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Women in combat do serve in different support areas in which they may leave military bases, perform other roles alongside combat soldiers, face direct fire, and may become war casualties. They may be military medics, police, pilots, intelligence, mechanics, and other positions. Women in the military may be subjected to combat experiences, which expose them to greater risks of developing post-traumatic stress disorder (PTSD) and other mental health challenges (Possemato, McKenzie, McDevitt-Murphy, Williams, & Ouimette, 2014). Relative to the general population of women, enlisted women are more likely to be screened positive for PTSD and other mental disorders following their combat experiences. Majorities of women in combat may report injuries, assaults, wounds, or hurt in combat zones. Such traumatic combat experiences usually affect mental health and, therefore, normal integration into society.
Summary of the Main Points
Combat trauma exposure was generally associated with PTSD post-deployment. Possemato et al. (2014) sought to determine other factors that were responsible for severe PTSD following warzone exposure. The study involved pre-deployment, peri-deployment, and post-deployment factors that could predict severe PTSD independent of warzone trauma in a sample of veterans. Possemato et al. (2014) noted that the deployment work condition, post-deployment support, alcoholism, and stressors were direct contributors to severe cases of PTSD when other variables, such as combat trauma, length of deployment, and socio-demographic factors were controlled because they were known to correlate with severe PTSD. These results were based on the theory of Conservation of Resource (COR), which is widely used to determine deployment risk factors among war veterans.
This theory posits that traumatic stress is identified through an abrupt loss of resources, and it could cause enhanced vulnerability to later stressors. Resources are rapidly depleted because they are consumed at a high rate during deployment. Staff are expected to offer assistance to others using both mental and physical capabilities. At the same time, persons who are expected to offer support also experience elevated psychological distress. The theory shows how other non-traumatic stressing factors could contribute to the development and severity of PTSD through resource consumption, leaving people more exposed and susceptible to traumatic stress reactions. Overall, Possemato et al. (2014) concluded that negative mental health outcomes, including PTSD, after war exposure increased in severity due to alcohol use, joblessness, lack of social support, and non-traumatic stressful life events.
Cognitive Processing Therapy (CPT) is used as the gold standard for managing PTSD (Castillo, Lacefield, Baca, Blankenship, & Qualls, 2014). CPT is generally recommended as the first line of treatment and widely adopted by PTSD therapists attending to veterans. It relies on a manual cognitive behavioral intervention based on the emotional processing theory. The emotional processing theory shows that PTSD occurs because of a breakdown in the natural process of recovery following traumatic event experiences. CPT strives to access and transform changed mental structures, instead of directly addressing emotional processes used in the Prolonged Exposure Therapy (Castillo et al., 2014). In their study, Castillo et al. (2014) examined the use of the group delivery cognitive therapy and found out that it was an effective, efficient, time-restricted intervention for PTSD.
Discussion and Implications
PTSD has impacts on the body and activities of the somatic memory. That is, individuals who have been exposed to traumatic events bear implicit memories in their bodies and brains (Rothschild, 2000). Such individuals express their memories through symptomatology of PSTD nightmares, alarmed reactions, hallucinations, and dissociative behaviors and, therefore, treatments should account for both the body and the mind (Rothschild, 2000). Among war veterans who may experience extreme severity of torture, PTSD could escalate the experience of a tortured body. In this case, PTSD acts as an implicit memory of the past traumatic events, which is displayed in the reoccurring somatic episodes that reflect the traumatic memory (Rothschild, 2000). Rothschild (2000) refers to these somatic experiences of PTSD as a somatic memory of trauma. Thus, treatments should strive to address the source of clients’ symptoms and include the needs of the body into the therapy, ultimately to achieve the mind-body integration during interventions.
Perry and Szalavitz (2006) show that early life violence and stress negatively affect brain development. Consequently, traumatic experiences shatter the connection between the body and the mind, as well as enduring, caring relationships with others. In such instances, treatments should go beyond therapies and medication to include developing strong relationships with other people. Past losses occasioned by trauma ought to be counteracted, and the patient should be the center of therapeutic engagements, as therapies seek to re-mold the brain in safer environments.
Apart from Rothschild’s (2000) approach, Castillo et al. (2014) observe that group delivered CPT could provide positive outcomes for war veterans. In fact, past studies by Zappert and Westrup showed significant achievements among patients who suffered military sexual trauma (as cited in Castillo et al. 2014). Additionally, patients who got interventions had positive improvements in coping with their conditions, psychological distress, quality of life, and exhibited potential signs of recovery at discharge periods. These two approaches show various ways through which clinicians may approach therapies, but Rothschild advocates for the mind-body integration in these intervention strategies.
These studies present important findings for social workers when caring for individuals with PTSD, especially among veterans. Possemato et al. (2014) observed that exhausted resources and escalating demands often led to adoption of some maladaptive coping methods, including alcohol consumption, to cope with the PTSD symptoms and stress. Individuals may opt for self-medication to control PTSD symptoms. The use of substance further exposes patients to increased risks for trauma, hinders natural processes and resolution of distress through body mechanisms. Substance use enhances physiologic stimulation and escalates PTSD symptoms and, thus, the need to ensure a connection between the body and the mind (Rothschild, 2000). Post-deployment exposure assessment should account for hazardous alcohol (commencement of heavy drinking) and substance usages because they are linked with combat exposure, post-deployment stress-related factors, depression, anxiety, and PTSD.
For social work practitioners, clinicians, and clients, there is a significant value in comprehending PTSD psychophysiology and knowing how to handle various manifestations. Thus, understanding body-mind is imperative for successful therapies. These study results provide opportunities for clinicians treating PTSD among women in combat to include strategies that encourage family and social support, healthy consumption of alcohol, and effective management of stress.
This literature review shows that women in combat experience PTSD due to their experiences in warzones. PTSD severity may increase due to post-deployment experiences. Treatments should therefore strive to address both body and mind connections. More importantly, therapists and social workers should identify factors that increase severity and develop the most effective therapies.
Castillo, D. T., Lacefield, K., Baca, J. C., Blankenship, A., & Qualls, C. (2014). Effectiveness of group-delivered cognitive therapy and treatment length in women veterans with PTSD. Behavioral Science, 4, 31-41. Web.
Perry, B., & Szalavitz, M. (2006). The boy who was raised as a dog: And other stories from a child psychiatrist’s notebook. New York, NY: Basic Books.
Possemato, K., McKenzie, S., McDevitt-Murphy, M. E., Williams, J., & Ouimette, P. (2014). The relationship between post-deployment factors and PTSD severity in recent combat veterans. Military Psychology, 26(1), 15–22. Web.
Rothschild, B. (2000). The body remembers: The psychophysiology of trauma and trauma treatment. New York, NY: W. W. Norton Company, Inc.