All we can hope for is to provide positive conditions for PTSD management The most positive results have come from cognitive and mindfulness methods. However, they are compromised by intruding thoughts, hypervigilance and attention deficit Compound movements performed in relatively isolated (“protected”) environments, heavy enough to require complete recruitment of cortical (motor cortex) and non-cortical (extra-pyramidal) CNS resources may “short-circuit” the automatic trauma response. In other words, technique-oriented compound movement strength training may provide the necessary resources for trauma survivors to gain some control over their lives

1. z
Veterans space
A program for combat PTSD survivors, suicide
vulnerable population among veterans and otherwise
psychological trauma affected individuals
Marilia Coutinho, Ph.D.
August 2017

2. z
PTSD and suicide in numbers
 About 7 or 8 out of every 100 people (or 7-8% of the population) will have PTSD at some point in their lives.
 About 8 million adults have PTSD during a given year. This is only a small portion of those who have gone through a trauma.
 About 10 of every 100 women (or 10%) develop PTSD sometime in their lives compared with about 4 of every 100 men (or 4%).
 Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF): About 11-20 out of every 100 Veterans (or between 11-20%) who
served in OIF or OEF have PTSD in a given year.
 Gulf War (Desert Storm): About 12 out of every 100 Gulf War Veterans (or 12%) have PTSD in a given year.
 Vietnam War: About 15 out of every 100 Vietnam Veterans (or 15%) were currently diagnosed with PTSD at the time of the most recent
study in the late 1980s, the National Vietnam Veterans Readjustment Study (NVVRS). It is estimated that about 30 out of every 100 (or
30%) of Vietnam Veterans have had PTSD in their lifetime.
Among Veterans who use VA health care, about:
 23 out of 100 women (or 23%) reported sexual assault when in the military.
 55 out of 100 women (or 55%) and 38 out of 100 men (or 38%) have experienced sexual harassment when in the military.

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In other words
 For the same cohort (age group), male combat veterans are at
least 3 times as likely to develop PTSD as their counterpart in
the general population.
 Military women, on the other hand, are 6 times more likely to
develop PTSD as their counterpart in the general population
 Whereas male military personal is more vulnerable to PTSD and
suicide due to combat experience, female military personal is
more vulnerable to PTSD due to sexual assault

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What is PTSD and why are victims more
vulnerable to suicide, substance addiction
and poor general health
 The exact physiological causes of PTSD are still unclear and there is no
consensus in the medical literature concerning affected brain regions and
functions.
 We know that there are structural changes to important areas of the brain
that control functions such as stress response, memory, affection and also
cognitive function
 In a nutshell, PTSD is the result of an unknown set of structural changes in
the brain that occur as a consequence of trauma

7. z
PTSD, combat and suicide
 There is a positive correlation between combat PTSD diagnosis and poor
sleep and/or recurrent nightmares
 There is a positive correlation between combat PTSD diagnosis and suicide
rate increase for a given cohort
 Suicide seems to be correlated with disturbed sleep, although the results
are inconclusive
 Inability to control cognitive and emotional stress response is a diagnostic
criteria for PTSD

12. z
Criterion A (one required): The person was exposed to: death,
threatened death, actual or threatened serious injury, or actual or
threatened sexual violence, in the following way(s):
 Direct exposure
 Witnessing the trauma
 Learning that a relative or close friend was exposed to a trauma
 Indirect exposure to aversive details of the trauma, usually in the
course of professional duties (e.g., first responders, medics)

13. z
Criterion B (one required): The traumatic event is persistently re-
experienced, in the following way(s):
 Intrusive thoughts
 Nightmares
 Flashbacks
 Emotional distress after exposure to traumatic reminders
 Physical reactivity after exposure to traumatic reminders

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Criterion D (two required): Negative thoughts or feelings that began or
worsened after the trauma, in the following way(s):
 Inability to recall key features of the trauma
 Overly negative thoughts and assumptions about oneself or the world
 Exaggerated blame of self or others for causing the trauma
 Negative affect
 Decreased interest in activities
 Feeling isolated
 Difficulty experiencing positive affect

15. z
Criterion E (two required): Trauma-related arousal and reactivity that
began or worsened after the trauma, in the following way(s):
 Irritability or aggression
 Risky or destructive behavior
 Hypervigilance
 Heightened startle reaction
 Difficulty concentrating
 Difficulty sleeping

16. z
“Mindfulness” and behavioral treatments
 Certain treatments have shown positive results with PTSD patients
 Many of them involve mindfulness techniques. The available, standard,
mindfulness techniques involve relaxation methods
 However, going back to the DSM (5 or 6) criteria, one of the issues with
PTSD are intruding and obsessive thoughts. These create serious
problems while teaching and training relaxation methods

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Conclusions for a Veteran’s safe place
 All we can hope for is to provide positive conditions for PTSD management
 The most positive results have come from cognitive and mindfulness methods.
However, they are compromised by intruding thoughts, hypervigilance and
attention deficit
 Compound movements performed in relatively isolated (“protected”)
environments, heavy enough to require complete recruitment of cortical (motor
cortex) and non-cortical (extra-pyramidal) CNS resources may “short-circuit”
the automatic trauma response.
 In other words, technique-oriented compound movement strength training may
provide the necessary resources for trauma survivors to gain some control
over their lives

19. z
A small step…
 It definitely is a small step. However, we are dealing with a major
epidemical situation. Any small step is a step, especially
considering the affected population will not stop growing.
Trauma came to stay.
 That small step may be what that survivor needs to kick start his
recovery.