PASP on Letting Go of PTSD

Life can only be understood backwards; but it must be lived forward. ~ Søren Kierkegaard

If suggesting that letting go was actually the best and easiest option, then the world be a different place and I would of “fixed” myself long ago. Might as well hand the novice a boomerang in a shaming pose and quietly say, “Throw it.”

I have been angry for most of my life and all too often I take it out on people close to me. When my mother was alive, she carried the brunt of my rage. I did not know why but back then it felt like she was the source of it all. It probably kept me out of prison. On some level she may have known, and took my verbal abuse. Betty was an anger sink for me, keeping me safe when blaming and railing against her for my vulnerability.

With my mother, I wasn't jesting with the world against the stacked house of facades we call society. Done enough, you may find your face filleted. If you are lucky, I'm told. I was better able to fair storms when she lived. When veterans and families have a strong support network, living with the consequences of war is hard enough. For those with little to no support, or loose it they will more often spiral out of control.

I am not here to deny that most of it was my wreckage, nor get into a trolling fight with agents against change. Mind bending, while great for special effects on an unattached screen it is better coped understanding what to expect. I am here for people with PTSD and other brain injuries to navigate the vortex of inner experience in hopes they can better cope.

The house of facades becomes a disorientating sea of emotions, memories and nightmares lost in the waves hurt, delusion, pain and rage for vets with Complex PTSD and Moral Injury. Any one distortion to our self-image could trip a hallucination, attack with your delusions and I

Hurt can become a stoking force under bridges. ~ Scott Lee

Moral Injury, it tries to kill me most days. For us trusting comes too quick, or not fast enough. Hurt, can become a heat sink drowning out reason and clarity. It is rooted in my hate for me, I get that.

I see the struggle for people to take the amount of sorrow silently exuding from my pores. Imagine the internal state one must carry to radiate this energy. It is uncomfortable, I get it. Let's not forget the lion tongue cuts both ways, see my face.

One of the best medicines I have found, is the person willing to sit with you in your sorrow. Whether I am raging at unseen forces, or help me brave the deafening silence.

The crashing waves atop the sea looks scary, to you. I know the unrealized terror of the undercurrents, invisible to the reality above and carry the most power. Where we begin to see scary sea swimming on top, my third eye is constantly churning. Just because we don't talk about it or have a good day, does not mean we do not think about what we did and saw every day.

Not one vet deployed to combat and seen or participated in inflicting high casualty rates comes back unchanged. Apathetic, angry at everyone, betrayed by the media and government on all fronts. Why wouldn't we feel apathetic to your plight, when our problems kill us? We get high profile "veterans" organizations pulling in multi-millions, but those vets get rock star treatment while it's filmed for promotional purposes.

Stop telling veterans to let go. The only way to let go of PTSD is by death, and too many veterans succumb to the ravages of posttramatic stress. I dare say few of us give up, more like died while waiting on care. Someone care now?

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.

Live Honoring America's Fallen

By CJ Crisham


As you can tell, I haven't been writing a lot lately. To tell the truth, I haven't really felt like it. But, I've also been busy with a training week. We worked through the past two weekends and I'm REALLY looking forward to this Saturday for my first day off in a few weeks. I'm not complaining though. Guys in Iraq and Afghanistan go months without a day off.

Today, I had my second appointment with my psychologist. Originally, he was going to complete a command assessment, but I have to go to another post in Georgia for that. Not really sure why and neither is my doc. But, I'll do whatever it takes. The road time will be much needed.

What I don't want to turn this blog into is a constant repetition of PTSD issues. There's a lot going in the military and national security world that needs to be talked about – like the release of GITMO detainee Mohammed Jawad to Afghanistan. Jawad is accused of attacking two American soldiers and their Afghani translator in Afghanistan in 2002 by tossing a grenade at them. Instead of getting myself all wrapped up in that, I'll publish what Vets For Freedom Chairman, Pete Hegseth, said about the release since I agree with him on this:

The lives of our troops and the safety of our nation should be of paramount concern to the Obama Administration, not an afterthought. Today’s decision to release yet another trained terrorist shows a lack of consideration for the risks our war-fighters take to help bring insurgents and terrorists to justice.

Jawad’s treatment as a prisoner was unfortunate. However, his treatment does not exonerate him from throwing a grenade at American troops. America cannot afford to have terrorists released back to the battlefield and rejoining the fight to kill Soldiers and Marines, all for the purpose of appeasing a campaign promise.

Having served at Guantanamo Bay and in Iraq, I witnessed the cause of radical Islamists on two vital fronts. I saw how my fellow soldiers risked their lives in battle to capture these terrorists and the hard work and professionalism it took to hold them at Guantanamo Bay. Additional releases such as this will make the continuing mission of our troops far more dangerous and deadly.

