We've all been told that exercise promotes physical health. It is a common knowledge that routinely going for a walk, run or bike ride can stave off diseases such as obesity, diabetes, and cardiovascular disorder. But a new incentive for exercise is emerging from recent scientific research: what is good for the body is also good for the mind. Over the course of human history, people had to spend a good portion of time actively seeking and gathering food. In modern society, however, obtaining food is no longer such a mental or physical challenge. We can now drive to the supermarket, stroll through the aisles and pick some items from a huge selection of prepared products, check out, and then drive back home. It is easy to get caught up in an inactive lifestyle, but our ancestors would not have survived if they had behaved the same way.
Although our environment has drastically changed, our physical bodies and brains are largely the same as those of our ancestors - meaning we are built for much higher levels of physically activity. With the mind-body connection still intact, it is expected that physical activity - once intricately linked to the reward of obtaining food - should have profound effects on mood. We are now discovering that this is indeed the case, and we are beginning to understand how exercise affects the brain to induce mood changes.
People often report that a casual walk or jog of moderate intensity can lift their mood. When asked why exercise induces positive emotions, a regular gym-rat might attribute the feelings to an "endorphin rush" that follows high intensity exercise. Endorphins are chemicals that are produced by the body and are released into the bloodstream during both moderate and high intensity exercise. However, endorphins are not the only chemicals released during exercise; we now know that physical activity also increases levels of neurotransmitter molecules such as serotonin, dopamine, endocannabinoids. Scientists believe that these substances work together to induce changes in brain function that exert positive effects on mood and cognitive abilities. Interestingly, some of the chemicals that are released during exercise are also the targets of drug treatments for mood disorders. For example, popular medications for depression act to elevate serotonin levels in the brain. Going for a run may produce similar effects on the serotonin system, potentially mediating improvements in mood. It is more likely, though, that exercise stabilizes mood through multiple biological effects beyond just serotonin pathways.
A remarkable discovery that has emerged from studies of mice is that exercise sparks neurogenesis, or the birth of new brain cells. Exercise-induced neurogenesis has consistently been found in an area of the brain known as the hippocampus. We don't completely understand the function of neurogenesis in the hippocampus, but this brain region is involved in memory and navigating through space. It remains an open question whether neurogenesis in the hippocampus affects mood. Equally exciting as the discovery of neurogenesis has been the finding that exercise changes the structure of the human brain. It appears that specific brain structures, such as areas of the frontal cortex (just behind the forehead), enlarge after people participate in fitness training programs. The frontal cortex is the part of the brain that helps us solve complex problems that require strategizing and planning, for instance while playing chess. It has been theorized that a bigger frontal cortex allows better regulation of brain areas that control mood, but this possibility has not been thoroughly explored. Some studies have demonstrated that fitness training leads to more efficient use of frontal brain activity during mental tasks that require high attention.
J. Carson Smith is an exercise neuroscientist at the University of Wisconsin-Milwaukee who uses brain imaging to study the effects of exercise on the brain and emotion. His work examines brain activity both during and after cardiovascular exercise. "Studying how people attend to emotion during exercise may give clues as to which brain circuits may carry over and give long-term positive mood effects," says Smith. His studies suggest that during exercise, people shift their attentional bias toward pleasant stimuli (such as happy faces) and away from unpleasant stimuli (such as sad faces). These changes in focused attention may drive brain activity that underlies mood-enhancing effects even after exercise has ended. Smith's work also shows that blood flow to the brain remains elevated after exercise is over. This finding indicates that the effects of physical activity on the brain are still at work after an exercise session has finished. These lasting effects could give rise to long-term positive changes in brain function. Notably, most studies on the effects of physical activity on the brain and mood have focused on aerobic exercises, such as running and cycling, which are the types of exercises that increase heart rate and breathing. Aerobic exercises cause blood flow to the brain, potentially allowing the transfer of neurotransmitter molecules to brain regions involved in regulating mood. However, less work has examined exercises such as resistance training and weightlifting which affect the body much differently than typical aerobic exercises. There are clearly some positive effects of resistance strength training, but more research is needed to compare the effects of different types of exercises on the brain.
