DOES TORTURE CAUSE PTSD?

What kind of ignorance and denial is required for supposedly intelligent people not to realize that they are killing a brain with anoxia and constant slamming a head into a plywood wall causing concussion, swelling, and brain damage? After a war, how many POWs would the USA want back who are arguably close to being brain dead?

A lot has been written about frequent concussions possibly being a precursor to Alzheimer's Disease. That might take a bit of time to develop but is the torture any less the culprit because the effect happens later? Violent personal assaults are a basic cause of PTSD. That Americans can defend the torture practices used in the GW Bush administration is shameful. Depriving a brain of oxygen 183 times, sometimes twice daily for periods, is certainly one way to kill brain cells. It is laughable that an attempt to justify this treatment as means of getting helpful information from the subject is even attempted by ex VP Cheney and others. They have clearly not spoken to neurologists or neuro-psychologists.

If reasonably informed people stopped to examine some of the arguments that were used, it would be clear that more sadism and cruelty was being used than meaningful interrogation techniques regardless of whether they were referred to as torture or enhanced interrogation techniques. Regardless of what you call killing a person's brain, it should be seen as slowly killing a person. While I commend President Obama's wish to close down Guantanamo, I wonder what will become of these damaged people? Are they not some mother's children? We still talk, justifiably, about the cruelty to humans during the Holocaust. Can we look at ourselves in the world's mirrors and see ourselves differently than Hitler's goons? So we didn't make lampshades from human skin...we have stolen mental and physical health, and likely made some prisoners the equivalent of human vegetables.

How is it that Americans can severely punish cruelty to animals and not be outraged at what was done to our 'terrorist' prisoners who never even had a trial to find them guilty? I am not a bleeding heart liberal and am not under the illusion that most of the detainees were really innocent as altar boys. To his shame, Pat Buchanan recently said on MSNBC that all criminals put to death in Texas while Bush was governor were guilty because they had been adjudicated so. Later evidence found this was not always the case and that some innocents were put to death. The future has yet to reveal the atrocities the USA committed with the torture program, but history will have the full picture because people will put the picture puzzle pieces of it together as a record of the Bush-Cheney dictatorship.

PTSD: POST TRAUMATIC STRESS DISORDER

PTSD (Post-Traumatic Stress Disorder) is defined by NIMH (National Institute for Mental Health) as: An anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat.

Medline writes: "Posttraumatic stress disorder (PTSD) is a highly disabling condition that is associated with intrusive recollections of a traumatic event, hyperarousal, avoidance of clues associated with the trauma, and psychological numbing. The field of neuroimaging has made tremendous advances in the past decade and has contributed greatly to our understanding of the physiology of fear and the pathophysiology of PTSD. Neuroimaging studies have demonstrated significant neurobiologic changes in PTSD. There appear to be 3 areas of the brain that are different in patients with PTSD compared with those in control subjects: the hippocampus, the amygdala, and the medial frontal cortex. The amygdala appears to be hyperreactive to trauma-related stimuli. The hallmark symptoms of PTSD, including exaggerated startle response and flashbacks, may be related to a failure of higher brain regions (i.e., the hippocampus and the medial frontal cortex) to dampen the exaggerated symptoms of arousal and distress that are mediated through the amygdala in response to reminders of the traumatic event. The findings of structural and functional neuroimaging studies of PTSD are reviewed as they relate to our current understanding of the pathophysiology of this disorder."

Having seen PTSD patients clinically, it has struck me that people are being treated much as a 'one size fits all'. Admittedly, I may not current with all the therapies being used but I have not heard that all patients are given brain imaging to find the extent of their brain changes through time. Nor am I aware that treatment programs are different as relates to the extent of those brain changes. It makes me question whether a Korean War or Viet Nam War veteran will have more brain change than a more recent veteran of Iraq, for example. Obviously there are physical and chemical brain changes that stress imposes on one's body. Stress hormones wreak their own havoc. The length of time they work on a brain and body must influence the degree of damage which is evidenced both physically and psychologically. Working with someone who has suffered the trauma many years ago is impressive in that logic plays little importance in the thought content of their view of the world and relationships around them. Assuming the singular, trauma, is even accurate. What about those individuals who suffered repeated traumas, many of different kinds of assaults, for years?