Anyway, I've been officially diagnosed with PTSD, something I wasn't exactly happy about. Why? I just want to go on living my life. I've been pretending nothing is wrong with me for years and suddenly there's a name attached to it. I spoke with my doc today about anxiety, anger, stress, and depression. I won't go into all the details, but wanted to focus on something he told me just before we ended.

What is the leading cause of PTSD in civilians in America? It's an interesting question because most people don't think about PTSD as a civilian issue. Yet, it is. The difference is in how civilians deal with it. The number one cause of PTSD in civilians is a car crash. Yet, most people don't exhibit signs of PTSD. Why is that? When a civilian survives a catastrophic event like a violent car wreck, they still need to get places. They get a new or used car to replace the wrecked one and continue on with their lives. It's hard at first, especially when they see similar cars to the one they were driving in or the one with which they crashed. Or when they pass the location where the wreck took place.

However they do it, the fact that they continue to face their fears of driving out of necessity helps them to overcome the root causes of PTSD. Eventually, they learn not to be afraid of driving because they are doing it so much without incident and their symptoms slowly disappear. So, I told him, the answer is simple. I just need to go back to Iraq, right? No. I need to confront those events (or spikes) that have contributed to my PTSD. How can I do that? The same way I did it when I started this blog five years ago – by writing.

I've published an edited version of my journal before, but I've never written about those events in detail and some I didn't publish at all. I'm not sure how I'm going to do that publicly or if I even want to, but I've decided to write my experiences down privately. One day, like my journal, I hope to publish it for others to read and identify or find solace with.

So, CJ, what's with the title? I have a LOT of survivor's guilt that I've lived with for years. I ask that question often about why did I come home? If there is a purpose behind it, have I served that purpose already? If so, then what? That's a lot of pressure I've put on myself. All I can do is follow the advice of the magnet I keep on back of my van: "Live Honoring America's Fallen."

Seeking Help is Not a Weakness

By CJ Grisham


I guess I could call this part III of my recovery. Earlier, I wrote about how I've been wrestling with inner turmoil for quite some time. I think I've largely been winning, but wrestling nonetheless (I was a wrestler in high school, so that may be helping). Throughout the years, I've learned how to cope with the hardest parts and other parts were no big deal.

Last week, I went to my first appointment with a local psychologist. My intent isn't to necessarily bare my soul here. It was hard enough to do in that office. My intent is to be an example to others that may be dealing with issues related to their combat experiences that they may be hiding.

The Army DOD has made it clear that they are trying to remove the stigma related to PTSD. It's a fundamental shift in attitude and mentality that must occur from the top down in order for it to be effective. A few weeks ago, I spoke with one of the assistants to General Chiarelli who is a LTC. She told me her experiences with PTSD which are encouraging considering that she is a Field Grade officer. She was likewise nervous about "coming out" about her PTSD issues.

I also don't want to get into this stupid debate about "you were only a signal guy or an MI guy, what are you so screwed up about?" Getting shot at, mortared, or having an IED blow up beside your truck doesn't care what MOS you hold. It affects us all differently. And, yes, there are some people simply looking for sympathy or a handout with claims of PTSD, but those will get flushed out in due time. PTSD is not an easy thing to fake, I would think. Maybe I'm wrong.

The bottom line is that I'm a senior NCO in the Army who takes an active role in his Soldiers' and civilians' lives. I impress upon them the importance of taking care of themselves. I've discussed suicide prevention and PTSD with them till I was blue in the face. But, all of that means nothing if I can't lead by example. How can I convince these troops to seek help and not worry about their clearances or jobs while inside I'm ignoring my own advice.

For over six years, my wife has endured uncomfortable nights of sleep while the man next her jerks, flails, tosses, and turns all night long while feeling powerless to help. I've woken up too many nights to an empty bed because it's easier for her to sleep on the couch instead of waking me up from the little sleep I'm able to scrounge up at night.

For over six years, Emily has learned to recognize when my inner temper is flaring up; to pull me aside before I absolutely explode or lash out. I'm not a physically abusive father, but I lose my temper too easily with my kids. The little things that are just the dumbest excuses in the world will set me off. Later, I just feel like the biggest ass because something so small as not closing a door or leaving something on the stairs sets me off.

I struggle with a deep sense of failure that my kids don't feel like they can come to me with their problems because my response is usually "suck it up and deal with it. What doesn't kill you makes you stronger." What a weak response and utter lack of love and compassion for a father to have towards kids who are learning to cope with life! It pierces my very soul when my kids are calling for mom and when she isn't around I ask what they need. Instead of telling me what is bothering them, they say they don't want to tell me because I'll "just get mad at them."

