and heart and breathing rates. Consequently, your body responds similarly to
anxiety-provoking and sexually arousing situations.” - Jack Morin, The Erotic
Mind ...
"I am human, and nothing human is alien to me."
War Zone Stress and Sex All Is Fair In Love And War
Eve Boyer, MFT
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You would be… • in the military. • “property of the government”. • in chronic traumatic stress. • not the same person sexually as you were when you left. • in a war zone.
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In San Diego County • • • • • • • • • •
Marine Corps Air Station, Miramar Marine Corps Recruit Depot, San Diego Marine Corps Base, Camp Pendleton Marine Corps Air Station, Camp Pendleton Naval Air Systems Command (NAVAIR) Depot, North Island Naval Base, Coronado Island Naval Air Station, North Island Naval Amphibious Base, Coronado Island Space and Naval Warfare Systems Center, San Diego Fleet Anti-Submarine Warfare Command, San Diego
Navy SEALs
http://www.sealchallenge.navy.mil
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Bibliography - Sources
Bibliography - Sources
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Bibliography - Sources
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Why the term “War Zone Stress”? The Department of Veterans Affairs Center for PTSD uses “War Zone Stress” instead of the term “Combat Stress” because they acknowledge that significant stress is born by military personnel that are deployed to war zones who are not in combat roles, but who also face life-threatening situations themselves.
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Physiology The Relationship Between The Stress Response and The Sexual Response
From Ogden, P., and Minton, K. “Sensorymotor Psychotherapy: One method for processing trauma.”
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From Ogden, P., and Minton, K. “Sensorymotor Psychotherapy: One method for processing trauma.”
Autonomic Nervous System the Stress Response Sympathetic (Excitatory) • • • • • • • •
Prepares for stress Heart rate increased Blood pressure increased Widen bronchial passage Pupil dilation Digestion inhibited Sphincters closed Decreased urine secretion
Parasympathetic (Inhibitory) • • • • • • • •
Repairs from stress Heart rate decreased Blood pressure decreased Constrict bronchial passage Pupil constriction Digestion increased Sphincters relaxed Increased urine secretion
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Stress Response ~ Sexual Response Gross Similarities That Cause Them To Merge
• Increased pulse rate • Increased respiration and blood pressure • Excitement/Fear • Adrenaline reflex
• Increased pulse rate • Increased respiration and blood pressure • Excitement/Arousal • Adrenaline reflex
Hormones, Neurotransmitters And Other Mechanisms Acting On The Human Sexual Response Cycle
Excitatory • • • • • • • • • • • •
Andregenic (Alpha1) Activity Beta2 Andregenic Activity Cholinergic Activity Cortisol (acutely excitatory) DHEA Dopamine Estrogens (both excitatory and inhibitory in women) Histamine Nitric Oxide (NO) Testosterone Vasopressin Zinc
Inhibitory • Andregenic (Alpha2) Activity • GABA • Cortisol (chronically inhibitory) • Estrogens (inhibitory in men) • Melatonin • Monoamine Oxidase (MAO) • Opioids • Progesterone • Prolactin • Serotonin (5-HT) • Thyroid hormone • Vasoconstrictive Peptides
from Sexual Pharmacology, by Theresa Crenshaw and James Goldberg, 1996.
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-From Back From The Front, by Aphrodite Matsakis “Note: all couples struggle with a variety of sexual issues, but this chapter focuses on concerns specifically related to combat trauma such as sexual disinterest and sexual urgency. You, or your veteran, or both of you may be troubled by one or more of the concerns described here and perhaps additional concerns as well. The purpose of this chapter is to describe some of the sexual struggles common among couples where one partner suffers from combat trauma, not to promote or critique any particular religious or philosophical view of human sexuality. Skip over any parts that you find uncomfortable. You can skip the entire chapter and still benefit from this book.”
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Sexualized Responses To War Zone Stress “Depending on the situation and the individuals involved, anxiety is either an anti-aphrodisiac or an aphrodisiac – occasionally both. All forms of excitement, sexual and non-sexual alike, increase muscular tension, blood flow and heart and breathing rates. Consequently, your body responds similarly to anxiety-provoking and sexually arousing situations.” - Jack Morin, The Erotic Mind
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The Erotic Equation ATTRACTION + OBSTACLES = EXCITEMENT
“The erotic experience, by its very nature, is shaped by the push-pull of opposing forces and is therefore energetic, interactive, and potentially dangerous.” - Jack Morin, The Erotic Mind
Types of Sexualized Responses 1. Sexualized death anxiety 2. Sexualized grief and anger 3. Sexualized Guilt
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• • • • • • • • • • •
Survivor guilt Childhood omnipotent guilt Superman/superwoman guilt Existential/Religious guilt Guilt of Being Shadow guilt Moral or Atrocity guilt Competency guilt Negligence guilt Catch-22 guilt Responsibility guilt
Types of Sexualized Responses 4. Sexualized aggression 5. Sexualized pain 6. Extra-marital sex 7. Madonna / whore syndrome 8. Sexual assault syndrome 9. Lack of interest / inhibited sexual desire 10. Compulsive sexuality 11. Celibacy
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Traumatic Brain Injury Among the returning combat wounded, 96% have been in or close to a concussive event, receiving artillery, mortar, or rocket fire. Walter Reed Hospital Just under 20% with TBI
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"I am human, and nothing human is alien to me."
Treatment Approaches Affect regulation “Brain wise” psychotherapies Integration
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Somatic Experiencing - Peter Levine
• Trauma as an “uncompleted biological response to threat”. • Work through the stuck energy. • Allow the release of sensory-motor expressions. • By-pass the cognitive brain, “speak the language of the primitive brain”.
Medication • Work with M.D. to help recognize when medication is called for. • Anti-depressants, anti-anxiety, pain medication, sleep medication, to name a few. • New therapies to deal with PTSD: D-Cycloserine and Propanerol, help with traumatic memory. • Alpha-Stim® cranial electrotherapy stimulation (CES).
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D.O.D. Task Force On Mental Health 2007 Report and
Iraq War Clinician’s Guide
• Remove stigma • Create a safe haven • Provide confidentiality
Remove Stigma Warriors Ethos I will always place the mission first I will never accept defeat I will never quit I will never leave a fallen comrade
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Safe Haven • Have the courage and confidence to talk about sex. • Avoid the temptation to minimize. • Assume there are sexual experiences the service person does not want to talk about. • Engaged, lively, non-judgemental, compassionate and wise.
Confidentiality • “Allows the personal narrative to be particular, not general” - Shay • Secrets - to keep or not to keep? • The War Zone is a parallel universe; the rules we are accustomed to may not apply.
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Poem from a vet cited in Shay’s Odysseus in America, “Four words are all that count: (1) (2) (3) (4)
YOU WERE NOT THERE!
It doesn’t matter if you really care.” - Sgt. Palmer
BUT IT DOES MATTER IF YOU’RE REALLY HERE!!
“With trauma clients, the relationship itself becomes the initial tool. Compassion must be conveyed before competence can be appreciated.” - Linda Schupp
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Attentiveness is the natural prayer of the human soul. - Paul Celan, poet
"I am human, and nothing human is alien to me."
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