A recent study at the University of British Columbia showed that weight-lifting once or twice a week led to improved cognitive functions such as attention in elderly women. Further studies will determine the effects of resistance training on brain structure and function as well as mood. Additionally, the combination of cardiovascular and resistance training might give different effects than either type of exercise alone. Taken together, all these biological and psychological effects of exercise might sound impressive, but can exercise training programs effectively treat clinically diagnosed disorders like depression and bipolar disorder? The results of many studies conducted in patients with depression are encouraging. Mental health professionals are increasingly recognizing the potential value of exercise in treating psychiatric disorders. Exercise participation appears to reduce the severity of depression, but details such as how much and what kind of exercise is most beneficial have not been figured out. It is possible, however, that these details depend on the person experiencing depression; each individual may have an exercise program that is right for them. Keeping up an exercise routine - for example, 30 minutes a day of brisk walking - likely gives the most beneficial effects on mental health. In the case of depression, the current research indicates that exercise should be incorporated into a patient's existing treatment regimen.
Several gaps in our knowledge about exercise and mood disorders still exist. For example, exercise appears to be beneficial for women with postpartum depression following childbirth, but few studies have been conducted in this population. Very few studies have been conducted in patients with bipolar disorder. Some studies have compared exercise to medicinal antidepressant and psychological treatments, with results suggesting that exercise may be just as beneficial as other forms of treatment. However, more comparative studies are needed in different populations. The known biological effects of exercise on the brain should motivate further studies in patients who could likely benefit from structured exercise programs. With the details of biological and psychological effects of exercise still being figured out, one thing remains certain: we were made to move. Exercise has always been a key component of physical and mental wellbeing. Although new technology and societal trends can make it hard to remain physically active, exercise is as important as it always was to our bodies and minds.
Aaron Kucyi received a BSc Honours degree in Biology at York University. He is currently training as a graduate student studying neuroscience at the University of Toronto. Aaron has published peer-reviewed journal articles on the topic of exercise and mood disorders with colleagues at the Mood Disorders Psychopharmacology Unit of the University Health Network in Toronto.
Hand In Hand Depression and Anxiety
By David J. Dozois, PH.D.
Most of us have heard the familiar phrase, " Love and marriage go together like a horse and carriage." Sadly, though, a similar relationship is found between depression and anxiety. When two or more disorders co-occur more often than you would expect by chance alone, these disorders are said to be comorbid. The comorbidity of anxiety and depression is frequently the rule rather than the exception. Many research studies indicate that the comorbidity rates of anxiety and depression are often in excess of 50 per cent. In other words, about half of individuals with depression also suffer from anxiety and the reverse is also true. People with both depression and anxiety often have more severe symptoms and impairment than those with only one of these disorders.
Anxiety usually (although not always) occurs before depression and may, in fact, lead to depression. Someone might, for example, experience a lot of anxiety in social situations and start to avoid going out. The loneliness, isolation, and decreased activity may eventually make this person feel depressed.
Why do depression and anxiety so often go hand-in-hand?
So what accounts for this comorbidity? Well, there are several factors that come into play. Biological factors such as genetics seem to contribute at least somewhat to this relationship. For example, there may be a common genetic link that seems to predispose individuals to general distress (being high strung or nervous) although genetics do not seem to predict which disorder an individual will eventually develop.
Another general finding is that depression and anxiety are similar to one another in terms of what is called negative affect (feelings of distress, anger, disgust, fear, and worry). However, what seems to be different between these disorders is positive affect. Both anxious and depressed people experience a lot of negative feelings, but those who are depressed also seem to lack positive feelings and experiences. A related commonality between depression and anxiety is negative repetitive thinking. A number of researchers have found that individuals with depression and anxiety chew over their problems again and again, continue to think negatively, and worry excessively. With depression, the focus is usually on the past and on loss whereas in anxiety it is oriented toward the future and the possibility of threat and danger.
