When it Comes to PTSD in the Military, Sexual Trauma Can Cause as Much Damage as Combat
@ Kim Dennis, M.D., Timberline Knolls Residential Treatment Center
February 1, 2011
Post-traumatic stress disorder, or PTSD, continues to inflict a mental and physical toll on America’s soldiers, leaving physical, emotional and spiritual scars long after these veterans have left their posts in Iraq and Afghanistan. Additionally, for female soldiers, sexual assault and rape can create similar and many times more treatment-resistant symptoms of PTSD.
It has been well-documented in research literature that women are already twice as likely to develop PTSD as men following a trauma. But in the military, women have to deal with increased rates of sexual harassment and assault. Recent studies show that even without exposure to combat, our female troops could have increased rates of developing PTSD following rape or sexual assault than they could after combat exposure.
Sexual assault in the military has been a serious problem throughout history. Among those seeking VA disability following the first Persian Gulf War, 71 percent of women reported sexual assault during their military service. At present time for women in the military, 21.5 percent suffer some kind of sexual harassment or assault while serving, while among men the numbers are closer to 1.1 percent.
At this year’s National Eating Disorders Association (NEDA) Conference, I presented on this topic and how trauma affects the brain’s ability to function. Sexual trauma can be particularly damaging, especially if it occurs in infancy or early childhood. Trauma exposure in predisposed children and adults can lead to psychological reactivity, exaggerated startle response, symptoms of avoidance and numbing, and co-morbid mood, substance abuse and/or eating disorders. Post traumatic stress disorder can have devastating effects on all areas of a sufferer’s life. I witness this daily in the girls and women at Timberline Knolls.
The issues faced by those with PTSD can be manifold, including symptoms directly related to PTSD and also symptoms related to other illnesses that frequently co-occur with PTSD (substance abuse/ dependence, depression, eating disorders, compulsive self-injury and other addictive behaviors). PTSD symptoms are generally broken into 3 categories: re-experiencing of the traumatic event (for example, flashbacks, nightmares and/or body memories), hyperarousal symptoms (such as hyper vigilance, sensitivity to loud noises and heightened sense of anxiety), and avoidance symptoms (emotional numbing, dissociation and avoiding anything that reminds the person of the trauma—including human relationships!).
A Veterans Health Administration (VHA) outpatient survey discovered that 55 percent of servicewomen reported sexual harassment and 23 percent reported sexual assault. A recent study of reservists found that 60 percent of female soldiers had been sexually harassed and 13.1 percent sexually assaulted.
Even though the numbers are staggering for our service women, there is hope. PTSD can be effectively treated with trauma informed interventions. By integrating mental health, addiction, eating disorder and trauma treatment approaches into counseling, greater improvements can be yielded than by just providing basic psychological treatments or several core therapies separately. People with PTSD struggle with a sense of disintegration and many times profound brokenness. Treatment programs that use trauma-informed approaches in a unified way are particularly healing to the patients who suffer from PTSD. Individual, group and family therapies are very helpful for people with PTSD. These all offer education about the illness, normalization of the patient’s experience and specific ways to recover. Treatment programs that have the capacity to treat co-occurring depressive disorders, substance abuse disorders and eating disorders offer the most effective treatment and lead to the best long-term outcomes. Those that facilitate engagement in the 12 step recovery (especially SIA or ISA for those with histories of incest) give their patients the extra benefit of being able to continue their recoveries with 12 step groups in their home communities. Recovery is possible, even for the multiply-addicted survivors of trauma.
Limited access to care for our soldiers and civilians alike with PTSD continues to be a major obstacle to recovery. A 2007 congressionally mandated task force found the existing Department of Defense mental health system to be overburdened, understaffed and under-resourced. Additionally, stigma deters many soldiers from accessing what little mental health care is available. Fewer than 40 percent of those members of the military who meet strict diagnostic criteria receive the mental health services they need. If we as Americans really want to “support our troops,” we must provide them with easier access to high-quality, trauma-informed treatment that works for the duration of time they need it.
Kimberly Dennis, MD, is the medical director at Timberline Knolls Residential Treatment Center. Located in Lemont, Ill., TK is designed exclusively for women and adolescent girls with emotional disorders, including eating disorders, addiction, mood disorders and other co-occurring disorders. Dr. Dennis is a member of the Academy of Eating Disorders, the American Academy of Addiction Psychiatry, and the American Society of Addiction Medicine.
