Tag Archives: ptsd stigma

July 21, 2011 · 23:59

The Tapestry of Life: How PTSD and Combat Stress is a Part of Who and What We Are

I have been dealing with the effects of Post Traumatic Stress over 3 ½ years.  In that time I have had my struggles going ranging from falling into the abyss to a measure of recovery and occasional relapses.  It has been a difficult time which has stretched me in ways that I never dreamed and given me perspective on what it is to live, to have faith and to experience life in ways that I could not have imagined before I deployed toIraq.

Within a few weeks of beginning therapy I was asked by my therapist what I wanted to do with my experience.  I really didn’t know, I was in the midst of a complete emotional breakdown and crisis of faith.  When my therapist asked me “well Padre how are you with the Big Guy” I could only answer “I don’t know if God exists anymore or if he does if he cares about me.”  My therapist was the first person that asked me about my spiritual life after I returned.  No clergy of any kind asked that question.  I guess that they assumed quite wrongly that I hadn’t really changed.  There is a tendency among clergy to ignore the obvious when a colleague begins to fall apart.

In fact it is really a cultural problem.  Often the advice to someone dealing with trauma and the experience of grief which often compounds traumatic experience is to “forget about it” or “put it behind you and move forward.”  Some therapists and pastors seem to have burying the experience, reliving it time and time again until you are numb or simply try to expunge it from memory as their goal.

The problem with all of these “methods” is that they label the person who has been traumatized and the complex grief that they experience as a result of the trauma as ill, damaged or broken.  But it the opposite is true, people that have experienced trauma especially in a combat zone are simply having a normal reaction to experiences that are not normal.

We adapt to war and the experience becomes part of who we are.  It is a survival tool that humans have had ever since the first skirmishes between primitive tribes.  However primitives actually have an advantage over the modern human.  They went to war to defend their families and homes.  The warriors would be sent out with fanfare, religious ceremonies and ritual. When they returned they would be brought back into the tribe, new warriors who had distinguished themselves would be noted, sometimes marked in some physical manner.  Rituals marked the re-entry of the warriors and they would be reincorporated into the community. Some societies would incorporate rituals for individuals to do as they re-entered the community. Their stories would become part of the tribe’s oral tradition and passed down to successive generations.

Today’s modern American warrior doesn’t go to war with his neighbors.  These warriors go to war with men and women that come from many parts of the country, US territories or immigrants and when they leave service they often return to neighbors, friends and families that care about them but do not understand them or their experience. The reactions that they developed in combat and their response to perceived threats are considered dangerous or abnormal.  People tell them that they need to go back to what they were before the war experience but they can’t because they have been changed by their experiences.

We live in a culture of denial. All too often it seems that society simply wants the traumatized and grieving veteran just be quiet, see a shrink, go to a PTSD group and “get well.”  Many times churches and religious institutions treat the problem as some kind of spiritual shortcoming.  Many Christian veterans come home and find that they are shunned because they have doubts or because they don’t “get better” after people pray for them.  I was reading a faux news article which was more like an infomercial for a CD that promotes a method as “Be still and know….”  It was developed by a reserve Army Chaplain and Christian therapist. It is designed to make it all go away.  Do the method right and you get better, God heals you and you live happily ever after until something breaks the cycle of denial and you crash.  I do believe that God heals but I don’t believe that God makes everything magically go away like it never happened.  Such a belief is not supported in Scripture, the testimony of the early Church or for that matter most of the Christian tradition.

This week I was being filmed for a Department of Defense program called The Real Warriors Campaign   http://www.realwarriors.net/which is designed to de-stigmatize Combat Stress injuries including PTSD and Traumatic Brain Injury.  They picked up the article that was written about me in the Jacksonville Daily News in April of this year and asked if I would be willing to participate.   http://www.enctoday.com/articles/cmdr-89433-jdn-stephen-military.html

It was a hard week for me. I went to a functioned hosted by our hospital Wardroom at the base Officer’s Club Saturday night and while I enjoyed myself I hit sensory overload. When I got hope I was pretty edgy and to add to the situation we had some Marine helicopters flying in the area I live that night. As I tried to calm down I realized that I was going to be interviewed Tuesday and the thought scared the shit out of me.  Yes I had agreed to do it and yes I thought I needed to do it but my heavily introverted and relatively anti-social personality type now seasoned with reactivated PTSD symptoms couldn’t handle it.  I couldn’t sleep and had the firstIraqrelated dreams I have had in many months. I did not even open the front door of my place on Sunday.  I couldn’t sleep Sunday night and got permission of my boss to get some assistance.  Since I couldn’t get a no-notice appointment with my current psychiatrist I called my first therapist and he was helpful. I went to a ball game and that helped calm me down.  I was still anxious but functional.

The two days of filming went pretty well for me, although I know with the possible exception of “COPS” there is no such thing as reality television.  This was not “reality television” but the goal was to try to show how I live life, work and relate to people after deployment.  The crew was really good and handled things professionally but even so it was packaged and things had to be have lighting, have different camera angles and required me to repeat things sometimes because of the privacy issues of patients in the hospital.  But it is what it is.  By the end of the two days I was pretty wiped out and simply rested last night.

However on Monday night before the interview I had an epiphany.  That simple illumination came from an episode of Star Trek the Next Generation called Tapestry I won’t ruin it for you but the final segment of the episode is linked here:

http://www.youtube.com/watch?v=hZeGzaJiP6g&feature=related

The epiphany was very simple.  All of our life, the good, the bad, the enjoyable and even the traumatic are part of a rich tapestry.  Those painful threads, the ones that we cause ourselves or the ones that are the result of trauma, grief and loss are part of who we are as human beings.  If we try to remove them we damage the tapestry and if we try or are persuaded by those that deny the reality of pain and suffering to remove the really painful and deep hurts, those which are the most tightly wound into the fabric of our lives, especially for the combat veteran we risk long lasting damage to our very soul.

