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  • Carlos,

  • the Vietnam vet Marine

  • who volunteered for three tours and got shot up in every one.

  • In 1971, he was medically retired

  • because he had so much shrapnel in his body

  • that he was setting off metal detectors.

  • For the next 42 years, he suffered from nightmares,

  • extreme anxiety in public,

  • isolation, depression.

  • He self-medicated with alcohol.

  • He was married and divorced three times.

  • Carlos had post-traumatic stress disorder.

  • Now, I became a psychologist to help mitigate human suffering,

  • and for the past 10 years, my target has been the suffering caused by PTSD,

  • as experienced by veterans like Carlos.

  • Until recently, the science of PTSD just wasn't there.

  • And so, we didn't know what to do.

  • We put some veterans on heavy drugs.

  • Others we hospitalized and gave generic group therapy,

  • and others still we simply said to them,

  • "Just go home and try to forget about your experiences."

  • More recently, we've tried therapy dogs, wilderness retreats --

  • many things which may temporarily relieve stress,

  • but which don't actually eliminate PTSD symptoms over the long term.

  • But things have changed.

  • And I am here to tell you that we can now eliminate PTSD,

  • not just manage the symptoms,

  • and in huge numbers of veterans.

  • Because new scientific research has been able to show,

  • objectively, repeatedly,

  • which treatments actually get rid of symptoms and which do not.

  • Now as it turns out,

  • the best treatments for PTSD use many of the very same training principles

  • that the military uses in preparing its trainees for war.

  • Now, making war --

  • this is something that we are good at.

  • We humans have been making war since before we were even fully human.

  • And since then, we have gone from using stone and sinew

  • to developing the most sophisticated and devastating weapon systems imaginable.

  • And to enable our warriors to use these weapons,

  • we employ the most cutting-edge training methods.

  • We are good at making war.

  • And we are good at training our warriors to fight.

  • Yet, when we consider the experience of the modern-day combat veteran,

  • we begin to see that we have not been as good

  • at preparing them to come home.

  • Why is that?

  • Well, our ancestors lived immersed in conflict,

  • and they fought right where they lived.

  • So until only very recently in our evolutionary history,

  • there was hardly a need to learn how to come home from war,

  • because we never really did.

  • But thankfully, today,

  • most of humanity lives in far more peaceful societies,

  • and when there is conflict, we, especially in the United States,

  • now have the technology to put our warriors through advanced training,

  • drop them in to fight anywhere on the globe

  • and when they're done,

  • jet them back to peacetime suburbia.

  • But just imagine for a moment what this must feel like.

  • I've spoken with veterans who've told me

  • that one day they're in a brutal firefight in Afghanistan

  • where they saw carnage and death,

  • and just three days later, they found themselves

  • toting an ice chest to their kid's soccer game.

  • "Mindfuck" is the most common term.

  • (Laughter)

  • It's the most common term I've heard to describe that experience.

  • And that's exactly what that is.

  • Because while our warriors spend countless hours training for war,

  • we've only recently come to understand

  • that many require training on how to return to civilian life.

  • Now, like any training, the best PTSD treatments require repetition.

  • In the military,

  • we don't simply hand trainees Mark-19 automatic grenade launchers

  • and say, "Here's the trigger, here's some ammo and good luck."

  • No. We train them, on the range and in specific contexts,

  • over and over and over

  • until lifting their weapon and engaging their target

  • is so engrained into muscle memory

  • that it can be performed without even thinking,

  • even under the most stressful conditions you can imagine.

  • Now, the same holds for training-based treatments.

  • The first of these treatments is cognitive therapy,

  • and this is a kind of mental recalibration.

  • When veterans come home from war,

  • their way of mentally framing the world is calibrated

  • to an immensely more dangerous environment.

  • So when you try to overlay that mind frame onto a peacetime environment,

  • you get problems.

  • You begin drowning in worries about dangers that aren't present.

  • You begin not trusting family or friends.

  • Which is not to say there are no dangers in civilian life; there are.

  • It's just that the probability of encountering them

  • compared to combat

  • is astronomically lower.

  • So we never advise veterans to turn off caution completely.

