Series of good articles in the Cleveland Plain Dealer on Family issues with PTSD. I tried to get them to include my resources, but they didn't, so I left this comment:
More resources at patiencepress.com. I am the wife of a Vietnam vet and have written a lot of stuff from a non-professional perspective for other wives. There are pages of free pamphlets, articles, Post-Traumatic Gazettes, and some books for kids, all of which you can download, print, pass along. I suggest if you want your spouse to read something, print it and put it in the bathroom. PTSD people hate being given things to read that are supposed to help them... like all of us!
I also wrote a book, Recovering from the War, which is on Amazon and also a kindle.
If you are struggling, despairing and fed up, so was I. I share what worked for me (50 yrs next Dec.) and suggest a lot of things that have helped others, because you are different than me.
If you are dealing with a lot of anger, I suggest Post-Traumatic Gazettes #10 and 22 and my blog post, Irritability and Outbursts of Anger and the pamphlet on the spouse page, The War at Home. Things can get better. They have for me!
Tuesday, March 26, 2013
Wednesday, March 20, 2013
What PTSD is by Myke Cole
I found another great blog post, this one by Myke Cole, veteran and writer and asked for permission to repost it, which he kindly gave.
One of my strongest beliefs is that we do not know all the causes and symptoms of PTSD. I believe, as he does, that most military PTSD is the result of a long period of days, not necessarily one super-traumatic event, and that by focusing on that, shrinks can miss a lot.
Here is a link to it followed by the text:
What PTSD is by Myke Cole
I’ve talked before about genre writers who have been very open about personal trials, particularly the kind of depression/anxiety conditions that I feel are a natural part of the uneven terrain all authors have to walk. I’ve always appreciated their willingness to go public with these issues, as the first (and false) thing that most people suffering from these sorts of things think is a.) that they’re alone and b.) the problem is unique to them. When your literary heroes step into the spotlight and say, “hey, this is more normal than you think and you can figure out how to live with it,” well, let’s just say I wouldn’t be surprised if there are more than a few folks still pushing air past their teeth because of a blog post they read.
The thought of talking about what goes on in my head in anything but the most general terms in the public square takes me way out of my comfort zone. But I reread the first paragraph of this post, especially that last line. Sometimes, you need to go outside your comfort zone, talk about a thing not because you need to get it off your chest, but because it might help others to hear it.
I was diagnosed with PTSD in August of ’09, just after my third tour in Iraq. Of course my first concern (like everyone in my line of work) was losing my security clearance, and that kept me from going for help for a long time. But DoD did right by me, and I kept working for another 2 years before the book deal got me out of the business.
I had a hard time admitting it to myself. There was a culture in my line of work, that PTSD was the province of the hard operators, the doorkickers who got into 2–3 firefights every single day. Like most cultures, you bought into it silently, it was simply a thing that was, not worth questioning any more than the law of gravity.
I mean, sure I’d supported certain specialized units, sure I’d been to some funerals, sure there’d been some danger close indirect rounds. Sure I’d had some misgivings about what I was fighting for, what my actions were contributing to. But, I’d seen the ads on AFN, showing young men with gunpowder still on their hands, often fresh off the battlefield, having trembling flashbacks of a firefight where their best friend went down right next to them. THAT was PTSD.
Except, it wasn’t.
I kept seeing nonprofit TV spots, charity pieces and solemn psychoanalytical essays. They all described a PTSD that I’d never seen in myself, and more importantly, in anyone else I knew who suffered from it. I’ll never forget this one spot on AFN, where a soldier washes his hands, only to find blood pouring out of the faucet Stephen King’s Shining style. He hears gunfire, looks into the mirror, the background is a desert battlefield strewn with corpses, glowing red.
I picked that apart with some friends for an hour. I’m not saying that there aren’t people out there for whom PTSD is like that, but it sure as hell wasn’t like that for any of us. As I thought about that spot, as I considered the mounting reports of suicides, homeless vets, collapsing families, I began to get the uneasy feeling that PTSD is a lot like autism: A thing identified, but poorly understood. I read about the supposed symptoms, the heightened alertness, the re-experiencing of specific trauma, the going numb. It was all true. Up to a point.
When James Lowder invited me to write an essay for BEYOND THE WALL, we started brainstorming what it would be about. After a few rounds of back and forth, I realized that I wanted to write about PTSD, and how I saw it manifesting in fantasy characters. I used the Cooper Color System, talked about how living in the perpetual state of readiness known as “Condition Yellow,” both enfranchised and hurt people. Constant vigilance has its uses, but it is exhausting and, over time, transforming.
After the book was published I realized that I hadn’t gotten close enough to the issue. Arya Stark and Theon Greyjoy aren’t real people, and so addressing their PTSD was tackling the issue at a safe remove. It was a toe in the water. It wasn’t good enough.
Because the truth is, I’ve never heard anyone, medical professional, spiritual leader or otherwise describe the PTSD I know. What I see are people embracing a definition that explains PTSD using the vocabulary of classical pathology. It implies that, like a disease, you can prescribe a course of treatment and fix it.
But, in my experience, PTSD doesn’t get fixed. That’s because it was never about getting shot at, or seeing people die. It was never the snap trauma, the quick moment of action that breaks a person. PTSD is the wages of a life spent in crisis, the slow, thematic build that gradually changes the way the sufferer sees the world. You get boiled by heating the water one degree each hour. By the time you finally succumb, you realize you had no idea it was getting hotter.
Because you kept adjusting.
Because PTSD isn’t a disease, it’s a world view.
War, disaster response, police work, these things force a person to live in the spaces where trauma happens, to spend most of their time there, until that world becomes yours, seeps through your skin and runs in your blood. Most of us in industrialized western societies live with feeling that we are safe, that our lives are singular, meaningful, that we are loved, that we matter. We know intellectually that this may not be the case, but we don’t feel it.
PTSD is what happens when all that is stripped away. It is the curtain pulled back, the deep and thematic realization that life is fungible, that death is capricious and sudden. That anyone’s life can be snuffed out or worse, ruined, in the space of a few seconds. It is the shaking realization that love cannot protect you, and even worse, that you cannot protect those you love. It is the final surrendering of the myth that, if you are decent enough, ethical enough, skilled enough, you’ll be spared. The warriors that the media ascribes so much power are the first to truly know powerlessness, as death becomes commoditized, statistics that you use to make an argument for promotion, or funding, or to score political points.
