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The silent sentinel of PTSD

The Sentinel was recruited by Roy’s brain the day he came face to face with death.

This excitable, demanding little soldier was called into service for a very important job.

He performed well. Roy had survived the fight and injury because the Sentinel marshaled all of Roy’s experiences, body chemistry, and senses with the singular goal that is always the Sentinel’s mission — keep the body alive for a few minutes more.

The Sentinel Speaks
“Roy nearly died,” said the Sentinel. “He came so close to losing his life and his sense of who he is. Everything in his world turned upside down that day. I will never let that happen to Roy again! EVER!” said the Sentinel, as he quietly moves the levers and switches of Roy’s brain.

With the purest of intentions, the Sentinel began to take over Roy’s life.

“I can’t let other parts of Roy’s brain know what I’m doing. Logic will tell Roy that there is not really any danger, so I will never let logic know what I’m up to. The best way is to use Emotion as a diversion.”

The Sentinel surveys the body systems.

“Hey senses, listen up! If you see, hear, touch, smell, or taste anything remotely similar to anything Roy experienced during his brush with death, report it to me immediately! And don’t bother running your perceptions past Logic. We don’t want to waste any time!” 

While the silent Sentinel ordered Roy’s body to keep pushing adrenaline through Roy to keep him alert, Logic and Emotion were wondering what was happening.

“I feel a little off,” Logic said to Emotion.

“I know,” Emotion replied. “I’m feeling sad and anxious and you need to figure out why.” 

The Sentinel Dominates
The Sentinel was pleased. The more that Emotion and Logic wrestled with the way adrenaline made the body and mind feel, the less Roy will realize that his brains chemistry and neural pathways had been biologically altered by the traumatic event.

If Roy knew, then he might get the medical and therapeutic treatment needed to restore him to health. The Sentinel did not want that to happen, for then Roy might let down his guard and be vulnerable again.

Roy wasn’t sleeping well, he wasn’t digesting his food and his muscles were aching. Sometimes Logic felt that Emotion wanted to take over and Roy’s body reacted in panic, feeling out of control and under attack.

Roy would sometimes talk to friends about it. They all said that talking about it would help. Roy, in some moments of confidence, would talk about his terrible event, but talking and thinking about it didn’t seem to help.

In fact, it seemed to make things worse since whenever Roy thought about that day, the Sentinel would work furiously to respond. For all its caution, the sentinel simply never knew the difference between a mental image and reality.

For him it was all the same, and he put all the chemicals in full-on flight-or-fight mode. The Sentinel would do this stealthily, making emotion think it was just a feeling and not real. Logic worked overtime to make sense of it all. But Roy’s life didn’t seem to make sense.

Roy’s body dutifully obeyed the Sentinel’s orders to constantly squirt adrenaline through the bloodstream. To keep at a constant state of readiness, the heart needed to beat faster and harder. Blood was diverted from the digestive process. The large muscles were in constant tension, ready to explode in running, kicking, or punching.

Roy suffered stomach upset bathroom problems.

His blood pressure soared.

His muscles ached and he noticed a slight tremor in his hands.

The Sentinel knew he was robbing Roy’s body of normal operation. But the Sentinel didn’t care about the future or Roy’s quality of life. The Sentinel’s job is limited to surviving the next few minutes. Roy had to be alert and ready at all times! Who needs fine dexterity to run or fight or freeze in place as a defense? Who cares if the last meal gets digested? Roy may not even live long enough!

Roy’s wife couldn’t understand why, even when she provided as much love and support as she could, that Roy seemed distant and often complained of not feeling well. Their sex life was losing ground, and Roy didn’t even seem to care about his friends like he used to.

He did care about his booze though — logic had resorted to self-medication to control emotion.

The Sentinel didn’t feel bad about Roy’s degraded quality of life.

Only life itself — survival! — mattered. So what if the Sentinel’s demands on body chemistry kept Roy’s body from fighting off illness? So what if Logic was telling Roy that if Emotion was going to be such a jerk, there was no need to maintain a relationship with anyone?

And who needs sexual potency, interest, or healthy sperm if you are only going to live a few more minutes?

And the next few minutes is all that the Sentinel ever cared about.

The Sentinel Subsides
Logic finally talked Roy into seeing a doctor.

Something was physically wrong. Roy couldn’t keep blaming emotion.

Roy’s physician was one of the few who knew the Sentinel well. The doctor helped Roy develop a strategy to stop the sentinel’s dictatorial control over Roy’s mind and body. Roy’s medical team found ways to get balance back to his body’s brain chemistry, and to deal with emotion-packed perceptions without getting the Sentinel all excited again.

Once the Sentinel’s secret mission was out in the open, Roy was able to fight the enemy that had once been his best friend.

There might be a time when the Sentinel needs to have his way again. There might be another fight, another crash, another life-and-death moment.

But for now, Roy could live his life fully, and not be the Sentinel’s slave just to survive the next few minutes every minute of the day. 

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