Suicide Prevention for Combat Veterans

“Every day, five U.S. soldiers try to kill themselves”(CNN.com).

HEALING SUICIDAL VETERANS: Recognizing, Supporting and Answering Their Pleas for Help (October 2009, New Horizon Press) is written by Victor Montgomery, III, MAEd., CMAC, RAS, who has worked with thousands of veterans and families as a former crisis intervention therapist at the National Veterans’ Suicide Prevention Lifeline and as an addiction therapist in outpatient clinics.


In HEALING SUICIDAL VETERANS, Montgomery provides,

• Tips and effective strategies for veterans to cope and heal.
• Checklists to identify symptoms of depression, post-traumatic stress disorder, traumatic brain injury and substance abuse.
• Twelve real-life stories featuring veterans from the Iraq, Afghanistan, Gulf, Beirut, Vietnam and Korean wars.
• Resources for veterans to seek the help they need.

HEALING SUICIDAL VETERANS is a vital guide for any veteran struggling with suicidal impulses.

Finding a Therapeutic Framework for Trauma-Based Disorders

I received a comment last night from Jeannie and thought that this would have a wider application to those of us who seek treatment for our trauma-based disorders. Talk therapy is an extremely useful tool when utilizing a proper framework with a trauma-based philosophy, which is beyond the scope of this posting. So, intimacy in a therapeutic framework is where I want to go. Without establishing this environment with a therapist we could run the risk of intellectualizing our trauma and not actually internalizing it. To internalize our trauma and absorb it within our consciousness is to finally find freedom from a foreboding foe.

To all of you who are seeking help with ptsd keep on working at it. My years of sexual abuse hapened over 50 years ago (I'm 62 years old) and I have lived my life with more then my share of ad bad choices, bad decisions and worse choices in relationships.

I would like to mention that finding the right right therapist and the right treatment is like tring to find the right pair of jeans. If the fit between you and your therapist isn't working it's not your fault...the fit just doesn't work. Please don't give up. Seek referrals and don't be hesitant about requesting an informational interview.

PTSD therapy is about as intimate soul bearing as it gets. It is imperative to find the right person to help you through the process.

EMDR - just had my second treatment and I am truly amazed. If the light bothers you then you can close your ears and just listen to the beeps.

My comment,

Jeannie is absolutely correct. It is imperative to find the therapist that you can connect with. The nature and structure; the kernel of trauma-based disorders rest in the most recessed parts of our minds. We will not be able to access this information properly if we do not bond with our treatment provider. To begin the journey of recovery we must find a therapeutic window into our minds substrate. Without developing intimacy between your this would not be possible. This could take several appointments, please be patient you deserve it.

PTSD, The Signature Wound of Modern Warfare

In this reposting I am explaining the split within the combat veteran that allows him or her to be "one person" in a moment and then shift into another completely incompatible individual in the same second. This manifestation of opposing self-states have become a common experience for those of us who have received the "signature wound" of modern warfare.

The leading theorists on the subject recognize that reactions to extreme stress can lead to one or more differing diagnosis, and that inherent in said traumatic reactions is structural dissociation of the personality. Where three types of structural dissociation have been postulated: primary structural dissociation, secondary structural dissociation and tertiary structural dissociation.

Primary structural dissociation involves simple PTSD, and dissociative amnesia, where the Emotional Personality (EP) and the Apparently Normal Personality (ANP) have become disenfranchised or fragmented. The EP "...is fixated in the trauma and associated experiences....[and the ANP]...is fixated in avoidance of the trauma, manifesting detachment, numbing, and partial or complete amnesia" (Steele, van der Hart, and Nijenhuis, n.d., para. 8).

PTSD is not only about personal protection or self preservation but in its essence a mechanism of such endeavors, thus becoming a self-perpetual entity in of itself (the EP can develop into a sub-personality, a component of Dissociative Identity Disorder [DID]). Almost as if it has become self-aware and not only will it steer one away from danger, but also away from its own demise; a seemingly serendipitous supra-intelligent guidance of the subconscious.

The EP has evolutionary roots in defensive mechanisms that propelled us through the traumatic experience(s), an inborn reactionary system that can become entrenched within the mind. The EP's success in our survival leads us to firmly identify with this part of ourselves and engages in obsessive and compulsive rumination of the defensive mechanisms and exhibits as symptomatology.

The ANP has become the mode of operation whereby the individual can engage everyday operational tasks. Such as "...attachment, energy management, reproduction and rearing of children, socialization, play, and exploration" (para. 12). To do so, the ANP’s main function is to avoid the intrusive thoughts and fear potentials.