Regardless of whether or not I wanted to set an example for those Soldiers out there reading this that are going through the same thing, I NEED to find my family again. My issues have caused them to adjust their lives as much as mine. They have had to alter how they speak to me or behave around me. The families are just as much affected by PTSD as the Soldier who is afflicted with it. They cannot be forgotten.

Probably one of the factors that helped me cope these past few years is patience and love. The patience and love provided by wife and kids has been met with constant apathy. But, I've made the decision to finally allow that patience to pay off. My family is more important to me than anything in this life except my God. Even if the Army weren't serious about legitimately helping troops and wanted to use this to ruin my career, I simply don't care.

The good news is that the Army IS serious about this. Secretary Gates has put in black and white in no uncertain terms that seeking mental help will NOT affect your clearance. Seeking help with mental issues is NOT a weakness. Walking into that building last week and being surrounded by junior troops was a LOT harder than simply continuing through life hoping I live to see my grandchildren. Baring my soul to a complete stranger wasn't exactly on my list of the funnest things to do in life. But, it had to be done.

So far, I think I've had good command support. I am being given the time I need to navigate this road to recovery and normalcy. They have shown me that they understand the Army's intent. To be honest, I wasn't so sure at first. And only time will tell, but I'm convinced so far that I didn't make the wrong decision, as least as far as my career goes. And I honestly believe the Army wants to help us get through this the best way possible.

One Step at a Time

By CJ Grisham


For those that listen to our You Served Radio Show each Thursday evening, you probably missed an announcement I made at the end. Our interview with General Chiarelli went long so those listening live probably didn't catch it unless they went back and listened to the archives.

I've been noticeably missing the past week or so for a number of reasons. Not the least of which is Army business, but I can't blame it all on work. At the end of the show, I publicly admitted that I'm having issues dealing with life. Not in the sense of ending it, but just coping and interpersonal issues. I consider admitting that I have a problem phase I of my new recovery.

Last week, my company completed Phase II of the Army's Suicide Prevention program. We watched the video, "Shoulder To Shoulder: No Soldier Stands Alone" (I'll have it uploaded later) and then discussed some scenarios afterwords. When the training was complete, I sat down with my Soldiers to talk them face to face about what we had just trained on. I explained to them that NOTHING in this life – nothing in this Army – is worth taking your own life for. Life sucks…a LOT. But, it's never so bad that you should end your life.

I explained that in my experience there is a common thread to people who want to commit suicide. Almost without fail, the inner thought of suicidal people is that "life [for others] would be better without me." Or, "I'm inconsequential." A common goal of suicide is to easy the burden of one's life on other people. What they don't realize is that suicide only compounds the burden's on other people. The only thing it ends is that individual's problems while placing those problems in the hands of someone else. I looked my Soldiers in the eye and told them from the heart that I and the commander are there for them if they EVER feel like life is too burdensome to continue. We will not chastise them, mock them, make light of their situation, or try to convince them that their problems aren't real. We will do everything within our power to help them overcome whatever in their life is causing them pain and anguish.

I then explained that seeking that help, either from us or real professionals, is not a sign of weakness. I talked about my conversation with General Chiarelli and the Army's commitment to ending the stigma that has historically been attached to seeking mental health counseling. To lend credibility to what I had just told them, I entered phase II of my recovery – telling my Soldiers that I am seeking counseling. For far too long since returning from Iraq, people both inside and outside of the military have sort of hinted to me that I should seek help. My lovely wife has mentioned it a few times, sometimes joking for fear of offending me. Even my Command Sergeant Major suggested I seek professional help when he spoke to me about my IG complaint. I met each suggestion with either humor, disinterest, ambivalence, or anger depending on whom was telling me. There's nothing wrong with me. I'm fine. You're crazy for even suggesting such a thing. Haha, that's funny.

As most of you know, I started this blog as self-medication. It worked for a few years, but I'm not sure what's happened in recent months and years. Perhaps it's the physical pain I've been in for more than six years now. Maybe it's the accumulated lack of sleep that is catching up to me. Maybe there really is nothing wrong and I'm just really tired! Whatever it is, my behavior has changed and it sort of scares me.

I am always tired. No matter how long I "sleep," I NEVER wake up rested. I toss and turn throughout the night. I lie awake for hours enjoying the company of the beautiful woman beside, soundly sleeping. Sometimes, I get up and walk around the house or surf the internet. I'm not willing to get specific about the things keeping me awake at night publicly, but it's a combination of bad dreams, everyday stresses, and physical discomfort. I have a prescription to Vicodin for nights that I can't sleep through the pain that I rarely take. I'm afraid to get addicted to the pills if I take them every time I need them. A bottle typically lasts me about six to eight months. But, when I take them I keep Emily awake. Sometimes, they even keep me awake. I'm not in pain, but they make me itch.

