When a person walks through the doors of a Military Entrance Processing Station, they know they are signing a contract that gives their mind and body to the military. Most believe it is for a set period of time. For many, the contract is lifelong as the effects of being in the military follow them the rest of their lives.
When a soldier, sailor, marine, or airman is deployed, more is lost than the every day mundainness of life in the United States. Military personnel leave behind home, friends, and family. Often times this loss is permanent but not because the soldier is killed in combat. Most often, losses are because of the strain of being in the military and the effects the soldier carries with them.
The media is quick to jump on stories about military suicides, combat deaths, and active and veteran military members going on a homicidal rampage fueled by PTSD. This is what gets headlines and ratings. This is what people click on when looking for news on the internet. This is what people post and repost to social media. The bloodier and gorier, the more the story is shared, commented on, and used for political issues like gun control.
What happens when a veteran with PTSD is faced with the loss of their home and family? Where is the media then? There are no ratings or headlines for veterans who fight for their rights as parents. A father who is fleeced of his disability pay because courts use past employment to calculate child support is not newsworthy. A man with a bonified disability is discriminated in our countries courts is not a headline when the disability is PTSD. False accusations are believed because the father was labeled with four simple letters.
Where is the outcry? Where is the balance of justice? Courts have spent decades ensuring father's get equal treatment in custody and child support cases. But because lawyers do not understand PTSD, and judges base their opinions on sensationalized headlines of an extreme minority of cases involving violence, a disabled father risks losing his children after already losing his home because he cannot afford child support that was erroneously calculated.
We are not talking about deadbeat dads. We are talking about disabled military veterans who are also parents. Cecil Ranne is one of those fathers struggling for his rights as a parent, and rights to support himself and his children in spite of a disability as a result of his military service. Years after his divorce, Ranne is still fighting a miscalculated child support order while supporting three children with another on the way. Now, he faces jail time for lack of payment for one child in the custody of his ex-spouse.
The amount awarded is in excess of $1300 per month. Shortly after filing for a divorce in 2012, Ranne lost his job and has supported himself and his three other children on his military disability. Despite dozens of attempts to work within the system to get the order modified, Ranne is caught in the child support vortex many parents face who live in one state while the ex-spouse lives in another. Instead of child support services working for the good of the family, child support services in several states are passing the buck amongst themselves causing Ranne to overpay, double pay, and have little to no chance of getting the erroneous order modified and avoid jail.
Each state claims Ranne's issue is the problem of another state because there is an open file in that other state. Oregon where Ranne lives, has decided to harass him for back due child support instead of helping the disabled veteran get things straightened out. Montana, Colorado, and New Mexico pass Ranne off as not being their problem. In addition to passing the buck, each of these state's child support office and family court have apparently forgotten their obligation to assist Ranne through this process per the Americans with Disabilities Act (ADA).
According to the ADA, courts and agencies are required to assist persons with disabilities in completing paperwork and making sure the disabled individual understands everything that is part of the court process. To date, Oregon Child Support Services and Family Court has refused to abide by the ADA in Ranne's case.
Cecil Ranne has PTSD from his two deployments into combat for the United States military. He is not violent. He is a caring and diligent father. He is trying to support his family despite his disabilities. But because of sensationalized media headlines about "crazy" and violent veterans, Ranne has been stereotyped and resultingly discriminated against by a system that purports to act in the best interests of the family.
Where is the media? Where are the headlines? Where is the ACLU when a war veteran carrying the burden of his service to the United States becomes a victim of the United States court system? Where is the justice for a disabled veteran who is also a devoted father?
People enter the military knowing that they are potentially signing away their lives to their country. They did not sign away their civil rights. They did not sign away the lives of their children. Veterans carry the burdens of war. They did not sign away their humanity.
July 9, 2014
Profiling Veterans with PTSD
Profiling Veterans with PTSD
After serving our country and defending the freedom of this
nation, Veterans are faced with PTSD profiling. The stigma accompanying service-related
Post Traumatic Stress Disorder is a difficult obstacle for our Vets. Inaccurate and demeaning images of veterans
in the media are casting an undeserved shadow over our nation’s heroes. Veterans need our utmost respect and care,
instead of chastising them for injuries received while fighting our country’s
battles.
Earlier this year Kevin Bowlus’ case was dismissed in
Illinois after his testimony on being treated for PTSD.
