Fighting post traumatic stress disorder

Captain Mark Lyndhurst served in Afghanistan and describes how the experience has left scars.

Mark -   My name is Captain Mark Lyndhurst.  I was serving in Afghanistan for approximately seven months.  The first five were relatively quiet: dealing with your usual explosion, shootings.  About five months in I was involved in an explosion.  We drove over what we think was a Russian antitank mine, largely saved by the soft sand that was beneath it and it blew a crater in the ground. I walked away largely physically unhurt.  Everyone else walked away with some broken bones.  

I came home and went back to Afghanistan after my leave and I got immediately flown to a place called Nad Ali where I was on the last transport to actually make it in there in about 7 weeks. It's just after I got in there the Taliban surrounded us cut off the position. And then we proceeded for the next 7 weeks to defend our position whilst the army was unable to come and rescue us.  

There was people running out of food, running out of ammunition, we've got problems of water.  We were under contact every day that we were there, things got so bad at one point that the RF refused to fly in because it was too high risk to them.  So, they started dropping.  Dropping all our supplies, we'd watch our supplies drift slowly towards the Taliban lines and then have to go out and fight for them.  

And all through this, as a young officer, your duty is to do what you're told from above and also, to look after your soldiers.  And that leaves you in the middle being under incredible pressure and incredibly alone because when soldiers look at you and go, "Boss, why are we doing this?"  On some level, you've got to sympathise because you can't just tell them to shut up and get on with it because the situation is ridiculous.  But on the other level, you need to come up with an answer and then come up with a reason that they follow you back our the gate the next day even though you know you're going to get shot up.  Seven weeks of that.  That's what left me with my PTSD.  

It took just over a year before I was actually diagnosed with posttraumatic stress over which period of time the posttraumatic stress builds up and builds up, until it got to a critical point at which it was eventually noticed.  The predominant symptom is, it's the obsessive thoughts, the continual re-thinking of the situation.  It's been a lot therapy and talking because a lot of feelings that I was caught up and again, largely to do with the army, that there is a sense of fear when these things happen.  And that's something that you feel particularly as the commander, you feel quite ashamed of because you think that you should be able to deal with things much better.  And you know, that your priority is to actually put that aside and carry on.  You've also got a set of very high standards to work that you go through when you do with this training back at home and you try and get everything as perfect as possible.  But then the reality of it is when these things happen in war, the scenario isn't perfect.  There are things you have to adapt to and there are many, many limitations that you can't really reconcile.  And so, you're quite often left with this overarching feeling of, "I could've done better."  

The army lives in this wonderful alpha male type world where it plays on machismo and ego and those are things that helps make it bold and strong and carry it through a lot of these times, and particularly allows you to lead.  But sometimes it captures you there and you forget about the other side of things about emotion, about compassion, and the sort of the other parts that make up the human condition.

Hannah -   And what kind of advice would you give anyone who is experiencing PTSD, whether they're in the military or otherwise?

Mark -   There's only one thing which is just and it's the hardest thing to do.  You need to talk to somebody.  You just tell somebody.  

My story is, when I came back, so to me every year to actually speak to anyone about things and that was largely through being pretty much frog marched to a doctor by some very close friends when it got to a point in time that it was beyond obvious that there was a problem.  

But you're very concerned and caught up in yourself to the point actually that quite often; you don't really want to talk to other people about it.  One, for fear that you're boring them because it's on your mind the whole time and two, because you're often living in this world of fear or guilt, or you're having problems reconciling your own thoughts.  And they usually become confused because you relive these moments, the memory is an odd thing.  You're not really remembering actually what was going on.  Before you know it, you've remembered it so many times that it's become a confusion and a fantasy.  You don't really feel justified in telling it to anyone because it's a very personal problem.  But if you don't, it finds other ways to escape and people turn to alcohol, to drugs.  And alcohol in particular, although to a certain degree, it quashes these thoughts, it also provides a vehicle for them to come alive and just express the emotions, the anger, the fear, and everything should come out.  

In my case, I ended up with self harm and suicide attempts.  So, once I started talking to the therapists, it was by no means a quick fix.  I was in and out of therapy on a number of occasions.  There's a lot of denial and I was very lucky to have a close support network of friends and family who sort of held my hand and kept me fighting and can help me find the help I needed.  

You talk to a therapist and you work through the emotion and you rationalise the emotion as well to the extent, you look at things and go:  "I was afraid.  Is that okay?"  And the answer is, "Well, yes."

I'm still, by no means cured. There's a lot of things, that still affect me now.  Although possibly on the outside, you won't see them.  

One thing that happens when I was in Afghanistan was that I was blown up a land rover.  So, I was driving along to the dessert and hit an anti land mine.  There was four of us in the vehicle.  Three ended up being carried back to the UK and I walked away with a small cut to my left shin. I was in command of the vehicle and this left me very much questioning, what right I had to be alive.  The next day, I was out patrolling again, so I haven't had the time to actually sit down and have a cup of tea and a fag and allow my mind and body to catch up with each other.  

When we started doing my therapy with this technique that was used called EMDR which is a lot of the tapping and bits and bobs, and it's very close to hypnosis. Nobody seems to be able to understand or explain exactly what it does, but it's very good at changing acute thought patterns.  

Now, a vehicle, when it gets blown up in the dessert, there is one smell that will stay with me for the rest of my life and it's this mix of tar and sand and diesel, and it's horrific and it stings at the back of your throat and it stings at the back of your nostrils.  It's something that I could never really get rid of.  But sometimes, if you're walking past like road works where there was bitchemen boiling, or tarmac boiling, it's that same acrid smell and something like that which will flick me back in an instant.  

But the EMDR was something used in particular to tackle that one situation because it was so acute that we talked about the bad situation and then there's a sort of tapping going on and then we talked about good things.  As far as I understand, what it does is it changes the neural pathway so that you were going bitchemen, explosion, "Good God!  I'm nearly dead."  Bitchemen explosion, "It's a nice day!"

Hannah -   Thanks to Mark Lyndhurst.  And Mark talked about EMDR, so eye movement desensitisation and reprocessing.  This is a treatment that was developed by clinical psychologist, Dr. Francine Shapiro in the 1980s.  It involves making side to side eye movements and listening to taps whilst recalling the traumatic incident before thinking of more positive thoughts.  

It's thought that this left right eye movement stimulates the brain in a similar way to REM sleep, so rapid eye movement sleep when your eyes move rapidly from side to side.  During this phase of sleep, memory reinforcement seems to happen.  So, it's in this way that EMDR could've changed how Mark reacted to cues in the environment and stopped his flashbacks.