Tuesday, July 22, 2014

Intimate Partner Violence(IPV)- Post-Traumatic Stress Disorder(PTSD) and Traumatic Brain Injury(TBI)

      Although combat-related conditions like PTSD and TBI are sometimes correlated with certain types of violence, we need to be careful not to let them be used as an excuse for violent behavior. “My PTSD made me do it” is not a valid excuse for committing acts designed to enforce coercive control over a partner. It is always vital to look carefully at the history of such behaviors by the abuser. A TBI or PTSD will NOT turn someone into a person who believes s/he is entitled to have what s/he wants when s/he wants it, without regard for the partner’s wishes or needs. If that attitude of entitlement is already present, combat trauma and related conditions may in fact exacerbate the violence already present in the relationship. More overt forms of violence, which are often physical or sexual, are more likely to come to the attention of law enforcement. Physical and sexual violence are usually the only kinds of violence that are officially recognized and counted. It is also true that some physical violence by one intimate partner against the other actually is related to symptoms of PTSD or TBI. However, this violence does not involve use of coercive control. It may happen in sleep or during a flashback and happens to be directed at the intimate partner because that is the person who is there at the moment. This violence, however, is likely to be seen as a problem by those committing the acts and is not an IPV tactic. This is a complex area in a world that looks for simple answers to problems. One of the real issues in IPV is that there are no simple answers. Treating PTSD will help if the violence is truly part of the symptoms being suffered by the veteran or service member. However, treating PTSD will not change people’s sense of entitlement and belief that whatever they do is justified; neither will anger management, substance abuse treatment, incarceration, or batterers’ intervention programs if these beliefs are not challenged. Victims would certainly like those programs to help. Research, however, shows that they do not help everyone. The only thing that can help is a radical re-focus of abusers’ sense of entitlement, so they no longer view themselves as the center of the universe. That can only happen when abusers recognize that their behavior is a problem and sincerely want to change. Sometimes the criminal justice system can be the catalyst for that necessary change, but sometimes it is not. While it is important to recognize when service members and veterans are dealing with problems stemming from their service to our country, we do them no favors by excusing or condoning their acts of coercive control against intimate partners, and in so doing, may endanger the victims and their children.
Source of this blog: Battered Women’s Justice Project

R.E.D. Friday - Sea of Red


R.E.D. Friday
Very soon, you will see a great many people wearing Red every Friday. The reason Americans who support our troops used to be called the “silent majority.” We are no longer silent, and are voicing our love for God, country and home in record breaking numbers. We are not organized, boisterous or overbearing. Many Americans, like you, me and our friends, simply want to recognize the vast majority of America supports our troops. Our idea of showing solidarity and support for our troops with dignity and respect starts this Friday and continues each and every Friday until the troops all come home, sending a deafening message that…every red-blooded American who support our men and women afar, will wear something red. By work of mouth, press, TV – Let’s make the United States on every Friday a "Sea of Red" much like a homecoming football game in the bleachers. If every one of us who loves this country will share this with acquaintances, coworkers, friends, and family, it will not be long before the USA is covered in RED and it will let our troops know the once “silent” majority is on their side more than ever, certainly more than the media lets on.The first thing a soldier say when asked “What can we do to make things better for you?” is, “We need your support and your prayers.” Let’s get the word out and lead with class and dignity, by example and wear something red every Friday.
 #TYFYS,
#VeteransPTSD
Photo Art by Vietnam Veteran Gilbert Padilla