“When she found out I was fighting for
my stepson and was being seen at the PTSD clinic she dropped representation the
day before a court hearing.”
-Kevin Bowles
Veterans often have their diagnosis used against them in
court violating their rights.
Kevin, a Navy Veteran is fighting for custody of his son and
his stepson due to an alleged unsafe environment caused by the children’s
mother. Absent till now, the biological father of the child has come forward. The child has been under Kevin’s primary care
since he was eight from infancy, till now.
In May, Kevin decided to end his alleged abusive r In May,
Kevin decided to end his alleged abusive relationship with his wife and the
children’s biological mother. Despite
the marriage ending, he still wants to continue as primary caretaker for the
children. He filed for a protective
order against the children’s mother and it's proving difficult for the courts
to see beyond the stigma and misunderstanding of his diagnosis. Not his actions, if it were for that he would
have his children.
.jpg)
Photo courtesy of- www.umkc.edu
“The police didn't believe I was a
victim”
-Kevin says
After appearing before the judge, Kevin was awarded an order
of protection. When the police
attempted to serve her with the order of protection they
discovered she took the children. They
found
her in Kentucky with the biological father. The mother signed over her rights to the
biological father 10 days after the order of protection. Kevin’s estranged wife
was then severed the order of protection and Kevin was able to retrieve the
children. Kevin adds, “Thankfully the police here blocked their attempt to
recover my stepson citing the protection order.”
“I have been
attempting like hell to get help for these kids from all avenues of government
but here in Illinois stepparents have no rights.”
Kevin states
Image
courtesy of stopsoldiersuicide.org
Kevin is awaiting a hearing for the order of protection in
Illinois on July 8, 2014. Both children
are in Kevin’s custody pending the results of the court appearance. He expresses deep concern about the upcoming
court date stating, “It is boiling down that I may have to let this child go
with a person with a violent history, and no one willing to protect him.”
As of Friday, June 27th Kevin was still in search of an attorney
to help with his upcoming case in Indiana. “I am still scrambling to find
another one and with no funds that is kinda hard,” Kevin explained. Thankfully a caring team at the Veterans’ PTSD
Project and an anonymous donor has come together and to help cover the cost of
Kevin’s legal fees. This act of kindness from fellow Veterans and the donor
allows Kevin to have the proper legal representation in his pending case to
secure the custody of his son and stepson.
We are still awaiting the outcome of Kevin’s Bowlus’
upcoming court appearance. The fight for
this Veteran’s children could potentially boil down to the stigma of his
service-related injury overshadowing his ability to parent and care for his
children. As Americans we need to band
together and follow the lead of the Veterans’ PTSD Project and anonymous donor
and take a stand to help veterans in need. It’s time to stop profiling veterans and start
supporting America’s heroes.
Written by Rebecca
Monahan
Blogger & USMC
Wife
June 9, 2014
Satisfied With My Best Effort (Syndrome of Survival)
This last Saturday I failed to finish my second attempt at a 100 mile race.
As I winded through the repeated switchbacks on the TARC 100 from mile twenty five to thirty I became increasingly aware that I was more and more disoriented. After three years of ultra running I had manage the first 85 degree day of the year as well as any central Maine resident could. Because of the heat I started cramping at ten miles, and I troubleshooted it with extra water, electrolyte pills and more calories than I could stand in the heat. I was strong physically but every time I ran I would heat up and cramp, but after I hit the marathon mark I started getting disoriented. Heat cramps were rapidly turning into heat exhaustion, but if I could only make it to the night I might have a chance...
My Ranger brain was on point, I was outside myself worrying about my weakening cognition. My limbic system in was kicking ass despite my cortex being massacred by the heat. I was both dizzy, less aware of my location on a map, as well as outside of myself and increasingly aware that failing to make it to the next aid station might be dangerous. In other situations I might have tried to take a more direct course towards support, but I knew that I was not reliable enough to do my own navigation. I was paradoxically disoriented and present at the same time. In my miserable state I had enough composure to know that I could no longer trust myself to do anything but keep moving on the course. Despite being delirious at thirty miles they were able to drop my core temp, by spraying me with a hose, and after sitting for five minutes drinking all I could and being offered ice (which was only available for medical issues). I ran some more.
