This is the last post I’m doing on combat PTSD, at least for a while, and to write it I’ve been searching for answers to this crucial question. What are the treatments that actually work? It’s the same question that I spent years struggling with as I tried one therapy after another to help with depression. The military is experimenting with a great many alternatives to standard medication, including several also used for treating depression. I’m not at all surprised since this condition so commonly adds to the other problems of PTSD.

That leads me to ask your help in thinking about effective treatments. Some of you have PTSD as well as depression, whether through exposure to a single overwhelming event or a more prolonged experience living in a threatening, unsafe environment - and whether or not you’ve had a formal diagnosis. These experiences may not compare to the violence of combat and daily living with lethal threats all around, but the problems of treatment are similar. Imperfect as the parallel may be, I’d like to hear about what’s worked for you.

The whole question of treatment also raises the question of what its goal is - how far can it go in improving life? A recent comment by the blogger at Healing Combat Trauma has given me a new way to think about this. He points out that there’s a big difference between “healing” and “curing”.

As he sees it, curing is all about reversing the course of an illness by treating symptoms. He calls this looking for the “toggle switch” to turn them off. Healing is a process that restores a state of wellbeing, a “flourishing condition” - as the dictionary defines “health” - and takes much longer to achieve in a sustainable way. That distinction makes a lot of sense to me and brings out the fact that new approaches to PTSD in the military definitely look to curing rather than healing.

The military is experimenting with all sorts of alternative treatments. There are programs testing the effectiveness of Reiki or “touch healing,” spiritual ministry, yoga practice and Qi Gong - a form of controlled breathing, meditation and physical movement that is a mainstay of Chinese healthcare. These must sound far out to the conservative military, but, of course, they’re widely used in civilian life.

The one treatment that is well supported by rigorous trials is a form of cognitive therapy known as Prolonged Exposure. It consists of repeated telling of the story of traumatic events - exactly the ones the veteran wants to avoid - in order to defuse their impact and enable relaxed remembrance of the past. The result can be an ability by the veteran to talk calmly about memories that used to bring on terrifying nightmares. This form of exposure, combined with other cognitive therapy to change negative habits of thought, has worked well with such veterans as Warren, who told his story in the PBS series, This Emotional Life.