Women, Trauma, and PTSD


Trauma is common in women; five out of ten women experience a traumatic event. Women tend to experience different traumas than men. While both men and women report the same symptoms of PTSD (hyperarousal, reexperiencing, avoidance, and numbing), some symptoms are more common for women or men.
History
Most early information on trauma and PTSD came from studies of male Veterans, mostly Vietnam Veterans. Researchers began to study the effects of sexual assault and found that women’s reactions were similar to male combat Veterans. Women’s experiences of trauma can also cause PTSD. This finding led to more research on women’s exposure to trauma and PTSD.
Risk of experiencing trauma
Findings from a large national mental health study show that a little more than half of all women will experience at least one traumatic event in their life. Women are slightly less likely to experience trauma than men. The most common trauma for women is sexual assault or child sexual abuse. About one in three women will experience a sexual assault in their lifetime. Rates of sexual assault are higher for women than men. Women are also more likely to be neglected or abused in childhood, to experience domestic violence, or to have a loved one suddenly die.
What happens after trauma
After a trauma, some women may feel depressed, start drinking or using drugs, or develop PTSD. Women are more than twice as likely to develop PTSD than men (10% for women and 4% for men). There are a few reasons women might get PTSD more than men:
  • Women are more likely to experience sexual assault.
  • Sexual assault is more likely to cause PTSD than many other events.
  • Women may be more likely to blame themselves for trauma experiences than men.
Why are some women at higher risk for PTSD?
Not all women who experience a traumatic event develop PTSD. Women are more likely to develop PTSD if they:
  • Have a past mental health problem (for example depression or anxiety)
  • Experienced a very severe or life-threatening trauma
  • Were sexually assaulted
  • Were injured during the event
  • Had a severe reaction at the time of the event
  • Experienced other stressful events afterwards
  • Do not have good social support
What PTSD is like for women
Some PTSD symptoms are more common in women than men. Women are more likely to be jumpy, to have more trouble feeling emotions, and to avoid things that remind them of the trauma than men. Men are more likely to feel angry and to have trouble controlling their anger then women. Women with PTSD are more likely to feel depressed and anxious, while men with PTSD are more likely to have problems with alcohol or drugs. Both women and men who experience PTSD may develop physical health problems.
Treatment for PTSD
There are good treatments for PTSD. However, not everyone who experiences a trauma seeks treatment. Women may be more likely than men to seek help after a traumatic event. At least one study found that women respond to treatment as well as or better than men. This may be because women are generally more comfortable sharing feelings and talking about personal things with others than men.
Women in the military
Women in the military are at high risk for exposure to traumatic events, especially during times of war. Currently, about 15% of all military personnel in Iraq are women. Although men are more likely to experience combat, a growing number of women are now being exposed to combat. Women in the military are at higher risk for exposure to sexual harassment or sexual assault than men. Future studies are needed to better understand the effects of women’s exposure to both combat and sexual assault.
PTSD Information Voice Mail:
(802) 296-6300
Contact Us: ncptsd@va.gov
Also see: VA Mental Health
Veterans PTSD strongly urges anyone feeling that they may harm themselves or others should call Veterans Crisis Line:
1-800-273-8255 PRESS 1