I had trained hard, and instantly picked up my pace passing several runners that transitioned better in the aid station. However, I drank my water bottles so fast that I was out of water more than a mile away from the next aid station. I kept saying to myself "when are the fifty miler runners going to pass me" but everyone was crippled by the same heat. This mile and a quarter took thirty minutes, and the dizziness returned. Dehydrated I tried to rally again, but I couldn't seem to cool down. When a medic cooled me down I nearly went into hypothermia, and was advised to call it a day. I obliged without regrets.
In the days that have followed I have not been disappointed because, when you give your best effort and fail, there is nothing to be unsatisfied about. My Fitbit sensor recorded 4690 ft of elevation gain and 35 miles of running. My worst day was ten hours of running, and was still something to be proud of. Subsequently looking at the stats also made it apparent that I ran precisely according to my plans, based on my steps per minute. Typically I would have covered 42-5 miles and would have arrived at aids stations more rapidly.
I am not a fan of PTSD as an excuse, but taking diarrhetic medications for PTSD and mTBI has make heat especially hard for me to regulate my temperature in the summer. I also have a history of heat injuries of high dosages of antibiotics in Ranger School for cellulitis, and the high heat of swamp patrol, made me pass out with heat exhaustion during a long movement in Florida. On my second ultra I had similar issues only to spend three days in the hospital with rhabdo. PTSD is also linked to inflammation that compounds heat regulation. This is not an excuse, it is something that makes me proud to have fought so hard for the thirty five miles I managed to complete rather than disappointed about the sixty five miles that never could have been on a day like that. This year it did not heat up until my rest period so there was no way to employ my more typical stadium run for heat management, though in the winter I trained inside with maximum gear to train for the June race. I hiked easy for ten miles in Acadia last Saturday and walked Darby during the hottest part of the day (there were streams and rivers for him) all week, but my acclimatization did not help at all.
Still to have the maturity to listen to my body, recognize a bad day and make a stronger attempt in the fall, or winter when it is more healthy. Being confident and aware of my limitations is as important never accepting those limitations as permanent immovable burdens. Letting my lesson be that I need to try in the winter and start with smaller distances in the summer is not giving up finishing a race on my worst days, rather for me it is learning my limits and moving forward.
Most importantly when I was on the edge of passing out with heat exhaustion my overly capable limbic system reminded me the ways that all the stigmatized "PTSD Symptoms" are so useful in times of real danger. PTSD or as I like to call it the Syndrome of Survival still works when your life is on the line. I wouldn't wish those moments on anyone so please learn my lesson, and let my miserable failed attempted at 100 miles remind you that PTSD ultimately kept us alive when we needed it too. All of that of our baggage comes from strengths and is still a resource during an actual crisis. You don't have to be as crazy as I am by running ultra distances to learn how to yield the fruits of trauma as well as the sorrow.
April 21, 2014
Iraq Did Not Create the Fort Hood Shooter
There is an increasingly troubling narrative that essentially argues that service in Iraq and Afghanistan explains the criminal behavior at Fort Hood. This is an over simplification of most veterans with PTSD who will never commit a crime, but moreover a profound misunderstanding of the nature of counterinsurgency in Iraq. By doctrine we were deescalators of violence not perpetuators and we most often recognized that our best weapons "did not shoot." Any Iraq or Afghanistan veteran will tell you, if you take a couple of minutes to talk to them from time to time, that most tense situations in combat were dangerous situations caused by unidentified enemies and US forces refrained engagement because of a lack of positive identification. Units that departed from this course committed crimes, and were the exception.
The most tense moment for me occurred in just this way, and I have been hesitant to publicly discuss the night of my worst concussion because the situation got heated and there was some understandable personal tensions going on, though only momentary, and that I may seem like I am criticizing other people. That is not the case, I am going to describe an awful situation when everyone had the right intentions, and calmer heads prevailed. This will emphasize my roll because of the limits of my own memory, but I will assure that just as many or more times other soldiers, non commissioned officers of superiors played similar roles. You might assume the situation to be exceptional, but I think that day gets to the marrow of the US Army's, at company level, propensity to deescalate violence rather than perpetuate it in Iraq. The argument that we are more violent is a profound misunderstanding of what we did in Iraq, and more often we chose non violence. Anyone using our war as an excuse is exploiting a popular idea base on very little material evidence.
