he belongs of the history of his battalion during the Ardennes
Offensive and its relation to other units including the rationale
of troop and supply movements. The reading of this took several
hours and was described as a difficult, yet tolerable and helpful,
experience. Next, for several sessions, we discussed his personal
experiences at the Battle of the Bulge from December 16th to
December 21st 1944 and had detailed discussions of the events
of the engagement and his feelings surrounding various situations.
Initially, the topics covered were of the least emotionally
upsetting (e.g., his position and a general description of the
landscape and troop movements). C.R. was asked to only superficially
describe his experiences and, when comfortable with
one event, to continue to progress to more graphic and traumatizing
experiences (e.g., the decision to “storm” a home and the
events that occurred once inside). Painful memories were spoken
about first in the office until some sense of mastery was
acquired over them by the patient. At that point, he made a
cassette tape recording of himself discussing these experiences
in detail to be listened to daily for at least 1 month for habituation.
C.R. was instructed to only make the tapes of the previously
discussed experiences until the most traumatic experiences
(e.g., the request of a friend for a “mercy killing” and
seeing dismembered corpses of fellow soldiers) were mastered.
Concurrently, the frequency of nightmares decreased from approximately
two weekly to one every 2 to 3 weeks and the number
of flashbacks decreased from approximately five weekly to
two to three every 2 weeks. After approximately 2 to 3 more
months of medication treatment, he reported only the occasional
nightmare and flashback. C.R. described less sensitivity
to disturbing stimuli and less arousal but still noted avoidance
symptoms. Nonetheless, by the end of treatment he began to
have less avoidance as evidenced by his attending two crowded
church bazaars without difficulty.