The challenge is not to be “healed” or to compartmentalize the trauma and put it in some deep closet in our brain.  Nor is it to deny the trauma or for that matter keep trying to relive the trauma so that we are desensitized to the pain.  The real challenge is to allow our experiences of war, grief, loss and trauma to have their place in our lives knowing that without them we are not who we are.

I’m not saying that I have any real answer to what all of us that experience combat stress injuries deal with.  All I know is that I just want to be real and there are risks in opening up to people and reaching out to get help.  At the same time it is important to find a way to get help so we can adapt to our new reality.

As for me I went through some terrible times that still affect me.  Yes I went through a period of profound spiritual crisis and even a loss of faith and when I began to recover faith people that had been okay with me being broken ended up asking me to leave my church because the faith that I have now didn’t fit the narrow box that defined that church.

All that being said I am glad that my therapists or my supervisors allowed me and continue to allow me to work through the issues that still impact me and my ability to function in society, deal with others and even effect my marriage.  I wish every combat vet and survivor of trauma had that support.  I just hope that I can be worthy of the trust that they have place in me and that I will care for those entrusted to me with the same care and compassion that I was and am being shown.

Peace

Padre Steve+

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June 22, 2011 · 01:08

Till the Smoke Clears: A Reflection on PTSD and Faith

A morning drive in Iraq, looks like that here too

We are in a drought in Eastern North Carolina and with that drought have come forest and peat fires in the areas surrounding the Crystal Coast. The fires have now shrouded the summer sky with a layer of dense smoke and the National Weather Service is predicting poor air quality and visibilities of a mile or less.

I had been noticing it periodically over the past few weeks and occasionally the stench from the fires would catch me unsuspecting and send me back to Iraq. Anyone that has served in Iraq can testify of the pall of smoke from burn pits and in locations around the cities and countryside of Iraq. Those afflicted with PTSD often have a heightened sense of awareness to things that most people take for granted such as noise, light and smell.  Having experienced this myself and talked to many more men and women that served in Iraq, especially those with PTSD these normal parts of everyday life now seem to be hard wired into our brains along with a need for safety and a certain level of hyper-vigilance.

Sand smoke and clouds

I had to drive to the Marine Corps Air Station at Cherry Point for my BLS recertification at the Medical Clinic this morning and the sky was weird hue. It reminded me somewhat of Iraq and the smell of the smoke hit me as did the sound of helicopters and jets taking part in a large exercise.  For a fair amount of the trip I was back in Iraq.  When I returned to LeJeune I had to stop by the UPS Store for a simple transaction and as I was filling out the paperwork someone barged in and slammed the door to the store as the sound of bombs exploding on the bombing ranges of the coast of Camp LeJeune went off. About that time a police car roared by with its siren wailing, just like they did in Iraq. I had to about put myself back into my skin as I remembered a morning doing PT near the perimeter of Taqaddam air base when an explosion rocked the town of Habbinyah less than a mile away with gunfire and sirens following the explosion. That’s some good living.  Hurriedly paying I got out of the store got in my trusty 2001 Honda CR-V and got on the road. As I drove west toward the base the smoke was worse in places as was the stench.

Sunset in the smoke and sand and a smoky day in ENC

I got back to the Hospital and took care of what I needed to do and went home. On the way out the door I could not find my Blackberry. It was nowhere. Not in my uniform, my desk or anywhere. I wracked my brain wondering where it could be.  Then I thought that it had to be at the UPS store, the Cherry Point Clinic or the Cherry Point base gas station.  I was beginning to hit panic mode but was able to calm down and as I drove back home toward the UPS store I just prayed that I had left it there. Thankfully I had and the very kind lady that runs the store had safeguarded it.  Evidently when the other customer had slammed herself through the door I had dropped it out of my hand without even noticing.  That old startle response is still there and thank God for life in small towns.

I finally arrived at home relatively calm and turned on baseball. As I fixed dinner I could hear more bombs exploding on the ocean bombing range which is only about 6 or 7 miles away from my apartment.  Meanwhile the aircraft were much more active even deep into the night. I turned up the television and hunkered down on my big bean bag, finished an article that I began yesterday about the Battle of the Philippine Sea and tried to tune out the aircraft and the occasional explosion.

Hanging on at the end of the Iraq deployment with RP1 Nelson Lebron

A friend of mine recently wrote about the “tentacles of PTSD” which I think is an apt description of the neuro-sensory reactions that are part of life with PTSD.  While I have had a lot fewer reactions over the past few months I have noticed an increase of hyper-arousal and hyper vigilance as these stimuli trigger physical responses to perceived danger.

I remember when I was collapsing in the summer of 2008 there was a rather large and long burning fire in the Great Dismal Swamp. I walked out one morning and the smoke was so thick that the sky looked just like Iraq between the smoke and sandstorms.  That was the day that after a daylong seminar on combat and trauma that my medical officer looked at me and asked if I was okay and I said that I wasn’t. In fact that was around June 16th 2008.  It marked the beginning of me recognizing that I was different and damaged and that nothing was the same including my faith which was shattered to the point that for all practical purposes I was an agnostic. But that day was also my first step to healing.

Now I do not expect a major crash because I am a lot more aware of what is going on and what triggers me. At the same time I do feel less safe in large part due to the sights sounds and smells that are running rampant and reminding me of Iraq. They say that the smoke will be worse tomorrow and the temperatures will also rise into the mid-90s, low by Iraq standards but enough to increase sensitivity to the sights sounds and smells that I and thousands of other Iraq and Afghanistan veterans in the area will experience.