My worst of moment of Iraq was after a suicide bombing, but the second worse occurred after and IED blew up and convoy of Bradley's while my platoon was set in over-watch to prevent just such an attack. I have not now, nor will I ever feel like a greater failure, than watching a piece of dirt that I had personally been observing for six hours with multiple soldiers pulling rotations blow up right in front of me. In the moment I could not even see it. The force of the blast was faster than my brain's ability to process the image and I was thrown down a stairwell by over pressure. I fell face down and I came to face up, as if it were glitch in the matrix. It could not have been a second but I lost some consciousness. I was dizzy, very confused, but a Lieutenant with eyes on IED. The platoon of Bradley's was from another battalion passing through our area so they had no idea that Americans were occupying our building and mechanized and airborne units use different night optics. Concussed or not we could all die if we did not immediately mark our position in every way possible. Their fire discipline saved our lives, but we we would be tested the same way very quickly.
Local Iraqi Army or Policemen ran to to occupy a road block to the north of the attack, but their winter cloths made them hard to identify. Balaclavas and no helmets made friendly force identification nearly impossible, and created very tense moment with a few of my soldiers fearing an insurgent attack. Simultaneously on my radio, my company commander was very unhappy that bomb blew up right in may face. Why wouldn't he be. I certainly was not happy about it and to this day I second guess myself about that night. So while dealing with dizziness, disorientation and terrible situation I was simultaneously getting my ass chewed and preventing soldiers who wanted to fire on what they thought was a very legitimate threat to our security. These soldier were woken from sleep by bomb less that 50 meters away, so anger was par for the course, but the enemy did not usually sit in the middle of the street and gaggle up like Iraq soldiers so I wanted to take the time for confirmation. Everyone was angry from the lowest private to the battalion commander and tempers were hotter than they should have been on the radio, mine included. Not hotter than human beings woken up by a bomb at 4 AM though. However, despite all of anger and frustration everyone's actions were exemplary. My soldiers wanted to fire, but headed orders, I kept command and control until my platoon sergeant got on top of things and until a my commander was on the ground. After they were on top of it I actually put microphone up because I was getting really loopy and having trouble grasping the basic geographic layout.
People say that no one trains you for days like that, but the truth is I was trained precisely for days like that. My service in Iraq was more often events when I was attacked and had no clear enemy to engage so I waited for better opportunity rather than risking the lives of innocent people. So I cannot by any stretch of the imagination understand how Iraq, and the war I fought could be a source of anything, but level headed others centered decision making under the most adverse, frustrating and enraging situations. Frankly I am sick and tired of being compared to criminals because I have PTSD from all the days that I made the emotionally draining, but the ultimately least violent decisions only to be characterized as some non thinking killer with no human agency or power over my situation in Iraq and its aftermath. I was then and I am now, like the vast majority of other veterans, making the best of a far from ideal situation, and I am beyond frustrated that every-time another mass murder happens all people with mental illnesses are lumped together with an incredible minority of violent criminals. Especially in the wake of war of occupation and counterinsurgency that stressed nonviolent outcomes whenever they could be attained.
The most tense moment for me occurred in just this way, and I have been hesitant to publicly discuss the night of my worst concussion because the situation got heated and there was some understandable personal tensions going on, though only momentary, and that I may seem like I am criticizing other people. That is not the case, I am going to describe an awful situation when everyone had the right intentions, and calmer heads prevailed. This will emphasize my roll because of the limits of my own memory, but I will assure that just as many or more times other soldiers, non commissioned officers of superiors played similar roles. You might assume the situation to be exceptional, but I think that day gets to the marrow of the US Army's, at company level, propensity to deescalate violence rather than perpetuate it in Iraq. The argument that we are more violent is a profound misunderstanding of what we did in Iraq, and more often we chose non violence. Anyone using our war as an excuse is exploiting a popular idea base on very little material evidence.
My worst of moment of Iraq was after a suicide bombing, but the second worse occurred after and IED blew up and convoy of Bradley's while my platoon was set in over-watch to prevent just such an attack. I have not now, nor will I ever feel like a greater failure, than watching a piece of dirt that I had personally been observing for six hours with multiple soldiers pulling rotations blow up right in front of me. In the moment I could not even see it. The force of the blast was faster than my brain's ability to process the image and I was thrown down a stairwell by over pressure. I fell face down and I came to face up, as if it were glitch in the matrix. It could not have been a second but I lost some consciousness. I was dizzy, very confused, but a Lieutenant with eyes on IED. The platoon of Bradley's was from another battalion passing through our area so they had no idea that Americans were occupying our building and mechanized and airborne units use different night optics. Concussed or not we could all die if we did not immediately mark our position in every way possible. Their fire discipline saved our lives, but we we would be tested the same way very quickly.
