"New Normal" following PTSD and TBI

My experience running a Vet Center has proven time and again, that the  primary emotional problems confronting returning  veterans  are relating  to both post traumatic stress (PTSD)  and traumatic brain injury (TBI). Often the symptoms are experienced by the men and women who were near Improvised Explosive Devises (IED)  explosions  which in very mild cases  can cause similar  concussion injuries seen in boxers and footballers who been battered repeatedly. I'm speaking mostly to these milder head injuries here although some of these principles can apply to more severe trauma as well.  

Having worked in the field of trauma for more than 18 years and written my doctoral thesis on resiliency following trauma after  9/11.  I have found that a lot of progress lies in ones ability to accept his "new normal." A normal where the baseline is sometimes substantially lower than it was before their injury, but nonetheless is now a starting point from where progress can be made.  Apart from the symptoms of PTSD or TBI there are the co-morbidity or co-occurring issues like hyper-vigilence; and anger management that have received much public attention, as has substance abuse.  All of which are also very stressful and disconcerting to the Veterans with both PTSD and TBI and their families.  

Veterans are often angry at themselves and feel they have no "true" outlet for their pent up rage which often comes out in self destructive ways e.g.; substance abuse, reckless behavior, etc.  This impulsiveness is displaced and obviously misunderstood by their families and let alone themselves.  

Basically, you can get better, but you are no longer the same as you were before your injury. This this is tough to hear, it is the truth though and that will free you from some of your suffering and the need to go it alone.  One plus one doesn't quite always equal 2 anymore.  Those once simple tasks are now herculean efforts, tying your shoes, to making change for a taxi. Instead of getting angry at yourself for this, accept it as a new baseline and with a therapist get help to better understand where you are at today compared to where you once were and move toward acceptance.  

TBI differs in that it is primarily a physiological disorder, with genuine cognitive impairment that is measurable.  Although it presents often in very similar ways as PTSD, it is best treated early by a neurological psychologist or someone specializing in working with TBI in conjunction with neuro- psychological testing to measure the degree of damage.  

There is no cure for either of these conditions as yet, but with counseling we can teach veterans how to control their reactions to known triggers. Education, normalization, humanization, self-forgiveness, and coming to and understanding of a new normal are essentials to treating Veterans with and helping them move on to far more productive lives.

For more information or a consultation feel free to contact me at DrKevinOBrien@me.com  or visit my webpage DrKevinOBrien.com

All the Best,
Dr Kevin