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
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.