In a constant threat environment, the evolutionary response system and the benefits of survival further encapsulates the differentiated states of mind. Secondary structural dissociation is a result of this prolonged and saturated state of being. A fluid environment demands that we engage in concerted efforts to survive, to do otherwise means death. Animalistic reflexive defense mechanisms such as the fight or flight response or submissive freezing, delve into the realm of “…complex PTSD or disorders of extreme stress (DES), trauma-induced borderline personality disorder, and dissociative disorders not otherwise specified” (para. 12).

Tertiary structural dissociation results from the complete fragmentation of the EP and the ANP. Whereby numerous ANP’s can develop to engage different aspects of a persons life, such as putting on your “work hat” to enable the separation of a traumatic existence to a work self, the social self, etc. Here we find the diagnosis of DID, where traumatic associations or triggers have inundated the individual and submerges them into a function of constantly changing identities governed by situational exchanges.

Combat Veterans Bring the Monster of War Home: The Story of SGT Travis Triggs

Image via Wikipedia

Welcome home my brothers and sisters, welcome home. Thank you for your service and continuing sacrifices. I pray that you have a blessed Veterans Day. Below I mention Sgt. Travis Triggs who had lost his way home from spiritual and mental wounds of war. Sgt. Triggs is fast becoming the norm when counting the revolving doors and tours of duty. Imagine having lived through the horrors of war and in going home knowing that in all probability you will run with death again.

How would you release the demon raging in your mind?

I was just reading about Sgt. Travis Triggs again, for those that do not know who I am talking about he was the soldier who had 5, yes FIVE tours of combat, that shot himself and his brother in the head after a police car chase. He went to Iraq 4 times and Afghanistan once. He had never been in trouble before that day even though the media had portrayed them both as having violent criminal histories. Sgt. Triggs volunteered for the extra deployments,

My symptoms went away. After all, I was going back to the fight, back to shared adversity, where the tempo is high and our adrenaline pulses through our veins like hot blood (as cited in Times Online, November 23, 2008).

The article gives an account of a lost soul that had left everything over in a far away land where the blood runs thick as the bonds of brotherhood. He had assumed a culture of killing and the persona of a "combat self," a subsumption of the "Soldier's Heart," shedding all of the remnants of his civilian identity and connections to self and home. He had become the perfect soldier, much too perfect.

There is disconnection between everything that is human and the necessities of killing and what has to be done in combat. Imagine being in an unimaginable situation and having to do the unthinkable. How can this be done? A disconnection between everything human and having to do the unimaginable resounds in combat. For we must wholly demonize our adversary and in the process we dehumanize ourselves, whereas the monster must die. A neurological reprogramming engaging dissociative states and a compartmentalization splitting. In doing so some veterans and soldiers lose their way, not only on the inside of our mind but now they become outsiders in society. Everything at home had become foreign to him, he had become lost within a once comfortable environment.

The parallel contrasts to my article on identity and dissociation and Sgt. Triggs? On the night where I had lost myself into psychosis, if the police had shown up, or if someone had confronted me on my abnormal behavior, it would had became real and the psychotic break would have been complete. I was convinced that everyone was out to get me and I would have responded with violence to "protect" myself due to a warped conception of a perceived threat.

I ran out of that house and jumped into my car and drove away; drunk, high and out of my mind. Easily I could have been in an incident that probably would have resulted in a similar outcome. My death, an innocent bystander and possibly the police.

To survive war is not a relief, it is a sentence of grief, guilt, pain and shame from killing and surviving.

Let me ask again, How would you release the demon raging in your mind?

PBS to Air Special on Supporting our Veterans

Tomorrow on Veterans Day PBS will air a special celebrating a group of senior citizens who honor us as a nation when the general public is busy about their lives. I will be representing my service to our country and honoring those who have fallen. I invite you to tune into PBS and watch.



On call 24 hours a day for the past five years, a group of senior citizens has made history by greeting nearly 900,000 American troops at a tiny airport in Bangor,Maine.The Way We Get By is an intimate look at three of these greeters as they confront the universal losses that come with aging and rediscover their reason for living. Bill Knight, Jerry Mundy and Joan Gaudet find the strength to overcome their personal battles and transform their lives through service. This inspirational and surprising story shatters the stereotypes of today's senior citizens as the greeters redefine the meaning of community (copied from email by PBS's Community Engagement and Outreach Assistant).
Our troops deserve every ounce of support.

Soldiers, Guilt, Grief, Killing and Survival

In the last few posts I have been reposting some writings with a central theme. What a combat veteran goes through after returning from the battlefield, what we bring home to our families and communities. Below I discuss an identification with the crippling guilt that had blocked access to fully realizing my memories. Years after combat I could not remember most of what I had witnessed, but wished I could forget the guilt and self-condemnation haunting me. I demonized my enemy and in doing so lost my humanity.

I was writing about the "troop organism" and the squad mentality in my last paper. This line of inquiry took me back to a time when I felt totality, never since have I been more alive. A complete sense of unity, an omnipresence with my squad so whole within my surroundings, including the enemy we snuffed, especially those souls. I carry them today; the weight of such suffering that I now hold within. I have a sense of responsibility to those lives we took, I hold such guilt that at times it overwhelms me to the point of incapacitation.

