Discussion: Combating Post traumatic Disorder

Discussion: Combating Post traumatic Disorder

Discussion: Combating Post traumatic Disorder

An Innovative Approach to Treating Combat Veterans with PTSD at Risk for Suicide
Suicide rates among military personnel had a significant drop in 2013, but there is no evidence of a drop among veterans. The problem of suicide among combat veterans with posttraumatic stress disorder (PTSD) remains a source of concern. The Department of Defense and the Department of Veterans Affairs are now calling for innovative treatment approaches to the problem. A short-term psychodynamic therapy presented here may be able to fill that need by dissipating the guilt from veterans’ combat-related actions that leads to suicidal behavior. The treatment showed promise of success with veterans of the war in Vietnam. Preliminary work with combat veterans of the wars in Iraq and Afghanistan indicates that it may be equally successful in treating them. Basic aspects of the psychodynamic approach could be incorporated into current therapies and should improve their ability to treat veterans with PTSD at risk for suicide.

A 7-year research and treatment project with combat veterans of the Vietnam War with posttraumatic stress disorder (PTSD) and at risk for suicide at a Veterans Administration (VA) Medical Center laid the groundwork for the material in this article (Hendin & Pollinger Haas, 1984a,b). Comparable research being performed at the Michael E. DeBakey VA Medical Center in Houston, Texas, which includes veterans of the wars in Iraq and Afghanistan as well as Vietnam, is building on this work (Hendin, Al Jurdi, Houck, Hughes, & Turner, 2010).
Vietnam veterans with PTSD are four times more likely to die by suicide than veterans without PTSD (Bullman & Kang,
1994). Although PTSD is the disorder most associated with suicide among veterans, most veterans with PTSD are not at risk for suicide. Veterans at risk for suicide who do not have PTSD have very different problems than veterans at risk for suicide who do. This study only addresses the problems of veterans with PTSD. The study of Vietnam combat veterans with PTSD provided insight into the factors associated with suicide among them. Persistent severe guilt over combat experiences was found to be the major factor differentiating veterans who had attempted suicide and those who were seriously preoccupied with suicide from those veterans who were neither (Hendin & Pollinger Haas, 1991). Nineteen of 100 combat veterans with PTSD had attempted suicide at least once since returning from Vietnam. Guilt related to combat actions was significantly marked in all 19 of the suicide attempters, but in only 32 of the 66 nonsuicidal veterans (v2 = 14.24, df = 1, p < .001). Fifteen had been seriously preoccupied with suicide since they left the service. Guilt was also marked in 12 of these 15 veterans compared to the 66 nonsuicidal Discussion: Combating Post traumatic Disorder
HERBERT HENDIN, Suicide Prevention Initiatives, New York, NY, USA and New York Medical College, Valhalla, New York. Address correspondence to Herbert Hendin, Suicide Prevention Initiatives, 1045 Park Avenue, New York, NY 10028; E-mail: hhendin@ spiorg.org
582 Suicide and Life-Threatening Behavior 44(5) October 2014 © 2014 The American Association of Suicidology DOI: 10.1111/sltb.12135
veterans (v2 = 3.71; df = 1, p = .05). Although anxiety, survivor guilt, and depression marked those at risk for suicide, combat guilt outperformed the other three predictors, including depression, when all four were entered into a logistic regression simultaneously. The combat experiences of the suicidal veterans were examined for possible determinants of their guilt. The chaotic nature of guerilla warfare in Vietnam, the uncertainty about who was the enemy, the emphasis on body counts, and the Viet Cong’s use of women, children, and the elderly as combatants contributed to combat actions about which veterans felt severe guilt. The Viet Cong would strip American soldiers they had killed and hang their naked bodies from a tree with their genitals stuffed into their mouths. Such tactics, designed to frighten soldiers, also tended to infuriate them and contributed to atrocities on both sides. A more common provocation was rage precipitated by experiencing the death of close comrades (Hendin & Pollinger Haas, 1991; Shay, 1995).
How each veteran experienced combat events; that is, the meaning of the combat experience to the veteran, was integral in determining the nature of the guilt and the risk for suicidal behavior. The term meaning of combat refers to the subjective, often unconscious perception of the traumatic event, and includes the affective state of the veteran before the event took place, when it took place, and the affects experienced subsequently. Nightmares and other re-experiencing symptoms are cardinal symptoms of PTSD. Both are valuable tools in determining the meaning of the experience to the veteran. The following case example is illustrative (Hendin & Pollinger Haas, 1984a). (Informed consent was obtained from all project participants and some cloaking was performed with case presented).
Throughout his tour, Greg L. thought he would be killed in action. The thought was comforting to him because it would enable him to avoid having his friends, family, and fiancee discover that he had lost control of his anger and killed without reason in Vietnam. During the last two weeks of his tour, when he learned that he was not going to be assigned to any more combat missions, he tried to kill himself with an overdose of drugs. He had been an artillery spotter in Vietnam. He was preoccupied with a memory of a friendly village that he and his sergeant had helped to destroy in a contest designed to see who could call in the best coordinates. Through his binoculars, Greg had watched with excitement as the shells landed. As the village was being destroyed, he saw an old woman with betel nut stains on her teeth running in his direction. She was shaking her arms trying to get him to stop the shelling. As she ran toward him, she was killed by an artillery round. After he returned to the United States, Greg was tormented by a painful recurring nightmare that expressed his intense guilt over the destruction of the village. In the dream, he is captured by South Vietnamese villagers, strung on a pole like a pig carcass, and paraded around the village so that everyone could throw stones at him, hit him, spit on him, and curse him. The old woman with the betel nut stained teeth is taunting him. The villagers hold him responsible for all the death and destruction in their village. He knows they are going to kill him. Greg made a second suicide attempt during a re-experiencing event in which he thought he saw the villagers covered in blood. He cut his wrists and described feeling a sense of relief as the blood spurted out. Both the nightmare and the reliving experience express his sense of guilt and need for punishment. The nightmares of most veterans with PTSD correspond closely with the combat experiences, and the terror over being killed that they engender. Veterans who have severe guilt over their actions in Discussion: Combating Post traumatic Disorder


