,but his friend,who was pilot,was scheduled to go out on a mission,and he felt it would be his last one. The next day,he got shot down and killed. The Vet Ken is working with felt his death was his fault,since  he could've told someone that his pilot friend had this foreshadowing,and that maybe he could've had him pulled from the mission. Ken asked what his rank was,and he was an E-3. Ken told him that no one listens to an E-3,and that even if he had said something,his friend would still have gone on that mission.It was not his fault. During this example,Rick started to cry,which of course, made me cry a bit. Apparently Ken hit a nerve. Ken kept talking,but did tell Rick that whenever he had emotion about something,that he had to promise to talk to Ken about it and be honest,which Rick agreed to do.

Rick's homework this first week is an impact statement. No discussion about the traumatic event until the sixth week.He has to write about how it has effected his views  on himself,others,and the world in terms of safety,trust,power/control,esteem,and intimacy. At the next meeting,Ken will go through his answers lines by line,and pull out "stuck points". "Stuck points" are 'conflicting beliefs or strong negative beliefs that create unpleasant emotions and problematic or unhealthy behavior' -to quote the workbook page.

At the beginning of each session,Rick has to fill out a form with questions by answering 1-5...1 being not such an issue and 5 being a big old issue. The questions are along the lines of  if he has thought of suicide,how  his hyper- vigilance is,etc. Last week,he scored a 67 out of 85,which means he has moderate-high PTSD. By the end of the 12 weeks,the goal is to have that score come down considerably.

He is suppose to do the homework on the day that our appt is,but so far, he has not done it.He says he will do it today. Ken said most vets will put it off because they don't want to go there,but it's important to do the work.It's going to be very difficult because of the emotions it's going to bring up,but,like Ken says," We want you to own the PTSD,not have the PTSD own you."

We meet for the next 11 Tuesdays.