Lights signal end of Iraq trauma
A ‘bonkers’ treatment ended five years of horrifying flashbacks for Hilary Horton.
Hilary Horton has the no-nonsense attitude you’d expect from someone who was an intensive care nurse for 20 years, has worked in women’s prisons and is a former Air Force reservist. So it is a surprise to learn that five years of her life were virtually destroyed by constantly reliving one of the Iraq war’s grimmest episodes.
The former Air Force nurse was responsible for the bodies of six Royal Military Policemen who were murdered as they manned a police station in southern Iraq in June 2003, a killing spree that became notorious. Hilary was badly affected by her experience, and in 2009 she was diagnosed with severe post-traumatic stress disorder (PTSD), suffering regular flashbacks, fits of weeping and loss of confidence.
She is a lifelong sceptic about alternative therapies, yet she has found recovery from the trauma through a little-known treatment that required her to sit in a darkened room and watch lights flashing alternately left and right.
“At my first session I just thought it was bonkers,” she says. “I couldn’t believe it would ever help me.”
The therapy, called EMDR (Eye Movement Desensitisation and Reprocessing), is designed primarily to treat PTSD, a disorder triggered by the experience of a shocking or violent event. Although EMDR remains controversial, its reputation is gaining ground.
With recent figures showing that almost one in 50 servicemen and women were diagnosed with mental health problems last year, the Ministry of Defence signed a three-year contract in June to provide EMDR for personnel with psychological trauma.
Had it come earlier, this initiative might have made all the difference to Hilary.
The 55-year-old from Stafford, who became a reservist 16 years ago, was deployed to Iraq in May 2003 in the aftermath of Saddam Hussein’s fall. She was a flight lieutenant nursing officer managing a team of 15 nurses at the hospital at Al Amarah base.
Everything was routine until June 24, when the bodies of the six murdered Red Caps were brought to the base. Hilary was responsible for tending to the bodies before they were repatriated, and performing the last offices. The injuries the soldiers had suffered were horrific; as well as being shot multiple times, they had been attacked with machetes.
Later that same year, with the arrival of her first grandchild, Hilary returned home to civilian life, believing that she had coped with what she had witnessed. But in 2004, working as an occupational health nurse, she was called to attend to a seriously injured railway worker.
“I rolled up his sleeve to take his blood pressure, and saw a Celtic tattoo,” she recalls. “It was the same as one I had seen on the arm of a dead soldier. I was instantly transported back to Iraq. I could see the bodies and smell the cordite, the blood, the stench.”
Soon Hilary found herself reliving the horror “film” of that day in Iraq on a daily basis.
“It got to the point that I knew when the ‘film’ was starting to come – I would see one of the men’s faces – and do a bargain in my head that I would ‘watch’ it later. It was the only way I could do a day’s work. But as soon as I left work and got into my car, it would come. Sometimes it would last five minutes, sometimes hours. The ‘film’ would always end with my feelings of utter failure.
“One evening a policeman came to my car to ask if I was OK. It was about 1am – and I had been sitting there, outside the office, having a flashback since 6pm.
“I also developed rituals – I would go through the names of the dead soldiers every day and talk to them.”
Outwardly she was determined to carry on as usual. “I was ashamed and embarrassed,” she says. “I had been such a senior nurse and here I was weeping like a child. I was tormented by thoughts of why had I been given the dead to look after, not the living. Was I not a good enough nurse?”
Hilary, who is divorced with three grown-up sons and two granddaughters, adds: “Before Iraq I had been in a serious relationship, but that ended after I came back. I now understand that it broke down because of everything I had been through.”
Things came to a head in 2009 when Hilary, by now lead consultant nurse for a large insurance company, was on her way to work. “The next thing I knew I was sitting in the park opposite the station having a flashback and an acquaintance was asking me if I was all right.”
This time Hilary went to her GP. She was also assessed by a military liaison officer and diagnosed with severe PTSD. “The military were supportive in a way that they hadn’t been in 2003,” Hilary says. “Back then I had mentioned that I thought I wasn’t right, but was told to get a grip, that I would be fine once I got back to civvy street.”
But now she was quickly referred for EMDR with Dr Shirley Timpson, a clinical psychologist specialising in PTSD at Stafford Hospital.
“I had serious doubts, but my GP had told me that if I didn’t take it seriously, then he would say I couldn’t work with patients any more.
“I had to look at a bank of blue lights. Dr Timpson then darkened the room and a light would flash from left to right which I had to follow with my eyes as I recalled what had happened.”
Therapists can create a similar effect by waving their fingers from left to right, or by clicking their fingers alternating from ear to ear. Hilary adds: “We realised the trigger for the flashbacks was the face of one of the men, and so she took me back to that repeatedly, asking me what I had felt.
“Those early sessions were traumatic. Each lasted for an hour or two, and I would be exhausted afterwards. For a while the flashbacks got worse.
“But during the fourth session I was able to recall that day without feeling dread, panic, fear or anger. From that point, we concentrated on how I wanted to remember those events – as an experience I could learn from professionally. I started to feel I had done a good job, rather than an overwhelming sense of failure.”
It’s not known exactly how EMDR works, but the act of repeatedly moving the eyes from left to right is thought to help unblock the brain’s information-processing system, which experts believe becomes frozen as a result of mental trauma.
While EMDR – which was developed in the 1980s by Dr Francine Shapiro, an American psychologist – doesn’t make distressing memories go away, it often causes them to lose their power.
While clinical trials have demonstrated high success rates, critics say eye movement plays no part in its effectiveness and that the therapy is simply a means of desensitisation. But the therapy has influential supporters. William Yule, Emeritus Professor of Applied Child Psychology at King’s College London, uses it for patients with PTSD and was on the National Institute for Health and Clinical Excellence committee that first approved EMDR for use in PTSD in 2005.
“When I first heard about it, it seemed crazy, but there was interesting outcome data,” Professor Yule says. “I had quite amazing success with children suffering from psychological trauma. In one series of cases, nine out of 10 lost their symptoms after three sessions.
“Yes, it’s an effective treatment without an explanation – but it shouldn’t be dismissed because of that.”
By the end of Hilary’s nine sessions, the flashbacks had gone. She was a changed person. Now running her own occupational health company, she says her feelings towards Iraq have been transformed.
“I was able to recover happy memories of Iraq – the time one of the lads sourced me some of my favourite marmalade, the day we had a pretend wedding with mosquito nets. And how positive it was that I, an experienced nurse, was there on that day. It would have been unfair to ask a less experienced colleague to look after the bodies of those soldiers.
“Most importantly, it was a privilege to care for those men at the end of their lives.”
What is PTSD and how is it treated?
Post traumatic stress disorder (PTSD) is a psychological condition that can develop after witnessing or experiencing a distressing event. Triggers include military combat, losing a loved one, violent mental or physical assault, natural disasters and serious road accidents.
The symptoms, which sometimes occur years after the event, are varied, but usually include flashbacks or nightmares in which patients relive the trauma. Sufferers may be distracted, unable to sleep and feel isolated from friends and family. It can have an impact on personal relationships, employment and driving ability.
PTSD affects up to 30 per cent of people who have had a traumatic experience. It can occur at any stage of life, including childhood, and is present in one in every 20 men and one in every 10 women. Treatment options range from patient monitoring to medication, cognitive behavioural therapy and eye-movement desensitisation and reprocessing (EMDR). .