My surviving has had such an impact on my life that many times I find myself not being worthy of having survived, and I know that this thought is not rational, but at times I cannot shake it. Many times in my life I thought of killing myself because of the crushing guilt, all due to my survival and inability to put behind me these thoughts of incompleteness.

Thinking back now, I feel that the absence of the completeness I felt back in 1991 coupled with the guilt of surviving have combined to form a disorganized attachment to the soldiers that we killed. In losing my attachment to the troop-organism, I unconsciously reformed that attachment on the one thing that I could take home with me, my guilt. In losing my squad-selves and my subsequent identifying with the enemy soldiers, I unwittingly formed a festoon of guilt and hung it upon my soul.

I know that they were the enemy, it was kill or be killed...But my God, when we were shooting and hitting them I saw their tanks and vehicles blowing up in grand fashion, it seemed so beautiful. I remember the sight was so awe inspiring, the turrets flipping end over end, fire spraying upwards to a hundred feet. I could feel in the back of my mind, my humanity, trying to tell me that there were people in those tanks. My mind tried to tell that I could actually see the bodies felling over and over, within the upwelling of fire...no, no that cannot be...I was too far from them to actually see. So I told myself.< The reality set in when we saw the charred remains of the vehicles and realizing that no one could have lived through that. I remember trying not to think of my vehicle getting hit like that. The guilt began to creep up on me when we saw the pitiful encampments of the regular soldiers; we saw their food stocks...rice and rotting tomatoes...nothing more, and little of that. We joked of how we were glad to be on our side, again I felt the little bit of guilt niggling at me to witness and take in what we saw. Today, I carry the guilt of thousands of soldiers who lost their lives to the meat grinder of the US Army by way of the M1A1 Abrams Main Battle tank sabot rounds, of the Apache helicopter hellfire missiles, the 30mm A10 Warthog Gatling guns, multiple launch rocket systems and the 105 mm howitzer to name a few. To find out how bravely the Iraqi Republican Guard units fought against an over whelming foe, follow this link (then click on "correcting myths").

I still chase that sense of totality...I was the driver, on point for the division, so I saw it all.

Precipice of Death, A Soldier's Vista

If you are just now joining us, I am posting overlooked articles that I think can build on an understanding of your combat veteran. In this post I attempt to portray the minds landscape of the veteran or soldier have gone to the brink of death and found the place where others lose theirs and how do we come back from this precipice.

To understand what a person with PTSD goes through "in the moment" we have to think beyond our belief of how we would handle ourselves in a high stress life or death situation. Put self away, go to that place that enables you to kill or be killed.

Forget the theoretical self analyzing the process, but concentrate on the dominating, primeval alpha self that goes beyond rationalizing why or why not, realize that part of you that goes without thinking. This part operates from the law of the wild, the component that keeps you alive when your life becomes threatened to be snatched away. Your will to survive is an entity of its own and will separate from your rationale to preserve itself, self preservation.

We have a filtering mechanism inside of the mind that strains experience looking for the pertinent information needed to navigate stimuli in the environment. The subconscious screens the information through our emotive center which guides us on appropriate actions. When this controller becomes overloaded, the trigger is pulled and the irrational takes over. The flood gate becomes inundated and can no longer hold the storm wind and rain, the dam breaks releasing the rainwater's natural propensity to flow and overwhelm everything in its path.

Once this part of us has been released due to a death threat, it places itself on point and plows the way to safety. That part of us summoned by the heat of anger and the fire of rage and shuts down all thinking and rationalizing to do the deed, the dance of death.

Attachments with Family & Friends Give Way to Squad Cohesion

Again I am reposting past articles to help others in their quest for reasons and rationalities of irrational behavior of a combat veteran.

The question about will a soldier seek out help when they are losing sleep and exhibiting signs of PTSD. Probably not if they are still in the military, because the military has a deep ingrained belief that PTSD is a weakness.

Another thing to consider, soldiers in combat develop a powerful attachment to one another. The strength of this bonding overshadows all others, even family. First of all the degree of familiarity and closeness that extreme survival situations such as combat, brings people together to a height one has never experinced before. People have an instinctual need to feel a belonging such as in a herd where they feel safe.

A small combat squad that has experinced several fire fights develops a sense of oneness with each other, they have become one organism through the forging process of fight or flight. Due to the nature of killing and survival all of their other emotionality has become severed from their environment and channeled into the solidarity that soldiering brings. If one of them gets wounded or killed they all feel it through their connection of unity.

This herdness has supplanted all other attachments while people they once knew intimately have become foreign and strange. The family, friends and soldier feel this estrangement and all involved become unfamiliar and uncomfortable. Family and friends cannot understand what they have been through, so they seek others who do.