Eventually the smoke from the fires will clear away and with it the neuro-stimuli should decrease and life will return to my “post Iraq normal” where the hyper-vigilance will subside a bit. In the mean time I have the wonderful privilege of caring for and providing ministry to those who like me have returned from war changed.

My faith which was shattered when I returned from Iraq has returned and while I still have days where I have doubts I am no longer an agnostic.  I am able to be with those that doubt and even those that have “broken up with God” to use the term of Sarah Sentilles, especially those who had their faith damaged by war. I see a lot of that here as well as a lot of men and women that have doubts but try to hold onto faith while battling PTSD, TBI, depression, substance abuse and even suicidal thoughts.  Many like I did probably have to lie to their friends and families about their doubts, fears and struggles because most people don’t want to hear them.  When people do start talking they become “radioactive” to use the term of Dr. Robert Grant.  For me that openness cost me friends in my former denomination and led to me being asked to leave it in September of last year. I am better for the experience but it is still somewhat painful as I see more young men and women coming home from war not only injured or damaged in mind body and spirit but also wondering about the war itself and feeling cut off from their countrymen.  No one likes to talk about that but there are tens of thousands of veterans including many still on active duty that struggle with all of this.

Yes the smoke will clear someday, I am confident that somehow God’s grace mercy and love shown to us in Jesus will get us all through.  Until then we wait for that day when the smoke clears and we can see clearly.

Peace

Padre Steve+

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May 14, 2011 · 22:00

A New Start…Life off the Fat Boy Program

Back in Standards 

“Every day is a new opportunity. You can build on yesterday’s success or put its failures behind and start over again. That’s the way life is, with a new game every day, and that’s the way baseball is.” Bob Feller

One of the biggest effects of my post-Iraq PTSD crash was how I tried to cope with this multi-faceted beast. Of course psychologically and spiritually I was in the toilet so much so that I was in the midst of a spiritual crisis so great that I was for all practical purposes an agnostic.  I struggled to hold myself together during 2008 and early 2009 trying to believe again and keep in shape. To compensate for my lack of belief, depression and the other nasty effects of PTSD such as night terrors, insomnia, hyper-vigilance, flashbacks I threw myself totally into work on the critical care units of the hospital I was serving. I finished my Masters Degree program and worked hard to better our hospital’s Clinical Pastoral Education Program and served on various committees including the Ethics Committee.  It was too much and the collapse deepened so I sought other coping mechanisms. I turned to comfort food and drink as a way to cope, especially food that was bad for me and way too much very good beer.

After my physical fitness test and weigh in during April of 2009 I lost all control of the latter two. While I had been drinking more since my return from Iraq than before the deployment in the spring of 2009 it became a problem.  I would leave work and on days when the Norfolk Tides were in town I would take to my season ticket seat in Section 102 Row B Seat 2 and seek refuge from my problems.  The ballpark and baseball helped bring some peace to my soul, but it would only last for 3 hours.  At the ballpark I would drink two to three beers with a chili dog and fries and maybe a pretzel, peanuts or ice cream.  After the game I would swing by the Krispy Crème Donut shop on the way home and pick up a dozen hot and fresh glazed donuts. I would then get on my computer and write on this site. While writing I would down three to six of the donuts with another two to four beers and repeat the cycle the next day for the rest of the home stand. On other nights I would go over to get donuts and drink more beer with them often after eating a heavy meal with very good beer at the Gordon Biersch Brewery Restaurant in Town Center.  By November I weighed 194 pounds and though I passed the PT test with a very good score for someone my age I was way over my weight and body fat limits. Thereafter it was a struggle to get below 180 pounds. I failed my next body composition assessment by a percentage point and though scoring well enough to qualify for the DOD waiver which would have taken me off of the program it was not approved.  I weighed in weekly and continued to improve my physical condition to the point that I was within the body fat standard by the time I left that duty assignment I transferred before the next official physical fitness assessment and got to my new assignment after the period was over.  Thus I remained on the program.

To those that have never experienced life in any military branch Fat Boy or Girl program it is humiliating, at least if you are a military professional.  There is a stigma to being fat because the military is run by tall skinny people.  Those of us of the under tall variety understand this stigma very well even when we are within standards.  I know a good number of good Soldiers, Sailors and Marines put out of the military because they did not meet their service body fat and weight standards.  Many like me are those suffering the effects of war and just trying to cope with life.  Others are men and women who are suffering the effects of time with shrinking bodies due to spinal disc compression and other injuries, illnesses and the slowing of metabolism which conspire against them. The military is a young person’s game and 51 year old 30 year veteran relics like me are in the minority.  For me the physical requirements are little different than when I first went on active duty in 1983. Back then I thought that when you got older you would catch a few breaks. Well in the age of budget cutting and a shrinking military force those standards continue to tighten and few breaks are to be found.

Bursting at the seams in my Summer Whites in 2009, this was not a comfortable uniform at the time, now it is very loose

While I had lost weight and body fat I was still over my weight limit.  The body fat measurement in the Navy is the measuring tape around the neck and the fattest part of the belly.  It is a terribly subjective and according to many scientific studies inaccurate test.  Nonetheless if you are over the weight limit you must be taped.  I didn’t want to go through that again so I decided that I was going to start really eating healthy and diversifying my exercise regimen.  When I arrived at my new assignment I weighed 184 pounds and during the winter added a few more pounds. At the beginning of January I bought a digital scale and began to weigh myself several times a week. I stopped the comfort foods except for an occasional hamburger or piece of pizza.  Even if I ate a hamburger I omitted the fries and held the cheese and mayo. I began to look at the nutritional information on everything that I ate even looking up restaurant data to ensure that I had the healthiest food that I also liked, it does no good to eat healthy if you hate what you are eating because you don’t stick with it.  I cut back on my drinking a lot, even going to Yuengling Light Beer at home.  I counted every calorie and measured calories burned. If I went over on one thing I compensated rather than continuing as if I had not.

