Successful PTSD EFT Session with 3-Tour Iraq Vet
In this transcript, one of the hundreds of wonderful volunteers from the Veterans Stress Project recounts the EFT work she did with an Iraq veteran who had developed PTSD after several deployments.
By Sue Hannibal
History: Army Sgt. age 27, 10 years in, male, three tours in Iraq - first tour 2003: 18 months, second tour 12 months, 2005-6, third tour 9 months, 2007-08 at which point he was MEDEVACed out for PTSD.
He was sent to Landstuhl Army Medical Center in Germany for one week, then to Ft. Bragg, N.C. At Bragg he was given various drugs including anti-psychotics and anti-depressants, none of which helped. He’s not on any drugs at this date.
He went to Army therapy for a year, most of which he described as "visualize about what happened and put a positive ending on it," which didn’t help. Symptoms he described: nightmares, flashbacks of three or four specific scenes, chronic insomnia, irritable/angry, anxiety/can't relax, hypervigilant, avoids crowds. At this date he is non-deployable and is on medical board list to be separated from the Army due to PTSD. He wants to heal and might stay in the Army.
Joshua was referred by an Army doctor at Ft. Bragg. Two standard PTSD scales were administered prior to our first 90-minute session on Tues. Jan 27th. PCL-M score 54, SA-45 score 99. The day after our session, Wednesday morning, he reported to the doctor and to me that he slept all night Tuesday without awakening and free of nightmares for the first time in over one year.
He came back for session two, three days later, on Friday. The first session was videotaped but there was a problem with the microphone, so an edited transcript is below. In the second session, we only did one round of tapping on a perception of never feeling safe in Iraq, but all other issues were already a zero.
During treatment we addressed, in an indirect, non-retraumatizing way using the EFT Movie Technique, the worst memory of his entire time in Iraq, which occurred during the first tour - an ambush and fierce firefight where three soldiers were killed by RPGs in an unarmored humvee. His affect was nervous, subdued voice, shoulders forward, eyes down, fighting back tears and couldn't maintain eye contact with me. There was no flooding.
His job was convoy security which was once a day seven days a week. He estimated the convoy was attacked four or five times per week, ranging from a spray of AK-47 bullets by an insurgent to IEDs (roadside bombs) to RPGs, (rock-propelled grenades) to full on ambushes. The first time he was in an IED attack, the humvee flipped over and he was thrown out of the back, lost his weapon and he had only his 9 mm handgun.
Symptoms: hypervigilance, can’t relax, chronic insomnia, nightmares/flashbacks, anger/irritability, avoiding crowds
I started in a general way, watching his affect carefully flooding or any signs of dissociation, which is when consciousness checks out of present time. During treatment we used the EFT Movie Technique to address, in an indirect, non-retraumatizing way, the worst memory of his entire time in Iraq, which occurred during the first tour--an ambush and fierce firefight where three soldiers were killed by RPGs in an unarmored humvee. His affect was nervous, subdued voice, shoulders forward, eyes down, fighting back tears and couldn't maintain eye contact with me. There was no flooding.
About 45 minutes into the session, we took a break. He reported that the charge on the ambush flashback/memory he titled "HELL" ("if that event was a movie, what would be the title?") was down to about a four-five from a 10+ on an intensity scale of 0 to10. We continued treatment, his affect became more animated, he relaxed into the chair, smiled, eye contact began.
At the end, when I asked what number on the 1-10 scale that HELL memory was now, he shrugged his shoulders, moved his head from side to side said, "I don't know, I feel really calm about it now, I think it's gone. I can remember what happened but I don't feel anything bad about it."
Here’s how we did it:
KC: ( Karate chop side of hand) Even though I have this anxiety from Iraq, and even though it’s been with me for a long time, I’m a good soldier and I did a good job over there and I’m doing the best I can now. Even though this thing has really got hold of me, I choose to do best I can and I’m open to releasing these old memories. I did the best I could at the time over there, and I’m doing the best I can now.
EB: Iraq, I thought I’d never get out of there alive.
OE: They came close to getting me several times.
UE: I thought I was a goner. I had a lot of close calls, I thought they were gonna get me for sure.
UN: They tried to kill me. They tried to kill me a lot of times and a lot of ways.
CH: I thought I was gonna die over there a few times.
CB: Even though I thought I was gonna die over there, and I lost friends over there, I didn’t die, it wasn’t my time.