Intimate Partner Violence- Female Veterans at Higher Risk for Partner Violence

Home » News » Stress News » Female Veterans at Higher Risk for Partner Violence


Female Veterans at Higher Risk for Partner Violence

By  Senior News Editor
Reviewed by John M. Grohol, Psy.D. on July 7, 2014
Female Veterans at Higher Risk for Partner Violence
Over the past decade, researchers have learned that intimate partner violence (IPV) is a significant health issue faced by women veterans.
However, until recently little has been known about women’s perception of the care they have been receiving.
Now, a new study discovers that most of these women support routine screening for IPV and want options, follow-up support, transparent documentation, and Veterans Health Administration (VHA) and community resources.
Findings from the new report have been published in the journal Research in Nursing and Health.
Although women of all sociodemographic groups are at risk for IPV, population-based research suggests that women veterans are at higher risk for IPV than non-veteran women.
In order to better understand their attitudes and preferences regarding IPV screening and response issues, five focus groups were conducted with 24 female patients of the Veterans Health Administration (VHA) with and without a lifetime history of IPV.
“In general, we found that women veterans support routine IPV screening and comprehensive IPV-related care within the VHA,” said Katherine Iverson, Ph.D. “As we move forward with routine IPV screening, it is important that these women are offered options in terms of what, how, when, and to whom to disclose and follow-up support.
“In addition, these women must be approached with sensitivity and connectedness with the understanding that different patients are in different stages of recovery.”
Overall, women indicated that the HITS screening tool (the four-item Hurt/Insult/Threaten/Scream), tested by Iverson and her colleagues for use in under four minutes, could be useful in helping VHA providers identify women who have experienced IPV.
Using the existing clinical reminder dialogue system a notification could be embedded into a patients’ electronic medical records (EMR’s) to use HITS to assess IPV, ensuring that screening is occurring. This would be similar to clinical EMRs for mammograms and pap smears.
The researchers point out that use of EMRs may be a potential barrier to disclose for some women because of privacy and confidentiality concerns.
Study participants suggested that this barrier can be overcome by providers’ use of transparency with respect to documentation.
For example, providers can talk with their patients about what they would like to document in the EMR and problem-solve any concerns the patients may raise.
In addition, providers can discuss privacy protections in place at VHA and engage patients in conversations about the advantages and disadvantages of documentation.
EMRs can also prompt providers to engage in other procedures that were recommended by participants in this study, such as offering information about VHA and community resources.
The researchers believe the VHA has a timely opportunity and is well-positioned to serve as a national model for the implementation of best practices for IPV screening and response.
“By incorporating the recommendations expressed by women in this study, VHA and other health care providers may increase the likelihood of identifying IPV, improve patient satisfaction with care, connect veterans with the services they need, reduce health care costs to the patient and system at large, and ultimately improve the health and well-being of female veteran patients,” added Iverson.

Veterans PTSD, Inc.- Nonprofit Veterans Service Organization


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I'm Patrick C. Sullivan, Executive Director and Founder of Veterans PTSD, Inc.. I'm the Creator, Founder and Lead Administrative Manager of Veterans PTSD Facebook page. I created, founded and manage a Twitter account at @VeteransPTSD and a Google+ page at +Veterans PTSD. This is in the effort to post jobs, civilian and gov't contracts, financial assistance resources, seminars/webinars, grant information, housing assistance programs and resources, health services for physical and emotional ailments, service animal relocation and placement, Veteran Owned Small Business interests and promotion for Veterans in search of the resources needed to better their future. This is done in an effort to build a stronger Veteran, Community, State and Nation. Veterans are the most unique individuals of the United States. We possess the most determined willpower of all our nations citizens. Even when we are beaten, bruised and lay face down in the gutter we find the capability to pull ourselves out. I believe that the combination of our sheer will and desire with the willingness to help our fellow brothers and sisters in arms gives us the ability to survive and prosper in the face of any form of adversity. Together, we make up the backbone of this nations infrastructure. United, we drive an unstoppable force capable of great feats against unfathomable odds. Combined, Veterans, Coast Guard, National Guard, Active and Inactive Reserves and Active duty Armed Forces out number any and all Armies to have ever walked the face of the Earth. We can do anything we set our collective intelligent minds to do. Now, in this time, when our nation needs us the most, we must help strengthen one another in an effort to build a greater United States. In the process of our mission to help each other, we will accomplish our goal of healing ourselves and our fellow soldiers. My simple work thus far has greatly improved my own suffering ailments. If given purpose, each of us can find sanctuary inside the congregation of family we call "Veterans". While doing so we inherently build a stronger America. This is the proven theory behind uniting our resources to evacuate the problems in our society. Starting with ourselves gives us that hope we desire for a serene tomorrow, but it all starts with today. Please, brothers and sisters, let us use our knowledge to lift each other up and brighten each others future. Use this page as a tool to begin the healing within ourselves, while helping our fellow man. Together let us build a better tomorrow for the next generation. The Veterans PTSD Informant is a continuation of our goals, as well as providing news that effects our Veteran/Military community as a whole. Thank You For Your Service! - Veterans PTSD
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Sleep and PTSD