Some soldiers will long for that interconnectedness left in the field when they came home and reenlist or volunteer for another tour. Many soldiers find that their PTSD symptoms dissipate or vanish while back in the theater of combat, they have reentered the realm of survival, fight or flight and oneness with soldiering.

A Combat Veteran Struggles with Leaving the Ethics of War Behind

Soldiers and veterans with full blown PTSD usually have low personal self-esteem, a self-constructed foundation of self-affirmations grounded in positive thought, word and deeds, reinforced through values and principles. Esteem manifests in an outward appearance of honor and moral mastery, integrity and humility as others would know a consistency of character established through words, deed and actions. Where all of these principles were meet and mastered in the field of battle they no longer apply to a civilian life or civil society.

The combat schema, a defined preconditioned set of beliefs and values enabling the warrior to navigate efficiently through the adversity of combat without a detailed consideration of consequences. To engage in a mortal fight with the enemy this schema spells out our actions in a given situation as being preoccupied with survivability of the moment can get you killed. The warrior with PTSD has grown accustomed to the value and belief systems of war and feels threatened when they become faced with having to let go of this security to reintegrate back into society.

Without a proper identification of values and a conceptualization of a solid schema we can become lost to the reality of a situation and possibly lose out on our interactions necessary for relationship building. Combat critically changes our value systems, mostly to the detriment of constructing and maintaining significant relationships with family and friends. A disconnect happens between the soldier or veteran that leaves everyone feeling as though an insurmountable wall has been erected.

By an identification of values, along with acknowledging and deconstructing the combat schema one could find the ability to critically analyze in the moment, the validity of said beliefs as required by situational reflection enabling readjustments and disallowing an inflexibility of position. An underpinning of empowering schema and a reevaluation of ethical morality allows one to find plasticity in the moment producing a positive self-efficacy; a confident and self-assured person.

A Solider's Conviction, Why We Fight

Another reposting to bring forth knowledge to those who wish to understand their combat veteran.

My war was in 1991, fought against a invading force foregoing a countries self-determination and rule. A soldier has to believe that their cause has been a just one. For without this belief, war has become an act of tyranny and we amount to mercenaries. King Khalid of Saudia Arabia offered our commander in chief to pay each American soldier in the Gulf War I $1500, he refused as he should have.

I was proud to have served a noble cause of restoring a countries rights, borders and sovereignty. I had been awake fighting for seven days straight without any sleep and was upset when the cease fire had been called. We had engaged in three hard fought campaigns against the Iraqi Republican Guard, Saddam's best armored forces. We had their remaining Division cut off from returning to Iraq in a low lying basin, both opposing forces within firing range.

As we looked upon each other in anticipation, with our trigger fingers itching, we knew that this would be a heavy fought battle with many casualties. Both sides in a bid for life within a surreal cloud of apprehension, waiting for the order to fire.

A soldiers conviction carries them through the inferno of warfare, for a cause linked in faith to higher principles better enables the mind to rest within its self-preservation mode. Engaged by the confidence that our presence will be felt and fueled through our fealty to freedom for everyone. In moments like this, time stands still and listens to the call of the soldiers communion with all and none.

Combat Values Theory and the Veteran: A Marriage of Defensive Mechanisms and Role Switching

My readership has grown pretty steady in the last two years and I want to tell you that I am truly blessed to have people look to me for understanding when not so long ago I seriously lacked such perceptions. Soon I will have my 200th post here at PASP, Thank you for your continued patronage. I would like to bring some attention to some overlooked posts that I think will shed some light on a combat veterans thinking process, feelings, behaviors, reactions and interactions with others. I hope to bring forth an illumination into why we do what we do.

Photo by Scott Lee

Dichotomous Subdivisions Within the Subconscious, an existence without realizing our true nature results in a separation from reality and our connection to one another. An either-or duality dissociates discernment from reason leaving a fractured self. We cut up and separate rationalities in an attempt to preserve our sanity as the mind forms dissections to preserve and protect itself. The defensive mechanism overwhelms our thinking process and compartmentalizes our personality. The split in our mental reflections enables a combat veteran to 'role switch' from a killer instinct with no remorse to a loving and caring father with great capacity for empathy. For the combat vet this can become troublesome to dangerous when these roles begin to blur and wreck havoc.

Everyone sets up belief systems, a schema that enable us to react to situations as they arrive. By using this system of rules as a guide in life we can interact in society without having to analyze every aspect of our experience. We can convince ourselves that our ideology is who we are, when in reality living within our dogma cuts us off from a greater understanding and reaching our potentiality. The combat veteran's brain has invoked a divided self to ensure the integrity of the differing internal representations. His or her mind has been subdivided into incompatible subsections to deal with life in the clashing realms of their subconscious.