Warrior cults (and, heck, most religions) were invented to give death meaning. Even if you look past the promise of immortality, they offer a tremor in the world, a ripple of significance in your passing. You do the right thing knowing that, somewhere down the line, you have a meaningful death. PTSD is what happens when you realize that you won’t, that your survival will be determined by something as random as the moment you bent over to tie your shoelace.
Diseases are discrete things. But how do you treat a change in perspective? Joe Abercrombie captured it best in his description of Ferro Maljinn’s final revelation of the world of demons just alongside our own. Once seen, the creatures cannot be unseen. When you’re quiet enough, you can hear them breathing.
Nobody talks about this. Nobody talks about the boredom, the impossibility of finding meaning in 8 hours work in an air-conditioned office after you just spent months working 18 hours a day on a battlefield where your touch altered history. Nobody talks about the surreal experience of trying to remember how you got excited about a book, or clothing, or even a car or house. On the battlefield, in the burning building, the ground trembled, we felt our impact in everything we did, until the world seemed to ripple at our touch. Back home, or off shift, we are suddenly the subject of sympathetic glances, of silly, repetitive questions. The anonymity of the uniform is nothing compared the anonymity of comfort. We drown in it, cut off from what makes it worthwhile for others, unable to carve out a piece of it for ourselves.
Time helps you to shift back, but you never shift back all the way. You develop the dreaded “cop’s eyes,” where you see the potential threat around every corner, where you ask the waiter for the chair with its back to the wall. Where the trust essential to build relationships is compromised, because in the world you live in, everybody is trying to harm someone.
And this is why so many of us, even post diagnosis, go back to work in the fields that exposed us to the trauma in the first place. Because the fear is bone deep, and the only thing that puts it to sleep is the thought that you can maybe patch a few of the holes in the swiss cheese net under the high wire. Because we are frightened from the moment we wake until the moment we sleep, and if we can stave that off for someone else, well, then maybe that’s something to live for.
And that’s for those of us who get off easy. In the worst cases, people aren’t able to find meaning in a regular job, or in wealth-building, or relationships, or any of the things that modern societies tell us charts the course of a life. These are the people that PTSD takes, as they flail their way into suicide, or crime, or insanity, desperately trying to carve meaning out of a world where all the goal posts have suddenly moved, where the giant question that no one can answer is, “why bother?”
The root of the treatment has to come from meeting those who suffer where they are. It isn’t just hard operators. It’s clerks and phlebotomists and chemical engineers. It’s people who thought they were fine, only to wake up one morning and realize that the last few years have changed them in ways they don’t quite understand. It isn’t just soldiers and cops and ER nurses. Life in poverty can bring on PTSD. An abusive parent can have the same effect.
We need to treat the fear, address the world view, acknowledging that these aren’t things you cure, maybe aren’t even things you change. We need to tip our hat to the trauma, and look instead at what the life after it looks like. We have to find a way to construct significance, to help a changed person forge a path in a world that hasn’t changed along with them.
And if you’re a vet, or an EMT, or a cop, or firefighter and you’re reading this, I want you to know that you can’t put the curtain back, but it’s possible to build ways to move forward, to find alternatives to the rush of crisis. There are ways you can matter. There is a way to rejoin the dust of the world, to find your own space on the dance floor.
I know this.
Because I did it, am still doing it, every day.
Don’t give up.
One of my strongest beliefs is that we do not know all the causes and symptoms of PTSD. I believe, as he does, that most military PTSD is the result of a long period of days, not necessarily one super-traumatic event, and that by focusing on that, shrinks can miss a lot.
Here is a link to it followed by the text:
What PTSD is by Myke Cole
I’ve talked before about genre writers who have been very open about personal trials, particularly the kind of depression/anxiety conditions that I feel are a natural part of the uneven terrain all authors have to walk. I’ve always appreciated their willingness to go public with these issues, as the first (and false) thing that most people suffering from these sorts of things think is a.) that they’re alone and b.) the problem is unique to them. When your literary heroes step into the spotlight and say, “hey, this is more normal than you think and you can figure out how to live with it,” well, let’s just say I wouldn’t be surprised if there are more than a few folks still pushing air past their teeth because of a blog post they read.
The thought of talking about what goes on in my head in anything but the most general terms in the public square takes me way out of my comfort zone. But I reread the first paragraph of this post, especially that last line. Sometimes, you need to go outside your comfort zone, talk about a thing not because you need to get it off your chest, but because it might help others to hear it.
I was diagnosed with PTSD in August of ’09, just after my third tour in Iraq. Of course my first concern (like everyone in my line of work) was losing my security clearance, and that kept me from going for help for a long time. But DoD did right by me, and I kept working for another 2 years before the book deal got me out of the business.
I had a hard time admitting it to myself. There was a culture in my line of work, that PTSD was the province of the hard operators, the doorkickers who got into 2–3 firefights every single day. Like most cultures, you bought into it silently, it was simply a thing that was, not worth questioning any more than the law of gravity.
I mean, sure I’d supported certain specialized units, sure I’d been to some funerals, sure there’d been some danger close indirect rounds. Sure I’d had some misgivings about what I was fighting for, what my actions were contributing to. But, I’d seen the ads on AFN, showing young men with gunpowder still on their hands, often fresh off the battlefield, having trembling flashbacks of a firefight where their best friend went down right next to them. THAT was PTSD.
Except, it wasn’t.
I kept seeing nonprofit TV spots, charity pieces and solemn psychoanalytical essays. They all described a PTSD that I’d never seen in myself, and more importantly, in anyone else I knew who suffered from it. I’ll never forget this one spot on AFN, where a soldier washes his hands, only to find blood pouring out of the faucet Stephen King’s Shining style. He hears gunfire, looks into the mirror, the background is a desert battlefield strewn with corpses, glowing red.
I picked that apart with some friends for an hour. I’m not saying that there aren’t people out there for whom PTSD is like that, but it sure as hell wasn’t like that for any of us. As I thought about that spot, as I considered the mounting reports of suicides, homeless vets, collapsing families, I began to get the uneasy feeling that PTSD is a lot like autism: A thing identified, but poorly understood. I read about the supposed symptoms, the heightened alertness, the re-experiencing of specific trauma, the going numb. It was all true. Up to a point.
