Stress Disorder Not Just For Vets

By Mary Winters – Rocky Mountain News columnist  April 4, 2008

He's a strong, self-reliant, outdoor type. The guy you'd pick to survive a snowstorm, set a broken bone, find the trail back to civilization.

So I was surprised when he told me he was being treated for severe post- traumatic stress disorder.

The diagnosis surprised him as well. He was in the National Guard during Vietnam, but he didn't see combat. He wasn't abused, nor had he been in a bad accident. Nothing especially horrific had happened in his life.

Still, in his fifth decade, feelings of anger and grief overwhelmed him, and his marriage headed south. He walled himself off. He cried for no reason. He cried "because I was just full," he says. "The dam was full and everything was close to the surface."

A few sessions with a psychotherapist produced a likely suspect: PTSD.

My friend, it turned out, had been exposed to repeated trauma. Trained as a sniper in the Guard, he helped to quell a bloody three-day prison riot as a young man. Then, for at least 20 years, his work as a photo editor entailed dealing daily with thousands of photos of the world's worst acts of violence, including the Okla- homa City bombing, the Serb-Croatian War, the Columbine High School slayings and the World Trade Center collapse.

We tend to think of PTSD as a casualty of war, but in fact, a negligent parent or an abusive spouse can also cause PTSD. And increasingly, the culprit is around- the-clock exposure to violent media, says Deb Bishop, a Denver psychotherapist.

"If we don't have the opportunity to heal it, trauma is cumulative," Bishop says. We silently absorb it and deal with it "by tossing it behind a wall. But at some point the question becomes 'How high is the wall?' "

When another brush with trauma triggers that stored trauma, "we can feel afraid for no apparent reason," she says. "We might feel anger and rage."

One of the most powerful tools Bishop has found for treating trauma is EMDR, or eye-movement desensitization and re- processing. It sounds weird, and no one can explain why it works for some people. In her office, she showed me how it's done.

The therapist helps the patient concentrate on a disturbing event. Then, in what's called bilateral stimulation of the brain, the therapist moves her hand from left to right and has the patient follow with his eyes. The stimulation can also be accomplished with a headset that emits tones that alternate in each ear.

The patient may then re-experience the trauma by "watching" it, as if it were a movie, or becoming immersed in it, feeling intense emotions.

My friend says his first EMDR session drove him to the floor. "It was like a firestorm of images, a horrific slide show of images that wouldn't stop."

He concluded that his head is "a giant filing cabinet," he says. "I have files with the rubble of war, files of fathers holding dead kids, files of burned corpses . . . "

For the therapist, a crucial part of EMDR involves replacing the negative beliefs the patient has formed around the trauma with more positive, realistic thoughts.

Basically, you rewrite the event and put it behind you, says Bishop. "Trauma arises out of the fact we're powerless to stop it - it makes us fearful. But handing back that sense of control is very healing."

Bishop says most patients find the process surprisingly cathartic. They still remember the trauma, but it no longer upsets them.

Bishop, who received training in EMDR in 2001, uses it with about a quarter of her patients in her practices in Denver and Westminster. "EMDR is not a panacea, but it can be an extraordinary mechanism that fits well in ordinary lives," she says.

EMDR, developed in the 1980s, isn't without its critics. Some say the traditional talk therapy that's part of EMDR is what's effective, not the bilateral stimulation.

The American Psychiatric Association lists EMDR as an effective treatment for post-traumatic stress. The U.S. Department of Veterans Affairs and Department of Defense also supports its use.

My friend is still a little awed by its power. "For me, it was like a dam broke," he says. For two weeks after his first session, he says, he felt almost lightheaded, as if his brain were a supercomputer processing data at warp speed, cleaning out the old memory banks.

EMDR hasn't solved all his problems, and he still gets ambushed pretty regularly by haunting images, but a weight has been lifted. He doesn't sweat the small stuff, and once in a while, he feels so good he laughs out loud at people who do.