Local Iraqi Army or Policemen ran to to occupy a road block to the north of the attack, but their winter cloths made them hard to identify. Balaclavas and no helmets made friendly force identification nearly impossible, and created very tense moment with a few of my soldiers fearing an insurgent attack. Simultaneously on my radio, my company commander was very unhappy that bomb blew up right in may face. Why wouldn't he be. I certainly was not happy about it and to this day I second guess myself about that night. So while dealing with dizziness, disorientation and terrible situation I was simultaneously getting my ass chewed and preventing soldiers who wanted to fire on what they thought was a very legitimate threat to our security. These soldier were woken from sleep by bomb less that 50 meters away, so anger was par for the course, but the enemy did not usually sit in the middle of the street and gaggle up like Iraq soldiers so I wanted to take the time for confirmation. Everyone was angry from the lowest private to the battalion commander and tempers were hotter than they should have been on the radio, mine included. Not hotter than human beings woken up by a bomb at 4 AM though. However, despite all of anger and frustration everyone's actions were exemplary. My soldiers wanted to fire, but headed orders, I kept command and control until my platoon sergeant got on top of things and until a my commander was on the ground. After they were on top of it I actually put microphone up because I was getting really loopy and having trouble grasping the basic geographic layout.
People say that no one trains you for days like that, but the truth is I was trained precisely for days like that. My service in Iraq was more often events when I was attacked and had no clear enemy to engage so I waited for better opportunity rather than risking the lives of innocent people. So I cannot by any stretch of the imagination understand how Iraq, and the war I fought could be a source of anything, but level headed others centered decision making under the most adverse, frustrating and enraging situations. Frankly I am sick and tired of being compared to criminals because I have PTSD from all the days that I made the emotionally draining, but the ultimately least violent decisions only to be characterized as some non thinking killer with no human agency or power over my situation in Iraq and its aftermath. I was then and I am now, like the vast majority of other veterans, making the best of a far from ideal situation, and I am beyond frustrated that every-time another mass murder happens all people with mental illnesses are lumped together with an incredible minority of violent criminals. Especially in the wake of war of occupation and counterinsurgency that stressed nonviolent outcomes whenever they could be attained.
March 31, 2014
Hombrewing as Creative Expression and a Seemingly Counter-intuitive, but Effective Check to Alcoholism
My wife noticed my love of microbrew beer and quickly bought me a homebrew kit for Christmas. When I started brewing I developed a much more nuanced and complicated appreciation to the subtleties of flavor and ingredients in beer.
To say it simply good beer tastes good and that leads you to drink more slowly in order to better appreciate it. Great beer is even better. By developing a greater affinity for the process of brewing and all of the differing factors that lead to a great beer, I began to start having more control over the temptation to numb my senses with alcohol. I also began studying home brewing and reading the books written my microbrewers. I came to realize how the rise of light beer increased binge drinking and that the growing microbrew movement regularly spoke out about alcoholism. Only an idiot would waste a great beer shotgunning chugging or funneling it.
Avoiding drinking altogether is a hard pill to swallow for some, but anyone can come to appreciate drinking good beer. Brewing helps one develop a healthy attitude about alcohol. Microbrew beer more expensive and it is harder to afford binge drinking it. For me home brewing has also served a means of creative expression that seems to balance me out a lot and overtime I began to realize that I needed more direct outlets, like this blog.
As a historian I used the analytical side of brain a lot and brewing helps me flex my creative muscles. I am often at loss because grade school did very little “boy or culturally masculine art” and I think this is a problem. For soldiers it is hard to express our feelings. As a historian I think the rise of masculine brewing culture is funny because in Early America women dominated the brewing of homebrew. I might be a feminist, but I can ultimately never escape a lifetime of bombardment by ideas as to what constitutes toughness and manhood. Military training has conditioned us to suppress emotion so hobbies that help us express ourselves are very useful for our return home.