Many people have trouble sleeping sometimes. This is even more likely, though, if you have PTSD. Trouble sleeping and nightmares are two symptoms of PTSD.
Why do people with PTSD have sleep problems?
  • They may be “on alert.” Many people with PTSD may feel they need to be on guard or “on the lookout,” to protect himself or herself from danger. It is difficult to have restful sleep when you feel the need to be always alert. You might have trouble falling asleep, or you might wake up easily in the night if you hear any noise.
  • They may worry or have negative thoughts. Your thoughts can make it difficult to fall asleep. People with PTSD often worry about general problems or worry that they are in danger. If you often have trouble getting to sleep, you may start to worry that you won’t be able to fall asleep. These thoughts can keep you awake.
  • They may use drugs or alcohol. Some people with PTSD use drugs or alcohol to help them cope with their symptoms. In fact, using too much alcohol can get in the way of restful sleep. Alcohol changes the quality of your sleep and makes it less refreshing. This is true of many drugs as well.
  • They may have bad dreams or nightmares. Nightmares are common for people with PTSD. Nightmares can wake you up in the middle of the night, making your sleep less restful. If you have frequent nightmares, you may find it difficult to fall asleep because you are afraid you might have a nightmare.
  • They may have medical problems. There are medical problems that are commonly found in people with PTSD, such as chronic pain, stomach problems, and pelvic-area problems in women. These physical problems can make going to sleep difficult.
What can you do if you have problems?
There are a number of things you can do to make it more likely that you will sleep well:
Change your sleeping area
Too much noise, light, or activity in your bedroom can make sleeping harder. Creating a quiet, comfortable sleeping area can help. Here are some things you can do to sleep better:
  • Use your bedroom only for sleeping and sex.
  • Move the TV and radio out of your bedroom.
  • Keep your bedroom quiet, dark, and cool. Use curtains or blinds to block out light. Consider using soothing music or a “white noise” machine to block out noise.
Keep a bedtime routine and sleep schedule
Having a bedtime routine and a set wake-up time will help your body get used to a sleeping schedule. You may want to ask others in your household to help you with your routine.
  • Don’t do stressful or energizing things within two hours of going to bed.
  • Create a relaxing bedtime routine. You might want to take a warm shower or bath, listen to soothing music, or drink a cup of tea with no caffeine in it.
  • Use a sleep mask and earplugs, if light and noise bother you.
  • Try to get up at the same time every morning, even if you feel tired. That will help to set your sleep schedule over time, and you will be more likely to fall asleep easily when bedtime comes. On weekends do not to sleep more than an hour past your regular wake-up time.
Try to relax if you can’t sleep
  • Imagine yourself in a peaceful, pleasant scene. Focus on the details and feelings of being in a place that is relaxing.
  • Get up and do a quiet activity, such as reading, until you feel sleepy.
Watch your activities during the day
Your daytime habits and activities can affect how well you sleep. Here are some tips:
  • Exercise during the day. Don’t exercise within two hours of going to bed, though, because it may be harder to fall asleep.
  • Get outside during daylight hours. Spending time in sunlight helps to reset your body’s sleep and wake cycles.
  • Cut out or limit what you drink or eat that has caffeine in it, such as coffee, tea, cola, and chocolate.
  • Don’t drink alcohol before bedtime. Alcohol can cause you to wake up more often during the night.
  • Don’t smoke or use tobacco, especially in the evening. Nicotine can keep you awake.
  • Don’t take naps during the day, especially close to bedtime.
  • Don’t drink any liquids after 6 p.m. if you wake up often because you have to go to the bathroom.
  • Don’t take medicine that may keep you awake, or make you feel hyper or energized right before bed. Your doctor can tell you if your medicine may do this and if you can take it earlier in the day.
Talk to your doctor
If you can’t sleep because you are in pain or have an injury, you often feel anxious at night, or you often have bad dreams or nightmares, talk to your doctor.
There are a number of medications that are helpful for sleep problems in PTSD. Depending on your sleep symptoms and other factors, your doctor may prescribe some medication for you. There are also other skills you can learn to help improve your sleep.