As winter became spring I noticed a difference, I was weighing less and all of my clothes continued to get loose to the point that things that I could not get into during the fall were baggy and some nearly falling off.  As the date approached my scales had me near the limit for a half inch below my real height just in case I got a bad measurement on my height, five pounds is five pounds.  I felt a lot of stress over the week and could feel every muscle in my back completely tense to the point that I was in pain. I weighed in Friday at 169 pounds and was six pounds below my weight limit and one pound below the lower height limit.  I have lost all 25 pounds that I gained during that horrible period of my life. On Monday I will take the physical fitness test something that I never have a problem doing well on.  When I do that I will be officially off the program.

Last night I was invited to do the invocation at the Navy Nurse Corps Birthday Ball at Camp LeJeune. I eased into my Mess Dress Blue uniform which last May I could barely squeeze my body into and in which I looked terrible.  The uniform was loose and fit very well. I went to the ball and had a wonderful time with my colleagues from the Naval Hospital and their guests.  I made sure that I had a friend take the picture which accompanies this post.

For me this is a comeback. I still have my struggles with PTSD but on the whole on the physical, psychological and spiritual aspects of life I am doing much better. Yes I still struggle at times and experience some of the manifestations of PTSD and of my spiritual crisis but I am not collapsing when something shakes me like I was between 2008 and even into 2010.

Had I failed the body composition assessment I could have been separated from the Navy and while I probably would have been able to retire it would have been a most humiliating way to leave the service.  Instead as long as I am alive and haven’t done anything incredibly stupid I will be promoted to Commander on September 1st and continue to be able to serve God’s people in the Navy for years to come. Of course I cannot fail a physical fitness assessment for the next two years but now that I have my diet stabilized and composed of things that I like and live in a place at the Island Hermitage where I love to run, walk and bike I do not expect to ever fail that again. My goal is to get back to the weight that I was when I was commissioned as an Army Officer in 1983, 158 pounds and keep it there. Thus my task is still incomplete.  I have succeeded in my first goal and now it is time to complete the deal and live healthy from here on out.

Today is a new opportunity and I am putting past failures behind.

Peace

Padre Steve+

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March 29, 2011 · 23:30

The Front Page: Padre Steve talks about a Newspaper Interview on His Battle with PTSD

“Gratitude changes the pangs of memory into a tranquil joy.” Dietrich Bonhoeffer

I was interviewed about a week and a half ago by Hope Hodge a reporter for the Jacksonville Daily News. The paper had discovered me through an article I wrote last September entitled Raw Edges: Are there other Chaplains out there Like Me? The editor assigned Hope to the project. After thinking about the request a number of days I knew that I needed to do the interview and had Hope contact our Public Affairs Officer, Raymond Applewhite. When he secured the permission of my Commanding Officer Captain Daniel Zinder he set up the interview with Hope and photographer Chuck Beckley.  

The interview was a very healing experience and the article was well done and I have nothing but thanks to Hope and those that arranged this. While I have talked extensively about my tour in Iraq and subsequent battles with PTSD, loss of faith and my slow recovery on this site as well as with individuals but I have carefully avoided media until now.  While I write a lot tend to be somewhat reclusive in real life especially since coming home from Iraq with my safe places being Harbor Park in Norfolk and Gordon Biersch Virginia Beach.

I knew that the interview would trigger some memories and I knew that once the article was out in public that there would be varied reactions including some that I knew would be negative.  At the same time the negative has been far outweighed by the positive reactions, especially among those that have gone through similar dark times. As I read the comments I knew despite that any negative reactions or attacks on me that the interview was the right thing to do. I read the stories of those who told about their battles with PTSD, experiences with military and VA healthcare as well as their crisis’s of faith posted in comments section and was touched.  They were telling things that are hard to talk about, especially in a public forum of a local newspaper where people can be quite vicious.  I know that even in that forum when most remain anonymous there is a risk and an emotional cost in posting experiences that in a sense are holy to the people sharing them and should be respected so I am glad to see that for some the article was helpful and encouraging. I was also blessed and even comforted by those that spoke well of me.  The kindness, support and comradeship that one has with such people is amazing, there is a brotherhood of war and we will support each other.

There was one man that was particularly nasty and I do need to deal with his comment here, not because I am upset but rather because I know how war, especially was like Vietnam and the current wars can do to a person.  The man who is an anonymous poster to this and other articles on the Daily News website claims to be a veteran of Vietnam in 1969-1970. I have no reason to doubt him as there are a lot of Vietnam Era combat vets in the local area and since I am a child of a Vietnam combat veteran and remember the shameful way that these men were treated when they returned I would never disrespect his service or even his feelings about how he was treated and the abuses that he saw when he came home.  I am very close to the Marine veterans of the Battle of Hue City and still maintain correspondence with these men who I count as friends.

At the same time I think that this man’s comments need to be addressed, not because of his service or experience following his return but because of the use of character assassination that is so common in our national discourse now days. The last time I experienced an attack on this site of similar invective was when a Neo-Nazi or White Supremacist from East Tennessee went so far as to physically threaten me. That man claimed to be a former paratroop officer. I really don’t know what brings people to launch such attacks on people that they never have even met but it is part of life and I knew that I might get something like this so it is what it is.  This is what this man said:

“This man should never have been in the military as he is too weak-minded. And/or, he, like a surprising number of his fellow officers have found it is best to get out under a disability as it’s a tax free cream puff ride to the bank each month. Imagine if he was one of the thousands of trigger pullers afield and try to pull this off? Pathetic!!” Comment by Your62 on Jacksonville Daily News (This and other posts by this man was removed by the newspaper sometime today 3/30/11)

Needless to say he was pretty nasty to others who commented on the article as well so I cannot take it personally and some of them gave it back to him in spades. As for me I hope that this man finds peace someday.