Home brewing is a way to express ourselves in a way that respects our sense of toughness within a masculine cultural ideals. Better it should help us develop an appreciation for alcohol and not an obsession with drunkenness. It is also a hobby that is cost effective (I dare you to try and find another one) and one that you can spend a lifetime getting better at. You can easily brew beer that would cost $3 a bottle in batches of 48 bottles costing a total of $60 (this averages $1.25 per bottle), so after three batches you cover the initial investment.
This certainly would not help us all, and I would discourage this for people with addictive personalities, but it is something I have come to really value. Anything that helps you come to terms with the problems of alcoholism or any hobby that helps make you a better person is useful. I just thought I would share my affinity for brewing and how this unlikely hobby has helped me check the impulse to numb my senses with alcoholism in the hopes that it might help others find new muses or face their own problems.
February 25, 2014
The OIF/OEF Cocktail: Shell Shock or mTBI and PTSD
I am often frustrated when people mistake mTBI and PTSD because they can be so different. Admittedly PTSD is the hardest thing I face from day to day, but that is because of mTBI. Anatomically speaking PTSD is the over stimulation or use of the Hypothalmic Pituitary Adrenal (HPA) Axis. There is no simple way to describe neurology, but I will do my best at explaining my experiences in relation to my limited understanding of brain anatomy. The HPA is a apart of the limbic system which is one of the oldest traits in the human body. Our dogs and horses are some of the best aids to PTSD because we share this structure even if our cortex functioning is very different. The HPA and limbic system creates a stress response by emitting the chemical cortisol (often called adrenaline) which gives you energy (anger), pulls the blood out of your extremities in preference to organs (you will simply feel tingling or numbness in your limbs), and activates a larger part of your brain making you hyperaware. Think of the golden hour a casualty has to get into surgery, and to get fresh blood and coagulants before they start to crash. That is the final aspect of the limbic system's response to stress: the crash that inevitably comes after your body works at such high levels. That feeling of extreme fatigue and the inability to sleep is a direct result of cortisol, and also why battle fatigue was one of the first terms for PTSD.
PTSD is the persistence of this complex stress response into non dangerous situations. This interplay works with the cortex because the limbic system will provide the stressors to your consciousness so that you can more quickly respond to similar situations in the future. The HPA cortex relationship is a two way loop that can be instinctually triggered, by the older limbic system or by the cortex's memory of previously stressful events. I can see the way that anatomy and social construction works together in my memory of soldiers saying that sooner or later we are going to jump when a car back fires just like all these other guys, already favoring the stress responses of previous groups of veterans through a learned behavior, as well as reflexive reactions to triggers common to the tactics of insurgents in Iraq and Afghanistan. I was blown up in a stairwell so I hyperventilate in stairwells to this day. The anatomy of stress, the events themselves and the way that others have responded socially all effect the way we experience danger as well as the way we choose to process our memory.
But this is a post about mTBI and PTSD. How does this matter?
mTBI is actually a lot less complicated neurological than PTSD, though the experience is incredibly complicated, the concussive nature of high explosives as well as hitting ones head generally damages the brain and most effects the frontal cortex. The brain's protective coating is damaged by concussion and the cortex gets slammed into your skull. This generally erodes your whole brain functioning, but has one set of symptoms that makes PTSD a lot harder to manage. Cortex injuries limit a person's impulse control, and when a person has been exposed to serious life or death situations they are more likely to have a cortex that always fires up the limbic system's response to any stressor. Hence why for me the graduate seminar table and public speaking will often trigger panic attacks. Also the anger I felt in battle is worse because my cortex is not as capable as it was prior to concussions or repeated exposures to explosions. Everything is worse because you have eroded impulse control and every part yourb rain as a system is not your own. Your body is literally not yours to control. The WWI and WWII crack ups were not solely PTSD, but also damage to the cortex from shelling, because as Jonathan Shay as observed, PTSD is actually useful in combat. You always want to fight or fly, but you fight better as a unit so your trained to stick to the plan, that is until blasts and concussions add to this mix and make it harder to control the stress impulse.
You crash because we are only designed to go that hard in brief instances: the golden hour. You become depressed because you are exceeding the capability of human anatomy, and because you are losing control of your impulses. Worse cortisol damages the conscious memory when it is overused and the center of your brain that is self aware is consistently damaged. Kurt Vonnegut referred to scouts, himself included, as people that were controlled by their spinal column, shared location with the limbic system, because he understood the human brain in a profoundly human and intellectual fashion, but when the cortex is damaged it is nearly impossible to stop this life or death impulsivity.