When James Lowder invited me to write an essay for BEYOND THE WALL, we started brainstorming what it would be about. After a few rounds of back and forth, I realized that I wanted to write about PTSD, and how I saw it manifesting in fantasy characters. I used the Cooper Color System, talked about how living in the perpetual state of readiness known as “Condition Yellow,” both enfranchised and hurt people. Constant vigilance has its uses, but it is exhausting and, over time, transforming.
After the book was published I realized that I hadn’t gotten close enough to the issue. Arya Stark and Theon Greyjoy aren’t real people, and so addressing their PTSD was tackling the issue at a safe remove. It was a toe in the water. It wasn’t good enough.
Because the truth is, I’ve never heard anyone, medical professional, spiritual leader or otherwise describe the PTSD I know. What I see are people embracing a definition that explains PTSD using the vocabulary of classical pathology. It implies that, like a disease, you can prescribe a course of treatment and fix it.
But, in my experience, PTSD doesn’t get fixed. That’s because it was never about getting shot at, or seeing people die. It was never the snap trauma, the quick moment of action that breaks a person. PTSD is the wages of a life spent in crisis, the slow, thematic build that gradually changes the way the sufferer sees the world. You get boiled by heating the water one degree each hour. By the time you finally succumb, you realize you had no idea it was getting hotter.
Because you kept adjusting.
Because PTSD isn’t a disease, it’s a world view.
War, disaster response, police work, these things force a person to live in the spaces where trauma happens, to spend most of their time there, until that world becomes yours, seeps through your skin and runs in your blood. Most of us in industrialized western societies live with feeling that we are safe, that our lives are singular, meaningful, that we are loved, that we matter. We know intellectually that this may not be the case, but we don’t feel it.
PTSD is what happens when all that is stripped away. It is the curtain pulled back, the deep and thematic realization that life is fungible, that death is capricious and sudden. That anyone’s life can be snuffed out or worse, ruined, in the space of a few seconds. It is the shaking realization that love cannot protect you, and even worse, that you cannot protect those you love. It is the final surrendering of the myth that, if you are decent enough, ethical enough, skilled enough, you’ll be spared. The warriors that the media ascribes so much power are the first to truly know powerlessness, as death becomes commoditized, statistics that you use to make an argument for promotion, or funding, or to score political points.
Warrior cults (and, heck, most religions) were invented to give death meaning. Even if you look past the promise of immortality, they offer a tremor in the world, a ripple of significance in your passing. You do the right thing knowing that, somewhere down the line, you have a meaningful death. PTSD is what happens when you realize that you won’t, that your survival will be determined by something as random as the moment you bent over to tie your shoelace.
Diseases are discrete things. But how do you treat a change in perspective? Joe Abercrombie captured it best in his description of Ferro Maljinn’s final revelation of the world of demons just alongside our own. Once seen, the creatures cannot be unseen. When you’re quiet enough, you can hear them breathing.
Nobody talks about this. Nobody talks about the boredom, the impossibility of finding meaning in 8 hours work in an air-conditioned office after you just spent months working 18 hours a day on a battlefield where your touch altered history. Nobody talks about the surreal experience of trying to remember how you got excited about a book, or clothing, or even a car or house. On the battlefield, in the burning building, the ground trembled, we felt our impact in everything we did, until the world seemed to ripple at our touch. Back home, or off shift, we are suddenly the subject of sympathetic glances, of silly, repetitive questions. The anonymity of the uniform is nothing compared the anonymity of comfort. We drown in it, cut off from what makes it worthwhile for others, unable to carve out a piece of it for ourselves.
Time helps you to shift back, but you never shift back all the way. You develop the dreaded “cop’s eyes,” where you see the potential threat around every corner, where you ask the waiter for the chair with its back to the wall. Where the trust essential to build relationships is compromised, because in the world you live in, everybody is trying to harm someone.
And this is why so many of us, even post diagnosis, go back to work in the fields that exposed us to the trauma in the first place. Because the fear is bone deep, and the only thing that puts it to sleep is the thought that you can maybe patch a few of the holes in the swiss cheese net under the high wire. Because we are frightened from the moment we wake until the moment we sleep, and if we can stave that off for someone else, well, then maybe that’s something to live for.
And that’s for those of us who get off easy. In the worst cases, people aren’t able to find meaning in a regular job, or in wealth-building, or relationships, or any of the things that modern societies tell us charts the course of a life. These are the people that PTSD takes, as they flail their way into suicide, or crime, or insanity, desperately trying to carve meaning out of a world where all the goal posts have suddenly moved, where the giant question that no one can answer is, “why bother?”
The root of the treatment has to come from meeting those who suffer where they are. It isn’t just hard operators. It’s clerks and phlebotomists and chemical engineers. It’s people who thought they were fine, only to wake up one morning and realize that the last few years have changed them in ways they don’t quite understand. It isn’t just soldiers and cops and ER nurses. Life in poverty can bring on PTSD. An abusive parent can have the same effect.
We need to treat the fear, address the world view, acknowledging that these aren’t things you cure, maybe aren’t even things you change. We need to tip our hat to the trauma, and look instead at what the life after it looks like. We have to find a way to construct significance, to help a changed person forge a path in a world that hasn’t changed along with them.
And if you’re a vet, or an EMT, or a cop, or firefighter and you’re reading this, I want you to know that you can’t put the curtain back, but it’s possible to build ways to move forward, to find alternatives to the rush of crisis. There are ways you can matter. There is a way to rejoin the dust of the world, to find your own space on the dance floor.
I know this.
Because I did it, am still doing it, every day.
Don’t give up.
Tuesday, March 19, 2013
Story from a vet
I just got this wonderful story from a FB friend:
Craig Latham
Craig Latham
Hello,
Pardon me for sending this to you, but I was diagnosed with PTSD in the late 80s. This helped me and I wanted to share with you.
My Time At The Wall
by Craig Latham
It had been twenty-five years since I left Vietnam. My brother-in-law and I had just finished a weekend at Bristol, Tennesee, where we watched our first Nascar race in person. We still had to go to Virginia Beach for a couple of days and then on to Washington D.C.
