PTSD Therapies: Prolonged Exposure (PE)

- [Voiceover] My initial response to PE

after it was explained to me what it was was fear.

(laughs in disbelief) I can't believe you want me

to go through this again!

It's kind of like I had a closet.

I got a closet with a lock on there with emotions

that I'm really comfortable keepin' there.

And you dare to ask me to open that door.

I'm not prepared for what's gonna come out.

(sensitive music)

My experiences of Iraq had a severe impact

on how I dealt with the world when I returned.

It had a severe impact on how I interacted with my family

and (sighs) even trying to get work and sustaining work.

(melancholy music)

I acted out in ways that were not healthy.

I couldn't keep a job well.

My interactions were limited because I knew

I couldn't sustain relationships.

And I just got tired of wakin' up, sweating.

I got tired of being irritable with my wife and my children.

It was hard for me to engage with anyone that appeared

to be Middle Eastern.

My heart would palpitate.

Those feelings were hatred:

hatred, mistrust, just a lot of false thoughts.

Yeah, I looked at them as a insult to my country.

I looked at them as attackers.

(plaintive music)

I have parents.

My mother and father always taught me

that you should love everyone in accordance with the Bible.

So

for me to have this hatred and anger

for Middle Eastern people,

I didn't know what to do with that.

The only one I trusted really was my wife.

I would only go out with her.

And if we got separated,

I got sweaty palms, constant anxiety.

(tense music)

I felt horrible feeling that way.

It made me feel like my manhood was diminished.

I felt like my backbone was taken away.

I felt weak.

We live

in a hell if I could say it that way,

livin' in a hell that you're just not functioning at.

So I had to make a decision, which one you wanna live with,

takin' a chance on this PE and this treatment

and the medication or

continue hidin'.

It took a few weeks for me to make that decision.

But during that period of time, my life was fallin' apart.

(traffic sounds)

- [Voiceover] Coming to the VA to get help

was a bit difficult, because people who

never put on a uniform were treating me.

This was my mindset:

"What could you tell me that could help me,

"when you've never put on a uniform,

"never picked up a M16,

"I doubt, if I gave you a grenade, you would know

"how to pull the pin."

(somber keyboard music)

Going into the process, first I had to write out

what am I avoiding, what am I running from?

When I got to the part of my emotional feelings

towards Middle Easterners, I went through

at least two or three pencils, because of the anger.

I was breaking the lead, breaking the pencil,

going through the paper.

I was offended.

I was upset.

I don't even think I stayed this full session.

How could my core be damaged like this?

My whole center was disturbed off of a war.

After the first session, I canceled a couple appointments.

And assessing how difficult it is to live this way,

with a lot of prayer, and my wife's support,

and my pastor's support, I made up in my mind

that if I'm gonna do this, I'm gonna do it right.

And I'm gonna do it all the way.

Because I can't live like this.

- [Voiceover] Going through the trauma for the first time was

I'll just use the word tough,

but it's much, much more than that.

It was very hard because I could see it in color.

(somber music)

In my mind, I could almost

smell the sulfur.

I could smell the smoke.

I could see faces.

(somber music)

All I saw was what I was most angry about.

The heightened parts of my emotions.

As I kept going,

I started to see other details,

like what the person was wearing,

what emblem was on their uniform, facial expressions,

certain things that were more and more detail.

The doctor was very patient.

She was very understanding.

I can appreciate that.

(traffic noise)

Was it hard? Yes.

Was it difficult?

Unimaginably difficult.

(traffic noise)

In listening to the recordings,

I wrote down what I was feeling.

I didn't wanna keep anything in that closet

that was gonna haunt me later.

So I took as though it were a broom

and swept that stuff out and brought it on the table,

and I had to trust the expertise of this doctor

and this program to do what it said it was gonna do.

(somber music)

You're talking about your discomfort,

and you're putting a rating on it.

Your whole goal is to get those numbers for the zero or one.

In the beginning, my numbers were high.

(somber music)

The change, it came in Session Four.

I was going through the imaginal,

and I could see it.

And I felt

a diminished amount of anxiety.

I celebrated that because I wasn't a 95.

I was a 92.

It was a large relief because I was like,

"This is gonna work.

"I can trust this process."

- [Voiceover] The in vivo process is actually puttin'

yourself in an experience that you know is uncomfortable

and stayin' in it to the point of feelin' uncomfortable

without bailing out, so that you can be

less and less uncomfortable as you expose yourself

to that environment or that experience.

(tense music)

My in vivos I chose was goin' into a part of town

where I knew a substantial amount

of Middle Eastern people lived

and going into a restaurant,

at first just sitting there.

And I'd bring my own water

and my own drink or whatever, and I'd sit there.

And

I vowed from within myself, I'm gonna stay there

at least 45 minutes.

I'm not gonna leave.

(anxious music)

Within 15 minutes, (laughs)

my anxiety was high.

(fan whirs)

(portentous music)

I brought a hand towel with me, so that I can wipe my face.

I didn't wanna show everyone else that I was feelin' this.

I held my hands tight under the table,

so that

the fidgeting wouldn't be apparent.

This scar on my hand here

was from all of the anxiety I felt

'cause I would constantly rub it.

(clock ticks)

I got to 30 minutes, started slightly easin' up.

The first time, honestly, at 45 minutes, I got up and left.

(clock ticks)

It worked.

It did.

In vivo process worked for me.

It helped me rearrange my thought process

that got jumbled up.

My whole pattern in my life was messed up.

I had to put those boxes back

the way they were supposed to be.

For me to go in a Middle Eastern restaurant today,

I actually welcome it.

My core has been reestablished, I could say that.

My core was reestablished to where I was before

that I don't have any hatred in my heart.

I don't have any reason to hate.

It was very helpful.

(gentle electronic music)

- [Voiceover] Today I'm a minister at my church.

(gentle electronic music)

Society has its ills,

and there's no utopia,

but I am in a safe place.

(gentle electronic music)

Process of PE, and going through it, was painful.

It was staggering even,

and a lot of anxiety was raised,

but it was worth it,

because I don't feel that any more.

(gentle electronic music)

It doesn't erase my memory.

I feel it was designed to help me

put everything in its proper perspective.

My memory serves as something

I can pull out of a cubbyhole and share,

(gentle electronic music)

and then, when I'm done sharing it,

I put it back where it belongs,

(gentle electronic music)

and it stays there.

(gentle electronic music)

I don't get sweaty palms

going to a fireworks display,

and I see the world as a safe place.

(gentle electronic music)

As long as I'm able to keep things in their perspective,

to keep it where it needs to be,

it doesn't get in my way in front of me

for me to stumble over,

(gentle electronic music)

and I wouldn't tell anyone that it's easy,

but I will tell them that if you do it,

and you get help doing it,

you can get the help that you want,

you can get the healing that you want,

or at least be on the road to it.

(gentle electronic music)