As for me I figure that since I have been in the military, not only as a Navy chaplain but also an Army Officer for nearly 29 years and that I have volunteered for every combat, humanitarian or contingency mission that I could over the course of my career, much to the chagrin of my wife, family and friends that I am by no means weak or lack courage. I know that I didn’t volunteer to go to Iraq to come out of it with PTSD and all that I have gone through since and what I have put my wife through.

Much to the surprise of this veteran I am not looking for a “tax free crème puff” as I figure that 5-10 years from now when I actually retire that I will have maxed out about every pay scale that there is and probably will have another deployment or two in me before I am done.  I figure that the way things are going in the world I will get a shot in Afghanistan or North Africa before all is said and done.

I certainly do not claim to be anywhere or done anything that I did not do or experience and never claim that I experienced what many other veterans of our current wars or past wars have in any of their wounds.  I see too many young men and women who have suffered grievous wounds to body and soul as a result of war to do such a thing. Likewise the many veterans of previous wars that I know who still suffer their wounds I would never dishonor. I consider it an honor to have served alongside such fine men and women or to met them long after their service in Vietnam, Korea or the Second World War or at the end of their careers when I was a young and idealistic know nothing officer in the early 1980s.

My war was different than others. It was in a lot of places where many never went serving alongside small units of 15-20 American advisers stationed with Iraqi units.  These men were remarkable because they were incredibly exposed to danger and often far from big units that could help them if they ran into trouble. They were the men that help organize and train the Iraqi Army to help turn the tide against Al Qaeda in 2007 and 2008 as much as anyone they were responsible for helping build friendships with Iraqi military officers that will be a cornerstone of our friendship with Iraq in the future.

As for me I did not shrink from danger. I went on foot patrols, night convoys in the badlands and was in a helicopter that was shot at and returned fire. I have had rockets fly over my head and being on a convoy that took some fire. Thankfully I was never in a convoy hit by an IED or big coordinated ambush. Since the convoys that I travelled with usually had three HUMMVs with nothing heavier than a single .50 cal or 240 series machine gun that any such action would have been a battle for life and death and I know what I would have done had such a situation occurred. Since Al Qaeda Iraq had Chaplains as a high value target and since our Iraqis new that I was the “American Imam” and that such word would filter out of the camps the men that I served with took good care of me even in very exposed locations. Likewise even Iraqi officers sought my counsel and asked me to bless or to pray for their soldiers.  I will never forget the Iraqi soldiers that asked me to bless their vehicles on one of our convoys with Holy Water as I did for our advisers as we set off on Route Uranium west of Ramadi.

Through it all I can now say that I am grateful for what I have been through. It still is not easy as even though I continue to see improvement I still on occasion have flashbacks, nightmares and have to make the effort to go into places where I don’t feel safe.  At the same time I would gladly go back to Iraq or to Afghanistan or anywhere else to serve the men and women of the Navy, Marine Corps, Army and Air Force that I love and respect so much.  There is not a day that goes by when I don’t think about serving in combat again, much to the chagrin of my wife and family.  I am not a proponent of war, in fact the more I see I am against it.  I fully agree with General Robert E. Lee who said “It is good that war is so terrible. We should grow too fond of it.” However, I know my place until the day that I retire from the Navy is when my Marines, Sailors, Soldiers and Airmen are in harm’s way.

For those who are silently suffering the ravages of PTSD and moral injury related to their service I know the pressure. I didn’t seek help until the EOD Diving Medical Officer saw me falling apart and got me into the medical system.  Unfortunately there can be and often is a stigma attached to PTSD and for some to suffer in silence is preferable to the stigma of seeking help and being called weak.  I made the choice to get help when I couldn’t do it on my own any longer but have seen others be traumatized by other servicemen and women for seeking help, that whole thing about being “weak.” I got lucky when I was sent for help, not everyone has my experience.

Despite that I encourage those suffering from such injuries to seek help because there are a lot of us out here that really care because we know what it is like. I admit that it is not easy to seek help and sometimes getting it can be problematic simply because of the stress on the medical system, but help is there.

Blessings and Peace

Padre Steve+

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September 16, 2009 · 21:50

Survival on the Home Front: Dealing with Other People’s Reactions to My PTSD

081

Being in Iraq  was in Many Ways Less Frightening than Being in the USA

I find it interesting and sometimes painful to see how institutions and some people within the institution will label those of us who have gone to war and came back as gooned up with PTSD.  The biggest tension and issue, and I admit it as my own is that we get stereotyped and sometimes viewed as “broken.”  I admit that I have issues, in fact a lot of frickin’ issues and I have a pretty good awareness of them.  I see Elmer the Shrink to help me through the rough spots but there are times when I bump across those that appear to use my condition as a weapon against me.  Whether it is intentional or not, it is not fun to deal with.  I’ve had it happen a few times since I have started getting help last year and every one of the people involved were people who have not been to combat to use a pejorative term from Vietnam they are REMFs .

I know several others who have experienced this mentality.  We all feel really vulnerable because all of us have opened up to people, or to use the Star Trek analogy to “drop our deflector shields.”  Pulling down shields makes you vulnerable, if you do it because you think you are in a safe area.  When you take “friendly fire” is really sucks. It is actually easier in theater.  If I was sent to Iraq or Afghanistan today I would be back in my element and probably suffer little from PTSD symptoms.  Sometimes I wonder if the Navy would be better off to ship me over again.  Admittedly with the health of my parents and a position at my medical center that is important for me to remain in for the time being, there is something that says at some point I need to go back, maybe not now but later.  See out there the PTSD defensive reactions fit.  There are bad guys and good guys, friend and foe and the body and brains’ reaction to real or perceived danger are natural.  I am wary of people until I figure out if they are friend or foe. When I make a mistake in my IFF it usually bodes ill for me.

