I’ve only got a pretty bare bones outline here, so please take this with a grain of salt. But if he’s been diagnosed with PTS by a reliable clinician who knows what he or she is talking about, I’d start with the PTS and put the rest on a back burner for now. Of course, he has to want to do this, too. I’m assuming he does, even if the depression tamps down his energy and motivation somewhat.
If he gets help for the PTS, it could make a nice dent on the sleep problems and maybe even reduce some of the stress that fuels his smoking – although that last one is a stretch. It’s more realistic to get some help for the PTS, then address the depression (which overlaps with the PTS but is still separate from it). And then you can work on taking away the poor dude’s cigarettes. I’d probably leave that for last, given what’s already on his plate. It also depends on how addicted he is to nicotine, how difficult that step will be. There’s some really wide range there.
I see from your area code that you’re in Canada, and I’m not sure what treatment modalities are available in your area. That said, I’d address the PTS with a combination of things. If he’s already got a good counselor he trusts, great. Stick with that, especially if this person has some particular skill in traumatic stress. A therapist who uses EMDR, TFT, Somatic Experiencing or Emotional Freedom Technique would be great.
You may also want to track down a Healing Touch or Therapeutic Touch practitioner – I know Canada has a substantial number of those guys. In addition, Therapeutic massage could help him too, as could yoga or Tai Chi. All or any of these practices could help him re-regulate his nervous system, which is one of the keys to treating PTS.
You can also add some digital resources for maximum impact and synergy:
- Guided imagery for general relaxation for a few weeks, followed by upping the intensity to imagery that specifically targets trauma.
- Mary Sise’s DVD teaches a very simple, effective acupoint tapping technique that can be helpful and not too demanding on a depressed, traumatized person.
- If the method seems promising, he may want to sign up for a free energy psychology teleseminar series at the Energy Psychology Café, which you can find here: http://www.energypsychologycafe.com/healing/Shealy/invite. It features a lot of highly regarded experts in this burgeoning field, so it’s worth a try.
I hope this is a start. We wish you both the best. Let us know how it goes.