I'm not comfortable being around people. I'm not the social butterfly I pretend to be anymore. This year's Milblog Conference was the most uncomfortable I've been in years. I used to love being the center of attention of making an ass out of myself. I don't like doing anything anymore. I hate leaving the house and when I do, I make sure I'm always armed. There's a sense of impending doom just walking out my front door. To at least get me out and about, I've turned to geocaching. It's something I can alone or with my family. It keeps me moving, but I don't have pay for anything or worry about large crowds.  Even when I went to the Tea Parties, I tried to keep mostly to myself and not draw attention.
That is what is so great about the internet. I can have all these friends and be in the company of hundreds of people and I feel perfectly fine. The problem is that I've made a lot of GREAT friends online that I truly love, respect and admire. Yet, I dread the eventuality of being social except with certain people. That tends to push people away or cause them to think that they've somehow done something wrong or that they aren't important to me which is completely untrue. I don't even like hanging out with my own family! My sister just finished a visit and I felt so distant the whole time.

One of the things that keeps me up at night is the fact that I expend a LOT of energy trying to keep my life in order. For many years I've had memory issues and it's gotten much worse lately. I have to write EVERYTHING down or I forget it. I'm not talking about complicated things or detailed things, I'm talking about virtually everything. I forget meetings, appointments, names, faces, promises made, places I've been, things I've done or not done, etc. The list literally goes on and on. It's frustrating because I used to be a virtual encyclopedia of information. Now I have to strain to remember anything.
There's nothing more frustrating than when my commander asks me a question about a Soldier's issue that I know about, but need to check my notes to brief. Hell, I even forget which Soldiers are at which field offices and I've been doing this for nearly two years!! Every day I come into my office, I open up my "go book" that I recently created and read through the list of offices and the troops located there so I don't forget. I used to be able to spout out with ease when someone was ETSing, in their promotion window, having a birthday, etc. I knew their family members' names and had them committed to memory. Now I'm lucky if I can get my own nieces and nephews' names right. I don't know if this is a result of stress or all the wonderful, cool explosions I had the pleasure of sitting through, but it's the one thing that I probably spend the most time trying to combat!

There is a bright side to all this. In my quest to deflect the attention I receive, I work hard to draw attention to other, more worthy, individuals. Instead of worrying about myself, I can put all my energy into worrying about my troops and making sure that their achievements are recognized. I try to focus on those injured or killed in combat. They deserve to be recognized for what they've sacrificed for their country.

Why am I writing all of this? Well, for the same reason I started this blog – to get it off my chest. To "tell someone without having to tell anyone." It makes me feel better – a little. The last thing I want/need is sympathy or people feeling sorry for me. I'm no victim here! I don't want special attention, help, or pawing. I don't need pats on the back and I don't want to be a poster child. I don't want money, congressional testimony, or the support of VoteVets or IVAW who want to politicize these issues. I want other Soldiers to realize that the Army is serious about removing the stigma. I have a problem! And I'm still "Army Strong" in spite of it! Don't believe me? Screw up and I'll still nail your arse to the wall and start shooting darts. I'll still put you in the front leaning rest for a decade or "until I get tired." I can still pass my PT test, qualify expert on my weapon, and meet my daily suspenses (thanks to Outlook's "tasks" function).

There's nothing weak about me because I'm having these issues. I can still lead by example, accomplish the mission, and take care of my Soldiers. And if my Soldiers feel like they can't trust me or serve under me, tough! Suck it up until your ETS or call your branch manager and get the hell out of here. Thankfully, I have good Soldiers who embody the Warrior Ethos and Army Values. They see that I'm still very much in control as "Top."

The stigma is hereby dead. I challenge all leaders to understand this and apply it where they can. Our troops need to understand that there is nothing weak about seeking help. I know because it has been much harder to acknowledge these issues than to hide them. It's been a lot harder knowing I may very well be ending my career by admitting that I'm not all there mentally. Talking about this now after 15+ years – and prior to being eligible for retirement benefits – is probably the hardest thing I've ever done. I'd be lying if I said I wasn't worried. I am, but I trust the Army on its word and I'm challenging that mentality. And as I do so, I will be documenting most of my progress here. There are still a great many issues I will probably never feel comfortable talking about, but I owe to others out there that may be trying to hide their problems for fear of losing their jobs or risking their reputation. I need to lead by example. And if I can do it, so can you!

Now, I'm gonna go get some sleep and enjoy the rest of my vacation. I'll be leaving my cell phone in the room tomorrow so I can really relax!

