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Troy said:
If most vets are like me, they're going to resist meds for treatment of ptsd, resist being drugged up ... that's another element of being out of control, and we already feel like we're not enough in control.

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Bravo for you. I also avoid drugs.

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Troy said:
]And we're going to resist working with shrinks - especially those who have never stepped across the LD (Line of Departure) into combat. And, like, how many shrinks every even visited a battle zone, much less were shot at or wounded, much less shot at the enemy or fought hand to hand? They are probably non existent.

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There are a few shrinks (mental health professionals) that have seen the horrors of war. But I don't think that a shrink needs to have seen those horrors to be an effective helper to someone who is suffering with PTSD. There's all kinds of help out there. The question is whether or not the person suffering with PTSD is willing to find a type of help that works for him/her.

I have PTSD from sexual assault. I don't know if my counselors were ever sexually assaulted. I had a few that I care not to ever see again. But two of the counselors were very experienced at listening and PATIENT with me. I think patience is the most important criteria for helping someone who is suffering ... especially because no one really helps you get better ... you help you get better ... the role of the counselor is to BE THERE FOR YOU, symbolically hold your hand, be your cheerleader, be there for when you are a mess and break down and say awful words, LISTEN, WATCH, WAIT. I also think a good counselor will make you laugh because laughter is the most therapeutic drug. That's my opinion. (I'm in awe I just wrote that without too much thought. I've struggled with therapy for a few years, never quite understanding it. But now I do!)

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Troy said:
Is combat ptsd like other kinds of ptsd?

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I think the DSM criteria for diagnosing are absolutely the same.

However, I think combat soldiers with PTSD should NOT discuss combat around other PTSD folks who never went to war. Also as a non-combat soldier, I would NOT want to be put in another group with soldiers talking about their combat experiences. I think the groups I've attended encouraged me to become more hypervigilant and paranoid. For the combat PTSD vet, I think the group therapy with others with combat PTSD should be controlled so that discussion doesn't get too graphic, especially if it's triggering others in the group. Hypnosis or other relaxation methods should be utilized to calm the group before the group is dismissed. I've see a few groups end and soldiers storm off in a dissociated state and the counselors be clueless to the signs that the soldier would be harming themselves/others in a very short time frame.

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Troy said:
How can you even tell a non combat veteran about any of this? It's easier to just tell them it was a "walk in the park" -- why burden them with any of the horrors we've seen?

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I think within discretion you may tell others who haven't seen war horrors. A person's gaze tells a lot. If you choose to talk to a non-professional, then try to be sensitive to that person's body language. But you should also be sensitive to your own body language. For instance, as you tell your story and you begin to see/feel/hear/smell/taste the memories, you should also do "grounding" exercises so you can stay in the present (you are not in the past, you are here and safe, don't float off to misery, feel the floor, etc.) The mind is a powerful organ that you can control, and if you feel out of control then you shouldn't be discussing your issues to a non-professional. This point would be a good idea to call a counselor.

I think it is important to talk about things you want to talk about. If you want to share your experiences about war and you find someone who is very interested in hearing your story, then that's something good to work on discussing. This isn't like any conversation so take it slow. Like all relationships, you just don't DUMP on a person.

Another tidbit ... some things aren't anyone's business but your own. Keep discretion and try to be wise when and what to disclose. On the other hand, "total non-disclosure forever" is called avoidance, a symptom of PTSD. For me, I disclose a little bit sometimes just to force myself out of avoidance.