An Adaption from Clinicians Guide for Treating Stress After War
Submitted by Mulzim R. Fidai
CDR MAVA National
In order to help veteran combat war fighters understand their relationship between their combat experience and their increased feelings of irritability and anger, a discussion with the veterans need to take place as to why that anger might have been helpful for them to survive while in their combat zone.
Those feelings can be hard to turn off, after returning home (stateside). Key points include:
Increased irritability may be related to overall over-activation of the Amygdala: The amygdala is an almond shaped mass of nuclei located deep within the temporal lobe of the brain. It is a limbic system structured that is involved in many of our emotions and motivations, particularly those that are related to survival.
The amygdala is involved in the processing of emotions, such as fear, anger and pleasure. The amygdala is also responsible for determining what memories is stored and where and memories are stored in the brain.
It is thought that this determination is based on how huge an emotional response an event invokes. In combat it influences, the fight, flight or freeze response. The amygdala takes 26 years for it to be fully developed. Most combat veterans are way below that age while in combat.
Increasing overall levels of anxiety and fear, feelings of irritability and anger, may be related to successful adaptation to the war environment (i.e., adaptation to being constantly on guard for danger) can sometimes increase levels of anger.
Those who were in actual combat also may have grown accustomed to tapping into those angers to give themselves the motivation and energy needed to accomplish their missions; anger is an emotion that facilitates aggressive action, which is adaptive in a combat environment.
Veterans learned how to adapt to the war zone, where sudden bursts of anger enabled them to spring into action. Anger may have given them the energy to stay alive.
This is where help is needed, to help veterans stop or prevent this cycle by empathizing with their symptoms, letting them know that they alone are responsible for their actions, and helping them to develop tools to manage anger.
Veterans also need help in becoming aware of anger building up and see how feelings of irritation and anger can be harmful. This exploration them develops a basic understanding of what happens physically when you gets angry.
Healthy anger outlets should be explored, that are productive mentally and behaviorally. Further more, anger should be explored to determine whether it is positive or negative. It also important for veterans to understand that reducing their overall level of irritability and anger is one part of their overall readjustment following their deployment.
As they do all of the different exercises, and work in numerous ways to help their system adjust back in a safer environment, many changes will begin to take place. Among these are improvement in sleep, feeling more at generally safe environments, feeling less edgy, and feeling less irritability and anger overall.
What is anger?
You may begin introducing the topic of anger by asking the veterans what they think anger is. As they share their thoughts, you can list them on the. Beginning with these questions, gets veterans engaged and helps them to begin thinking about anger more flexibly:
Are there different kinds of anger? Can anger be controlled by thoughts?
Allow the veteran to share their thoughts. Veterans can generate their own list of words associated with anger and different types of anger, such as annoyance, frustration, disappointment, irritation, hurt and rage.
Add other words to their list as necessary to round out the concept of anger as energy that can come up with themselves. Introduce the concept of anger as energy motivated by an emotional attitude that can be focused for use in either harmful activity or for use in helpful, productive activity.
Veterans need to be reminded that they may be feeling extra irritation and edginess right now, and may need extra steps to take care of themselves. Although anger is a common and expected reaction, the impact of anger over time can be extremely damaging.
Discuss the physical ramifications of anger: The physiological changes that occur when one becomes angry. Provide a brief basic laymans description of what happens physically and chemically inside the body during anger, and explore the mental changes that take place.
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