If You Need Help Ask For It

By CJ Grisham


I then explained that seeking that help, either from us or real professionals, is not a sign of weakness. I talked about my conversation with General Chiarelli and the Army's commitment to ending the stigma that has historically been attached to seeking mental health counseling. To lend credibility to what I had just told them, I entered phase II of my recovery – telling my Soldiers that I am seeking counseling. For far too long since returning from Iraq, people both inside and outside of the military have sort of hinted to me that I should seek help. My lovely wife has mentioned it a few times, sometimes joking for fear of offending me. Even my Command Sergeant Major suggested I seek professional help when he spoke to me about my IG complaint. I met each suggestion with either humor, disinterest, ambivalence, or anger depending on whom was telling me. There's nothing wrong with me. I'm fine. You're crazy for even suggesting such a thing. Haha, that's funny.

As most of you know, I started this blog as self-medication. It worked for a few years, but I'm not sure what's happened in recent months and years. Perhaps it's the physical pain I've been in for more than six years now. Maybe it's the accumulated lack of sleep that is catching up to me. Maybe there really is nothing wrong and I'm just really tired! Whatever it is, my behavior has changed and it sort of scares me.

I am always tired. No matter how long I "sleep," I NEVER wake up rested. I toss and turn throughout the night. I lie awake for hours enjoying the company of the beautiful woman beside, soundly sleeping. Sometimes, I get up and walk around the house or surf the internet. I'm not willing to get specific about the things keeping me awake at night publicly, but it's a combination of bad dreams, everyday stresses, and physical discomfort. I have a prescription to Vicodin for nights that I can't sleep through the pain that I rarely take. I'm afraid to get addicted to the pills if I take them every time I need them. A bottle typically lasts me about six to eight months. But, when I take them I keep Emily awake. Sometimes, they even keep me awake. I'm not in pain, but they make me itch.

I'm not comfortable being around people. I'm not the social butterfly I pretend to be anymore. This year's Milblog Conference was the most uncomfortable I've been in years. I used to love being the center of attention of making an ass out of myself. I don't like doing anything anymore. I hate leaving the house and when I do, I make sure I'm always armed. There's a sense of impending doom just walking out my front door. To at least get me out and about, I've turned to geocaching. It's something I can alone or with my family. It keeps me moving, but I don't have pay for anything or worry about large crowds. Even when I went to the Tea Parties, I tried to keep mostly to myself and not draw attention.

Information Can Lead to Knowledge But Not Necessarily to Wisdom

Early in my recovery I had many thinking errors, or mental actions based on a false belief system. I had a thinking dichotomy that reflected an "either or" proposition, an "If this then that" codification and a black or white opposition. A mind mostly grounded in defensive mechanisms.

When I had the realization of my condition, that a name could be assigned, I felt an immense relief. But then it hit me that nothing had changed at all! I expected this awareness would have a greater impact than it did. What I did find in this new perception, a deep profoundness and discernment which had escaped me before, I finally found myself to be no longer alone.

I thought with finally learning what I had, or what was wrong with me (PTSD), it would be more helpful than it actually was. In the back of my mind I believed I was literally crazy until I learned about my malady. I had the thought that by knowing what was "wrong" with me, that in someway I would get better. I assumed this knowledge would somehow cause a shift in my thinking. I had expectations of my enlightenment to be more profound than it was, nothing changed except that I now knew more than I did before. My mind at this time could not fathom that I had become a member of the walking wounded.

It hit me just recently that; information can lead to knowledge but not necessarily to wisdom.

PTSD-Where Does It Hurt?

I followed a comment to another blog and found this article by Peg at PegSpot. She is a Family Physician who has decided to branch out and take up creative writing. I heard her voice in this piece and felt it from within, I wanted to share this with you.

People speak of PTSD as if it were all the same.

"He fought in Iraq and now he has PTSD." End of story, as if those 4 little letters explain it all. Oh, yes, PTSD. Now we know what he's going through.

I don't believe it. Are all physical wounds the same? Of course not. You wouldn't say, "He had a fracture" and expect his suffering to be explained. There's a big difference between a fractured pinky and a fractured pelvis.

And what about a flesh wound? Well, there's flesh and then there's flesh. A suturable laceration in the leg, muscle-deep but no deeper, is worlds apart from a face half blown off, but both are "flesh wounds." The wounded person's experience is vastly different in these two scenarios.

Body parts matter when it comes to understanding wounds and healing. In the same way, I think mind parts matter when it comes to wounds of the psyche. I'm not talking necessarily about sections of the brain as an organ, although there is clearly correlation between the two, but about regions of the mind. What part was hurt? What coping pathway was railroaded? What belief system was shattered? What concept of self was blasted to smithereens? It matters.

