Veterans are individuals who have served in military organizations such as armies, navies, air forces, marine corps, coast guards, etc., for a certain amount of time and often experience a range of physical and psychological traumas due to their service. Post-traumatic stress disorder is a mental health condition that can occur after exposure to life-threatening events such as combat, sexual assault, natural disasters, terrorist attacks, car accidents, etc. Veterans who have experienced post-trauma find it difficult to function normally and may feel isolated from society. They face challenges in reconstructing narratives related to their experiences because they struggle to cope with memories, thoughts, emotions, and behaviors associated with traumatic events. This article explains how veterans reconstruct narratives post-trauma through various interventions such as cognitive processing therapy, prolonged exposure therapy, mindfulness meditation, eye movement desensitization and reprocessing, imagery rescripting therapy, acceptance and commitment therapy, etc.
Cognitive Processing Therapy (CPT)
CPT is an evidence-based approach that helps veterans process distressing or unpleasant thoughts about the past by identifying negative beliefs and modifying them into more realistic ones. The therapist helps the patient identify distorted or irrational thoughts, explore alternative interpretations, and challenge maladaptive thinking patterns. CPT consists of four phases: psychoeducation, cognitive restructuring, in vivo exposure, and consolidation. Psychoeducation involves teaching patients about PTSD symptoms and why they are experiencing them. Cognitive restructuring focuses on correcting dysfunctional thoughts and developing new ways of coping. In vivo exposure exposes veterans to triggers that cause fear, anxiety, or arousal to confront feared situations. Consolidation ensures that the patient can maintain progress even after treatment ends. CPT has been proven effective for PTSD in many studies.
Prolonged Exposure Therapy (PE)
PE involves gradually exposing veterans to traumatic memories and other reminders of their experiences until the associated emotional response is diminished. It involves 8-12 weekly sessions with a trained therapist who guides the patient through a specific protocol involving imaginal and in vivo exposures. During imaginal exposure, the patient recalls the traumatic event while sitting comfortably in the therapist's office, followed by in vivo exposure where the patient faces physical triggers such as places, people, objects, etc., related to their experience. PE reduces avoidance behaviors, intrusive memories, and hyperarousal symptoms, leading to improved functioning. Studies have shown that PE is more effective than other interventions for PTSD.
Mindfulness Meditation
Mindfulness meditation helps veterans manage stress, negative thoughts, and emotions by being present in the current moment without judgment. The practice encourages acceptance of negative feelings and trains the mind to cope with distressing situations. Mindfulness meditation involves focusing on one's breath and body sensations, noticing thoughts and emotions without judgment, observing them dispassionately, and letting go of them. Veterans are taught various techniques such as loving-kindness meditation, body scan meditation, breath awareness, and so on. Several studies demonstrate that mindfulness meditation can reduce PTSD symptoms significantly.
Eye Movement Desensitization and Reprocessing (EMDR)
EMDR is an eight-phase approach that uses eye movements or tapping to help veterans process past experiences and reprocess painful memories. It is based on the theory that memories become stored when they are unresolved due to overwhelming emotional content. EMDR targets this dysfunctional memory storage and integrates the traumatic event into a coherent narrative. During treatment sessions, patients follow their therapist's finger movements while recounting the trauma until they experience decreased intensity of distress associated with it. EMDR has been found to be an effective treatment for PTSD, anxiety, depression, and other mental health conditions.
Imagery Rescripting Therapy (IRT)
IRT utilizes imagery rescripting to help veterans rewrite their traumatic memories by changing self-talk and images related to the events. The technique focuses on creating a new narrative that helps veterans resolve feelings of guilt, shame, anger, and fear. IRT involves three steps: identifying negative beliefs and replacing them with positive ones, visualizing alternative endings to the original trauma, and practicing new imagery. Studies show that IRT reduces hyperarousal symptoms, intrusive thoughts, avoidance behaviors, and flashbacks in individuals with PTSD.
Acceptance and Commitment Therapy (ACT)
ACT encourages acceptance of negative thoughts, feelings, and sensations without judgment or struggle, focusing on present moment awareness and personal values. ACT incorporates mindfulness practices such as nonjudgmental self-observation, mindful movement, breathing exercises, etc., and behavior change techniques like committed action plans, value identification, and cognitive defusion strategies. Veterans are taught how to cope with unpleasant emotions and act in line with their core values despite suffering. ACT is beneficial for individuals with PTSD, anxiety disorders, depressive symptoms, and substance abuse problems.
Reconstructing narratives post-trauma can be challenging for veterans but various interventions such as CPT, PE, mindfulness meditation, EMDR, IRT, and ACT have been found to be effective. These therapies help veterans process traumatic mem
How do veterans reconstruct narratives post-trauma?
After experiencing traumatic events, veterans often struggle with how to make sense of their experiences. They may attempt to reconstruct narratives that help them process what happened and come to terms with any resulting mental health issues. This can be a challenging task because trauma is complex and multifaceted, and there are many different ways to tell stories about it.