Tag Archives: post traumatic stress disorder

349: Active Duty Military Suicides Hit New High in 2012

220px-Tom_Lea_-_2000_Yard_Stare

The 2000 Yard Stare by Thomas Lea

The Defense Department released the numbers for what Secretary of Defense Leon Panetta has described as “epidemic” of military suicides. The total of 349 active duty personnel includes 182 Soldiers, 48 Marines, 59 Airmen and 60 Sailors. It does not include Coast Guard personnel. The last statistics for that service showed 5 active duty suicides for 2012 as of mid-August, the service had only seen 6 in 2011.

As of November there were 124 Army Reserve and National Guard suicides not on active duty, 6 Naval Reservists. I have not been able to find the data for Air Force Reserve and National Guard or the Marine Corps Reserve.  The reserve figures are of drilling reservists not of those in the Individual Ready Reserve (inactive reserve) who do not attend drill but have served their obligated active time and can be recalled to active duty until the end of their service obligation.

The Veterans Administration estimates that nearly 6,500 veterans take their lives yearly. The numbers include veterans of all wars not just those of Iraq and Afghanistan nor are they complete because sometimes death certificates do not record a veteran’s service.

It is growing problem that unfortunately will not get any better anytime soon. Part of the issue is that despite service attempts to change the culture there is still a stigma attached to those that seek mental health care. There are other reasons that factor into the equation, deployments, high operational tempo, lack of enough mental health care providers to meet the demands as well as the effects of combat stress injuries, PTSD,

Traumatic Brain Injury as well as what is now called “moral injury. One definition of Moral Injury “the lasting psychological, biological, spiritual, behavioral, and social impact of perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations.” 

Marine Corps Major General Smedley Butler who was awarded the Congressional Medal of Honor twice wrote a moving of those afflicted with what we now call Moral Injury after World War One:  “Boys with a normal viewpoint were taken out of the fields and offices and factories and classrooms and put into the ranks. They were remolded; they were made over; they were made to “about face”; to regard murder as the order of the day. They were put shoulder to shoulder and through mass psychology, they were entirely changed. We used them for a couple of years and trained them to think of nothing but killing and being killed.

The effects are as chilling now as they were in Butler’s day when he wrote:

“These have already been mentally destroyed. These boys don’t even look like human beings. Oh, the looks on their faces! Physically they are in good shape but mentally they are gone….There are thousands and thousands of these cases and more and more are coming in all the time…”

I know. I see it every day but I see it in a number of ways. I see it in the faces of the Marines and Sailors going back and forth between Afghanistan, Iraq and now North Africa and also among those in the medical, mental health and chaplain services that care for these men and women.

Provider burnout, including suicide is a problem. Just recently a former Army Psychologist who had served in Iraq during the surge and had been treating veterans in the VA committed suicide. Less than two years ago, this man was the lead author of a article that dealt with burnout and suicide of caregivers. Peter Linnerooth who was awarded the Bronze Star in Iraq committed suicide on January 2nd 2013. His widow, also a mental health professional commented:

“He was really, really suffering…And it didn’t matter that he was a mental health professional, and it didn’t matter that I was a mental health professional. I couldn’t help him, and he couldn’t help himself.”

Linnerooth’s faculty advisor commented: “When he went in and when he came out, it was shockingly different…”

That was a problem then and it is a problem now. The thing is that these active duty 349 men and women, as well as the others I have mentioned where the numbers are not well defined are not just numbers. They are people. Real men and women, sons and daughters, husbands and wives, fathers and mothers. Their deaths at their own hand are more than the combat deaths in Afghanistan this year.

Dr Larry Shellito the Commissioner for Veterans Affairs in Minnesota said something that is dead on:

“Oftentimes, you have to look at the people that surround the people with (PTSD) to make sure they are also OK, because it’s got a multiple impact…It’s not just the individual who suffers, it’s the people who care for him.”

I see it all the time. Butler’s description of the men who served in the trenches that were in veterans hospitals and facilities nearly 20 years after the war ended are as true today as they were then. Ask any caregiver in the service or in the VA system and they will tell you how overwhelming this epidemic is.

It cannot be wished away and assuaged by people simply doing the bumper sticker “I support the troops” thing without looking deeply at what is causing this and investing in the lives of these men and women before their lives are completely destroyed. It also means that politicians and their think tank and media advisors who constantly beat the drums of war, without fully funding it and without caring for those that are sent to fight them must be held accountable by voters.