UA: I thought they were gonna kill me.
TH: The ambushes, I never saw it coming . All of a sudden they were everywhere.
IF: The mortars, the IEDs, the RPGs...
MF: As soon as we were outside the wire we were at risk, the chaos began.
LF: I could never relax, if I relaxed, that could spell my death and my soldiers.
Back to the EB
EB: This remaining anxiety from IRAQ...
OE: I could never relax for a moment. If I ever relaxed, I could die and my soldiers could die.
UN: It was never safe to let go. Even in sleep, I couldn’t let go. Bad things could happen at night while we’re sleeping. Never felt safe.
CH: I couldn’t relax-- even now, I can’t relax.
CB: Even though not relaxing over there kept me alive, and there’s part of me that still thinks if I don’t relax, I’ll stay alive, I choose to allow that part of me to go off-duty, I’m home now. There’re no mortars and RPGs here. I’m a combat-hardened soldier, I know how to stay safe.
UA: If you relax you could die over there. If you relax, you don’t survive.
TH: So many times I thought it was going to be my day to die.
IF: Other people died over there that I cared about, but it wasn’t my time. I don’t understand that, but it just wasn’t my time. That’s how the cards played out.
MF: Every day was filled with chaos. I could never relax.
BF: We always knew bad things would happen, we just didn’t know what or when.
Gamut point: Just think about Iraq in general.
Eyes down right: Everything that happened in Iraq.
Eyes down left: Everything that happened in Iraq, I could never relax.
Eyes circle. I could never relax over there. I never knew when bad things were going to happen, hum, count 1,2,3,4,5, hum.
Tap on top of head: Everything that happened in Iraq - part of it stayed with me.
When a client’s eyes move in a rigid manner sideways or up and down rather than flowing in a smooth circle, that indicates that there is stuck trauma energy in a part of the brain, apparently related to the direction(s) they were looking and what they saw at the time the trauma was imprinted.
Interestingly, clients will often confirm that they recall looking in a certain direction or multiple directions when a trauma happened.
In this case, during the ambush Joshua was defending the convoy with a 50-caliber machine gun, shooting at dozens of insurgents who were attacking them from every direction. That may explain why he was unable to follow my finger in a smooth circle with his eyes.
After one round of EFT and treatment with the eye movement technique, his affect dropped about another 2-three points, down to a 6-7 from 10+. As we proceeded with EFT, his eyes were able to follow my finger in a smoothly flowing circle.
KC: Even though I went through that day in hell, and it’s still a part of me, I choose to call all the parts of myself back from Iraq. A part of me is still stuck there. I choose to call all the parts myself back from Iraq. I’m home there and I want to be here totally and completely. Even though that ambush changed me and I’ll never me the same, I’m doing the best I can. I went through hell, all of us went through hell over there. I made it out alive and they didn’t get me.
EB: The ambush. All my training is the only thing that kept me alive that day.
OE: They hit us with overwhelming force.
UE: We fought back with everything we had.
UN: All of a sudden they were everywhere.
UL: We drove into a trap.
CB: The ambush in Iraq, We drove into a trap. Even though that happened to me, I survived it. They almost got me, but they didn’t get me. I came close to dying that day but I made it out all right.
UA: The ambush, I thought I was gonna die for sure.
TH: Joshua: I remember we went down a dirt road, walls on both sides...
IF: And we were getting shot at from both sides of the road. They were behind high walls. If we hadn’t had 50 Cals, we all would have gotten killed.
MF: So we had to use the 50 Cals to shoot thru the walls.
BF: It was terrible.
Back to EB: This remaining anxiety and terror about the ambush. I thought they were gonna kill us all.
OE: The got three of us.
UE: We blasted them with 50 Cals and we got away.
UN: We were out there alone.
UL: We had to fight for our lives.
CB: Even though I still have this ambush memory, I got out of it alive. They didn’t get me and I’m ok now.
UA: I thought I was gonna die that day.
TH: They got three of us. We got a lot more of them.
IF: Those 50 Cals are what saved our ass.
MF: We never saw it coming. We walked into a trap.
BF: That day was hell.
9-gamut: Sue: “Shut your eyes, keep tapping on the back of your hand and just breathe and run that movie of “Hell” through your mind.”
Eyes down right: I thought they were gonna kill us all.
Eyes down left: The ambush-- we never saw it coming.