Coping with Traumatic Stress Reactions


When trauma survivors take direct action to cope with their stress reactions, they put themselves in a position of power. Active coping with the trauma makes you begin to feel less helpless.
  • Active coping means accepting the impact of trauma on your life and taking direct action to improve things.
  • Active coping occurs even when there is no crisis. Active coping is a way of responding to everyday life. It is a habit that must be made stronger.
Know that recovery is a process
Following exposure to a trauma most people experience stress reactions. Understand that recovering from the trauma is a process and takes time. Knowing this will help you feel more in control.
  • Having an ongoing response to the trauma is normal.
  • Recovery is an ongoing, daily process. It happens little by little. It is not a matter of being cured all of a sudden.
  • Healing doesn’t mean forgetting traumatic events. It doesn’t mean you will have no pain or bad feelings when thinking about them.
  • Healing may mean fewer symptoms and symptoms that bother you less.
  • Healing means more confidence that you will be able to cope with your memories and symptoms. You will be better able to manage your feelings.
Positive coping actions
Certain actions can help to reduce your distressing symptoms and make things better. Plus, these actions can result in changes that last into the future. Here are some positive coping methods:
Learn about trauma and PTSD
It is useful for trauma survivors to learn more about common reactions to trauma and about PTSD. Find out what is normal. Find out what the signs are that you may need assistance from others. When you learn that the symptoms of PTSD are common, you realize that you are not alone, weak, or crazy. It helps to know your problems are shared by hundreds of thousands of others. When you seek treatment and begin to understand your response to trauma, you will be better able to cope with the symptoms of PTSD.
Talk to others for support
When survivors talk about their problems with others, something helpful often results. It is important not to isolate yourself. Instead make efforts to be with others. Of course, you must choose your support people with care. You must also ask them clearly for what you need. With support from others, you may feel less alone and more understood. You may also get concrete help with a problem you have.
Practice relaxation methods
Try some different ways to relax, including:
  • Muscle relaxation exercises
  • Breathing exercises
  • Meditation
  • Swimming, stretching, yoga
  • Prayer
  • Listening to quiet music
  • Spending time in nature
While relaxation techniques can be helpful, in a few people they can sometimes increase distress at first. This can happen when you focus attention on disturbing physical sensations and you reduce contact with the outside world. Most often, continuing with relaxation in small amounts that you can handle will help reduce negative reactions. You may want to try mixing relaxation in with music, walking, or other activities.
Distract yourself with positive activities
Pleasant recreational or work activities help distract a person from his or her memories and reactions. For example, art has been a way for many trauma survivors to express their feelings in a positive, creative way. Pleasant activities can improve your mood, limit the harm caused by PTSD, and help you rebuild your life.
Talking to your doctor or a counselor about trauma and PTSD
Part of taking care of yourself means using the helping resources around you. If efforts at coping don’t seem to work, you may become fearful or depressed. If your PTSD symptoms don’t begin to go away or get worse over time, it is important to reach out and call a counselor who can help turn things around. Your family doctor can also refer you to a specialist who can treat PTSD. Talk to your doctor about your trauma and your PTSD symptoms. That way, he or she can take care of your health better.
Many with PTSD have found treatment with medicines to be helpful for some symptoms. By taking medicines, some survivors of trauma are able to improve their sleep, anxiety, irritability, and anger. It can also reduce urges to drink or use drugs.
Coping with the symptoms of PTSD
Here are some direct ways to cope with these specific PTSD symptoms:
Unwanted distressing memories, images, or thoughts
  • Remind yourself that they are just that, memories.
