1. The Warrior’s Journey The Ordeal

2. War involves a wide range of violent and traumatic experiences  Immediate threat of death, physical injury or disfigurement,  Witnessing injury and severe pain and distress and/or death of others (including significant others: buddies)  Involvement in injuring or killing others (both combatants and civilians)

3. It may also involve  witnessing or participating in atrocities  undergoing rape  capture or confinement, torture  extreme physical deprivation. And support as well as combat personnel are affected

4. Modern Warfare  High-tech weaponry; diminished personal dimension of individual combat between warriors  Taught to kill, not just overcome (warrior standards: touch the enemy; take his weapon; take his horse; bring everyone back safely)  Not a rite of passage, nor attainment of the social definition of a role as those who protect and guard the community (incursion into hunting and camping grounds)

5. Guerilla war; insurgency--no uniforms the in-war community is involved and also directly in harm’s way Surprise: things are not as prior experience indicates—unable to trust one’s own senses Commanders are distant rather than in the battles--high-tech communications Multiple deployments Ability to communicate with home

6. Complex Trauma serial exposure to a wide variety of traumatic events trauma memory encoded, facts/details taken in, and at the same time the feelings and physical sensations are encoded the tiniest event can be so charged with intensity so overwhelming that it literally reprograms the central nervous system.

7. What happens in the mind/brain/body? Flight, Fight, Freeze body-based HPA Axis: Brakes and accelerator functions are coordinated and balanced neural integration: the linkage of anatomically or functionally differentiated neural regions in the brain into interconnections with body and brain Neural systems are changed by experience, repetition (plasticity)

8. The brain is plastic and self-renewing, capable of rewiring itself in response to changing circumstances

9. The cerebral cortex is the outer covering of the brain, where neurons are located. The hippocampus is the long, sausage-shaped organ present on both the left and right sides of the brain. At the head of the hippocampus sits the amyglala. The thalamus acts as a gateway from the outside world into the brain, and the hypothalamus regulates bodily changes like heart rate and temperature. The cingulate gyrus sits just over the corpus callosum, which connects the left and right sides of the brain. The frontal cortex, especially the medial prefrontal and orbitofrontal cortex, plays a critical role in the regulation of emotion

10. Functional areas of the brain are connected by neural pathways –areas deep in the brain, such as the amydgala, are responsible for appraisal of sensory information alert us to danger based on instinct, learning history (training), and emotional memory. –Rapid survival decisions are made here in miliseconds with a minimum of information. –Appraisals can be applied inappropriately without being based on external realities

11. The more highly evolved cortex is responsible for reasoning, planning and self-conscious awareness Processes information from the lower parts of the brain context is added inhibition of the amygdala self-soothing and self-regulation: the balanced and integrated flow of energy and information through the brain originates here Daniel Siegel, The Mindful Brain

12. Middle Prefrontal Functions Bodily Regulation Attuned Communication Emotional Balance Response Flexibility Empathy Insight (Self-knowing Awareness) Fear Modulation Intuition Morality Daniel Siegel, The Mindful Brain

13. Disconnect from Inner experience – Inexpressible overwhelming uncontrollable crazy shameful (weak) terrifying Alien painful Incomprehensible Kathy Steele, MS

14. OVERWHELMED with inner experience Shut Down of emotion, disconnect from sensations, thoughts numbing dysregulation drugs/alcohol disconnect from the rest of the body isolation

15. Relieved of Duty

16. REFERENCES War and The Soul, Edward Tick Achilles in Vietnam, Jonathan Shay On Killing, Dave Grossman Principles of Trauma Therapy, John Briere and Catherine Scott www.johnbriere.com Traumatic Stress, van der Kolk, McFarlane, and Weisaeth The Mindful Brain, Daniel Siegel One Veteran Speaks, Robert A. Cagle (special order)