I can remember my first nightmare and flashback like it was yesterday. I had just shot an RPG gunner in Mosul, I had a flashback that day and a nightmare that night. I knew it was PTS and I didn't care, I managed it and was upfront with the Physician Assistant about it. It was war, of course it was going to be terrible, but it was important for me to continue to do my part. However, when I got a concussion I could no longer see what was going on as natural and I got way to stuck in my limbic system. Everything was extreme and everything remains life or death because no matter how smart I can make myself my cortex doesn't have the impulse control that I once had. I can know something, but not feel something, because the emotional stress response is more powerful than my ability to control that impulse. I perform amazing feats because I am running on an extreme and then I crash because I am going way to hard all the time. I know this, but it is almost impossible to control the powerful impulse. I just hope I never lose the ultimate battle to the natural and constant ups and downs that come with the OIF/OEF cocktail.
PTSD is the persistence of this complex stress response into non dangerous situations. This interplay works with the cortex because the limbic system will provide the stressors to your consciousness so that you can more quickly respond to similar situations in the future. The HPA cortex relationship is a two way loop that can be instinctually triggered, by the older limbic system or by the cortex's memory of previously stressful events. I can see the way that anatomy and social construction works together in my memory of soldiers saying that sooner or later we are going to jump when a car back fires just like all these other guys, already favoring the stress responses of previous groups of veterans through a learned behavior, as well as reflexive reactions to triggers common to the tactics of insurgents in Iraq and Afghanistan. I was blown up in a stairwell so I hyperventilate in stairwells to this day. The anatomy of stress, the events themselves and the way that others have responded socially all effect the way we experience danger as well as the way we choose to process our memory.
But this is a post about mTBI and PTSD. How does this matter?
mTBI is actually a lot less complicated neurological than PTSD, though the experience is incredibly complicated, the concussive nature of high explosives as well as hitting ones head generally damages the brain and most effects the frontal cortex. The brain's protective coating is damaged by concussion and the cortex gets slammed into your skull. This generally erodes your whole brain functioning, but has one set of symptoms that makes PTSD a lot harder to manage. Cortex injuries limit a person's impulse control, and when a person has been exposed to serious life or death situations they are more likely to have a cortex that always fires up the limbic system's response to any stressor. Hence why for me the graduate seminar table and public speaking will often trigger panic attacks. Also the anger I felt in battle is worse because my cortex is not as capable as it was prior to concussions or repeated exposures to explosions. Everything is worse because you have eroded impulse control and every part yourb rain as a system is not your own. Your body is literally not yours to control. The WWI and WWII crack ups were not solely PTSD, but also damage to the cortex from shelling, because as Jonathan Shay as observed, PTSD is actually useful in combat. You always want to fight or fly, but you fight better as a unit so your trained to stick to the plan, that is until blasts and concussions add to this mix and make it harder to control the stress impulse.
You crash because we are only designed to go that hard in brief instances: the golden hour. You become depressed because you are exceeding the capability of human anatomy, and because you are losing control of your impulses. Worse cortisol damages the conscious memory when it is overused and the center of your brain that is self aware is consistently damaged. Kurt Vonnegut referred to scouts, himself included, as people that were controlled by their spinal column, shared location with the limbic system, because he understood the human brain in a profoundly human and intellectual fashion, but when the cortex is damaged it is nearly impossible to stop this life or death impulsivity.
I can remember my first nightmare and flashback like it was yesterday. I had just shot an RPG gunner in Mosul, I had a flashback that day and a nightmare that night. I knew it was PTS and I didn't care, I managed it and was upfront with the Physician Assistant about it. It was war, of course it was going to be terrible, but it was important for me to continue to do my part. However, when I got a concussion I could no longer see what was going on as natural and I got way to stuck in my limbic system. Everything was extreme and everything remains life or death because no matter how smart I can make myself my cortex doesn't have the impulse control that I once had. I can know something, but not feel something, because the emotional stress response is more powerful than my ability to control that impulse. I perform amazing feats because I am running on an extreme and then I crash because I am going way to hard all the time. I know this, but it is almost impossible to control the powerful impulse. I just hope I never lose the ultimate battle to the natural and constant ups and downs that come with the OIF/OEF cocktail.