When the body suffers a wound, it helps to know what weapon delivered the damage. What about the mind? What was the weapon, the injuring event, the final blow? We need to know. It helps assess and predict the damage. It makes a difference.

Finally, what about healing? If it is a wound of the body, do we suture? Splint and cast? Perform surgery, even, perhaps, amputate? Do we provide medicine, pills, creams, crutches? Not all treatments are equal, because not all wounds are equal. It's ludicrous to think otherwise.

So too wounds of the soul. What kind of healing is right for this crushed confidence? This lacerated faith? This broken, tender self? We can't treat them all the same, with the same drug cocktail, the same kind of therapy, even the same questions. It could be as bad as trying to sew a bone. Ineffective at best, at worst, deadly.

PTSD. The wounds are as individual as the wounded. We need to remember that.

My reply,

Peg, you have summed up the questions that riddles the horizon of the wound that of Post Traumatic Stress Disorder. One can see the distant scene and tell a delineation has split the skyline, a horizontal demarcation subdividing the plane.

No two sunsets have the same qualities or appearance. Upon walking toward this vista we find it forever escaping us, we can reach out in desperation and try to grasp it to find our fingers full of emptiness.

Tis much the same when we who have PTSD know nothing of its name and wrestle within repudiation, ever wrenching whilst the slipknot of insanity strengthens its grasp.

How a Soldier Prepares to Kill

To Do the Deed, the Dance of Death
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.

When PTSD is an Excuse and Ignorance Not

I was tooling around the internet and checking for some inspiration to write a post, oh boy did I ever find one. This piece I found was on a blog that I never would have thought would allow such lowbrow lack of insight and wholly judgmental holier than thou attitude perpetuated against our soldiers and veterans who have PTSD.

Just because we have a shortage of mental health workers to help our returning soldiers and veterans does not mean we should let just anybody in the doors to help. More damage can be done than good, even if they mean well. Especially if they have the kind of mental prowess and short sightedness such as this "counselor" who wrote this piece that I read.

I try not to wail on people because of who I used to be, but this guy goes on and on...well I will let you read his treatise of ignorance if you want to, but first here are some of his astounding mental feats of "I know I'm right because I said so"

I see the effects of PTSD on a regular basis and have dealt with it’s effects on people suffering from it for quite a few years. I strongly advocate for, is better health care for our returning Soldiers, whether they have physical injuries that can change their lives, or whether they’re suffering from TBI or PTSD.

No, nothing out of order here, even looks as though he might be on a roll to advocate actually, but keep going on,

Something that I’ve been seeing lately that really alarms me however, is Soldiers suffering from PTSD, committing crimes and then using their mental disorder as an excuse to not be held accountable for the crimes they commit. Unfortunately, that’s occurring more and more and it frightens me that they would be allowed to do so.

Ouch, believe it or not this is his next sentence. I do not see where we "let" or "allow" these crimes be done. Seems to me that the lack of mental health care might be contributing to this, but I doubt that's what he meant. Read on

The one thing that I want to stress here, is that just because someone is suffering from PTSD, doesn’t mean that they don’t know the difference between right and wrong and it doesn’t mean that they don’t have control over their behavior. If we allow them to use that as a crutch and an excuse their behavior, then honestly, I don’t see them bettering themselves. Instead, we’re inviting them to stay stuck in that behavior and never taking personal responsibility for their actions. We’re telling them that it’s okay for them to break the law or do bad things, because they have a mental disorder. That’s just not acceptable. When we allow it to become acceptable, then we’re opening the door for thousands of Americans from Soldiers to a crime victim, to do whatever they please and to use the excuse that they’re suffering from PTSD.

Well, I cannot read this anymore, so if you want to see what this guy who calls himself a counselor says, the link is here.

If you would rather skip his bull shit and get straight to my comment to his article then go to the first comment here, it is kind of long just letting you know, but it goes by real fast.

Combat Veterans and Institutions: A Systems Analysis

Returning Combat Veterans (RCV), have a difficult time reintegrating back into society and life within their family. They deal with a myriad of symptoms combining to hinder the RCV from coping in the civilian world, while having constructive relationships with their family and friends. The lack of psychological education and training while in the military poorly prepares the soldier for the horrors of war and the negative effects on mental functioning. Further compounding the problems for the RCV upon their return they encounter limited services and a Veterans Administration (VA) system more in tune with economics and regulations then providing best outcomes. The scope of this paper explains these concerns as they relate to the competition between veterans seeking help and a system geared toward a macro structural functionalist model that concentrates on peripheral wide applications. A deeper apprehension and awareness has to come forward for our veterans to get the help they need.