I know how this is on a real live up close personal basis as a chaplain. I went to Iraq and came back changed. The PTSD, depression, anxiety and hopelessness that I felt were overwhelming. Thankfully I am doing a lot better and I did get the therapy and assistance needed, but it took a while to get it and thankfully at my present command I had people that I worked with help me get the help that I needed. But I have been back almost five years. A lot of that time was spent in the wilderness wondering if there was hope, if I would ever get better and sometimes wondering if God even existed and if he did, did he care. During the whole time I continued to work with and care for others like me. Their injury also impacted me in ways that I could not imagine before I was afflicted.

I care about this issue, because it affects those that I serve as well as their families, communities and those that serve with them. 349 active duty suicides. Think about it. One is too many. 349 is inexcusable and that does not count all those that we cannot count because we don’t know the numbers or the full story.

349: Keep that number in your mind and do something about it.

Peace

Padre Steve+

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Filed under healthcare, Military, Pastoral Care, PTSD

Facing the Darkness that Lurks Behind Trauma

The Einsatzgrüppen: The Banality of Evil

I am in the second day of my conference and as I noted yesterday that the presenter, Dr. Robert Grant is dealing with spirituality and trauma.  As was the last time I listened to him this conference is full of good information.  For me though it is not merely information for information sake, but something very personal having gone through the living hell of a psychological, spiritual and physical collapse following my tour in Iraq and battle with chronic PTSD.  For me it was passing though the abyss and when I emerged I was a changed man.

Today Dr. Grant began with some existential truths about life which have to be acknowledged.  The basic list is his but I have taken those thoughts and ran with them.

Everyone Dies…. We can’t get around this one a recent study said that 96% of Americans will die someday.

No Guarantees…. We are not guaranteed anything in this life. You can live right, maintain good health, treat others right but still can meet with tragedy, betrayal and abandonment. 

No one can cover all contingencies…. No matter how well we plan there will be unanticipated events in life that shred our plans.  The old saying that “no plan ever survives contact with the enemy” is true.

The things that we sometimes believe are solid and long lasting are often transitory in nature…. Even things that we think are solid and will last to the end of time change, deteriorate or dissolve over time

We and our world are finite…. We have a beginning and an end and our finiteness is sandwiched between the creation and the consummation. Dietrich Bonhoeffer talked about “living in the uncomfortable middle.” Bonhoeffer was right, we don’t know the beginning because we were not there and we do not know the end because it has not yet happened.

Evil and malevolence exists in individuals, organizations and systems, even those that we esteem highly…. One only has to look at the number of trusted people and organizations that have perpetrated and covered up their own evil acts to know the truth of this. 

Nothing exposes these truths faster than trauma.  It does not matter if the trauma is impersonal and the result of a natural disaster or the result of individual or corporate evil and malevolence, be it physical, psychological or spiritual trauma the effect is often destructive.

In response to these facts we all as well as our society and culture develop patterns of denial about these existential truths.  They are truths that most of us don’t want to face and which we often will do anything to avoid most often attempting to find meaning and comfort in materialism and consumerism. Others seek a “solid” faith in more fundamental branches of their religious tradition.  Still others see to recreate a world that supposedly existed before our time attempting to roll back the clock to a time when the world was right. This is true especially in our political life, progressives think back to the Great Society or the New Deal, while conservatives tend to look back to what the Founding Fathers wrote or the ones that they agree with wrote.  The overarching theme, be it in the life philosophy, religion or political-ideological arena people seek to create a world that is stable, where they can exist in their comfort zone free of trauma and free of anxiety.  However the experience of trauma often blows such constructs into a million pieces.

The fact is that the comforts and protections that we seek refuge in are often fleeting or the myth that we have created for our self protection.  Such beliefs are often illusions.  One thing about trauma is that it tends to shake one’s world.  In fact trauma can destroy long held belief structures including faith in God, humanity and deeply held beliefs about life and one’s place in the world. Religious beliefs, political ideologies and belief the righteousness of one’s country, friends, family and heroes can be devastated when trauma picks the lock of our soul and reveals our vulnerability.  Such events including war, natural and manmade disasters, the loss of loved ones to death, divorce or the loss of one’s position in life, work and safety net all can be events that trigger crisis and reveal the startling truth that we are not invulnerable.  The recent earthquake and Tsunami in Japan is a classic example as it has shaken the long held beliefs of the Japanese people regarding the respect that they have for their government and corporations.

Collectively as Americans we have experienced numerous national traumas in the past 10 years beginning with the 9-11 attacks.  We have seen war, financial disaster and numerous natural disasters which have impacted our collective psyche as a nation.  In response we elect to deny the effect of trauma on us as individuals and on our society.  Politicians seek to find quick material fixes to a greater problem which is both spiritual and existential.  Simply put we seek to treat the symptom rather than the greater problem which is that we have been so shaken that we have stopped believing in our nation, our fellow human beings and sometimes even the Divine.

