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What is EMDR Therapy

Real Life Rambos Battle with PTSD Effect

PTSD Effect

  • The Story
  • The PTSD Problems
  • The Solution
  • EMDR

    Rambo is actually a term that has become symbolic of gung-ho action along with a persona that has become attached to the identity of movie action star icon Sylvester Stallone.  Today, Rambo is a word which is used to denote military or individual aggression.  It is additionally employed to refer to someone who is heroic and, at the same, able to perpetuate and unleash extreme violence against the opposition.

The Story

Taken from the 1982 movie that had been originally entitled First Blood, the film is approximately the character named John James Rambo, a member of the elite U.S. Army Green Berets.  Deployed in Vietnam, he fought from the Vietcong and North Vietnamese soldiers by making use of guerrilla jungle and tactics warfare strategy.

Depending on the novel, the location where the screenplay was adapted from, Rambo was caught by North Vietnamese soldiers in November 1971 and was put through inhuman abuse and torture in one of the infamous POW camps.  Together with other American prisoners of war, Rambo suffered extreme episodes of physical torment at the disposal of his captors.

He experienced almost daily beatings, water torture, electrocution, and other types of inflicting pain.  After 6 months of living hell, Rambo surely escaped from the POW camp.  After a time period of recuperation, he was again re-deployed to Vietnam and was finally honorably discharged from your U.S. Army in 1974.

what_is_ptsd

Rambo’s return to civilian life was not easy. The ’70s was a time period of student activism that had been seen as the development of the so-called peace movement and flower power.  During that period, the USA became divided over the issue in the Vietnam War.  Many student protests concentrated on the report that the Vietnam War was an unjust war which the USA was really committing an act of aggression.

Many soldiers and veterans like Rambo, most of whom were only drafted into the war, were subjected to protest and ridicule, and contempt.  Civilian protesters saw men like Rambo as warmongers and anti-peace.  But during that time, now many were mindful of the depression seen by many soldiers who needed to fight in Vietnam.

They, too, were verses of the war but needed to fulfill their duty as military servicemen.  The anxiety and stress of always being under fire and never knowing if it was already their last day made soldiers in Vietnam oppose the war up to the civilian protesters.

The PTSD Problems

Like many Vietnam veterans, Rambo endured Post-Traumatic Stress Disorder or PTSD. The novel depicts Rambo as a person who was deeply battling with his past experiences in Vietnam.  After losing his job as a mechanic, Rambo became a drifter and wandered from town to town.  Inside the movie, Rambo got into trouble after a local sheriff imprisoned him for possession of a jungle knife.  In jail, he was again put through torture.

The injustice he suffered at the hands of his captors made him choose to escape.  The cops, along with the National Guard, launched a manhunt.  However, Rambo surely could elude and deter the armed troops who were delivered to hunt him.  He again used his Green Beret skills to survive and deter his pursuers. Later in the movie, Rambo attacked this town center where the cruel sheriff was hiding.

To avert the further escalation of violence, Army Colonel Trautman came and persuaded Rambo to surrender to him.  The colonel was Rambo’s commanding officer in Vietnam.

Such as the movie as well as the character of Rambo, a large number of Vietnam veterans suffered from PTSD.  Many fell on the path to self-destruction through getting totally hooked on drugs and committing violent acts.

Others were struggling to manage the anger, guilt and frustration and rage they felt after completing their tours of duty in Vietnam.  Many veterans were identified as having PTSD and also other psychosis.

As the movie failed to demonstrate that Rambo received specialized help for his battle with PTSD, in real life, many war veterans needed to receive psychological or psychiatric treatment.  These veterans were designed to take antidepressant prescriptions to ensure them to manage their indications of rage, guilt, and depression along with other self-destructive behavior and emotions.

For many war veterans, getting via a day with a bit of semblance of normalcy required the use of anti-anxiety medication.  Their treatment has also been complemented by counseling, a procedure that helped them vent out their anger, frustrations, and fears.

Unlike the movie, real-life soldiers usually are not invincible Rambos who are able to undergo life without seeking professional help in dealing with the war-time experiences, emotional struggles, and psychological burdens.

Today’s conflicts in Iraq and Afghanistan are producing a growing number of soldiers who, like Rambo, needed to fight and win their own personal internal battles and …demons.

The Solution

Effective treatments for PTSD include different types of psychotherapy (talk therapy) or medication.

Trauma-focused Psychotherapies

Trauma-focused psychotherapies are the most highly recommended type of treatment for PTSD. “Trauma-focused” means that the treatment focuses on the memory of the traumatic event or its meaning. These treatments use different techniques to help you process your traumatic experience. Some involve visualizing, talking, or thinking about the traumatic memory.