When you come back out of that environment you find that even though you are “home” that you have changed and nothing is the same as it was before.  Your body and brain have divided the world into two camps, friend and foe or safe or unsafe or maybe even secure versus dangerous.  In my life I notice this with people as well as situations such as being on the road in our nutty Hampton Roads traffic which by the way even if you don’t have PTSD is quite the adventure I have become a very offensively minded defensive driver with faster reflexes and reaction time than I had before I went to Iraq.  I have to say that I am now a very aware person to perceived threats and actually that is not a bad thing of itself.  In Iraq I was probably operating at a 9 or 10 of ten on my perceptions of and reactions to real and perceived danger.  Since I have returned and gotten some therapy I probably operate at a 3.5 to 4 most of the time and depending on the situation move up higher sometimes being very aware of possible danger and hyper-vigilant .  Before I went to Iraq I probably operated at about a 1-2 on the scale of 10, pretty oblivious to danger and not too worried about it either.  Truthfully I am happy at an increased level of the 3.5-4 and maybe on occasion 5.  I don’t like getting up above 7-8 because it really makes a mess of my nerves and general requires that I take my docile pills.  Recently I’ve had a few of those days.  Trust me it is no fun to have a nervous tremor.  When that happens I feel like Gene Wilder’s character in Blazing Saddle’s Jim the Waco Kid response when Sherriff Bart (Cleavon Little) questions him:

Jim: Look at my hand.
[raises hand and holds it level]
Bart: Steady as a rock.
Jim: [raises his other hand, which is violently trembling] Yeah, but I shoot with this one.

Although I can occasionally find some morbid humor in what is going on with me I can’t say that it is any fun.

There is a perception by some, which I think is often systemic in parts of the military that people with PTSD are “broken.” Some in the system as well as others who have been granted the privilege of knowing your vulnerability consciously or unconsciously sometimes use it against you, I personally think it is intentional when this happens but I try to give the benefit of the doubt to the offender.  Like I said before this has happened to my on a number of occasions and in every instance I have felt attacked, devalued and re-traumatized and I don’t like that feeling and it takes me a while to get back through all the crap.  When it happens to me I get angry, defensive and now as opposed to my pre-Iraq life will shoot back.  I’ve stopped rolling over and letting people get away with this behavior and when I see it happen to others I get equally pissed.  Unfortunately I have a number of friends who have had similar experiences and as we share our stories we realize that some people or even the system in general will write you off as damaged goods.  What is the bad thing is that the worst comes from people who have not been in harm’s way.  Likewise, if they went to a combat zone never left one of the big FOBs and never had to deal with the danger of being outside the wire. Nor have they experienced what many medical personnel who remained on the big FOBs experienced in dealing with never ending trauma of dealing with the death, wounding and suffering of young Marines, Sailors, Soldiers and Airmen.  Another group are the men and women who perform the tasks of getting the fallen back home.  One of my Chaplain friends had this job in Kuwait and had to meet every aircraft with the bodies of the dead leaving theater performing memorials and conducting honors all the time caring for those who cared for the bodies of these Americans and came back in pretty bad shape.

What saddens me is that this still attitude of men and women dealing with PTSD being “broken” or as one called me a “shipwreck” happens even though we have been making the conscious effort since Vietnam to treat people traumatized by war.  The end result is that those who are traumatized are again and again re-traumatized by the system as well as individuals in it.  I have seen enough of this to make me throw up. Thankfully the Navy as a whole does better in this than the Army, Marines or Air Force but there is a lot to be done.   When I have a REMF screw with me or my friends it does get to me and I can say that I get angry and the person moves out of my “circle of trust.”

Likewise I get discouraged and when I see my countrymen from both of the major political parties, elected officials and regular party members tearing themselves and the country apart because of the hatred that they have for each other and each other’s positions on the issues that face our nation.   I came home at the beginning of the 2008 primary season and within a short time became quite disheartened by what I saw on both sides of the line.  There is no civility in the land and no peace at home for those of us coming home from war.  We come back and see our brothers and sisters, fellow Americans all saying and doing things doing things that can only in the long run further divide and destroy the nation.  I can understand the anger that the returning German soldiers and sailors of the First World War came home to in 1918-1919.  It seems that the only thing that we lack to be like Weimar Germany is for right and left wing militias begin fighting in the streets, killing each other and trying to take over power by force.  As it is these are fighting at political rallies and raising the invective to frightening levels.  In the case of one protest men brought semi-automatic assault weapons to protest outside of a venue the President was speaking at.  They said it was a Second Amendment rights protest but all that is needed is for one deranged individual to act on a homicidal urge to blow the whole damned place up.  I have seen the results of such folly in both the Middle East and the Balkans and I just don’t get it, it is frightening to me and the extremists on both sides of the political spectrum seem like they are doing their damnedest to destroy the country that I love so much and went to war to serve. Regardless of what extreme they are on I just say a pox on them all.

I have been asked a number of times why I would open myself up and show my vulnerability on this website.  It is certainly not for fun when I deal with this subject because I am really wound up in it.  When I write I often have to live the experience again. While many times this is emotionally draining it is something is something that I know that I have to do.  I know so many vets from the current wars and Vietnam who struggle with some of the very things that I do and often a lot more but do not have the ability to really share their stories.  The Marines who fought at Hue City are a group that I still have contact with as are people from my last base chapel job, the Vietnam Veterans of America men who man the beer stand at the Church of Baseball Harbor Park Parish, Wayne the Army Chaplain and decorated Vietnam infantry scout who dealt with his own PTSD and helped me in my discernment process to become a Chaplain.  Likewise I have this connection with my brothers and sisters who have served in Iraq and or Afghanistan.  In a sense what I want to do in my articles about PTSD as well as those about my tour in Iraq is to help people who have not been or not experienced this to get some understanding of what happened to me and to many others.  I don’t want guys to fall through the crack like in Vietnam and I think that educating the public is the best way of raising the issue and helping people care for us.  So I guess this is my “cause” and maybe even a crusade.  I hope and pray that those who love and care for our combat veterans who read this will take the time to learn, take the time to care and take the time to be with us as we walk through the often dark places that we walk.