We arrived at the wall just about 6am as the sun was coming up. It was gonna be another hot day in August. This is when I realized it had been exactly twenty-five years to the day that I left the hot sun of Vietnam and boarded the "Freedom Bird" home. The heat in the United States was nothing, compared to the humid heat of the jungle. Sometimes you would sit in the sun to cool off because you were constantly hot and wet in the jungle.
Anyway, back to D.C. We got to the wall just as the sun was coming up and only one other couple was there. They had been there many times before. He had made this pilgrimage there every year for the past ten years. He told us it was part of his healing process. I asked him what he did in Vietnam and he said he had been a "grunt". We chatted for a few minutes, "Welcomed" each other home, and then he told us how to find what we were looking for.
My brother-in-law, Bob, had been in Vietnam about two years before me. I looked down the shiny black wall and noticed Bob was down on one knee. I didn't know if he was praying, crying, or a little bit of both. I didn't ask. This was his private time with someone he knew a long time ago.
I had a list of names of people I wanted to look up, too. Most were people from my home county (Coshocton, Ohio). I found them all, and made etchings of each. They had all been in Vietnam before me. Some were "Grunts", "Medic", "Crew Chief", "Door Gunner", and "Pilots".
The last one I looked for was my friend Andy B. He had been a "Door Gunner" for the 2nd Brigade Hq. in the 101St Airborne Division (Ambl) in Phu Bai, S. Vietnam. Andy was short, (not in stature, but in time left in Vietnam). He and his pilot were on their way back to Phu Bai when they heard a unit in trouble and went to see if they could be of any help. They were shot down. Both killed. Andy and I were gonna have a couple of beers that evening when he got back, but I drank alone that night. The next day, I had to go out with an infantry unit and wouldn't get back to Phu Bai for a week. I missed his "Memorial Service". I felt bad.
I had my own "Memorial Service" for Andy that day at the wall. Something happened that day. I found Andy's name on the wall and as I reached out to touch his name, all I could see was a hand (actually my reflection) coming at me from the blackness. As I touched the "Wall" and the hand, it felt as if something was stripped from my body. A weight of twenty-five years was gone. It was as if the hand belonged to Andy and he was saying, "It's over now. It's time to let go." That day, something happened. From that day forward, the night sweats slowly subsided. The waking up in the middle of the night screaming, stopped.
"The Wall" has healing powers and no one can tell me any different.
The ride home from D.C. with my brother-in-law was a quiet one. Each of us was reflecting on our past, present and probably our future.
Welcome home, all "Vietnam Veterans".
Craig Latham
Combat Writer/Photographer
1970-1971
34th Public Information Detachment (34th PID)
2nd Brigade/101st Airborne Division (Ambl)
Phu Bai, S. Vietnam
Pardon me for sending this to you, but I was diagnosed with PTSD in the late 80s. This helped me and I wanted to share with you.
My Time At The Wall
by Craig Latham
It had been twenty-five years since I left Vietnam. My brother-in-law and I had just finished a weekend at Bristol, Tennesee, where we watched our first Nascar race in person. We still had to go to Virginia Beach for a couple of days and then on to Washington D.C.
We arrived at the wall just about 6am as the sun was coming up. It was gonna be another hot day in August. This is when I realized it had been exactly twenty-five years to the day that I left the hot sun of Vietnam and boarded the "Freedom Bird" home. The heat in the United States was nothing, compared to the humid heat of the jungle. Sometimes you would sit in the sun to cool off because you were constantly hot and wet in the jungle.
Anyway, back to D.C. We got to the wall just as the sun was coming up and only one other couple was there. They had been there many times before. He had made this pilgrimage there every year for the past ten years. He told us it was part of his healing process. I asked him what he did in Vietnam and he said he had been a "grunt". We chatted for a few minutes, "Welcomed" each other home, and then he told us how to find what we were looking for.
My brother-in-law, Bob, had been in Vietnam about two years before me. I looked down the shiny black wall and noticed Bob was down on one knee. I didn't know if he was praying, crying, or a little bit of both. I didn't ask. This was his private time with someone he knew a long time ago.
I had a list of names of people I wanted to look up, too. Most were people from my home county (Coshocton, Ohio). I found them all, and made etchings of each. They had all been in Vietnam before me. Some were "Grunts", "Medic", "Crew Chief", "Door Gunner", and "Pilots".
The last one I looked for was my friend Andy B. He had been a "Door Gunner" for the 2nd Brigade Hq. in the 101St Airborne Division (Ambl) in Phu Bai, S. Vietnam. Andy was short, (not in stature, but in time left in Vietnam). He and his pilot were on their way back to Phu Bai when they heard a unit in trouble and went to see if they could be of any help. They were shot down. Both killed. Andy and I were gonna have a couple of beers that evening when he got back, but I drank alone that night. The next day, I had to go out with an infantry unit and wouldn't get back to Phu Bai for a week. I missed his "Memorial Service". I felt bad.
I had my own "Memorial Service" for Andy that day at the wall. Something happened that day. I found Andy's name on the wall and as I reached out to touch his name, all I could see was a hand (actually my reflection) coming at me from the blackness. As I touched the "Wall" and the hand, it felt as if something was stripped from my body. A weight of twenty-five years was gone. It was as if the hand belonged to Andy and he was saying, "It's over now. It's time to let go." That day, something happened. From that day forward, the night sweats slowly subsided. The waking up in the middle of the night screaming, stopped.
"The Wall" has healing powers and no one can tell me any different.
The ride home from D.C. with my brother-in-law was a quiet one. Each of us was reflecting on our past, present and probably our future.
Welcome home, all "Vietnam Veterans".
Craig Latham
Combat Writer/Photographer
1970-1971
34th Public Information Detachment (34th PID)
2nd Brigade/101st Airborne Division (Ambl)
Phu Bai, S. Vietnam
Thursday, March 14, 2013
Report on Army Mishandling of PTSD
On March 8th the News Tribune published an AP report on the Army's Mishandling of PTSD which confirms what most of us already know. It is not good!
As I have said before, there is an inherent conflict of interest in being a military psychiatrist, especially one who decides who does and doesn't have PTSD. The military does not want them to have PTSD. That's why they have stigma and resilience training: two attitudes which are very human but not particularly aware of human nature!