Stress is another common factor between depression and anxiety. In children, some of these risk factors include a change of schools, poverty, parental death, divorce and separation, violence, strained peer relationships and bullying, family conflict, and financial stress. In adulthood, stressors that are related to increased risk of emotional disturbance include unemployment, financial problems, marital instability, divorce, or single parenthood. Fortunately, there are also protective factors that reduce the risk of anxiety and depression. For example, having a supportive parent, close and supportive friends, and a set of coping skills can minimize the risks.
So what can I do to help reduce the risk?
• Gain a full understanding of the problem in terms of what's going on in the environment, your thoughts, your physical reactions, your mood, and your behaviour.
• Many depressed and anxious people report more negative thoughts and feelings when they are physically and socially inactive. Try scheduling task-oriented and pleasure-oriented activities. If you are finding yourself unmotivated to do things, start small and build up your activity level slowly. If you feel too anxious to do things, try to remind yourself that it is better to face your fears than to avoid them. In fact, facing your fears is the best way to get rid of your anxiety.
• Understand the relationship between your thoughts and your mood and behaviours. Whenever you experience a shift in your mood, there is always a thought connected to it. It doesn't always mean that your thinking is inaccurate or out of wack but our thoughts do affect our feelings, behaviours and even our brain chemistry.
• Monitoring your thoughts by writing them down is an excellent way to understand and change the way you think. This can help you to recognize the typical situations that trigger depressed or anxious mood, understand some of your negative thoughts, and challenge and change the way you think.
• When you experience a shift in emotion, it is important to take the time to deal with your thoughts. Once you begin to understand your thoughts, you can examine the evidence for or against the particular beliefs that you have been holding on to. Ask yourself: Can I think of any experiences that show me that this thought may not be accurate? If my friend had this thought, what would I tell him or her? If someone who loves me knew that I was thinking this thought, what might they tell me? When I am not so emotional how do I normally think about this situation? What thoughts helped me to feel better in the past? Am I ignoring evidence that suggests that this thought may not be true? Am I thinking in black and white terms and missing the grey? Am I looking at the whole picture?
• Challenge your negative thinking and develop new thoughts. Sometimes having a little bit of evidence can help you to change the way you think about a situation or yourself. If the evidence does not support your negative thoughts, the next step is to write down an alternative thought that is more consistent with the evidence. It is important not to be superficial here. The new thought needs to be believable and real for you.
• Understand the core beliefs that you are operating under. To understand what core beliefs or philosophies influence your negative thoughts and mood, examine your thoughts and look for themes that tie them together and that relate to similar emotions.
There are many other strategies that you can try to improve your mood. For example, you might try to increase your activities with friends, go for a walk, think of a plan so that you can better manage time, prioritize things so that you don't feel stressed out, buy a relaxation tape, or read some good self-help material. If your problems persist, you should consider speaking to a mental-health professional.
Dr. David J. A. Dozois is an Assistant Professor in the Departments of Psychology and Psychiatry at the University of Western Ontario in London. He received his Doctor of Philosophy degree in Clinical Psychology from the University of Calgary in 1999, and is registered as a psychologist. Dr. Dozois' research focuses on the role of cognition in depression and anxiety.
By Henny Westra, PHD, CPSYCH and Jennifer Leach
Anxiety and depression very commonly go together. In fact up to 50% of folks suffering with depression will also have an anxiety disorder at the same time and up to 95 per cent have past problems with excessive anxiety. Research on the time course of anxiety and depression has found that anxiety almost always comes first, then depression.In other words, having high levels of anxiety sharply increases one's vulnerability or probability of getting depressed. For this reason, we will be writing a series of articles in upcoming issues dealing with common types of anxiety that affect those who suffer from depression. This article is the first of a two-part series on worry. In this first installment, some common features of worry and why worry is important to learn to manage when you have a mood disorder will be outlined. In the second installment, specific strategies for managing worry will be discussed.
Anxiety and worry are normal and fundamental aspects of being human. Whether it's an upcoming exam, an ill family member or a speech you have to deliver, most people will worry to some degree about the outcome. Our minds work to address the problem and figure out what we need to do in order to generate the most positive outcome or help ourselves to feel less anxious. Overall, in moderation, worry can serve as a motivating force that helps us to effectively cope with unpleasant events that have happened or will happen. But when is worry undesirable or a problem? How much is too much worry? Here are some clues:
Do you . . .