Today was not a good day for me it was very painful but at least I was able in this post to use it to help explain what we who deal with our return from war go through.  I guess that the Deity Herself knew what she was doing today.  Pray for all of us who live in the surreal world of PTSD as we pray for you and our nation.  Pray for me a sinner.

not a happy camper

Peace,

Steve+

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August 31, 2009 · 22:54

Star Trek the Next Generation: Captain Jean-Luc Picard Deals with PTSD

Counselor Deanna Troi: Interesting.
Captain Jean-Luc Picard: Counselor…
Counselor Deanna Troi: I just find it interesting. Captain Jean-Luc Picard, the man who couldn’t be pried out of his seat for a vacation for three years!
Captain Jean-Luc Picard: It’s Earth. It’s home. Do I need another reason?
Counselor Deanna Troi: I don’t know, what do you think?
Captain Jean-Luc Picard: Your help has been invaluable during my recovery, but…look, I’m, uh…I’m better! The injuries are healing.
Counselor Deanna Troi: Those you can see in the mirror.
Captain Jean-Luc Picard: The nightmares have ended. All I need now is a little time to myself.
Counselor Deanna Troi: I agree. In fact, I’m delighted you’re going. It’s just that…the choice of where you’re going could stand some scrutiny.
Captain Jean-Luc Picard: If you wish to believe my going home is a direct result of being held captive by the Borg, be my guest.
Counselor Deanna Troi: Is that what you believe?
Captain Jean-Luc Picard: I hate it when you do that.
Counselor Deanna Troi: Captain, you do need time. You cannot achieve complete recovery so quickly. And it’s perfectly normal after what you’ve been through, to spend a great deal of time trying to find yourself again.
Captain Jean-Luc Picard: And what better place to find oneself than on the streets of one’s home village.
Counselor Deanna Troi: Interesting.

I have always found the Star Trek TNG episode Family quite compelling.  The episode (Season 4 Episode 2) deals with Captain Jean Luc Picard’s return home following his capture and assimilation by the race known as the Borg during The Best of Both World’s Part 1 and II (Season 3 Episode 26 and Season 4 episode 1.)

The story is interesting because it deals with some of the issues that people traumatized in combat deal with as they try to find themselves again.  In the story Captain Picard, in a very typical manner of someone traumatized by combat believes that his injuries are healing.  His counselor, Deanna Troi who serves as the Ship’s “Counselor” challenges him on his belief that he has recovered and his choice of where he wants to go to find himself again.

I saw the episode when I was in Seminary not long after completing the Chaplain Officer Basic Course and then saw it again when I was going through my Clinical Pastoral Education Residency.  It was during that process, one in which I was trying to find and define what “home” was, that it really caught me.  I was Captain Picard, the brother who left home to explore and travel while serving in the military.   My brother Jeff was Picard’s brother Robert.  He is the one who stayed home and minded family business.  The parallels then got me and even more so now.  My Residency Supervisor used this to good effect during that time in dealing with the issues of home, but the post combat and PTSD part was yet to come.

Back in the days of my residency I struggled with another of issues related to being a military brat and having begun a career in the Army.  In a sense I was a nomad.  I had lived a lot of places but none were really home, even where I had spent all of junior and senior high school.  Like Picard my eyes were set on far horizons of exploration and adventure of military life.  My brother Jeff on the other hand like Picard’s brother was content at staying at home, being near our parents, getting established in the school district and taking care of his family.   We both chose our own paths and both were right for us.  I still long for adventure and exploration but have begun to settle down.

When it came to the placement of the PTSD in this picture it was after Iraq that I had a crisis in a number of areas in my life and every time I thought that I was doing better and maybe even “getting well” that there was always something that could trigger the memories, bring back the dreams and keep me from sleep.  I can say that a year and a half after my return from Iraq I am doing better in a lot of ways but still having struggles with anxiety insomnia and hyper-vigilance.  I did find out that there is one thing that does not evoke a startle reflex is a foul ball that comes back against the screen in from of me in Section 102 at the Church of Baseball Harbor Park Parish.  Last night while taking pictures right up against the screen I had several balls that hit within a couple of feet of me, one of which hit my camera and knocked it out of my hand.  Anywhere else loud noise, unexpected crashes, things flying past me sends me into a hyper-alert status.

picard familyPicard Meets His Family after Many Years and Wounds Away

When Picard goes home it is not the confident Starship Captain who returns, but a man unsure of himself and where he fits in life.  His encounter with the Borg has changed him and he contrary to assurances to Counselor Troi is still wounded.  When I returned from Iraq I wondered where I fit, I felt like I had abandoned my advisers in Al Anbar when I returned because my relief had to be sent elsewhere do to circumstances beyond my control.  I did not feel a part of my own unit as nothing was the same when I came back.  I felt weak, useless and at the end of my rope after having completed incredible tour in combat of my then 26 years in the military.  Physically I was falling apart; I had several nagging injuries from Iraq that caused chronic pain.  I was flashing back with every moment, fires burning in the Great Dismal Swamp had turned our air the color of an Iraq sand storm while the smell was like that of the ever present burn pits, both military and Iraqi.  Walking out the door one morning with my neighborhood shrouded in smoke I began to melt down.  That day we had a seminar done by a nationally known speaker dealing with trauma and combat with the associated feelings and emotions.  At the end of the day I was a wreck.  My Unit Doctor, Chris Rogan looked at me and said “Chaplain you don’t look good, are you okay?”  I said “no I’m not, I’m losing it and I’m scared.”  That was the place where I finally began to get help.  It has been about 14 months since I started and it is still a process.  We made a trip home that summer and I did not do well.  It was painful and I had great difficulty both in the travel as well as the visit.  When I hear fellow vets talking about the surreal and often painful times that they experience I can understand.  The fact is that you can be with a hundred friends and family members and be totally alone when you return home because it is something that you cannot really share and that they usually don’t understand.  Once again I have been fortunate.  My little brother actually listens to me and lets me vent when I need to.  Of course dealing with our family’s stuff this is a two way street.