  • Remind yourself that it’s natural to have some memories of the trauma(s).
  • Talk about them to someone you trust.
  • Remember that, although reminders of trauma can feel overwhelming, they often lessen with time.
Sudden feelings of anxiety or panic
Traumatic stress reactions often include feeling your heart pounding and feeling lightheaded or spacey. This is usually caused by rapid breathing. If this happens, remember that:
  • These reactions are not dangerous. If you had them while exercising, they most likely would not worry you.
  • These feelings often come with scary thoughts that are not true. For example, you may think, “I’m going to die,” “I’m having a heart attack,” or “I will lose control.” It is the scary thoughts that make these reactions so upsetting.
  • Slowing down your breathing may help.
  • The sensations will pass soon and then you can go on with what you were doing.
Each time you respond in these positive ways to your anxiety or panic, you will be working toward making it happen less often. Practice will make it easier to cope.
Feeling like the trauma is happening again (flashbacks)
  • Keep your eyes open. Look around you and notice where you are.
  • Talk to yourself. Remind yourself where you are, what year you’re in, and that you are safe. The trauma happened in the past, and you are in the present.
  • Get up and move around. Have a drink of water and wash your hands.
  • Call someone you trust and tell them what is happening.
  • Remind yourself that this is a common response after trauma.
  • Tell your counselor or doctor about the flashback(s).
Dreams and nightmares related to the trauma
  • If you wake up from a nightmare in a panic, remind yourself that you are reacting to a dream. Having the dream is why you are in a panic, not because there is real danger now.
  • You may want to get up out of bed, regroup, and orient yourself to the here and now.
  • Engage in a pleasant, calming activity. For example, listen to some soothing music.
  • Talk to someone if possible.
  • Talk to your doctor about your nightmares. Certain medicines can be helpful.
Difficulty falling or staying asleep
  • Keep to a regular bedtime schedule.
  • Avoid heavy exercise for the few hours just before going to bed.
  • Avoid using your sleeping area for anything other than sleeping or sex.
  • Avoid alcohol, tobacco, and caffeine. These harm your ability to sleep.
  • Do not lie in bed thinking or worrying. Get up and enjoy something soothing or pleasant. Read a calming book, drink a glass of warm milk or herbal tea, or do a quiet hobby.
Irritability, anger, and rage
  • Take a time out to cool off or think things over. Walk away from the situation.
  • Get in the habit of exercise daily. Exercise reduces body tension and relieves stress.
  • Remember that staying angry doesn’t work. It actually increases your stress and can cause health problems.
  • Talk to your counselor or doctor about your anger. Take classes in how to manage anger.
  • If you blow up at family members or friends, find time as soon as you can to talk to them about it. Let them know how you feel and what you are doing to cope with your reactions.
Difficulty concentrating or staying focused
  • Slow down. Give yourself time to focus on what it is you need to learn or do.
  • Write things down. Making “to do” lists may be helpful.
  • Break tasks down into small do-able chunks.
  • Plan a realistic number of events or tasks for each day.
  • You may be depressed. Many people who are depressed have trouble concentrating. Again, this is something you can discuss with your counselor, doctor, or someone close to you.
Trouble feeling or expressing positive emotions
  • Remember that this is a common reaction to trauma. You are not doing this on purpose. You should not feel guilty for something you do not want to happen and cannot control.
  • Make sure to keep taking part in activities that you enjoy or used to enjoy. Even if you don’t think you will enjoy something, once you get into it, you may well start having feelings of pleasure.
  • Take steps to let your loved ones know that you care. You can express your caring in little ways: write a card, leave a small gift, or phone someone and say hello.
A Final Word
Try using all these ways of coping to find which ones are helpful to you. Then practice them. Like other skills, they work better with practice. Be aware that there are also behaviors that DON’T help.