• worry about future and past events with little or no problem-solving happening at the same time? You find that despite your constant thinking, it does not seem to generate solutions. You may also find that worrying interferes with your concentration.
• worry too much about events in your life? For example, even though you have financial struggles, you can't stop thinking about money. Or you may find yourself worrying about things that are very unlikely to happen. People around you may also comment that you worry too much.
• often think, prepare and plan for the worst to happen. People who struggle with excessive worry tend to constantly live in the future (what if) and have difficulty focusing on the present moment.
• find it difficult to stop worrying once you've started?
• find yourself worrying about everything? You may worry about many daily events such as work performance, health, money, relationships, etc.
• notice that when you are anxious and worried you also feel irritable, physically tense, restless, easily fatigued, unable to focus, and/or you are not sleeping well?
If you recognize yourself in the above descriptors, you may be suffering from what is known as Generalized Anxiety Disorder (GAD). This tendency to worry excessively can significantly affect many aspects of a person's life including their physical health, their performance and function at work and home, as well as their relationships with others. About 3 percent of the population has GAD, with women being twice as likely as men to be afflicted with it.
GAD is one of the anxiety disorders that most commonly co-occurs with depression. From 65 per cent to 80 per cent of those with GAD are depressed, and about 65 per cent of those with depression have a history of GAD. As well, GAD, or the tendency to worry excessively, is thought to be a precursor to depression, setting people up to eventually develop depression. Most people with GAD describe that it began very early and they usually report that they have always been a worrier. Most people also falsely believe that worry can't be controlled since they feel it is just the way they are wired. In our experience, worriers are usually the ones who are most pleasantly surprised and amazed that they can actually stop worrying all the time. How to do this will be the focus of our next installment and for more information, we suggest you check out the book referenced below.
Self-Help Reference John White, Ph.D. (1999). Overcoming Generalized Anxiety Disorder. New Harbinger.
Dr. Henny Westra is a Clinical Psychologist and Clinical Leader of the Anxiety and Affective Disorders Service at the London Health Sciences Centre. She is Assistant Professor in the Departments of Psychology at the York University. She has presented and published widely on treatment of anxiety and mood disorders. Jennifer Leach is an Occupational Therapist with the Anxiety and Affective Disorders Service at the London Health Sciences Centre.
Virtual Reality vs Internal Reality to Heal PTSD
By Amin Kanji BA, Bsw Hons., MSW., RSW
Comparing the uses of Virtual reality with internal reality as a means to heal PTSD sufferers
When I considered collecting my thoughts to write this article, I wondered about the shortcomings of existing treatment for PTSD for combatant personnel. The representative models were based on the mind and body reference. This, of course, suggested the notion of how the cognitive reference influences the behavior and with it, of course, emotions and the assertion of being healed or experiencing a reduction in symptoms to be able to cope. However, I observed that the notion of consciousness and the subconscious appeared to be missing altogether in military and other psychological and psychiatric literature. I wondered if this was due to the short-comings of the predominating Western movement towards postmodernism with a complete in time and over a period the modernization of the values, rejection of the spirit and its value in healing.
The postmodern direction is certainly not wrong and has its value in healing in social work literature. However, social work is also gaining ground in the therapeutic application of healing in the whole area of spiritual life and the subconscious. Today, there is a steady growth in this area and recognition that a valuable component of human existence is being thrown out of the window with the baby-in-the-bathwater so to speak because of the misguided view about relying on tangibilities or observables. Ironically, the military may gain sound wisdoms from Eastern modalities of thought and in particular from the historical experience of the Islamic world in the arts and science of healing. I hope that this contribution may offer the West the first step towards the healing of ties among the Judaist people, Christendom and the Islamic world which decries the dark forces of terror which represent and belong in segments to all three modern faiths, peoples and cultures. It may lead to the steady removal of the ignorance among the faiths and end the notion of the clashing syndrome among faiths.