Since the begining of history, people have had PTSD symptoms. With most wars it is recognized, perhaps with another name, nostalgia, soldier's heart, shell shock, combat fatigue, combat neurosis, post-Vietnam syndrome (along with post-rape syndrome, and other post-syndromes). Between wars the elite intellectuals who become doctors, psychiatrists, and psychologists for the most part try to prove that PTSD doesn't exist. The women's movement helped put a stop to that after Vietnam, because rape survivors and battered wives were no longer going to shut up and be good. They combined with the Vietnam vets who also were not willing to shut up and be good to get the diagnosis of PTSD added to DSMIII (Diagnostic and Statistical Manual of the American Psychiatric Association) in 1980. The first edition, published during the Korean War, had Gross Stress Reaction (gross meaning big, like a concentration camp or combat). The second, which came out in 1968, during the TET Offensive, pretended that if you had a problem with the war for more than 6 months after you got back, you'd been screwed up before you went. They liked giving PTSD vets personality disorders and other wrong diagnoses.
For a while, veterans could actually get help in the Vet Centers and some VA Hospitals, eventually many VA Hospitals.
Still after Somalia, and incredibly stupid paper was published by specialists in the PTSD field in which, when the soldiers who had PTSD reported worse experiences four years after their first interview, their conclusion was that they were making it up, instead of that they didn't tell the worst to a bunch of guys in white coats right after they got back. (Young cocky soldiers, right!)
Then we saw Sally Satel and her ilk trying to pretend PTSD was overdiagnosed and wouldn't be a problem in Iraq and Afghanistan. (Bangs head on desk.)
Now we have manualized 12 week treatments for PTSD and a thirty page questionnaire to fill out.
I swear to God, these people are entirely without compassion or the slightest conception of how this appears to the people they might be trying to help. Tell some mother who lost a kid in Iraq that you are going to cure her grief in 12 weeks... These people have lost their friends and seen horrors, and some of them have done things they can't look back on easily. They need to be listened to, not fixed like they were cars or something.
Today on NPR I heard a soldier (male) who was raped by his NCO and told not to report it, but he did, so he was sent to a psychiatrist who conveniently diagnosed him with a personality disorder.
I used to think nothing like Vietnam and the mistreatment of vets would ever happen again. I was wrong.
There are people out there who listen to vets, who care about vets, who help vets. I hope our vets can find them.
As I have said before, there is an inherent conflict of interest in being a military psychiatrist, especially one who decides who does and doesn't have PTSD. The military does not want them to have PTSD. That's why they have stigma and resilience training: two attitudes which are very human but not particularly aware of human nature!
Since the begining of history, people have had PTSD symptoms. With most wars it is recognized, perhaps with another name, nostalgia, soldier's heart, shell shock, combat fatigue, combat neurosis, post-Vietnam syndrome (along with post-rape syndrome, and other post-syndromes). Between wars the elite intellectuals who become doctors, psychiatrists, and psychologists for the most part try to prove that PTSD doesn't exist. The women's movement helped put a stop to that after Vietnam, because rape survivors and battered wives were no longer going to shut up and be good. They combined with the Vietnam vets who also were not willing to shut up and be good to get the diagnosis of PTSD added to DSMIII (Diagnostic and Statistical Manual of the American Psychiatric Association) in 1980. The first edition, published during the Korean War, had Gross Stress Reaction (gross meaning big, like a concentration camp or combat). The second, which came out in 1968, during the TET Offensive, pretended that if you had a problem with the war for more than 6 months after you got back, you'd been screwed up before you went. They liked giving PTSD vets personality disorders and other wrong diagnoses.
For a while, veterans could actually get help in the Vet Centers and some VA Hospitals, eventually many VA Hospitals.
Still after Somalia, and incredibly stupid paper was published by specialists in the PTSD field in which, when the soldiers who had PTSD reported worse experiences four years after their first interview, their conclusion was that they were making it up, instead of that they didn't tell the worst to a bunch of guys in white coats right after they got back. (Young cocky soldiers, right!)
Then we saw Sally Satel and her ilk trying to pretend PTSD was overdiagnosed and wouldn't be a problem in Iraq and Afghanistan. (Bangs head on desk.)
Now we have manualized 12 week treatments for PTSD and a thirty page questionnaire to fill out.
I swear to God, these people are entirely without compassion or the slightest conception of how this appears to the people they might be trying to help. Tell some mother who lost a kid in Iraq that you are going to cure her grief in 12 weeks... These people have lost their friends and seen horrors, and some of them have done things they can't look back on easily. They need to be listened to, not fixed like they were cars or something.
Today on NPR I heard a soldier (male) who was raped by his NCO and told not to report it, but he did, so he was sent to a psychiatrist who conveniently diagnosed him with a personality disorder.
I used to think nothing like Vietnam and the mistreatment of vets would ever happen again. I was wrong.
There are people out there who listen to vets, who care about vets, who help vets. I hope our vets can find them.
Do's and Do Not's for Spouses and Partners of Combat Veterans
This article is reprinted with permission from Ray Scurfield
“The Do’s and Do Not’s for Spouses and Partners of Combat Veterans”
By Ray Scurfield
The Do Not's
• Do not say, “I understand,” or “I know you feel.” No, you don’t. If you were not in war, you
don’t understand. Period. However, you may well understand from your own life
experience how it feels to not want to talk to anyone, or how it is to feel that no one can
understand about something you have experienced. You may know what it's like to hope
that if you could just ignore something festering inside you that it would eventually go
away.Seek help if you are hurting, whether or not your veteran partner does.
• Do not push or insist that your vet talk about the war if he/she does not want to. It is too sacred
a subject to attempt to pry the details out of someone. Remember, you are trampling on
hallowed ground.
• Do not say, “Did you kill anybody?” Or, “How did it feel to kill someone?” If the vet wants to
share this, the vet will share it. Otherwise, this is perceived as an invasive and unwanted
demand for the most extremely personal of information.
• Don’t take it personally when your veteran does not want to talk about it. Part of it is because
you are not a combat veteran. Your veteran partner will probably be far comfortable
talking about the war experiences in any detail with another combat veteran. It is crucial
to remember that the vast majority of war veterans feel that no one but other combat
veterans could possibly understand.