Sue: “Think about the ambush, keep tapping the back of your hand, eyes circle right. Eyes circle left, I thought they were gonna kill us all,
Eye roll 1(chin up, eyes down to floor, roll eyes slowly to horizon then to looking out top of head) The ambush, we never saw it coming.
Eye roll 2: The ambush, I thought they were gonna kill us, the didn’t get us all.
Hum count hum
EB: I was shocked. All of a sudden they were just everywhere.
SE: We weren’t armored up, we were helpless. Joshua: “All we had was body armor.
UE: We walked into a trap without being armored up! And we were real vulnerable.
UN: Somebody got on one 50 Cal and I got on another and
UL: We started shooting at everything.”
CB: I was terrified, we were all terrified. We thought they were gonna get us all. Sue: What were you doing? Joshua: “I was directing the fire. Sue: “What happened next?”
UA: I was shooting for everything I was worth. Everyone was yelling and screaming. Bullets were flying everywhere.
TH: It seemed like it took forever. I thought it was never going to be over.
IF: Joshua: “We called for MEDEVAC.”
MF: I held it together and my training saved me, I did my job that day.
BF: Even though that was the day from hell, we all did a good job and most of us came home. We got out of it alive.
Sue: Back of hand… shut your eyes, think about it again. What’s the worst part of it now? Joshua: I had bullet holes in my uniform, but they didn’t get me.” Sue: I came close to dying that day, but they didn’t get me. God protected me. There’s no other explanation. It wasn’t my time.
Eyes down right: I had holes in my uniform but the bullets didn’t get me.
Eyes down left: I had holes in my uniform, but the bullets didn’t touch me. God protected me.
Hum count hum
Eye roll 1: Even those bullets couldn’t touch me, God protected me.
Eye roll 2: I got out of it alive.
Joshua leans back in his chair, smiles at me. Relaxes, drinks water.
He tells me again a summary of the ambush, leaving out the gory details. Sue: “What number is it now? “ Joshua: “About a four-five.”
KC: Even though I witnessed so much carnage in Iraq (his word) and especially the day of the ambush, that was then and this is now. I went through all that and I survived it. I wish I never saw it, but I did see it and it’s over now and I’m safe. It did happen but it’s over now and I made it out alive and I’m home. Even though some comrades died over there, I choose to trust God for how this played out. I don’t know why I survived and they didn’t, but I did.
EB: Everything bad happened that day.
OE: The carnage, the shooting the screaming.
UE: The smoke and the bullets, I thought it would never stop.
UN: I can still see what happened and it haunts me in my dreams.
UL: Even though I saw all those terrible things, I lived thru it. I did my job and I did the best I could at the time. I know that people survived because I did my job.
CB: These remaining scenes of carnage and chaos. Even though I still have these remaining memories, and that did happen to me, and it happened to all of us, we have to go on.
UA: I’m not gonna let that experience take anymore of me than it already has. I choose to take myself back.
TH: I saw things that day that nobody should see.
IF: It’s part of the fabric of war.
MF: I wish I never saw it, but I did see it. I can let it go now.
BF: Even though that was the worst day of my life, I accept myself. I did what I had to do and I survived it.
9-gamut: The chaos and the carnage.
Down right: The chaos and the carnage I saw that day
Down left, repeat
Eyes in a circle: “The things that I did that I wish I didn’t have to do.”
Hum count hum,
EB: This remaining anguish about what I saw and did that day.
OE: I was on autopilot.
UE: Nothing mattered but surviving for me and my people. Surviving is what mattered.
UN: I did what I had to do to survive and protect my people.
UL: Sue: “If you could do it again, would you do anything different?” Joshua: “No. Once we were in it, we had to fight our way through to the end.”
CB: Even though it was the worst day of my life, and I did and saw things nobody should do or see, I did my job as a soldier. I did what I had to do. I performed according to the rules.
UA: It changed me as a person. Tragedy and trauma changes people but that’s the fabric of war.
TH: We fought to survive.
IF: Most of us made it out of there alive. We lost three guys.
MF: I tried to save them, but I couldn’t.
BF: They were too far gone.
At this point Joshua was fighting back tears so we took a break.
The Aftermath of the Ambush
KC: Even though I had to pull wounded guys out of the wreckage, and it was horrible and gory and I’ll never forget it, I did the best that I could at the time for them. I wish there was more I could have done but they were too badly injured. We got the MEDEVAC there as soon as we could.