We do the same as individuals because the darkness of trauma and the malevolence of those individuals and systems, governmental, corporate and ecclesiastical that inflict trauma on us is so great that we bear not to face them and face further trauma.  The impact on individuals is often devastating as the perpetrators often use their power to dehumanize people.  Thus facing the evil is to expose one to even greater danger.  Thus the more common reaction is to edit the trauma, sealing it off so that we can reenter the safety of our protected sandbox without having to face the darkness that exists.  The malevolence of evil, or what Hannah Arendt called the “banality of evil” manifests itself in ways that most of don’t ever want to face, thus the damage done by the trauma remains unhealed.

The problem is in order to really experience healing we have to be willing to face that darkness without succumbing to it.  To do this requires not only facing the existential truths about ourselves but also uncomfortable truths about respected individuals,  government, corporate and ecclesiastical organizations and systems which perpetuate trauma.   Most of us do not want to go there.  I know I didn’t until my crisis became an existential one where I had to face the darkness or try to cover it up.  For me it was a crisis of faith in God, my church and even in the actions of my government and the political party that I had been loyal to for 36 years.

The journey was painful but in time I began to recover beginning a process that continues to this day and which I expect will be part an ongoing part of my life.  In the process I know that I have changed hopefully for the better.   As I began my recovery I found that not everyone understood, in fact when I began to write about my faith journey it cost me friends and resulted in me being asked to leave my church.  To me it seemed that some people especially in the church were more comfortable with me being damaged and quiet than recovering and posing difficult questions especially when I deviated from the party line.

I found that many people did not want to walk with me through those dark times and I can understand why not.  To walk with someone through the darkness exposes us to that darkness and sometimes takes us to places that we would rather not go places that lay outside of our safety zone.  However those that did walk with me, those who held me but let me walk though the crisis without trying to force feed me formulas for success or what I needed to do to “be healed” when I was in free fall gave me the freedom to experience healing. Part of that was healing was spiritual, God’s grace became real again and not just a concept. Part was psychological as I became more stable and had fewer symptomatic episodes, and part was physical as the nagging injuries healed and I was able to reassert control over my diet and exercise.  Finally part has been relational as I have started to rebuild the relationship that I have with my wife Judy because I had neglected that relationship for far too long and when I came home from Iraq I did her no favors.   A few weeks ago she told me that she felt that she had me back for the first time since Iraq.

I have been through the abyss and have emerged from it different but I think better. I still have work to do because I know that I am still full of issues.  I still have anxiety at night, trouble sleeping, especially without medication.  Other times I can experience bouts of depression and anxiety and on some occasions still battle anger and occasionally rage when I feel endangered or see injustice being inflicted on others. I still have some measure of hyper-vigilance and hyper-arousal and I am much more aware of my surroundings than I used to be.  Even in ministry I am careful what I share with people. I figure on this website people can pick and chose what they want to read, but when counseling or teaching I have to be more careful.  I know that I have some deep work to do especially in relation to forgiveness of those people and systems that I felt hurt or betrayed me.  I don’t know how all of that will work out but that is part of the journey.

In the mean time I will walk in faith and hope even knowing that some of the answers that I seek will not always sit well with me or others. But then such is life.

Peace

Padre Steve+

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Filed under film, PTSD, traumatic national events

Raw Edges: Are there other Chaplains out there Like Me?

Before a Convoy

The past week or so I have had to go back and revisit my Iraq experience. Part of this is due to work, we have had seminars on the spiritual and moral affects of trauma, the challenge of forgiveness and most recently discussing best spiritual care practices for those who suffer from PTSD or Traumatic Brain Injury (TBI).  The training has been excellent but has kicked up a lot of stuff in me.  Added to this have been reports out of Afghanistan about more casualties in particular of a helicopter that crashed that killed 9 Americans, the Taliban claim credit for downing the aircraft but the circumstances are not fully known.

One of many helicopter flights, this a daylight flight in a Marine CH-46

The course last week on the spiritual and moral affect of trauma and the challenge of forgiveness brought up issues from Iraq but not upsetting.  In fact the seminar taught by Dr. Robert Grant author of The Way of the Wound was helpful to me in sorting out what I have been going through for the past couple of years.  The training this week is also good, good information but for me it is more unsettling because it deals with images, videos of convoys, burning vehicles and other things like that.  The convoy images coupled with the news of the helicopter crash actually had me pretty shaken as I spent a large amount of time in small convoys with small groups of Americans and Iraqis in pretty dangerous areas of Al Anbar Province stretching from Fallujah to the Syrian border as well as a couple of hundred hours in the air, usually at night in various Marine and Army helicopters as well as the MV-22 Osprey.  During those experiences we took fire a couple of times and had a few experiences on some of our flights that were a bit sporty.  So for a while I was lost in my own stuff but was able to pull out in not too long of time.