Side note: Also, the veteran may be very concerned about “taking the lid off” of all the pent-up
feelings and memories about war that have been buried. The fear is, “If I open the lid (of the
memories, emotions, trauma) I may not be able to put it back on again.” This reluctance is why
there are a number of other war veterans who just don’t want to talk much to anybody, not even to
other vets. As one such Vietnam veteran told me: "When I got back from Nam, the only people I
could relate to were other Vietnam vets---and they were the last ones I wanted to be around."
• Don’t make ultimatums or threats that have severe consequences and deadlines attached to
them unless you are absolutely at your wits end. An example of an ultimatum: “You need
to get it together now, it’s been ___weeks or ___months of being withdrawn, moping
around, etc. If you don’t go see a counselor this week, I’m going to leave you.” Big
mistake. Most combat vets do not respond very positively to threats. This is not a poker
game where bluffing and deception go hand-in-hand with winning.
• Don’t lay a guilt trip on your vet, or present it as a test of your relationship. For example: “If
you really loved me, you would share more with me” Or: "If you really loved me, you
would understand what’s going on inside me.” Your veteran partner may already be
feeling guilty about what he/she did or did not do in the war, or about the hardships you
and the family may have gone through while he/she was deployed.
• Do not ignore warning signs in your vet that there may be potentially serious problems, such as
excessive drinking, isolating, a deep-seated rage, mood swings, anxiety and sleep
disturbance. You need to point such things out, but not dwell on them, depending on how
severe the symptoms are.
• Do not ignore your own needs and wants. You have the right to have your needs and wants
met, no matter how troubled your veteran partner is. And so do your children.
• Do not ever allow your veteran partner to treat you meanly, disrespectfully, or in a threatening
way. This includes screaming, yelling and threatening behaviors. And do not EVER
tolerate your veteran partner hurting you or your family. Violence in war is one thing.
But to bring it back into the home is quite another. It is NEVER excusable. If you can’t
protect yourself or your family, then immediately go talk to someone who can help you.
The Do’s
• Do remember to reach down deep within and stay in touch with the love you have for your
veteran - even if it is more of a love for how he or she was before deployment than how
he or she is behaving right now.
• Do remember that your relationship that should be at least as important as the individual needs
and wants of each of you. Think about what is best for your relationship right now, not
what is best for you or what is best for your veteran partner.
• Do hold hands and look each other in the eyes. Try this: if you and your partner are having a
serious argument or harsh words, both of you stop. Be silent for a moment, compose
yourselves, stand in front of each other, hold hands, look in each other’s eyes, and start
talking to each other this way. You almost surely will calm down and start relating to
each other rather than talking meanly at each other.
• Do put yourself out there. Ask: "Do you want to talk a little with me about the war? Are you
willing to share with me some of the good times, some of the bad times? If not now,
possibly later?" And say, "I need to be able to ask you these same questions again at
another time, because otherwise you may never come to me first and start talking about
it. Tell me the best way to approach you."
• Do tell your vet partner about the warning signs and triggers about post traumatic stress and
combat stress that remind you of him or her. If you don’t know the signs, get some
literature ASAP from a military family support agency, a partner support group, a VA
Vet Center or a Veteran’s Service Organization.
• Do recognize that your veteran partner may well be very resistant to talking to anyone,
including you, about what is going on. The veteran may not respond positively to your
suggestions today or tomorrow or next week, and so you have to be both persistent and
diplomatic/gentle in continuing to bring up your concerns.
• Do say, "I know I can’t fully (or perhaps at all) understand what is going on with you, because
I wasn’t there in the war."
• Do say (if you genuinely mean it), "I really do want to better understand, and request that you
help me better understand. If you don’t tell me anything, then you are shutting me out and
it will be impossible for me to ever really understand. Please don’t shut me out
completely."
• Do ask your vet, "Are there any books, articles or other readings about war, or any
movies/songs/music that are personally meaningful that you could recommend to me that
could give me a better understanding of what it was all about, about what was so
meaningful for you? And then I would like to talk with you a little about it." Many vets
will be much more comfortable with you learning in this way, rather than you expecting
your veteran partner to talk in great detail.
• Do say, "Please let me know when it feels like I am trying to invade into your most deep and
personal feelings and issues. I really want you to tell me that gently, in a respectful
way. And that goes both ways. I am going to let you know when you may say something
offensive to me, or that hurts me, or when it feels like you’re trying to invade my most
deep and personal feelings and issues. I want to tell you that gently, in a respectful way."
• Do say, "I’m here for you. And I want you to be here for me, even if you can’t be here for me
as much right now as I want you to. Because I am in this for the long haul." However, if
you are having serious doubts that you still committed to this relationship, then that is
another matter entirely that requires immediate attention.
• Do put on your oxygen mask first. This is the bottom line do or don’t - to first take care of
yourself. As we all know, the proper procedure on an airplane when the oxygen masks
drop down is to put your oxygen mask on first; otherwise you will be in no position to
help anyone else. The same principle applies to you at home. Seek help if you are
hurting, whether or not your veteran partner does and whether or not your veteran partner
wants you to. This is your right. And one of the most powerful sources of support and
understanding will be with and from other military spouses whose spouses who have
returned from deployment.
from Raymond Scurfield,
War Trauma. Lessons Unlearned From Vietnam to Iraq. Volume 3 of a Vietnam Trilogy, New York: Algora, 2006,
Chapter 4, "The Return Home and the Ricochet Effect on the Family" (pp. 77-106)
“The Do’s and Do Not’s for Spouses and Partners of Combat Veterans”
By Ray Scurfield
The Do Not's
• Do not say, “I understand,” or “I know you feel.” No, you don’t. If you were not in war, you
don’t understand. Period. However, you may well understand from your own life
experience how it feels to not want to talk to anyone, or how it is to feel that no one can
understand about something you have experienced. You may know what it's like to hope
that if you could just ignore something festering inside you that it would eventually go
away.Seek help if you are hurting, whether or not your veteran partner does.
• Do not push or insist that your vet talk about the war if he/she does not want to. It is too sacred
a subject to attempt to pry the details out of someone. Remember, you are trampling on
hallowed ground.
• Do not say, “Did you kill anybody?” Or, “How did it feel to kill someone?” If the vet wants to
share this, the vet will share it. Otherwise, this is perceived as an invasive and unwanted
demand for the most extremely personal of information.
