Posttraumatic Stress Disorder (PTSD) helped by cultivating compassion.
By Dr Stan Steindl
Joe (not his real name) sits with me in my office, wringing his hands as his legs twitch. His experiences as a soldier in Afganistan have been the topic of our conversation. Despite a growing amount of time since his return to Australia following this deployment, he continues to be troubled by thoughts, memories and flashbacks of road side explosions, hunkering down among the rocks and dirt of the desert, and injured children caught in the cross fire. Right now, he’s feeling pretty angry.
Posttraumatic stress disorder (PTSD) is a common disorder that develops following trauma, especially trauma in which the person feels fear, helplessness and horror. It has far reaching implications for the individual, and also for the community. Apart from the many symptoms of re-experiencing the symptoms through flashbacks, symptoms of avoidance and emotional numbing, and symptoms of hyperarousal, fear and anger, a central problem of PTSD is the severe self-criticism, self-loathing, guilt and shame that is often associated.
While psychological therapies such as cognitive-behavioural therapy have been found to be effective in the treatment of PTSD, there is a growing interest in helping veterans further through programs aimed at cultivating compassion, and also self-compassion.
I invite Joe to close his eyes. “Think of someone in your life you care about. Develop a picture of that person in your mind. Feel the presence of that person in your life, in this room.” Joe sighs, shifts his body in the chair, and then settles. “Now consider and say to yourself, that person is just like me. And just like me, this person’s had ups and downs in his or her life. Just like me, this person’s had goals and dreams.”
We go on to explore other people in Joe’s life, people he knows, people he doesn’t know, people in other places in the world, and eventually all sentient beings. And eventually, we come to a place of compassion also for himself.
Compassion is very difficult for Joe. In combat, and throughout his training, he learned to think of everyone as a potential threat. Fear and distrust were essential for survival and you can’t allow yourself to see the enemy as a human being “just like me”. But with PTSD, things stay that way, even after combat is over. The veteran with PTSD finds it so difficult to relate to people as just people, let alone to relate to themselves with acceptance and forgiveness.
Compassion meditation, such as the one Joe and I practiced, is about getting that ability back, learning to see oneself in others, and learning to accept and forgive oneself as well. And results are encouraging. Compassion and self-compassion can be learned and practiced through meditation techniques (Jazaieri et al., 2012) and such approaches can help to reduce anxiety and stress (Berger et al., 2012).
About 15 minutes later the meditation comes to an end. Joe opens his eyes, rubs them a little and stretches his arms and shoulders. He gives me a wry smile. “Never thought I’d be a hippy,” he says, “But I know what you’re saying. I feel more relaxed. It’s good to just let go of the anger.”
Berger, R., Gelkopf, M., & Heineberg, Y. (2012). A teacher-delivered intervention for adolescents exposed to ongoing and intense traumatic war-related stress: A quasi-randomized controlled study. Journal of Adolescent Health, 51, 453–461
Jazaieri, H., Jinpa, G., McGonigal, K., Rosenberg, E., Finkelstein, J., Simon-Thomas, E., Cullen, M., Doty, J., Gross, J., & Goldin, P. (2012). Enhancing compassion: A randomized controlled trial of a Compassion Cultivation Training program. Journal of Happiness Studies. doi: 10.1007/s10902-012-9373-z