The problem between bureaucracies, the combat veteran and their family receiving help lies with the systems application of dynamic systems theory to address problems that require a more interactive ideology such as the ecological systems approach. The main criticism of systems theory treats the person as a machine or something that can be “fixed” lies central to the VA’s approach (Robbins, S.P., Pranab, C., Canda, E. R., pps. 28-47). The models and programs stemming from government to redress RCV issues fail to take into account the magnitude of their problems that extend beyond the medical model and psychological paradigm. The attempt by the VA to apply a blanket policy of treatment on all veterans who face problems such as the affects of psychological trauma in combat has failed.

The military way of life provides strong attachments through a communal approach to every aspect of interactions between soldiers and their families, whether through a support network for the spouse of a soldier to help one another, or to the training of our troops. Developing and enveloping the individual perspectives while opening them to a cohesive togetherness usually not felt before enlisting in the armed services. Now add in a military conflagration and this level of interpersonal commitment and associations become welded to each other’s identity (Lee, 2008f). By educating the soldiers on how personal bonds can be broken by combat and the importance of redeveloping connections with significant others could lessen the mental shock upon returning home.

While many physical features of the RCV may have changed, the deleterious effects of Traumatic Brain Injury (TBI) and Post Traumatic Stress Disorder (PTSD) leave nothing the same and completely alter the landscape of the mind. “Taking another's life in the name of freedom, patriotism and because of your job description profoundly changes the person.” (Lee, 2008a, para. 2) Their whole existence has been transformed by the experience of killing; the morality of war trumps the niceties of society and lends the RCV to a reflexive reactionary response to the environment. The enormous adaptive impositions caused by combat disposes of coping and social skills, personal values, cognitive development, definitions of boundaries, stress management, and appropriate responses to environmental stimuli. All of these issues combine to challenge the RCV’s reintegration back into society, “…the environment, which is physical and social…can either support or fail to support the adaptive achievements of autonomy, competence, identity formation, and relatedness to others” (Robbins, 35).

Value identifications have importance to the combat veteran with PTSD, as their value system has been compromised by the acts of killing and war. The values and morality of war greatly conflict with society’s norms and principles. When the combat veteran brings this survival perspective home with them it alienates them from everyone who has not experienced combat, war and or trauma. Combat changes and alters the soldier’s sense of importance and trivializes niceties that lubricate society’s interactions and exchanges. Without identifying what values the veteran or soldier deems important they will continue to operate from the old combat values set and wonder why people [fail to] understand them (Lee 2008c, para. 3).

Soldiers in combat develop a powerful attachment to one another; the strength of this symbiotic 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 experienced before. People have an instinctual need to feel a belonging such as in a herd where they feel safe. 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 the RCV has been through, so the soldier or veteran seeks other survivors who do (Lee, 2008e).

The militaristic concentration on rituals of drilling and killing so that one becomes a more efficient “terminator” through automatic reflexive responses to survival, leads the veteran prone to using violent behavior in any given situation where boundaries have been crossed. The open system dynamics of “normal” interaction has become highly dysfunctional for the RCV who has lost their “goodness of fit” within their home environment. The breakdown of a unifying suprasystem interferes with the holistic dimensions of the veteran, increasing the separation and antagonizing the loss of identity that humans claim from associations within their communities. Without an understanding of boundary maintenance the RCV often develops a feeling of being attacked at home and in their community due to their inability to adapt to the fluidity of boundaries inherent with socialization.

Ehrenreich (2003) seeks to advance an understanding of “social traumas” where, …[i]n the context of physical devastation, massive social displacement, and ongoing violence, the hierarchy of need reasserts itself: concrete needs for, health care, housing, and jobs, the need for social reconstruction and reintegration, and the necessity of social reconciliation may dwarf individual emotional needs.

The identification and reinforcement of values, emotion identification, and anger management techniques along with stress management training would enable soldiers to realize better coping strategies when coming out of the combat zone. Further, interpersonal communication and social skills education along with boundaries identification would foster closer relationships with significant others (Lee, 2008d). Further on the topic of values and principles, these systems have a connection to feelings and emotions or the lack thereof with one who dissociates as most RCVs and complex-PTSD sufferers do. Emotions and feelings are the arbiters of values, principles, and morality; the ethical dilemmas that keep most people in check can get bypassed with a combat veteran’s lack of affect. A normal reaction with a non-traumatized brain would trigger an emotive response cascading into consideration of appropriate responses. The higher level processes of cognitive interaction delve into a consideration of choices and consequences, whereas the traumatized brain operates from the lower base of primitive survival systems and defensive mechanisms forgoing the thought of repercussions (Lee, 2008c).