First of all, I want to discuss pros and cons of the mind/body component-based virtual reality treatment therapy. There is sufficient literature today about the value of virtual rea;out treatments in healing soldiers returning from the war zone under the mind/body component model and virtual reality applications fit into this area of thinking for a number of reasons. The combatants are able to regurgitate living copies of close to real scenarios through the use of a computer and undertake reflective work to reduce personal psychiatric symptoms. They undergo practical steps to seek positive outcomes. First of all, they meet with the therapist and explore the value of such treatment and then steady experience the copy or close to the copy on the virtual reality stream of visual impressions and finally they return to the therapist and undertake additional reflective work through CBT and mindfulness and over time reform their thinking and experience transformation.
There are a number of theories which support this type of approach and the two most useful models have been the conditioning and reconditioning thinking offered by those who are attuned to behavioral thinking and it certainly also the foundation of CBT where you identify the negative thought, the dark space and or the dark experience and than undertake an exploration to form a positive review and move out of the darkness. This thinking is based on the idea of transforming the brain, consciousness and active actions through conscious approach and training and it fits the model of the military work because the military is after all a training ground for soldiery where civilians undergo ideological and physical change to undertake military work as a profession.
The other model that is often used is that of the mindfulness. Here once again the ailing personal undertakes dialectical applications. Dialectics refers to a search for positive change. However, it is based on building the capacity of the individual. The individual is considered as the expert who undertakes change and transformation by acknowledging personal emotional problems, identifying the emotional negative impulses and undertaking care and or sensitive approach of recognition and change. In this work, silence, contemplation and recognition are key and then discussion adds to the transformation. Therefore, the therapist, unlike in the CBT approach, does not remain an expert but becomes and engager and reflective presence in the person undertaking the change and transformation. Both the CBT (cognitive behavioural change) and the DBT (dialectical behavioural change) are based on mental and behavioural change indirectly influencing the building of capacity of recognition and care. Each of them is considered useful in helping manage or reduce and extinguish dark emotionality.
A third model, which is often used to rationalize and support the other two, is the biochemical representations of the brain. Scientists have begun to unearth the powerful representative brain and its functions in particular the hypothalamus and the amygdale. The hypothalamus is roughly the size of an almond and is responsible for function of the autonomic nervous system. This system secretes hormones, which stimulate the body temperature, hunger, thirst, and feelings of fatigue, anger, sexual activity and desire, and other forms of influences, which are generated autonomously and represent sometimes the dark side of human beings, if left out of control. The amygaldae are also almond shaped and are a group of neurons, which are responsible for processing the memory and emotional reactions. Therefore, in a nutshell, if these two areas of the brain are left to wander in the wild, combatants can undergo emotional feelings, which can represent anxiety, fear, irritability, anger, and sexual repression. These feelings can in turn influence distrust in relationships, sexual dysfunction and even painful dreams, fear of crowds and startle responses.
Therefore, the view is that through CBT, which is therapist directed, rational emotive transformation, and DBT where the therapist engages a group of combatants into positive mindfulness, the brain function is reinforced and redirected and the combatant is able to bring balance to their personal life and through that experience a reduction in symptoms and an increase in the capacity of coping mechanisms. The view is that in time the experience and training becomes spontaneous and natural and the soldier is now fitted with a ready and trained self reinforced ability to cope with stresses of war and return back to some level interpersonal relational, emotional and spiritual normalcy. The key wisdom is intellectual refitting to change and heal and undergo and emotional revision and build strength. However, virtual training is not a panacea. It does have benefits, but there are draw backs as well and these drawbacks need to be studied more thoroughly and in time to search for more effective forms of treatment for anxiety disorders and in particular those which are afflicted on Combatants. There are reasons for the need for ongoing research and search for new knowledge.
