1. Post Traumatic Stress Disorder United States Army Medical Command Chaplain Joe Hughes

2. PTSD “When my best friend died, I wouldn’t cry because if I started crying for him, I’d wind up crying for all my friends who died and I would never stop crying.” -Anonymous Viet Nam Veteran

3. PTSD Community based studies show prevalence for PTSD ranges from 1% to 14%. BUT among combat vets it’s 5%- 58%.

4. PTSD WHAT CAUSES PTSD- - Exposure to extreme traumatic stress that involves actual or perceived threat to life and personal safety.

5. CAUSES -Event(s) that drive home the fact that the world is not a safe place. -Proximity to and intensity of the event.

6. INDICATORS Indicators fall into three categories – all not present before the traumatic events.

7. INDICATORS 1.Persistent re-experience of the event(s) to include one or more of the following. -uncontrolled recurring and intrusive memories -recurring dreams

8. INDICATORS -acting or feeling as if the event were recurring, i.e., sense of reliving the experience, hallucinations, and flashbacks -to include when intoxicated

9. INDICATORS -mental distress when exposed to internal or external cues that resemble or remind the person about the event.

10. INDICATORS -physiological reactions (increased heart rate and respirations, sick to stomach, etc.) when exposed to internal or external cues

11. INDICATORS 2.Persistent avoidance of things associated with the event and numbing of responsiveness. To include one or more of the following.

12. INDICATORS -attempts to avoid thoughts, feelings, or conversations associated with the events -efforts to avoid activities, places and people associated with the event

13. INDICATORS -inability to recall an important part of the event -markedly reduced interest or participation in important events

14. INDICATORS -feelings of detachment or estrangement from others -restricted range of emotions (e.g. unable to have loving Feelings)

15. INDICATORS -sense of foreshortened future, no expectations for a normal life…no career, no marriage, no children, no normal life span

16. INDICATORS 3.Persistent symptoms of increased arousal in two or more of the following.

17. INDICATORS -difficulty in falling or staying asleep -irritability or outbursts of anger -difficulty in concentrating

18. INDICATORS -hyper vigilance -exaggerated startle response

19. OUR TASK Treatment is usually combination of meds and therapy. But we do have a role to play.

20. OUR TASK The theological question is, first, the age old one of why does God allow bad things to happen to people of faith.

21. OUR TASK Second, what does that say about the nature of God and His love towards His people.

22. OUR TASK THE QUESTIONS TO DETERMINE 1.Where have you lost control in your life? 2.What are reasonable and consistent demands from Supervisors? 3.Have you lost respect from/to colleagues and co-workers? 4.Do you feel cared for, appreciated by co-workers, Supervisors? 5.Do you feel competent, reliable, dependable? 6.Has your work have purpose, meaning, and value? 7.How thankful are you for your work? 8.Are you busy and/or over-committed outside work? 9.Do you have a time each day to rest, relax, and replete? 10.What are you doing to stay healthy?

23. OUR TASK THE QUESTIONS TO DETERMINE 11.How are you coping with your pain, suffering, loss? 12.How are you dealing with death of those we grow close to? 13.Are you able to laugh, cry, and yell at something? 14.Do you know that you have something to give? 15.Are you loving and caring for yourself? 16.Are you spending time with friends? 17.Are you spending time with family? 18.Do you have balance in your life? 19.Do you have time away from work? 20.Do you share care-giving experiences (good and bad)? 21.Do you need to forgive co-workers/supervisors and receive forgiveness?

24. OUR TASK THE QUESTIONS TO DETERMINE 22.Do you still have your sense of calling? 23.Are you still in the ministry? 24.Do you feel loved, cared for, accepted by God? 25.Do you accept and receive spiritual repletion? 26.Do you have time alone to pray and worship? 27.Do you have time alone for inspirational reading? 28.Do you have time alone to listen to inspirational music? 29.Do you have a time with others to pray, worship, sing, relate? 30.Do you pray for your co-workers/supervisors/soldiers/ families? 31. Have you lost your sense of discipline and sacrifice?

25. IS RECOVERY POSSIBLE?

26. THE ANSWER? RETURN TO “NORMAL IS NOT POSSIBLE WE DON’T KNOW YES

27. QUESTIONS?