Therapy Born on the Battlefield May Help Ease Anyone’s PTSD

Selina Jackson, a veteran of the Army Reserves, has combat experience on and off the battlefield.

Jackson grew up in a place she calls a “combat zone” in upstate New York. She witnessed violent fights between her parents, which would often leave her mother unconscious. She saw her drug-addled, alcoholic father brutally beating her older sister. The teenage son of the best friends of her parents abused her sexually on numerous occasions. Her father destroyed their home.

She kept these life-threatening, often traumatic events hidden until the COVID-19 Pandemic struck, and she was stuck at home.

She said that she could not do what she usually did to keep herself entertained while working at home. “This was horrifying for me, because I thought, Oh my God, here I am, alone in my house, working. ‘”

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The symptoms of her PTSD became “overwhelming,” and she could not control them during the day. I still felt a great deal of shame and guilt. “I didn’t give a damn if I died or lived,” she said.

Jackson was diagnosed with Posttraumatic Stress Disorder, a mental illness that affects millions worldwide. It is twice as common in women as it is in men, and 13% of female young veterans are affected (compared to 6% for male veterans). Female Veterans also experience trauma and adverse childhoods prior to entering the military. These experiences are compounded further by high rates of sexual assault or sexual harassment while in military service.

These numbers do not paint the full picture. PTSD is not always diagnosed. Patients often ignore or try to hide symptoms such as guilt and shame, flashbacks, and other telltale signs. The symptoms of PTSD, such as depression or anxiety, are common among other psychiatric disorders. This can lead to misdiagnosis and incorrect treatment.

“For PTSD patients, the world shrinks. They avoid relationships, work and pleasure activities. Things that they used do.” said Tara Galovski, Ph.D. She is a psychology professor and director of the Women’s Health Sciences Division of Veteran Affairs National Center for PTSD.

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The memories come out in different forms, such as when people try to sleep but can’t because their thoughts are racing. They can affect concentration, irritability, and how PTSD patients see themselves and perceive the world.

Galovski warned that if these symptoms are not treated, they can become chronic, causing other types of health impairments, “in important ways in which we function.”

Striking Her Stride through STRIVE

Jackson, who is now 53 and lives in Ohio, attributes her recovery from PTSD to a program called STRIVE at the Ohio State University Wexner Medical Center.

She said, “I love myself right now.”

Craig J. Bryan is a clinical psychologist, professor, and retired Air Force Veteran. The program is based on research and aims to develop the best strategies to address trauma, gun violence, and suicide among adults, whether they are veterans or not. The program’s roots are in the strategies used to treat combat zone soldiers who suffered psychological trauma.

Bryan explained that the origins of massed therapy, a compressed format, stem from being deployed and downrange in a war zone. You do not get to come to therapy every week for an hour.

“Most cases I worked on were people with head injuries or vehicle rollovers. I had to decide quickly, within a couple of days, whether the person would be okay.

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Bryan’s treatment was tested on the battlefield before he brought it back to the U.S. to be given to the University of Utah and then Ohio State.

Cognitive processing therapy is the primary technique that STRIVE therapists use. The VA adopted the therapy 16 years ago, which was originally developed by University of Missouri Researchers as a treatment to help sexual assault victims.

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Galovski explained that the framework of “CPT” suggests that a traumatic experience has a significant impact on how people think and, for some, changes their beliefs as to why it happened. It also affects their beliefs about other people and the world.

Bryan says that “we use the term stuck points” a lot. This belief prevents us from using the natural, spontaneous recovery processes that help us to move on and recover after an event. “Stuck points” include sayings like “It’s all my fault.” or “I should have worn a different dress.”

Bryan explained that doctors use cognitive processing therapy to identify patterns in patients’ thinking and teach them how to look at their thoughts from a “balanced perspective.”

The therapy teaches patients to modify and challenge unhelpful beliefs, such as I was raped for wearing a short dress, and develop a more realistic view of the incident (such as, What else happened? Have you worn a skirt that was too short before? Do short skirts cause rape? ).

Bryan explained that “this more balanced thinking process will then alleviate anxiety, fear and guilt, as well as shame, shame and all the other effects of PTSD.”

Learn to Live Fully Again

The Ohio State program can be delivered in person or via telehealth over ten daily 1-hour sessions. The patients are expected to participate fully and complete the daily assignments.

STRIVE’s effectiveness is due to the fact that patients cannot cancel or skip sessions. Jackson stated that “the consistency of having to work at high levels every day was very prescriptive.”

Annabelle O. Bryan is the director of the STRIVE Program and a retired Air Force Veteran. She said that many patients begin to recover between the fourth session and the sixth, while others require the entire program, plus maybe an additional hour. She emphasizes, however, that patients will gain the most benefits if they continue to strengthen and practice what they have learned. STRIVE currently boasts a recovery rate of 76%, according to Craig Bryan. This is in line with studies that have shown that 70% to 80% of patients who complete cognitive-processing therapy experience a reduction and improvement of symptoms.

  • Annabelle Bryan says that relapses can occur six months after leaving the program. These flare-ups usually are a reminder of what happened rather than a full-blown PTSD episode.

Annabelle Bryan noted that 50% of patients recover fully after two years. We track their progress so that they can see it as it happens. This really helps with recovery.

STRIVE also offers “booster” sessions of one hour for those who require additional help. The program is also free. Participants help the organization with its research and receive quality therapy in exchange.

Jackson, with a fresh outlook on life and a plan to move upstate New York this spring, has decided to leave Ohio. She said that STRIVE has given her the chance to become a better human being for her and everyone in her life.

She said, “Rather than just surviving, I’ll finally be able live.”

Veterans, in particular, are encouraged to visit the National Center for PTSD for more information.

Learn more about STRIVE and your eligibility for the program.

You can get help 24 hours a day, seven days a week, by calling 988, the Suicide and Crisis Lifeline. Veterans and their families can call 988, press 1, and reach the Veterans Crisis Line or text 838255.

STRIVE provides help via a separate program – STRIVEBCBT – to service members, veterans, first responders without a history of military service, and family members experiencing suicidal thoughts and behaviors.


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