Have you heard about Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE)? This session-by-session therapist guide, written by Dr. Sudie Back and colleagues, was published in 2015. However, when I mention it at Prolonged Exposure Therapy (PE) workshops, few therapists in the audience have heard about it.
Several years ago, I was co-facilitating a group Cognitive Processing Therapy (CPT) session with several BIPOC (Black, Indiginous, People of Color), Vietnam Veterans. During agenda setting, one of the Veterans in the group wanted to discuss a Challenging Beliefs Worksheet (CBW) that he had completed during the past week. I acknowledged his request, and, since he didn’t often speak about his practice assignments, I asked the group if we could start with his agenda item. The rest of the group agreed.
A patient walks into your office and states that he is having a panic attack because he just saw a women in the pharmacy line wearing a Hijab. Just seeing the veil produced flashbacks and a quickened pulse. Upon further questioning, he reveals that he is avoiding certain Middle Eastern restaurants, and missed an elevator ride because he saw a Muslim women waiting in line. He even states that he thought he saw a soldier wearing a Hijab, but then states "I think I must be losing my mind." As a provider working with service members, how culturally informed are you on veiling policies to better assist this patient?
I had a patient who had once been a psychiatrist and left the field to return to general medicine. He was an active duty Service member who'd had multiple deployments. I remember thinking that he had become so burned out from working with Service members around behavioral health issues and combat that he had to leave that part of the profession altogether. But even then, I realized that "burned out" did not capture what I was seeing in him
For all its power to terrify, Covid-19 can’t keep us from marveling at the courage of frontline human service workers all over the world. They are braving not only the physical dangers of repeated exposure to the deadly virus, but also the emotional dangers of empathically sharing so much suffering with so many, and the moral dangers of possibly being unable to save every savable life, such as when intensive care services become overwhelmed. Their courage seems all the more remarkable given that all three of these dangers are invisible, operating mostly outside of anyone’s immediate awareness.