servicemembers. The main element of PE is Imaginal Exposure, which requires the patient to revisit the traumatic experience verbally numerous times. Prolonged Exposure typically lasts eight to 15 sessions.

I spoke with Andrew after his therapy session on that Thursday. He called it the most mentally taxing event of his life, yet at the end he felt a weight had been lifted off his shoulders.

***

In the beginning, he’s perched in his chair, leaning slightly forward and gripping his dog tags. Both eyes are closed, his sweaty palms move to grip the armrests. His legs twitch underneath the chair. The anxiety and tension in his voice are unmistakable.

The therapist guides him slowly as he describes the setting of his trauma. Smells of trash and feces begin to fill the room.The sun-baked mud houses turn real in his mind. He can feel and hear the Velcro on his gear, stretching and straining under its own weight. Smooth steel rests against his right index finger. It’s midnight in November 2010 and he is back on patrol in Afghanistan.

As he begins telling his traumatic event for the first time, Andrew begins to dissociate and succumb to a flashback. He is no longer just retelling the story. He believes he is living it.
But the therapist pulls him back in and the story continues. With it comes chaos and a firefight. Screaming. Confusion. Bloodshed.

He is now moist with sweat. In his mind, the bullet strikes him and he begins to massage his injured arm. He complains of phantom pains.

The therapist stops him.