The subsystem of a combat squad having experienced several fire fights develops a sense of oneness with each other; they have become an independent ecosystem; one organism through the forging process of fight or flight. Due to the nature of killing and survival their 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 and common goal of survival (Lee 2008d). Bonding through blood and battle takes the soldier to a new level of raw humanism forged through survival and fight or flight defensive mechanisms. The psychology of killing alters the terrain of the mind disabling the rational machinery and enabling the ancient reflexive responsive unconscious (Lee, 2008f).

The focus on killing without contemplating consequences severs the RCVs ritual of connection to community, family, and wholeness resulting in deviant adaptations. Their formative connections have remained back in the field of combat and killing, where they left part of themselves with their buddies who have yet to come home while carrying the guilt of leaving them behind. They feel that egoistic “warrior archetype” connection with the military and the battle buddy who had their back in the combat zone. In this mind frame when the veteran comes home; they become lost in a world that no longer makes sense to them due to adaptive process of bypassing the five senses and emotional attachment to considerations of interactions. The hard wiring of the combat veterans mind acts as if their life depends on the ritualism of defensive hyper-vigilance and keeps the RCV stuck in a malposition (Lee, 2008b).

When combat takes away the soldier who has became the centerpiece of an intimate community it breaks down. Whether he has been buried or she has become a prisoner of her own mind; war fractures the body, mind, spirit and the community that once knew cohesion (Lee, 2008f). 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 (Lee, 2008e).

The troops who do make it out of the theater of combat have been changed in body and mind. They have lost substantial parts of their mind, soul and community. Psychological trauma devastates the battle buddy, spouse, and children while splintering everything that once was the bedrock of the American Soldier (Lee, 2008f). In addition the military needs to teach mental health sensitivity training and PTSD awareness as a standard, in basic training and continuing throughout their careers thus giving mental injuries of war validity. Training in these areas would give our soldiers an extra set of tools and weapons in fighting the psychological effects of combat and war. Educating them before hand of what they may face upon going home would prepare them if they develop PTSD. Otherwise they will have gained the insights and ability to recognize when their fellow soldier suffers from PTSD (Lee, 2008d).

References
Ehrenreich, J. H., (2003). Understanding PTSD: forgetting trauma. Journal of Social Issues, 3 (1) 15-28.

Lee, S. (2008a, July 13). Forgive me. PTSD, a soldier’s perspective. Retrieved from http://ptsdasoldiersperspective.blogspot.com/2008/07/forgive-me.html

Lee, S (2008b, July 20). My first email response. PTSD, a soldier’s perspective. Retrieved from http://ptsdasoldiersperspective.blogspot.com/2008/07/my-first-e-mail-response.html

Lee, S. (2008c, August 22). Thoughts feelings and behavior. PTSD, a soldier’s perspective. Retrieved from http://ptsdasoldiersperspective.blogspot.com/2008/08/thoughts-eelings-and-actions.html

Lee, S. (2008d, September 5). Fully train our soldiers for the rigors of war. PTSD, a soldier’s perspective. Retrieved from http://ptsdasoldiersperspective.blogspot.com/2008/09/fully-train-our-soldiers-for-rigors-of.html

Lee, S. (2008e, September 6). Soldiers in combat develop powerful attachments to one another. PTSD, a soldier’s perspective. Retrieved from http://ptsdasoldiersperspective.blogspot.com/2008/09/soldiers-in-combat-develop-powerful.html

Lee, S. (2008f, September 14). Lower recruitment standards contributing to military suicide rates. PTSD, a soldier's perspective. Retrieved from http://ptsdasoldiersperspective.blogspot.com/2008/09/lower-recruitment-standards.html

Robbins, S. P., Pranab, C. and Canda, E. R. (2006). Contemporary human behavior theory: a critical perspective for social work. Boston: Pearson Education.

A Beginning

I struggled with PTSD for 14 years before I received help for it. My experience with the Veteran's Administration (VA) bureaucracy discouraged me from getting the help that I needed. I attempted to get help 7 times within the VA system. The VA requires that you receive a diagnosis before treatment can begin. But they have you talk about the trauma that gave you the problems without the aid to help you through the triggered responses. It always sent me into a tail spin with no way around it, until I landed in a drug and alcohol treatment center after 14 years of insanity.

I started reading about PTSD to find out why I felt the way that I felt and did the things that i did. I started college along this time and started to have a catharsis, life started coming together in a way that it never had before.

As things progress in a positive manner I began to see how my life could help others and that's when I decided to go to school and become a therapist and specialize in PTSD and trauma therapy. I'm going for a masters in social work, that being the quickest way to attain my goals. I want to work at the VA and try and do some changes on the inside to help other soldiers come to terms with their illness. Then I plan to have my own practice and treat combat trauma in a long term treatment center from a holistic perspective, working on the complete person.