November 17, 2023 – Army Reserve veteran Selina Jackson has years of combat experience…off the battlefield.
Jackson grew up in what she calls a combat zone in upstate New York and infrequently witnessed brutal fights between her parents, leaving her mother unconscious on the ground. She watched her alcoholic, drug-addicted father brutally beat her older sister more times than she cares to recollect. She was repeatedly sexually abused by the teenage son of her parents' best friends. Her father burned down their house.
And yet she kept these traumatic, often life-threatening events a secret until the COVID-19 pandemic hit and she or he was stuck at home.
“I wasn't physically able to do the things I always did to distract myself,” she said while working from home, “which was terrible for me because I used to be like, 'Oh my God, I'm here, I'm alone in my house all day, working.'”
Her post-traumatic stress disorder “became overwhelming.” She couldn't stop the symptoms during the day. “I still had such a heavy burden of guilt and shame. I didn’t care if I lived or died,” she said.
Jackson was eventually diagnosed Post-traumatic stress disorder (PTSD), a mental illness that affects tens of millions of individuals worldwide twice over just as many women in the general population and approximately 13% of young female veterans (versus 6% of male veterans). Also female veterans disproportionately experience trauma and adverse childhoods prior to military service, experiences that are compounded by high rates of sexual assault and/or sexual harassment during military service.
Unfortunately, these numbers do not give a complete picture. PTSD often goes undiagnosed. Many patients either don't recognize or run away from telltale signs and symptoms such as flashbacks, guilt, and shame. And the range of symptoms associated with PTSD – such as depression, anxiety, isolation, substance use disorders or suicidal thoughts – are also common in other psychiatric illnesses. This can lead to misdiagnosis, incorrect treatment and ongoing problems.
“For sufferers of PTSD, the world becomes smaller and smaller, they begin to avoid relationships, work, enjoyable activities and things they used to do,” said Tara Galovski PhD, director of the Division of Women's Health Sciences at the National Center for Veteran Affairs PTSD and a psychology professor at Boston University School of Medicine.
“But the memories come out in different ways, like when people try to fall asleep and can't because thoughts are running through their heads. They affect concentration, irritability, and the way PTSD sufferers see themselves in the world and think about themselves.”
Without treatment, Galovski said, these symptoms can become chronic and cause other types of health impairments “in important ways in how we function.”
Completely successful thanks to STRIVE
Jackson, now 53 and living in Ohio, is completing a program at The Ohio State University Wexner Medical Center called STRIVE (Suicide and Trauma Reduction Initiative) helped her deal with post-traumatic stress disorder and change her life.
“I love who I am right now,” she said.
STRIVE was founded by clinical psychologist, professor and retired Air Force veteran Craig J. Bryan, PsyD. The program is research-based and designed to develop the best strategies for coping with trauma, reducing the risk of gun violence and suicide in adult veterans or the general population. Its origins lie in strategies for treating psychological trauma in soldiers in combat zones.
“The origins of what we now call mass therapy – a condensed format – of course go back to deployment and placement in a combat zone where you don't have the luxury of therapy once a week for an hour over a period of a few months “To come.” Bryan said.
“Most of the cases I worked on involved people who had been blown up, had a vehicle rollover, or suffered head injuries, and I had to make quick decisions in a matter of days about whether that person would be OK or whether she had to go home.”
The battlefield provided a testing ground for the compressed, accelerated treatment that brought Bryan back to the United States, first to the University of Utah and then to Ohio State.
The primary technique used by STRIVE therapists is cognitive processing therapy. The therapy was originally developed by researchers at the University of Missouri as a treatment for victims of sexual assault and was also adopted and implemented by the VA 16 years ago.
The framework for “CPT suggests that a traumatic event has a major impact on the way people think and, for some, significantly alters their beliefs about why that trauma happened,” Galovski said. “It also affects their beliefs about themselves and other people and about the world.”
“We use the term ‘stuck points’ a lot,” Bryan said. “This is a belief that prevents natural, spontaneous, built-in recovery processes that help us move forward and overcome an event. The most common “stuck points” include things like, “It's my fault.” “I should have done things differently or worn a different outfit.” “I should never have trusted that person.”
With cognitive processing therapy, doctors identify patterns and teach patients to look at their own thoughts from a “more balanced, objective perspective,” Bryan said.
Essentially, therapy helps patients learn to question and modify unhelpful beliefs (for example, I was raped because I wore a short skirt) and develop a new, more realistic understanding of the event (for example: What was there anything else going on? Have you ever worn a short skirt? Do short skirts cause rape?
“This more balanced thought process then alleviates anxiety, fear, guilt, shame and all the other consequences of post-traumatic stress disorder,” Bryan said.
Learning to live fully again
Ohio State's program is obtainable in person or via telemedicine over 10 each day, one-hour sessions with a therapist. Patients are required to completely participate and complete each day tasks.
One of the explanations STRIVE is effective is that it leaves no room for patients to skip or cancel sessions. “The continuity of having to work in high temperatures every day was very mandatory,” Jackson said.
AnnaBelle O. Bryan, director of the STRIVE program and a retired Air Force veteran, said many patients begin to recuperate between the fourth and sixth sessions, while others need the total spectrum and maybe an extra hour after that. However, she emphasizes that the best profit comes when patients proceed to practice and reinforce what they've learned. Currently, STRIVE has a recovery rate of about 76%, which Craig Bryan says is consistent with what studies have shown; 70 to 80% of patients who complete cognitive processing therapy experience significant reduction and improvement in symptoms.
AnnaBelle Bryan said some people often relapse about six months after leaving this system, and typically these relapses are a reminder that something happened, reasonably than a return to full-blown PTSD episodes.
“If they manage to get through [these flare-ups] If we use the skills they learn, we won't hear from them again,” said AnnaBelle Bryan, noting that fifty% of patients make a full recovery after two years. “We track their progress so they can see their progress immediately, which really helps with recovery.”
For those others who need more help, STRIVE offers hour-long “booster” sessions. It is essential that this system is free. Those who participate help with the organization's research and receive high-quality therapy in return.
With a brand new outlook on life, Jackson plans to depart Ohio and move to upstate New York within the spring. She said STRIVE gave her the chance to finally be a greater person for herself and for everybody else in her life.
“Instead of surviving, I will finally be able to live,” she said.
For more information and resources, people – especially veterans – are encouraged to envision out National Center for PTSD.
You may learn more about STRIVE, including yours Eligibility for the program.
If you're having suicidal thoughts, help is out there 24 hours a day, 7 days per week on 988 (Suicide and Crisis Lifeline). Veterans and their family members can dial 988 and press 1 to make this occur Veterans Crisis Lineor text 838255.
STRIVE offers help through a separate program – STRIVE BCBT – to current military personnel; veterans; first responders (e.g., law enforcement officials, dispatchers, firefighters, and paramedics) with no military history; and their relations who exhibit symptoms of suicidal thoughts and behavior.