The journey of a combat veteran is often laden with profound and complex challenges, both visible and deeply embedded within physical, psychological, emotional, and spiritual dimensions. Adaptive Disclosure Therapy (ADT) has emerged as a beacon of hope, offering a compassionate and effective path to healing approach used to address post-traumatic stress disorder (PTSD), moral injury and survivor’s guilt in veterans. Adaptive Disclosure Therapy is a specialized form of cognitive-behavioral therapy designed for military personnel, particularly combat veterans, who grapple with the aftermath of trauma. Grounded in empirical research and a deep understanding of the military experience, ADT combines elements of exposure therapy with a focus on emotional regulation, making it particularly well-suited for those who have faced the harrowing realities of war.
Adaptive disclosure therapy aims to update the neurobiology of the reticular activating system (RAS), amygdala, hippocampus, and the limbic system by addressing the traumatic memories and the associated hyperarousal and emotional dysregulation. By gradually exposing the individual to these memories and providing cognitive restructuring, this therapy helps reduce sympathetic dominance, ultimately leading to a calmer, more balanced neurobiological response to trauma triggers.
Understanding these terms and their neurobiological underpinnings can contribute to a more comprehensive appreciation of the experiences and challenges faced by combat veterans. It also underscores the importance of holistic, neurobiologically informed approaches in supporting their mental health and well-being. PTSD is a mental health condition that may develop after exposure to a traumatic event. It can manifest through symptoms such as intrusive memories, nightmares, heightened reactivity, and emotional numbness.
PTG refers to positive psychological changes that individuals may experience as a result of struggling with and surviving trauma. It involves personal strength, enhanced relationships, and a deeper appreciation for life.
TBI results from a sudden blow or jolt to the head causing damage to the brain. It can lead to a range of cognitive, physical, and emotional symptoms.
Moral injury occurs when an individual's moral or ethical beliefs are violated, leading to profound inner conflict, guilt, or shame. In a military context, it can result from morally challenging situations in combat.
Survivor's guilt is a feeling of guilt that arises when an individual perceives themselves to have survived a traumatic event while others did not. It's common in combat veterans who may have lost comrades. Understanding these terms and their neurobiological underpinnings can contribute to a more comprehensive appreciation of the experiences and challenges faced by combat veterans. It also underscores the importance of holistic, neurobiologically informed approaches in supporting their mental health and well-being.
A few integral components of neuroanatomy when treating trauma: The Reticular Activating System (RAS) is a complex network of neurons located in the brainstem that plays a crucial role in regulating wakefulness, alertness, and consciousness. It is responsible for filtering and prioritizing sensory information from the environment and internal stimuli, allowing the brain to focus on important information while ignoring less critical signals.
Arousal: The RAS is responsible for maintaining a state of wakefulness and alertness. It helps individuals stay awake and attentive during the day and also regulates the sleep-wake cycle.
Filtering Sensory Information: The RAS filters the vast amount of sensory information received by the brain, allowing only the most relevant and important stimuli to reach higher brain regions for further processing. This filtering mechanism is essential for preventing sensory overload.
Modulation of Consciousness: The RAS can influence the level of consciousness. When the RAS is more active, a person is awake and alert, while reduced activity can lead to drowsiness or even loss of consciousness, as in sleep.
Integration with Other Brain Regions: The RAS has extensive connections with various other parts of the brain, including the thalamus, hypothalamus, and cortex. These connections allow it to influence a wide range of functions, from sensory perception to motor control.
Response to Novelty: The RAS is sensitive to novel or unexpected stimuli. When something new or potentially important is detected, the RAS can increase alertness to help the individual pay attention to the new information.
Influence on Autonomic Functions: The RAS also has connections to the autonomic nervous system, which controls involuntary bodily functions such as heart rate, respiration, and blood pressure. It can modulate these functions in response to changing circumstances.
In conclusion, Adaptive Disclosure Therapy stands as a testament to the commitment to healing the wounds that combat veterans carry. By combining exposure therapy with a nuanced understanding of emotional regulation and cognitive restructuring, ADT offers a compassionate and effective path forward. The steps outlined above provide a framework for therapists and combat veterans alike to embark on a journey of healing that honors the complexity of their experiences and fosters adaptive resilience. In the realm of post-traumatic growth, Adaptive Disclosure Therapy shines as a guiding light for those who have bravely borne the burdens of combat.
