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DrPsychologist, Doctor
Category: Mental Health
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Experience:  I am a licensed psychologist with over 10 years of psychotherapy experience.
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I am the Program Chaplain at Hiway 80 Rescue Ministries in

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I am the Program Chaplain at Hiway 80 Rescue Ministries in Longview Texas and have a man in our recovery program who is having some serious problems that I am not really equipped to help with. I have included below my case notes on his last revelation to me below. Please suggest anything that I may help this man with.

In counseling with Michael he has shared with me some real root problems, which to him are unshakeable. Some ten years ago he was guiding his platoon of about 23 men through Afghanistan when they entered an ambush of about 100 insurgents, which cost them over 2/3rds of their platoon. Michael feels personally responsible for their deaths, and has the same graphic dream of the attack every night. The only difference with his dream and reality is that in his dream, when it is all over his dead friends and brothers laying there in the sand all, one by one, begin to get up and pick up their weapons and then turn them on him and begin to fire at which point he wakes up.

Michael understands that there is no way he could have prevented this from happening in his conscious mind, but his sub conscious will not let go of it. I believe that this is a possible root for the "super Christian" behavior which we have seen in the past. He may believe that he has been forgiven by god but still has not forgiven himself, and unknowingly is trying to pay a penance of sorts with his Christianity. He is now becoming wore out from lack of sleep and keeping this front up. He is having the same dream every night and is terrified of going to sleep. Depression is starting to set in and he is starting to seek meds from doctors again.

Because he has not become an embarrassment to them he has been written off by the VA and he has been away from MHMR too long he is on a twe year waiting list. He intends to contact his parents for help through their contacts in Dallas for some meds just to sleep.

Please give some counseling advice.

DrPsychologist :

Hello. Thank you for reaching out on behalf of your client. It seems that Michael is suffering from the reexperiencing symptoms of Posttraumatic Stress Disorder (PTSD), which is actually a physiological response to trauma. He might also be having traumatic images pop up during waking life, he may find that he is startled more easily by loud noises than he used to be (hypervigilence) and you did indicate that he is dipping into some depression (restricted range of affect - a symptom of emotional numbing). My advice is that you refer Michael for twice a week therapy or a day program that specializes in trauma. Medication alone will not "cure" these symptoms.

DrPsychologist :

Here are some links with information about PTSD and resources in your area.

DrPsychologist :

Sleep disturbance, feelings of guilt and shame (esp survivor's guilt) are very common. The best thing for Michael would be to attend individual and group therapy at the VA. The VA is very well equipped to treat combat-related PTSD and being in a group with other veterans might be useful for Michael as they might actually not be nearly as rejecting if at all as he is towards himself.

DrPsychologist :

My recommendation: Call your local VA with Michael in the room and have him set up an appt with a psychologist or psychiatrist specializing in trauma.

DrPsychologist :

If he absolutely refuses, then reach out to other clinicians - again with him in the room and with him describing his symptoms (as much or as little as he feels comfortable disclosing in front of you) and making the appointment. Be on the lookout for suicidal thoughts. Although they may not be present, Michael's anger turned inward and feelings of guilt may lead to feelings of hopelessness at times.

DrPsychologist :

Above all, remember that there are professionals in mental health who can and will help and that you do not need to do this on your own, and neither does Michael.

DrPsychologist :

Please let me know if I might be of further assistance.

DrPsychologist :

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