First of all, there is a significant difference between reality and virtual reality. Virtual reality is an attempt to reenact reality with the exiting technical medium and while the volume of noise and the visual affects of the available video and computer technology may attempt to copy reality, it is a poor representation. The virtual components are not able to reenact the real, intense, emotionally charged event and or set of events the combatants may have experienced. Therefore, the virtual display often while may act as a sound reminder or trigger recollections and flashbacks, it will not form the actual experience and the triggers of the brain and emotions which may have taken place during the real event and or set of events. In addition, the fact that it is virtual, the benign factor invariably enters the play of pictures and often if not in the beginning, over a period of time the constant variable, the soldier may become unable to sustain the real experience on a prolonged basis. One might also argue about the associative trigger effects, by ascertaining that the copy of virtual reality may actually influence the reinforcement of the experience itself and add to the combatant's condition if this infection is not handled by an experienced therapist. While, the virtual reality application may function to trigger, over a period of time, the reinforcement factor may wear off and the use of virtual reality as a means to depict the real experience could undergo extinction. There are also the issues of beliefs. Those who dislike computers and technology in general may not be able to adjust to its use and of course some might even undergo an aversion experience but deny its affects to the chain of command out of fear of loosing personal respect in the military.
The other approach is that of the use of the spirit and in reference to the hidden aspect or which is often known in Western literature as the consciousness and the subconscious. However it is also known in the Eastern literature as an existent or a species being which is hidden in specialized entanglement of the atomic structure of the human being. This existence of the spirit is not new and the idea that the human being is an atomic creature with specialized atoms forms as building blocks of the human system is steadily being discovered in all aspects of thinking in bio-chemistry and physics. We are atomic creatures who are living tangible forms who operate the under the influence of the movement of atoms and which are today understood as waves and particles. There is clear recognition that the every species being is so specialized that it is able to take different forms, and also has different types of organ forms and biochemical engineering as well as genetic representation. And, yet, this whole structure of the species being is clearly formed of atoms with observable similarities and this is confounding. What is within systems and which represents the unseen aspects of the existence to offer it value and that is not clearly understood in the Western thought. While in the Eastern world it is understood as the spirit and this spirit is considered to be specialized across the chain of spiritual existences.
How can the understanding of the spirit help to heal the combatants from the anxiety disorder afflicted from war and war like work and interventions? Is the use of the spirit aloof and exclusive from any representative interventions like those of virtual reality interwoven with CBT, DBT and Brain bio-chemical approaches? Do they fit together and or add value to the healing of PTSD suffering combatants? We are aware that PTSD suffers experience exaggeration of symptoms in emotional irritations, sexual dysfunction, startle responses, dissociational and straight forward recollections and flashbacks, anger, rejection, suspicion, fear and uncertainty in crowds and bad dreams and night sweats and sometimes even more generalized fear of life to the point of feeling suicidal. The meaning of life under goes transformation with PTSD as the suffers enter into the darkest realms of their inner existence and exhibit outer behaviors which are representative of the ailment. What is unique is that these symptoms are not separate, they are an interconnected system and why should they not be. The human system is interconnected. Therefore, when one symptom is exaggerated the whole human condition is afflicted and or affected. However, there is an underlying single factor which influences the chain of symptoms. This underlying single factor is the intellect which permits the human being to interpret the symptom expression. The intellect is the source which is either affected and or it affects the emotional response. In turn the series of clashes and conflicts which begin to become self observant reinforce the intellect and the human system undergoes pain, confusion and often strong references the original experiences. As that happens, the human being experiences associational connections and with that conditioning and in time PTSD becomes a conditioned response. This conditioned response over a period of conditioning becomes susceptible to triggers and strong associational inflections and we are now into years of suffering from full blown PTSD.
The history of faith in Judaism, Christianity, and Islam and other religions have taught humanity a number of factors, and it is ironical. The first thing we have learned is that each of us have to a certain extent acquired zelotism and with that has come insecurities and as a result, humanity has undergone killing over centuries in the name of faith. The other thing we have learned is that faith offers us an avenue to move out of insecurities and enter into the being of the surreal and or the power that is above all else in whom we have our subsistence and existence. What we gain from this later view is that through any faith, if we consider instrumentalizing it, we would certainly undertake the useful nature of faith into consideration and begin to move our being towards a direction that is enlightening and with enlightenment enter into a world of freedom. This is the answer to self-actualization and the movement from the world of multiplicity into the world of order and single spirit or what is often referred to as the single soul where we are no longer a shadow in the physical form but an existence of eternal nature. Therefore, spiritual science offers us an avenue of recognizing how the spirit and or the Eternal in us functions.