  • We do train them, however, to adjust caution

  • according to where they are.

  • If you find yourself in a bad neighborhood,

  • you turn it up.

  • Out to dinner with family?

  • You turn it way down.

  • We train veterans to be fiercely rational,

  • to systematically gauge the actual statistical probability

  • of encountering, say, an IED here in peacetime America.

  • With enough practice, those recalibrations stick.

  • The next of these treatments is exposure therapy,

  • and this is a kind of field training,

  • and the fastest of the proven effective treatments out there.

  • You remember Carlos?

  • This was the treatment that he chose.

  • And so we started off by giving him exercises,

  • for him, challenging ones:

  • going to a grocery store,

  • going to a shopping mall, going to a restaurant,

  • sitting with his back to the door.

  • And, critically --

  • staying in these environments.

  • Now, at first he was very anxious.

  • He wanted to sit where he could scan the room,

  • where he could plan escape routes,

  • where he could get his hands on a makeshift weapon.

  • And he wanted to leave, but he didn't.

  • He remembered his training in the Marine Corps,

  • and he pushed through his discomfort.

  • And every time he did this, his anxiety ratcheted down a little bit,

  • and then a little bit more and then a little bit more,

  • until in the end,

  • he had effectively relearned how to sit in a public space

  • and just enjoy himself.

  • He also listened to recordings of his combat experiences,

  • over and over and over.

  • He listened until those memories no longer generated any anxiety.

  • He processed his memories so much

  • that his brain no longer needed to return to those experiences

  • in his sleep.

  • And when I spoke with him a year after treatment had finished,

  • he told me,

  • "Doc, this is the first time in 43 years

  • that I haven't had nightmares."

  • Now, this is different than erasing a memory.

  • Veterans will always remember their traumatic experiences,

  • but with enough practice,

  • those memories are no longer as raw or as painful as they once were.

  • They don't feel emotionally like they just happened yesterday,

  • and that is an immensely better place to be.

  • But it's often difficult.

  • And, like any training, it may not work for everybody.

  • And there are trust issues.

  • Sometimes I'm asked,

  • "If you haven't been there, Doc, how can you help me?"

  • Which is understandable.

  • But at the point of returning to civilian life,

  • you do not require somebody who's been there.

  • You don't require training for operations on the battlefield;

  • you require training on how to come home.

  • For the past 10 years of my work,

  • I have been exposed to detailed accounts

  • of the worst experiences that you can imagine,

  • daily.

  • And it hasn't always been easy.

  • There have been times where I have just felt my heart break

  • or that I've absorbed too much.

  • But these training-based treatments work so well,

  • that whatever this work takes out of me, it puts back even more,

  • because I see people get better.

  • I see people's lives transform.

  • Carlos can now enjoy outings with his grandchildren,

  • which is something he couldn't even do with his own children.

  • And what's amazing to me is that after 43 years of suffering,

  • it only took him 10 weeks of intense training to get his life back.

  • And when I spoke with him, he told me,

  • "I know that I can't get those years back.

  • But at least now, whatever days that I have left on this Earth,

  • I can live them in peace."

  • He also said, "I hope that these younger veterans don't wait

  • to get the help they need."

  • And that's my hope, too.

  • Because ...

  • this life is short,

  • and if you are fortunate enough to have survived war

  • or any kind of traumatic experience,

  • you owe it to yourself to live your life well.

  • And you shouldn't wait to get the training you need

  • to make that happen.

  • Now, the best way of ending human suffering caused by war

  • is to never go to war.

  • But we are just not there yet as a species.

  • Until we are,

  • the mental suffering that we create in our sons and in our daughters

  • when we send them off to fight

  • can be alleviated.

  • But we must ensure that the science, the energy level, the value

  • that we place on sending them off to war

  • is at the very least mirrored

  • in how well we prepare them to come back home to us.

  • This much, we owe them.

  • Thank you.

  • (Applause)

Carlos,

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B1 US TED training war ptsd carlos suffering

【TED】Hector Garcia: We train soldiers for war. Let's train them to come home, too (We train soldiers for war. Let's train them to come home, too | Hector Garcia)

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    yucyan posted on 2017/04/06
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