PTSD – a helpful guide for Waterways Chaplains

Hi, my name is Ron, I am a Probationary Waterways Chaplain. I have been a Christian since I was 31 years old, and I am 70 now. I have only been walking the tow paths for about a month due to Covid so have little experience to report so far. Given this, I would like to talk about one of the situations that I might expect to encounter.

I might expect to encounter ex- service personnel. I spent 16 years in the RAF serving as a psychiatric nurse in which time I was privileged to nurse service men and women suffering from Post Traumatic Stress Disorder (P.T.S.D.) We have all heard this term banded around on the media, but do we actually know enough about it. Needless to say, there is nothing new about P.T.S.D; it’s probably very old.

Shakespeare recorded an incident of someone suffering from P.T.S.D. In Henry the fourth [Hotspur]. He recorded that Hotspurs wife noted a change in him after serving in an Army of the day. Charles Dickens suffered a train accident and then wrote Bleak House which is a dark tale. During and after the First and Second World Wars, attempts were made at treatment. But it has only been very recently that much of the understanding has been achieved.

Whilst serving and being part of the treatment programme, I have come to understand P.T.S.D in the following way; The factors that affect someone suffering from P.T.S.D. can be remembered by the initials S.A.R.A . :

S Stands for Stressor.

There are many sorts of things that make us stressed, and they are fairly common.

One such common stressor is ‘hassles’; these are daily things that occur. An example would be missing your bus or trouble with a boss at work and so forth the list is endless. Another common occurrence that can make you stressed is life events –these are sad but, nevertheless, to be expected; this would include natural death, and I  am sure you can think of a few yourself.

The stressor that causes P.T.S.D is not hassles or life events; No, the stressor that causes this illness is overwhelming– it is taking your platoon through an action and surviving but then being taken prisoner only to be hit by “friendly” fire and then placed in a holding camp, and be forced to watch atrocities committed to your colleagues.

In a civilian organisation this could be a fireman working around the clock to cut someone out of a building, often putting themselves in danger only to learn that in doing so, in some way they caused the death of someone.

I hope you can see the difference between the stressors.

A Stands for Arousal.

This is quite debilitating as it means that you are unable to sleep. It also means that you are unable to concentrate on anything. Typically, someone who was the belle of the ball and could hold down a good job is now unable to hold down any job at all and cannot cope in social gatherings.

R Stands for Re-experience.

This also is quite debilitating and means that your sleep, when you manage to get some, is broken by nightmares, in which you find that you are re-living the events again and they are very real to you. I met a serviceman who used to barricade himself in his room during one of these nightmares. Another way they re-experience the event is by flashbacks, these can be triggered by anything at all, a smell, taste, sound, or touch; and like nightmares they bring them back to the event.

A Stands for Avoidance.

Because all these things that I have mentioned above are so debilitating, people tend to avoid situations that can bring them on, but this becomes part of the problem rather than a cure. Typically, they can withdraw from society, living rough, perhaps by the side of the canal or on a narrow boat. Certainly, some of the veterans of the Vietnam War disappeared into the hills to live.

So, these factors of SARA work on each other—because you had the stressor you re-experience and because you re-experience you become anxious— because you become anxious you avoid anything that can bring it on –so round and round you go with very little chance of closure without medical help.

If this was not sufficient, there is another factor which is hard to deal with and that is guilt, it takes two forms:

1. Survivor guilt – This is guilt associated with the fact that you survived, and many others did not –why would you have been spared and not your friend who you consider to be more worthy than you?

2. Acts of commission or omission – basically the thought that there was something you did or did not do that caused the loss of life.

Both of these cause people suffering from P.T.S.D. a great deal of mental trauma, and I think it is possible to keep going around in circles without finding closure until they seek medical intervention.

We, as Chaplains, are not therapists or counsellors –but we are a people of prayer, and we can be good listeners; listening not only to what is said but how it is said. We can suggest, when prompted, to seek medical help via a General Practitioner or an ex-servicemen’s association, of which there are many.

One thing sufferers of P.T.S.D. do to ease the symptoms is to use substances like Alcohol and Drugs –both of these cause other problems and do not help with their symptoms either. These are just a few reflections on P.T.S.D. and I have only scraped the surface—I hope I have whetted your appetite to learn more.

As we go about our ministry along the towpath we will meet all sorts of people– I believe we need to be good prayerful listeners– and I am sure Jesus will prompt us on how to react.