• Don’t take it personally when your veteran does not want to talk about it. Part of it is because
you are not a combat veteran. Your veteran partner will probably be far comfortable
talking about the war experiences in any detail with another combat veteran. It is crucial
to remember that the vast majority of war veterans feel that no one but other combat
veterans could possibly understand.
Side note: Also, the veteran may be very concerned about “taking the lid off” of all the pent-up
feelings and memories about war that have been buried. The fear is, “If I open the lid (of the
memories, emotions, trauma) I may not be able to put it back on again.” This reluctance is why
there are a number of other war veterans who just don’t want to talk much to anybody, not even to
other vets. As one such Vietnam veteran told me: "When I got back from Nam, the only people I
could relate to were other Vietnam vets---and they were the last ones I wanted to be around."
• Don’t make ultimatums or threats that have severe consequences and deadlines attached to
them unless you are absolutely at your wits end. An example of an ultimatum: “You need
to get it together now, it’s been ___weeks or ___months of being withdrawn, moping
around, etc. If you don’t go see a counselor this week, I’m going to leave you.” Big
mistake. Most combat vets do not respond very positively to threats. This is not a poker
game where bluffing and deception go hand-in-hand with winning.
• Don’t lay a guilt trip on your vet, or present it as a test of your relationship. For example: “If
you really loved me, you would share more with me” Or: "If you really loved me, you
would understand what’s going on inside me.” Your veteran partner may already be
feeling guilty about what he/she did or did not do in the war, or about the hardships you
and the family may have gone through while he/she was deployed.
• Do not ignore warning signs in your vet that there may be potentially serious problems, such as
excessive drinking, isolating, a deep-seated rage, mood swings, anxiety and sleep
disturbance. You need to point such things out, but not dwell on them, depending on how
severe the symptoms are.
• Do not ignore your own needs and wants. You have the right to have your needs and wants
met, no matter how troubled your veteran partner is. And so do your children.
• Do not ever allow your veteran partner to treat you meanly, disrespectfully, or in a threatening
way. This includes screaming, yelling and threatening behaviors. And do not EVER
tolerate your veteran partner hurting you or your family. Violence in war is one thing.
But to bring it back into the home is quite another. It is NEVER excusable. If you can’t
protect yourself or your family, then immediately go talk to someone who can help you.
The Do’s
• Do remember to reach down deep within and stay in touch with the love you have for your
veteran - even if it is more of a love for how he or she was before deployment than how
he or she is behaving right now.
• Do remember that your relationship that should be at least as important as the individual needs
and wants of each of you. Think about what is best for your relationship right now, not
what is best for you or what is best for your veteran partner.
• Do hold hands and look each other in the eyes. Try this: if you and your partner are having a
serious argument or harsh words, both of you stop. Be silent for a moment, compose
yourselves, stand in front of each other, hold hands, look in each other’s eyes, and start
talking to each other this way. You almost surely will calm down and start relating to
each other rather than talking meanly at each other.
• Do put yourself out there. Ask: "Do you want to talk a little with me about the war? Are you
willing to share with me some of the good times, some of the bad times? If not now,
possibly later?" And say, "I need to be able to ask you these same questions again at
another time, because otherwise you may never come to me first and start talking about
it. Tell me the best way to approach you."
• Do tell your vet partner about the warning signs and triggers about post traumatic stress and
combat stress that remind you of him or her. If you don’t know the signs, get some
literature ASAP from a military family support agency, a partner support group, a VA
Vet Center or a Veteran’s Service Organization.
• Do recognize that your veteran partner may well be very resistant to talking to anyone,
including you, about what is going on. The veteran may not respond positively to your
suggestions today or tomorrow or next week, and so you have to be both persistent and
diplomatic/gentle in continuing to bring up your concerns.
• Do say, "I know I can’t fully (or perhaps at all) understand what is going on with you, because
I wasn’t there in the war."
• Do say (if you genuinely mean it), "I really do want to better understand, and request that you
help me better understand. If you don’t tell me anything, then you are shutting me out and
it will be impossible for me to ever really understand. Please don’t shut me out
completely."
• Do ask your vet, "Are there any books, articles or other readings about war, or any
movies/songs/music that are personally meaningful that you could recommend to me that
could give me a better understanding of what it was all about, about what was so
meaningful for you? And then I would like to talk with you a little about it." Many vets
will be much more comfortable with you learning in this way, rather than you expecting
your veteran partner to talk in great detail.
• Do say, "Please let me know when it feels like I am trying to invade into your most deep and
personal feelings and issues. I really want you to tell me that gently, in a respectful
way. And that goes both ways. I am going to let you know when you may say something
offensive to me, or that hurts me, or when it feels like you’re trying to invade my most
deep and personal feelings and issues. I want to tell you that gently, in a respectful way."
• Do say, "I’m here for you. And I want you to be here for me, even if you can’t be here for me
as much right now as I want you to. Because I am in this for the long haul." However, if
you are having serious doubts that you still committed to this relationship, then that is
another matter entirely that requires immediate attention.
• Do put on your oxygen mask first. This is the bottom line do or don’t - to first take care of
yourself. As we all know, the proper procedure on an airplane when the oxygen masks
drop down is to put your oxygen mask on first; otherwise you will be in no position to
help anyone else. The same principle applies to you at home. Seek help if you are
hurting, whether or not your veteran partner does and whether or not your veteran partner
wants you to. This is your right. And one of the most powerful sources of support and
understanding will be with and from other military spouses whose spouses who have
returned from deployment.
from Raymond Scurfield,
War Trauma. Lessons Unlearned From Vietnam to Iraq. Volume 3 of a Vietnam Trilogy, New York: Algora, 2006,
Chapter 4, "The Return Home and the Ricochet Effect on the Family" (pp. 77-106)
Thursday, March 7, 2013
Meditation and PTSD
The military is apparently trying out meditation for PTSD which I think is a good idea. Bob uses it. When he first told me he was going to try it, I thought it was silly and wouldn't work, but luckily since I am in recovery and trying to stop giving advice, I didn't say anything.
Man, was I surprised when it helped him a lot.
He used John Kabat Zinn's, Wherever You Go, There You Are, a very amusing book which answered the question he used to get enraged over: "Why can't I blank my mind?" It was a big relief to know that was not the point.