Others focus on changing unhelpful beliefs about the trauma. They usually last about 8-16 sessions. The trauma-focused psychotherapies with the strongest evidence are:

  • Prolonged Exposure (PE)
    Teaches you how to gain control by facing your negative feelings. It involves talking about your trauma with a provider and doing some of the things you have avoided since the trauma.
  • Cognitive Processing Therapy (CPT)
    Teaches you to reframe negative thoughts about the trauma. It involves talking with your provider about your negative thoughts and doing short writing assignments.
  • Eye-Movement Desensitization and Reprocessing (EMDR)
    Helps you process and make sense of your trauma. It involves calling the trauma to mind while paying attention to a back-and-forth movement or sound (like a finger waving side to side, a light, or a tone).

There are other types of trauma-focused psychotherapy that are also recommended for people with PTSD. These include:

  • Brief Eclectic Psychotherapy (BEP)
    A therapy in which you practice relaxation skills, recall details of the traumatic memory, reframe negative thoughts about the trauma, write a letter about the traumatic event, and hold a farewell ritual to leave trauma in the past.
  • Narrative Exposure Therapy (NET)
    Developed for people who have experienced trauma from ongoing war, conflict, and organized violence. You talk through stressful life events in order (from birth to the present day) and put them together into a story.
  • Written Narrative Exposure
    Involves writing about the trauma during sessions. Your provider gives instructions on the writing assignment, allows you to complete the writing alone, and then returns at the end of the session to briefly discuss any reactions to the writing assignment.
  • Specific cognitive behavioral therapies (CBTs) for PTSD
    Include a limited number of psychotherapies shown to work for PTSD where the provider helps you learn how to change unhelpful behaviors or thoughts.

Antidepressants (SSRIs and SNRIs)

Medications that have been shown to be helpful in treating PTSD symptoms are some of the same medications also used for symptoms of depression and anxiety. These are antidepressant medications called SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors). SSRIs and SNRIs affect the level of naturally occurring chemicals in the brain called serotonin and/or norepinephrine. These chemicals play a role in brain cell communication and affect how you feel.

There are four antidepressant medications that are recommended for PTSD:

  • Sertraline (Zoloft)
  • Paroxetine (Paxil)
  • Fluoxetine (Prozac)
  • Venlafaxine (Effexor)

Note: Medications have two names: a brand name (for example, Zoloft) and a generic name (for example, Sertraline)

There are other types of antidepressant medications, but these four medications listed above are the ones that are most effective for PTSD.

If you decide to try one of these medications, your provider will give you a prescription. Once you fill your prescription, you will begin taking a pill at the regular time(s) each day. You will meet with your provider every few months or so. Your provider will monitor your response to the medication (including side effects) and change your dose if needed.

Suggested Treatments: Treatments with Some Research Support

Some psychotherapies do not focus on the traumatic event but do help you process your reactions to the trauma and manage symptoms related to PTSD. The research behind these treatments is not as strong as the research supporting trauma-focused psychotherapies (listed above). However, these psychotherapies may be a good option if you are not interested in trauma-focused psychotherapy, or if it is not available:

  • Stress Inoculation Training (SIT)
    A cognitive-behavioral therapy that teaches skills and techniques to manage stress and reduce anxiety.
  • Present-Centered Therapy (PCT)
    Focuses on current life problems that are related to PTSD.
  • Interpersonal Psychotherapy (IPT)
    Focuses on the impact of trauma on interpersonal relationships.

There are also other medications that may be helpful, although the evidence behind them is not as strong as for SSRIs and SNRIs (listed above). These include:

  • Nefazodone (Serzone)
    A serotonin reuptake inhibitor (SRI) that works by changing the levels and activity of naturally occurring chemical signals in the brain.
  • Imipramine (Tofranil)
    A tricyclic antidepressant (TCA) which acts by altering naturally occurring chemicals which help brain cells communicate and can lift the mood.
  • Phenelzine (Nardil)
    A monoamine oxidase inhibitor (MAOI) which inactivates a naturally-occurring enzyme which breaks down the neurotransmitters serotonin, norepinephrine and dopamine.

Other Treatments: Treatments That Do Not Yet Have Research Support

There may be other options available such as certain complementary and integrative medicine approaches (like yoga, meditation, or acupuncture), biological treatments (like hyperbaric oxygen therapy or transcranial magnetic stimulation), or online treatment programs. These treatments do not have strong research behind them at this time, but you and your doctor can discuss the benefits and risks of these options to determine whether or not they are right for you.

Choosing a Treatment

No one treatment is right for everyone. You can discuss treatment options with your healthcare provider, and determine which ones are best for you based on the benefits, risks, and side effects of each treatment. Some people are uncomfortable with the idea of seeking treatment because of concerns with stigma or worries about having to talk about difficult life experiences. However, treatment provides the opportunity to improve symptoms, personal and professional relationships, and quality of life.

To learn about evidence-based treatments, take a look at Understanding PTSD
and PTSD Treatment
 (PDF) or compare treatments using the PTSD Treatment Decision Aid.

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