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Abstract: The contemporary group treatment of veterans from the Vietnam War to the present who suffer from combat-related PTSD is reviewed in light of the dynamic understanding of combat trauma developed during and since World War II. Both dynamic and cognitive behavioral group therapies are explored. The common features of all group treatments of combat PTSD involve the development of trust and the communalization of trauma within a cohesive group. Further research is needed to increase our understanding of effectiveness, mediating factors, and relationships between childhood experience and combat trauma.
Although warfare and combat predate the dawn of recorded history, the organized and thoughtful treatment of the psychological casualties of warfare have been a fairly recent phenomena. Whether referred to as shell shock, war neurosis, or Posttraumatic Stress Disorder (American Psychiatric Association, 2000, p. 463), it is clear that there are powerful psychological costs for soldiers who have served in wartime. Jonathan Shay (1994) provides us with a vivid example from the words of a Vietnam combat veteran:
I haven't really slept for twenty years. I lie down, but I don't sleep. I'm always watching the door. I get up at least five times to walk my perimeter, sometimes it's ten or fifteen times. There's always something within reach, maybe a baseball bat or a knife, at every door. I used to sleep with a gun under my pillow, another under my mattress, and another in the drawer next to my bed. You made me get rid of them when I came into the program here. They're over at my mother's, so I know I can get them any time, but I don't. Sometimes I think about them-I want to have a gun in my hands so bad at night it makes my arms ache. (p. xiv)
While the definitions and understanding of the etiologies of combat trauma have developed and changed over the last century, the methods of treatment have consistently been pharmacological, individual, or group therapies. While the U.S. Military currently has extensive protocols for the identification, assessment and treatment of both Acute Stress Disorder (American Psychiatric Association, 2000, pp. 469-472) and PTSD for personnel on active duty (Veterans Health Administration, Department of Defense, 2004), there is minimal discussion of the...