Much effort is being put into researching PTSD, especially since it is now being recognized in troops returning from the Middle East. We must not forget that years of incest or domestic physical or emotional abuse can produce all the same symptoms. It is a concern of mine that research is not focusing (at least that I am aware of) on the difference in treatment responses in those who are fairly new to PTSD versus those for whom it has been part of most their lives and resulted brain change. In treating patients, I have often seen that they cannot retain images or explanations that are different than those they have held for years. Their seriously damaged self-images, wounded egos and sense of worth, their feeling responsible for all that befell them, their total acceptance that nothing can change how feel, is all encompassing. Medication, psychotherapy, cognitive behavior therapy, patience, and new and positive life experiences are only part of the some of the treatments.

If I were given a single wish, it might be to see that PTSD research address the differences in PTSD patients...the length of suffering post-trauma, the nature of the trauma and its being taken as a reflection of some fault of the patient, the brain and hormonal changes, levels of neurotransmitters, memory loss (as well as repression and denial), coping mechanisms, and so much more. I would want to know if there are differences reflected by gender difference since chemistry is such a variable between them.

In a perfect world, some of these questions would be answered. But, alas, the world is not yet perfect.

MATURITY: MAKING ALL PARTS OF SELF CONGRUENT

If a child's world is laden with violence, both witnessed and directly experienced; if there is inadequate nutrition and emotional nurturing; if the child's world is totally unpredictable as are the people in it; if the child is unable to read social and facial cues (eg. Asperger's, schizophrenia, and other conditions); if the child has never had to face frustration tolerance or amuse itself; if a child is never taught to take care of any of its own needs; if the child has witnessed murder of a parent or other extraordinary trauma, to name only a few factors, their mental, social and emotional development will be compromised.

Treating adults becomes complicated. If it is truly PTSD that keeps an adult unable to control feelings and behavior, brain changes have occurred that prevent the normal talk therapy, insight oriented or cognitive-behavioral, from being effective easily, if at all. Otherwise, trying to help a patient make their child-part (not really understood as it happened) and adult-part (now seen through more mature eyes, hopefully) merge, the goal of whatever therapy is used.

However, when the child and the adult stay as two separate entities with no hope of joining, the mental and emotional tug-of-war the person experiences is painful to them as well as others forced, helplessly, to view it. It is truly like talking to two people in the same body. Even knowing what is best, this person gives in to that which is tempting and easy to do, while denying consequences, only to be hit with excruciating guilt and disappointment to self while feeding their injured ego with more loss of self-esteem.

Longing and desire become obsessional. Getting the voices and directives out of one's head is difficult, if not impossible. Many who experience this want to run from it, mistakenly assuming the triggers are outside self. Obsessiveness follows you wherever you go because, like so many other things, it lives in your head.

Many people continue to assume that just telling people what they should do or say is enough. If they don't follow that 'good' advice, forget them. Life just is not that simple, nor are people, least of all people who have been compromised by not having the good luck to be genetically strong, raised with love and nurture, and exposed to those things that precipitate growth instead of, simply, pain.

If only more people could understand condition and respond with empathy and patience, how much better our human world would be. Many people seem to care more for animals than humans because they feel an unconditional love from their pets. All animals are not as loving to humans. Even animals who have been rescued from traumatic lives often can not be rehabilitated to give up their fears and unacceptable behaviors.

Another side effect of this war is that we are going to see a generation of traumatized children from the middle East who will have hardened their emotions with denial and projected hate to the supposed perpetrators of their misery. We will have hundreds of service people return with PTSD (post traumatic stress disorder) unable to sleep without recurring nightmares and fearful of life as they no longer know it. One can only sadly wonder how many people cannot easily be fixed by therapy, prayer, or 'good advice'.