EB: His skin came off in my hands, he was so badly burned. It was horrible.
OE: He was still alive.
UE: The scenes of the battle.
UN: The aftermath of horror.
UL: The aftermath of horror.
CB: Even though I saw the aftermath of horror, I did the best I could for those guys. It’s over now and my job is done.
UA: Even though we lost some guys that day. I did the best I could at the time.
TH: The horrible injuries. Blasting, shooting and burning.
IF: Nothing in my training prepared me for the carnage.
MF: I want to forget that day ever happened. It won’t happen again.
BF: Those guys that died are at peace now and I choose to accept what happened. It did happen, it’s over now and I choose peace for myself.
EB: Sue: “Tell me what happened..Do you feel responsible?” Joshua: “No, we were ambushed.”
UE: Shock and horror.
UE: Guys died...
UN: Guys died that day.
UL: I couldn’t do anything to save them. It broke my heart because I couldn’t save them.
CB: Even though that happened, I performed according to my training.
UA: Even though these images are burned into my memory, I choose peace anyway.
TH: It was horrible.
IF: I thought I was gonna die for sure.
MF: But I didn’t die. I was one of the lucky ones.
BF: The worst day of my life.
9-gamut: Eyes down right: that day in Hell.
Eyes down left: Can’t get these images out of my mind.
Hum count hum eye roll: These horrible images.
Sue: “What # is it now?”
Joshua: “The burned guy is still a 10.”
Sue: “Is that one of the flashback/nightmares?”
Sue: “Ok, are you feeling any release from the “Day in Hell?”
Joshua: “Yes, that’s less, but this one is still bad.”
Sue: “Ok, let’s try to be a little more specific about the guy that was burned. Can you tell me about that without getting too intense?”
KC: Even though I remember that graphic scene of the guy that was burned from the RPG, and even though I still have this horrible memory, I accept myself. I wish I never saw that, but I did see it. I’m doing the best I can.
EB: All of a sudden, the RPG ripped into the humvee and it was an inferno.
OE: He never had a chance.
UE: The RPG got the driver, he never had a chance.
UN: We got there as soon as we could after the shooting stopped.
UL: He was still alive. I tried to get him out of the vehicle.
CB: I couldn’t help him. He was too badly injured. Even though I witnessed that guy’s horrible suffering, I accept that it’s part of the fabric of war. There’s no answer. We were over there to do a job and this is what happened.
UA: He died for his country. It was his job and it’s what he signed up to do. Joshua: “We never should have been over there in the first place, but we did what we were ordered to do.”
TH: A lot of good people died over there in “George’s war.”
IF: A lot of good people died for nothing and he was one of them.
MF: I’m one of the survivors and I have to go on. Sue: “Do you want to go on?” Joshua: “I want to go on, but I don’t know if I want to stay in the Army.”
BF: Even though I have this conflict inside me, I choose to be at peace and close the book on these horrible memories. It’s all over now and I’m home.
EB: This remaining conflict and horror. The guy in the humvee that got hit by the RPG didn’t have a chance.
OE: He didn’t have a chance.
UE: I got there and tried to pull him out and I ended up holding the skin of his arms in my hands.
UN: That horrible memory.
UL: I did the best I could..nobody deserves to die like that.
CB: It was the worst day of my life but it’s over now and I’m home. I survived it. I don’t know why I survived it, but I did.
UA: I saw things nobody should see. I performed according to my duties.
TH: Whoever said war is hell was right.
IF: I’m not going to let them take anymore from me than they’ve already taken. I’m not gonna let them sink me with the PTSD.
MF: Even though I went through these horrible memories, I choose to accept them and put them in my scrapbook of things that have happened in my life.
LF: I choose to erase this horror from my body and my mind.
Back of hand, Sue: “Close your eyes, keep tapping, and look at the scene of the burned guy, what # is it?” Joshua: “It’s not a 10 anymore, it’s not gone, its somewhere in the middle.”
Eyes down right: I reached for him but it was too late.
Eyes down left: Repeat.
Hum count hum
Variation of eye movement: follow my finger very slowly in this horizontal figure-8 (8 times). Say: “I reached for him but it was too late. The RPG got him and I couldn’t save him.”
Top of head, tap.
Sue: “Ok, where are we now with the burned guy?”
