The Impact of PTSD on Veterans' Family Relationships: An Interpretative Phenomenological Inquiry

Introduction

In the past, a lot of information has been provided on how PTSD affects veterans, focusing mainly on their personal lives. However, very little information is provided on how PTSD affects the veterans' family relationships. Consequently, the impact PTSD has on the veterans' family relationships affects the rate at which the veterans heal from the trauma. As it turns out, there is substantial evidence that shows that support families and friends significantly contribute to the recovery of these veterans from PTSD. Therefore, there is a need for researchers to also focus on PTSD not just from a personal point of view but a broad family relationship point of view. At the same time, researchers need to come up with enough information that indicates how symptoms of PTSD impact the family relationships. It is only by understanding how PTSD affects the family that we can provide the necessary support to these veterans and help them heal from the trauma (Ray & Vanstone, 2009).

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The article takes an interpretative phenomenological approach as the primary methodology in analyzing previous studies that focused on peacekeepers that were healing from trauma (Ray & Vanstone, 2009). The peacekeeper was initially from Ontario but have roots all over Canada. They are also very experienced regarding service as they have been involved in other peacekeeping missions in other international locations. They differed however regarding specialization, experience, service, and ranks. However, they all had been receiving treatment for PTSD for over the last two years (Ray & Vanstone, 2009).

The data analysis was done so in a phenomenological fashion where researchers aimed at uncovering the meanings behind the experiences each of the veterans went through. These phenomena were personal for each, and therefore, the researchers focused on the descriptions provided by each (Ray & Vanstone, 2009). Keeping in mind that the analysis done was secondary, the secondary researchers looked at the transcripts that had been documented by the primary researcher. These transcripts verified the meaning to the exemplary quotes from the veterans (Ray & Vanstone, 2009).

As part of the results, two main themes stood out from the information that was gathered from the veterans and the transcripts provided about their family relationships. The first was emotional numbing and negative anger impacts familial relationships; and the second was emotional withdrawal from the family support which in turn creates a struggle when it comes to healing from the trauma (Ray & Vanstone, 2009).

The article provides a clear indication that there is a massive impact of PTSD not just on the individuals but on their family relationships. One of the effects PTSD has are symptoms of emotional numbing and anger. PTSD in most cases is manifested in the form of emotional numbing in which the individual hides his/her emotions and feeling. In most cases, this leads to depression and the patient might completely withdraw from his family members and friends. In other cases, PTSD symptoms may show in the form of anger. Whichever way these symptoms take, the families need to be well-informed for them to offer the necessary assistance required for healing purposes.

Healing from PTSD requires interpersonal skills and strength, but the involvement by the family may go a long way in helping the individual recover from the same. There is a need for the researchers to emphasize the importance of veterans' family relationships in the future for them to provide the best form of an all-inclusive kind of treatment. Although the following article does not provide a statistical point of view, it has dug deep into the personal lives of these veterans and provide information not found in may researches on PTSD in veterans.

Prolonged Exposure for PTSD in a Veterans Health Administration PTSD Clinic

Post-Traumatic Stress Disorder has increasingly become one of the leading medical concerns that affect many veterans after they return from military service. As a result, the Veteran Health Administration (VHA), has come up with various ways to help veterans overcome PTSD. One of these ways of prolonged exposure (PE). The article focuses on the effectiveness of prolonged exposure on veterans by sampling a few veterans under the VHA PTSD clinic (Rauch et al., 2009).

In the past, the following methods have been proven to significantly reduce PTSD symptoms which are associated with various forms of traumas such as combat. Apart from reducing the symptoms, prolonged exposure helps to minimize cases of guilt, anxiety, anger, and depression. It has been tried on veterans from Iraq and Afghanistan and has proven to work. However, PE is not always accessible to all veteran seeking PSTD treatment and especially those enrolled in the VA program. A study carried out in 2004 indicated that less than 10% of the PTSD therapist regularly use PE. This is as a result of the misconceptions that exist about PE which continue to increase the deficit (Rauch et al., 2009).

PE involves three primary forms of therapeutic components; in vivo exposure, psychoeducation, and imaginal exposure. The following article aims at breaking down the efficiency of this method which might increase its dissemination and modification to be incorporated in the treatment of PTSD. For PE to be disseminated, the U.S VHA decided to carry out a roll-out of PE which included gathering enough data to show its effectiveness on veterans.

The sample size used was N=10 veterans (eight men and two men) who were going through chronic PTSD and were treated using PE in the PTSD Clinic under the VHA program (Rauch et al., 2009). The clinic hired a clinician who was well specialized in PE and has also been training other providers on PE and implement this form of treatment on veterans. The procedure took place between January 2006 and December 2007 in which all statistical scores were presented (Rauch et al., 2009). The experiment aimed to see whether the PTSD symptoms, as well as others such as depression, would reduce.

The veterans used in the study had an average age of 39 years. Three of them were divorced or separated, two were remarried, and fiver was still married. From the ten, nine of them were high school graduates with six of them going up to college level and at the same time six of them were employed. All of them went through a comprehensive evaluation which included a Posttraumatic Diagnostic Scale, BDI-II score, Post-traumatic Cognitions Inventory, Dissociative Experiences Scale, Spielberger Trait Anger Inventory, Clinical Administered PTSD Scale as well as a Mini International Neuropsychiatric Interview (Rauch et al., 2009). All these tests formed a basis for the PDS which demonstrated a good test-retest reliability and a high internal consistency. After evaluation, all the veterans passed the 15 clinical cutoffs which were used to determine whether or not they met the criteria required for PTSD diagnosis (Rauch et al., 2009).

This meant that all the veterans met the criteria for PTSD and PE would be considered for each of them as a treatment method. Another factor was the fact that each of them had gone through a single traumatizing memory. The first step involved the observation and recording of the medication all the candidate were on irrespective of prolonged exposure. The next step involved training staff on how PE and minimal cognitive-behavior therapy is applied (Rauch et al., 2009). The last phase included the modification of the standard PE manual regarding the number and duration of the sessions (Rauch et al., 2009).

For the specialists to examine whether or not there were changes among the ten veterans regarding the reduction in PTSD symptoms, the team used four different variables, i.e., hyperarousal, avoidance numbing, re-experiencing, and total PDS. In the end, all veterans indicated a significant reduction in the PTSD symptoms (Rauch et al., 2009).

Conclusion

The experiment was a clear indication that PE is effective in reducing the PTSD symptoms for veterans receiving assistance under the VHA clinic program. The article is limited to the statistical point of view and does not provide a lot of information about the social aspect of belief. However, like most PTSD patients, it is assumed that symptoms such as depression and anxiety often affect the veteran, his/her family and the community around him/her. Nevertheless, the article does provide insight into how significant prolonged exposure can be if it well utilized in the treatment of PTSD among veterans. It also helps cross-out the misconceptions that have existed for a long time regarding PE and other PTSD treatment like it that may be utilized by clinicians.

References

Rauch, S. A., Defever, E., Favorite, T., Duroe, A., Garrity, C., Martis, B., & Liberzon, I. (2009). Prolonged exposure for PTSD in a Veterans Health Administration PTSD clinic. Journal of Traumatic Stress: Official Publication of The International Society for Traumatic Stress Studies, 22(1), 60-64.

Ray, S. L., & Vanstone, M. (2009). The impact of PTSD on veterans' family relationships: An interpretative phenomenological inquiry. International Journal of Nursing Studies, 46(6), 838-847.