Convoy stopped near Al Qaim

Some of our discussions revolved around how trauma and war can impact a person’s image and relationship with God, whatever that may be.  The focus was on us as pastoral care givers caring for those in our charge.  Once again this really good information for me as I will be dealing with a lot of PTSD and TBI cases are Camp LeJeune.  But there was one thing that got me.  I came back from Iraq as most of my readers know in pretty bad shape dealing with PTSD and issues of abandonment feeling disconnected with the Navy and my church.  Part of that was what amounted to be a loss of faith so severe that I was for all practical purposes an agnostic for almost two years because I couldn’t make sense of anything to do with God, I felt God forsaken it was to use the image of St. John of the Cross, my Dark Night of the Soul.  I am doing better now and feel like my faith has returned to some degree, certainly not like it was before but while I have doubts I am okay with that part of the journey now.

Christmas Eve not far from Syria

I know a number of military Chaplains from the Navy and Army that have returned from Iraq or Afghanistan in some sort of faith crisis many suffering from PTSD or TBI.  I am actually wondering how many are out there.  I know that I am not alone, but I need to know if others are going through this experience too.  It was for me a desperate feeling to be the Chaplain, Priest, Pastor and spiritual care giver when I was struggling having no answers and only questions, when people asked me about God and I didn’t even know if God existed.  This is the unspoken cry of at least some and possibly quite a few Chaplains and other ministers who have experienced trauma and moral injury.  One thing my incoming CO at my old unit asked me was “where does the Chaplain go for help?”  At that point I said that I didn’t know.  The sad thing is that I know many chaplains and ministers that have a basic lack of trust in their fellow clergy and do not feel safe confiding in them because they feel that they will be judged, not listened to or blown off.

A different war with the Bedouin in the western desert of Iraq about 5 km from Syria.

When I was diagnosed with PTSD in the summer of 2008 I made it my goal to grow through this and hopefully as I go through this to be there for others. Part of my recovery came through sharing experiences, the good and the bad on this site.  Elmer the Shrink asked me back when I started this if I thought that it would be helpful to me in my recovery, but he also asked if I was okay in opening up about this topic.  Since I didn’t see many people writing about this from the perspective of being a “wounded healer” I told him that I thought that I had to do it.  The experience has been terribly painful but at the same time I think that it has been worth it because as a Priest and Chaplain I think now more than ever in my weakness I can be with people in their difficult times without trying to “fix” them.

Colonel David Abramowitz with me and RP2 Nelson Lebron after presenting me with the Defense Meritorious Service Medal and Nelson the Joint Service Commendation Medal for our service with our advisors and Iraqis in Al Anbar with the Iraq Assistance Group. After this we both dealt with abandonment and other issues on our return home.

So who is there for “damaged” Chaplains? Who takes care of us? I was lucky or maybe blessed. I had Dr Chris Rogan ask me if I was okay. I had Elmer the Shrink do a lot of the hard work with me. At Naval Medical Center Portsmouth I had a Command Chaplain that was wise enough to protect me while I went through the deepest and darkest valley of my life.   As I recovered he challenged much like a Baseball Manager would challenge a pitcher who had been very successful on other clubs coming off the disabled list to regain his self confidence and ability to get back on the mound with a winning attitude. Not every Chaplain gets what I got and I am blessed.  I still have work to do and I need to recognize my limits, much as a pitcher who has recovered from Tommy John surgery makes adjustments.

So this is my question:  Are there others other there like me?  Are there other Chaplains experiencing such feelings after Iraq or Afghanistan? I’d really like to know because I believe that in what might be termed “a fellowship of the forsaken” that we can rediscover faith, belief and hope again and in doing so be there for others.

If you want please let me know if this encourages you or feel free to comment. Prayer is still hard for me but I promise that if someone asks that I will pray and to the best of my ability be available for them as others were for me because I don’t want any Chaplain to experience the abandonment that I felt went I returned from Iraq having felt that it was the pinnacle of my military career. To those Chaplains I just want to say that you are not alone.

Peace

Padre Steve+

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Filed under faith, iraq,afghanistan, Military, Pastoral Care, philosophy, PTSD, Religion, Tour in Iraq, US Navy