When I used to publish the Post-Traumatic Gazette, Bob wrote this for me for issue #25, PTSD and Spirituality:
Notes on Meditation by Robert Mason
A sign on my wall says, “Breathing is good for you.” It’s to remind me to focus on my breath for a moment. Why? Because once you are aware of your breath, you are in the present moment. And in the present moment, when you are aware of what you are actually saying or thinking or hearing or seeing, life is much more interesting and peaceful.
I’ve been reading about meditation for decades. I actually began doing it five years ago when I realized that to meditate is to practice being. Just being. I used to spend all my time in my mind, a very busy, chaotic, often scary place. Being alone with my thoughts was something I avoided because they were painful, so I diverted myself with drugs and adrenaline. That worked, more or less.
Meditation is better. I realized that when I meditate, I kind of step away from whatever stream of chaos happens to be splashing through my mind at the time, and look at it from outside. Sometimes I imagine I’m in a comfortable place under a waterfall of thoughts and ideas cascading overhead. I can be aware of the thoughts that come into my present, and then I can let them go. (Observe the thought, it is said, don’t be the thought.) When I discover I’ve been seduced by a thought (which happened constantly when I started), and have been involved with it for awhile, I just smile at the persistence of my mind trying to keep up its chatter, and return to my breath.
Ask a hundred people how to meditate, get a hundred answers. After read ing about the various methods, including a pricey Transcendental Meditation program, I decided to take Buddha’s advice to sit quietly and focus on my breathing.
Here’s what I recommend:
•Change your wake-up time to accommodate 10-30 minutes free time every morning. I meditate for 15-20 minutes.
•Find a quiet place where you can sit and not be disturbed. I’m immersed in bird calls in the morning, but that’s part of the environment, and it isn’t distracting.
•Sit. You can sit in a chair if you sit upright, not leaning back where you can fall asleep. You can sit cross-legged on a carpet, kneel in the Japanese tra dition, sit on pillows, whatever is comfortable for you.
•Set a timer or a clock to end the session. Close your eyes.
•Notice your breathing. Don’t change how you’re breathing. Just be aware of your breath coming in and going out. •When you breathe in, say to yourself “Breathing in.” When you breathe out say to yourself, “Breathing out.” Later, you can shorten this to simply “In” and “Out.” Eventually you won’t need the words at all. For now, the words help you to concentrate on the present moment. Your breath is your anchor. Whenever you lose your concentration, just refocus on your breath.
•Your breathing cycle has four distinct stages you can be aware of: 1) The beginning of breathing in. 2) The end of breathing in (pause). 3) The beginning of breathing out. 4) The end of breathing out.
•Notice whether you are breath ing fast or slow, but make no effort to consciously change that rate. Just notice what it is. Your breathing rate will naturally slow and quiet as you meditate.
•Do it every day for a few years and see how it works.
•Read about meditation to get other insights. My favorite books on the subject are Wherever You Go There You Are by Jon Kabat-Zinn and Walking Meditation by Thich Nhat Hanh.
Man, was I surprised when it helped him a lot.
He used John Kabat Zinn's, Wherever You Go, There You Are, a very amusing book which answered the question he used to get enraged over: "Why can't I blank my mind?" It was a big relief to know that was not the point.
When I used to publish the Post-Traumatic Gazette, Bob wrote this for me for issue #25, PTSD and Spirituality:
Notes on Meditation by Robert Mason
A sign on my wall says, “Breathing is good for you.” It’s to remind me to focus on my breath for a moment. Why? Because once you are aware of your breath, you are in the present moment. And in the present moment, when you are aware of what you are actually saying or thinking or hearing or seeing, life is much more interesting and peaceful.
I’ve been reading about meditation for decades. I actually began doing it five years ago when I realized that to meditate is to practice being. Just being. I used to spend all my time in my mind, a very busy, chaotic, often scary place. Being alone with my thoughts was something I avoided because they were painful, so I diverted myself with drugs and adrenaline. That worked, more or less.
Meditation is better. I realized that when I meditate, I kind of step away from whatever stream of chaos happens to be splashing through my mind at the time, and look at it from outside. Sometimes I imagine I’m in a comfortable place under a waterfall of thoughts and ideas cascading overhead. I can be aware of the thoughts that come into my present, and then I can let them go. (Observe the thought, it is said, don’t be the thought.) When I discover I’ve been seduced by a thought (which happened constantly when I started), and have been involved with it for awhile, I just smile at the persistence of my mind trying to keep up its chatter, and return to my breath.
Ask a hundred people how to meditate, get a hundred answers. After read ing about the various methods, including a pricey Transcendental Meditation program, I decided to take Buddha’s advice to sit quietly and focus on my breathing.
Here’s what I recommend:
•Change your wake-up time to accommodate 10-30 minutes free time every morning. I meditate for 15-20 minutes.
•Find a quiet place where you can sit and not be disturbed. I’m immersed in bird calls in the morning, but that’s part of the environment, and it isn’t distracting.
•Sit. You can sit in a chair if you sit upright, not leaning back where you can fall asleep. You can sit cross-legged on a carpet, kneel in the Japanese tra dition, sit on pillows, whatever is comfortable for you.
•Set a timer or a clock to end the session. Close your eyes.
•Notice your breathing. Don’t change how you’re breathing. Just be aware of your breath coming in and going out. •When you breathe in, say to yourself “Breathing in.” When you breathe out say to yourself, “Breathing out.” Later, you can shorten this to simply “In” and “Out.” Eventually you won’t need the words at all. For now, the words help you to concentrate on the present moment. Your breath is your anchor. Whenever you lose your concentration, just refocus on your breath.
•Your breathing cycle has four distinct stages you can be aware of: 1) The beginning of breathing in. 2) The end of breathing in (pause). 3) The beginning of breathing out. 4) The end of breathing out.
•Notice whether you are breath ing fast or slow, but make no effort to consciously change that rate. Just notice what it is. Your breathing rate will naturally slow and quiet as you meditate.
•Do it every day for a few years and see how it works.
•Read about meditation to get other insights. My favorite books on the subject are Wherever You Go There You Are by Jon Kabat-Zinn and Walking Meditation by Thich Nhat Hanh.
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