Instant Nursing Papers
Hire a Nursing Expert
Pages (550 words)
Approximate price: -

Why Choose Instant Nursing Papers?

Quality Nursing Papers

We assist students in achieving the best top-grade in their nursing papers, and in compliance with the provided instructions. Have your nursing paper written with a certified specialist Ph.D., Bachelor's, and Master's graduates with many years of experience in academic writing.

Experts with Ph.d., MDs and DNP Holders

Our writers have acquired Ph.D., MDs and DNP credentials from world class institutions. Our writers can handle papers from any discipline and can handle over 100+ subjects.

Nursing Papers Cheap

We provide a great deal of student-friendly prices and professionalism with all our nursing essay writing services. Our paper writing services have a user-friendly interface and professional nursing academic assistance. We are committed to assisting all students with their nursing assignments and projects regardless of their academic level.

Fast Paper Delivery

Our writers follow a strict schedule to ensure papers are delivered before the deadline to enable our editors to proofread before the final delivery to our customers. We strictly observe the early delivery of assignments to meet our clients' deadlines.

Plagiarism-free Nursing Papers

Our expert nursing paper writers are dedicated to conducting thorough research and writing papers from scratch to deliver original papers. To avoid paper plagiarism, all orders go through steps of writing, editing, and proofreading.

24Hour Customer Help

Our customer support is available 24/7/365 to help clients and make their paper writing services easy to use. Our experienced support team is available to answer your queries any time, 24 hours a day.

Try it now!

Calculate the price of your order

We'll send you the first draft for approval by at
Total price:

How it works?

Follow these simple steps to get your paper done

Place your order

Fill in the order form and provide all details of your assignment.

Proceed with the payment

Choose the payment system that suits you most.

Receive the final file

Once your paper is ready, we will email it to you.

Our Nursing Papers Writing Service

We provide Nursing Assignment Services to Nursing students. Also, we are not limited to providing Nursing assignment help to students only. We also provide assignment help and solutions to community health nursing, Anatomy & Physiology, Microbiology, Biochemistry and Biophysics, and Nutrition & Dietetics.


Nursing Essays

Sit back, relax while our writers sort you out on your most daunting nursing essay queries on how to write a good nursing essay. We got you if you are looking for the best nursing essay services.


Nursing Projects

It is no doubt that qualifying for a nursing career is difficult and requires a series of tests. Most nursing students must put in a lot of work in their assignments and coursework. Instantnursingpapers.com will help you answer queries such as “who can write my nursing research paper?”.


Nursing Dissertation Help

Instantnursingpapers.com will save you the hustle of undergoing pressure or even depression while doing your nursing dissertation paper. Save yourself from all the long sleepless nights and pressure by working with our best nursing dissertation writing professionals.


Nursing Coursework Help

If you happen to hop into our site in search of nursing coursework help, look no further. We are the number one solution for the best nursing coursework assignments. Therefore, to complete the best APA nursing coursework, seek help from professional nursing coursework experts at instantnursingpapers.com