not a happy camperVisiting Home and not Doing Well

In the story Picard is offered a chance to leave Starfleet and go to work on a project under the ocean on Earth.  He is sorely tempted to take it but before he can he has an encounter with his brother who challenges his decision.  They exchange words and Captain Picard feeling picked on starts a fight.  During the fight he breaks down about his experiences sobbing in his brother’s arms.  “His brother then said: So – my brother is a human being after all. This is going to be with you a long time, Jean-Luc. A long time. You’ll have to learn to live with it. You have a simple choice now. Live with it below the sea with Louis, or above the clouds with the Enterprise.”

In a sense that is something that all of us who serve after having been traumatized by the experience of wart have to deal with, the physical as well as the psychological and spiritual wounds.  For me it was the realization that I was human after all and the slow realization that this will be with me a long time.  The choice is how I choose to live my life and where I do so.

In the series and subsequent Star Trek: The Next Generation films Picard is forced to deal with his psychological wounds from the encounter with the Borg culminating in the second of those films Star Trek: First Contact. In it Starfleet Command leave Picard and the Enterprise out of the battle leading to this exchange between Picard and his First Officer which deals with the stigma associated with such an injury.

Cmdr. William Riker: Captain, why we are we out here chasing comets?
Captain Jean-Luc Picard: Let’s just say Starfleet has every confidence in the Enterprise and her crew – they’re just not sure about her Captain. They believe that a man who was once captured and assimilated by the Borg should not be put in a situation where he would face them again. To do so would introduce “an unstable element to a critical situation.”
Cmdr. William Riker: That’s ridiculous. Your experience with the Borg makes you the perfect man to lead this fight.
Captain Jean-Luc Picard: Admiral Hayes disagrees.

The stigma associated with psychological injuries is far greater than that of physical injuries.  The unseen injuries are not as well understood and those who suffer them often are broken down by the system as they try to get help and many simply go underground and self medicate.  Last year two Army Generals opened up about their struggles with PTSD. I was fortunate to have people come alongside of me when I went down hard.  People who did not give up on me and kept faith by caring about me when I was and still get down.

See the article at: http://edition.cnn.com/2009/HEALTH/03/06/generals.ptsd/

Despite this and the efforts of many in the Military to help those with PTSD and other “unseen” injuries, to include medical conditions brought on by exposure to toxins in the combat zone, there is still the stigma.  As the young officer suffering from a rare and eventually fatal pulmonary condition acquired in Iraq as well as yet untreated PTSD “I squarely wish I had lost my legs then than the lung function that I have lost!”

Captain Picard’s story of course is fictional, but it demonstrates to some degree what those who experience the psychological and spiritual wounds of war face when they “come home.”  This stuff doesn’t go away.  Here are some of the comments that I have had from readers who deal with their own or a family members PTSD.

Australian Vietnam Veteran who wrote me said:  “As an Australian Vietnam Veteran with PTSD, I find these articles fascinating. I long wondered why the world had to be such a hostile mongrel place. Then 30 years later I was diagnosed with PTSD and I can now relate to why I have the condition but the world has not changed and medication is of limited use. There are many of us who are still very isolated and have to limit our social contacts. I recently started a Vietnam Veterans group, for members of our small unit, on the web and I found men who were relieved to be part of something and someone they could relate to as they had all but withdrawn from society. Sadly a few of them refuse to take any medication for their medical conditions as they see that as prolonging their miserable existence.”

A family member of a WWII veteran said: “thank you. It’s really needed for women to read articles/memoirs like that. It’s easy to say someone has PTSD, but another to live with and love who has it. I come from a family with rich military history and this is an everyday issue. Never goes away, even after 40 – 60 years.”

A USMC Vietnam Vet that I know wrote: “It’s a bitch at times, and the sleep, or lack of will eventually come, although it will never be a fully restful sleep. The Hyper vigilance seems never to go away. Yes it could be good, but eventually it can be bad…. well do I know both.”

An Army Chaplain from Iraq noted: “I too am a chaplain who felt that he and his assistant were the best equipped to handle the horrors of war – just to find out after being home for about a year just how much I had changed. I was sitting with my daughter in my lap one weekend afternoon when she asked, “Daddy, why don’t you play and laugh with us like you use to before you went to Iraq?” It was the key event that brought everything to a point where I could get help. In the months since there have been good days and definitely bad days – however, my faith remains strong….”

I run into people like this every day in the course at work who deal with this and sometimes it spills over into my stuff.  However I am glad to know that I am not alone.  To those who have helped me since I have be back, Chris, Two Feathers, Limey, Greg, Jesse, Jeff, Elmer, my longsuffering wife the Abbess of the Abbey Normal Judy and my brother Jeff, Colonel P and Janet, the folks I work with, the people at Harbor Park, especially Ray, Charlie and the Vietnam Veterans of America who man the beer stand on the concourse behind home plate and all the others who have come alongside I am grateful.  It is my sincere wish and prayer that all veterans will have such fine people there for them when they hit the wall.

Peace, Steve+

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