January 15, 2014
My Case for the Syndrome of Survival
A popular argument to fight the stigma of PTSD is to abandon it as a disorder. There have also been cases for calling PTSD an injury because of damage to the hippocampus, but this is perhaps the worst piece of evidence because this scarring occurs in bi polar disorder and the entire spectrum of anxiety disorders: some caused by trauma, some not. The injury moniker's most problematic issue is that it seems to create an acceptable male, or females living up to male ideals, non mental illness. Even rape survivors are said to "have MST" instead of PTSD caused by rape in the military (why there is any effort to sterilize rape in the military continually blows my mind). However, the worst thing about injury or trauma titles is their omission of how paradoxical and complicated PTSD, Shell Shock, and Civil War Nostalgia have always been. Injuries are often a lot more simple: rest, ice elevate does very little to your identity. War alters our identity and what we have is a persistent illness, disorder or syndrome. Yet, anyone who truly understands PTSD grasps how it is the persistence of survival skills into non survival situations. Those survival skills ultimately saved our lives, but makes the mundane and routine parts of life harder to manage.
Syndromes are often permanent and the damage to our brain was not instant, it takes years of overuse of the limbic system to damage the brain's declarative memory and create the scaring identified by injury advocates. Moreover, calling it a syndrome of survival also will explain the deep longing and even nostalgic memory of war. We are damaged, but most of us possess some longing to return, and even miss combat or trauma. When we act like PTSD is solely an injury, we confuse injuries and disorders, all because of stigma. Assholes will be assholes whatever title is used, but calling PTSD what it is with respect to trauma's paradoxical complexity will help us accept what war, and survival have done to us. It will also, help war survivors recognize what they have in common with rape survivors, and that their persistent problems are extremely difficult and life altering, but they ultimately come from a place of strength, not weakness. We are all survivors and we should have a better title.
I know that this is a controversial topic that many well informed and capable people will disagree about, but as both a historian and combat veteran I have never been able to feel comfortable with any of the other popular titles. The syndrome of survival seems to captures all the complexity of survival as well as addressing lasting syndrome. Survival is a universally respected, even celebrated, aspect of the human experience and connecting our troubled lives to this ultimately positive fact will also encourage growth in all of those affect by trauma. We also need a title that people who suffer are more willing to bear publicly so that the conversation shifts, becomes broader and more substantive. A title that should come with a stronger sense of corporate pride and empathy from non survivors. A title that expresses a collective appreciation for what people have survived and the baggage that comes from it. No other title does that in the way that one crafted around survival. Survivor is a moniker that captures the fact that we are not leaves blow about by circumstances. We survived through merit and resilience, and we can also survive the way that those original experiences have changed us, maybe even let our survival motivate us to be something better than we would have been without our horrible experiences.
Syndromes are often permanent and the damage to our brain was not instant, it takes years of overuse of the limbic system to damage the brain's declarative memory and create the scaring identified by injury advocates. Moreover, calling it a syndrome of survival also will explain the deep longing and even nostalgic memory of war. We are damaged, but most of us possess some longing to return, and even miss combat or trauma. When we act like PTSD is solely an injury, we confuse injuries and disorders, all because of stigma. Assholes will be assholes whatever title is used, but calling PTSD what it is with respect to trauma's paradoxical complexity will help us accept what war, and survival have done to us. It will also, help war survivors recognize what they have in common with rape survivors, and that their persistent problems are extremely difficult and life altering, but they ultimately come from a place of strength, not weakness. We are all survivors and we should have a better title.
I know that this is a controversial topic that many well informed and capable people will disagree about, but as both a historian and combat veteran I have never been able to feel comfortable with any of the other popular titles. The syndrome of survival seems to captures all the complexity of survival as well as addressing lasting syndrome. Survival is a universally respected, even celebrated, aspect of the human experience and connecting our troubled lives to this ultimately positive fact will also encourage growth in all of those affect by trauma. We also need a title that people who suffer are more willing to bear publicly so that the conversation shifts, becomes broader and more substantive. A title that should come with a stronger sense of corporate pride and empathy from non survivors. A title that expresses a collective appreciation for what people have survived and the baggage that comes from it. No other title does that in the way that one crafted around survival. Survivor is a moniker that captures the fact that we are not leaves blow about by circumstances. We survived through merit and resilience, and we can also survive the way that those original experiences have changed us, maybe even let our survival motivate us to be something better than we would have been without our horrible experiences.
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