The world of specialized atoms in us is not new and also unlike the popular view not necessarily intangible. For example, the movement of waves and particles through sound, scent, floods of excitement and even expression of feelings can be observed by the various human senses. Smell, scent, pungency, stench can move in time and space. Feelings can do the same. How many times we have felt the feelings of others and undergone similar expressions. Crowd excitement can afflict us and we form the spread of waves and particles undergo similar sensations. Sexual excitement of one is easily noticeable and we make references to how horny the person may be. This is not just the observation of someone's behavior and an autonomous response by us, but it is an actual bombardment of waves and particles through various expressions which affect us. It is therefore, conceivable that through physics, biochemistry and organ stimulation, the whole area of psychology, social work dialectics and even psychiatry may undergo a revolution in knowledge. The world of spirit is not exclusive from science. There is no conflict between science and faith.
While the work on virtual reality functions on the premise of extinction and/or management, the surreal methods of introducing the spirit and spiritual life into the soldiers personal world, offers a window to come to terms with the profession of soldiery. A number of assumptions have to be cleared with the soldier before you entertain the method of internal reality over virtual reality. First of all, the treatment personnel need to believe that immaterial of their background prior to military training with anxiety and or depression issues and or a history of such issues in the family, they must be able to acknowledge that they are a unique, independent and healable individuals. Next, they must begin to work on the value that they were engaged in just wars. The reason behind this is the need to remove the stigma of armed conflict and fault finding. For example, the war in Afghanistan against the remnants of the Taliban governance and the remnant combatants from the various well known and unknown terrorists groups is a clear and determined indication of a just war. They must acknowledge that the theatre activity they were engaged in was to bring renewed hope for the general population immaterial of the mistakes and collateral damages and ravages of war interventions. Finally, they must accept the need to heal and remove the fear and anxiety that goes with some where PTSD and the symptoms are verbalized to make a presentation of exaggeration of symptoms in order to be able to get out of the military for reasons of personal fear, exhaustion and sometimes simply a desire to leave the profession with something in the pocket. Such references are opportunistic and based on foundation of aversion of the military work. Finally, they must be advised on the nature of internal reality work. Here the soldiers must follow the following steps:
Recognize that they must begin to work on normalizing their lives Recognize that they must begin to detach from the war zone activity and enter into the realities of their own interpersonal, social and spiritual lives at home. Recognize that the feelings they generate are from the war activity and the cultures they experienced and they must now undertake a transition. Each time they feel the sensation of anxiety at any level they must begin to normalize at once and dissociate from it and concentrate on activity on hand.
With these assumptions in hand, the soldiers must now begin to work on actively engaging in contemplation. Two other assumptions must be put into place. The first assumption is that during contemplation if they experience recollection sudden in a flashback or a progressive stream they should simply observe the movement and contemplate on the word of choice which must be centered in their forehead. This word of choice can be Peace , Lord, God, Rose etc. A very positive word. The practitioners must let the word and or visual representation generate on the forehead. A very key period of time must be chosen and that may be early in the morning and or a time when there is a chance for silence and no disturbance.
The practice of this model of internal reality guided under an experienced therapist can influence the following factors. First of all, the practitioner is able to begin to recognize the hidden inner energies. Next, the practitioner is able to realize the value of peace for all human kind. Also, the practitioner is able to realize that there is a more powerful and all encompassing reality whose existence we need to touch to be able to heal internally. Finally, this time is used to evaluate the self as a source of power and healing instead of allowing experiences from emotionally mutilating symptoms to influence conflict and emotional illness in us. What the individual is accomplishing through this model is steadily and progressively reconstructing the self and undertaking the evaluation of personal strength to reform the emotional interpretations of difficult and painful experiences. A word may appear miniscule, but its presence and meaning can influence powerful emotionally charged outcomes and if a positive word is used to undertake the balancing of the personal system, than the outcome can be positive and the generation of the strings of dark feelings can be steadily eradicated, sometimes extinguished and at other times even managed. Contemplating can be used to undertake visual experiences through the inner window of observations and the practitioner and move into places that are positive through practice and training.