Muscle test: Energy switched: KC: Even though my energy goes backwards when I think about the burned guy, because it still bothers me, I’m a good person, I’m a good soldier, I went thru hell, and I’m doing the best I can. I’m not going to let this PTSD sink my life..”
M/T: The guy that got burned is a 5 or less? Yes.
At this point about 45 minutes into the 90-minute session, we took a break. He reported that the charge on the ambush flashback/memory he titled, "HELL" ("if that event was a movie, what would be the title?") was down to about a four-five from a 10+ on an intensity scale of 1-10.
We continued treatment, his affect became more animated, he relaxed into the chair, smiled, eye contact began.
Sue: “Can you still see the details of the burned guy that you saw in your mind when we first started?”
Joshua: “I can still remember it, but it doesn’t feel that bad now. It’s less intense.”
Sue: “We really didn’t say it before, but the emotion we were working on was horror, is that true?”
Sue: “So take a moment and close your eyes and sort of review the tape of “Hell” in your mind and tell me if any of the scenes still bother you. Can you tell me the story in more detail now without much anxiety?”
Joshua tells me the story of the ambush again, without any noticeable emotional charge. At the end, when I asked what number on the 1-10 scale that HELL memory was now, he shrugged his shoulders, moved his head from side to side said, "I don't know, I feel really calm about it now, I think it's gone. I can remember what happened but I don't feel anything bad about it."
We concluded the session and he went to dinner with his girlfriend and other friends.
The next day, he reported to his doctor and to me that he slept for 10 hours without awakening and without any nightmares or flashbacks.
He came back for a second session three days later. He has not had any nightmares or flashbacks since our first session and his other symptoms are "much better or gone." He feels "much less" irritation/anger--"How do you know? Because I don't get pissed at people that I did before Tuesday."Hypervigilance is down about 50%, and he hasn't been in any crowds yet to test that. He says he feels much more relaxed now.
I didn't give him the PCL-M and SA-45 again because I was expecting to do it before our next (third) session, which is now apparently not necessary. I will ask the doctor to give the tests to him at their next appt. and report the results in a week or so.
The morning of session 2, he was so relaxed (and of course sleep deprived) that he yawned almost continuously throughout the session. I was expecting to go back over the "HELL" memory we treated Tues. from the first tour in 2003, which he said was the worst thing that happened during all three tours in Iraq.
I asked him what charge he felt about it now, (0-10 intensity scale) and he said he didn't feel any anxiety about it at all. I had him tell me the complete HELL/ambush story from the beginning. ("Then what happened? What did you do next? What did you see? Show me where the bullet hole was in your uniform...etc) and there was no affect that I could discern in his face, voice or body language.
He again shrugged his shoulders and noted that it was just a neutral memory now.
For the next 45 minutes I dug deeper, prodded, evoked with specific questions, ie:
"What about that part in the HELL movie where you went to pull that guy out of the burning humvee after the RPG hit and the skin on his arm came off in your hand?"
What about the other guy who bled to death and you were trying to put pressure on his wound and your hand went inside him?
He was on convoy protection during the 18 months and they were attacked about four-five times a week.
No affect on those times.
I asked about his childhood, (stable, loving, safe, parents still together and happy) any prior brushes with death (none) any other difficult memories, and he couldn't come up with any.
I asked about the 2nd worst thing that happened in Iraq, that was one of the other three repetitive nightmare/flashbacks.
He related that he drove over a trip wire for an IED in an unarmored humvee, and when he looked down there were 2 artillery shells in the ground "about as close to me as you are sitting right now" then he said the memory was "funny."
A client laughing or reflecting in a neutral or amused manner about a previous intense memory after EFT treatment is common.
Sometimes to test, I will say, "How can you laugh about this? You were crying your eyes out a few minutes ago... " and they will insist that "it's funny now."
Perhaps serotonin or some other feel-good chemical flooding the brain is producing the healing. Some of our researchers are looking at this question. For peer-reviewed studies and other papers see the research page eftuniverse.com
Sunday 2-1-09 teleconference with Joshua: sleeping about 6-8 hours without awakening, no nightmares or flashbacks. Previously charged aspects of the ambush memory and his other war memories from other deployments are a zero.
Note: The Stress Project has provided free EFT to hundreds of veterans, through a network of over 150 providers, and if you know of a veteran, please encourage her or him to seek help at stressproject.org.