Healing Combat Trauma

Conflict as Combat: When Words Become Bullets

A great comment in a panel discussion by veterans on re-integration, where one veteran was discussing how being asked the wrong questions can put him on the defensive and elicit an undesired response, thanks in part to military training and the normal reaction to being backed into a corner. "When rifles are no longer involved, words can become your bullets," he said.

For anyone who's ever been on either the "giving" or the "receiving" side of a difficult, heated conversation where it felt like life or identity was at stake, it's easy to understand exactly what he meant. It's also, obviously, not a prescription for harmonious communication that resolves issues effectively. For that, very different communication styles and skills are necessary. We try to cover that here from time to time, when we find someone with a worthwhile and constructive point of view -- and experience in the trenches, either as a veteran or a spouse of a veteran with PTSD.

Editor's note: To access that series of articles on communication skills, including those written by veterans and/or their spouses, click here. We're continuing to add more material to this section, including an upcoming article about "fair fighting." 

Intimate Survival: When the Veteran You Love Commits Suicide Anyway

Today is the 12th annual "National Survivors of Suicide Day." It's also a day of healing for survivors of suicide loss around the world.

Every day 18 veterans take their own lives; every 36 hours, an active duty soldier does. The pain is immeasurable, not only for the one who cannot bear it anymore and takes his or her own life, but also, importantly, for the ones they leave behind. They wait for time to heal those wounds; but it's almost impossible for time to do that; the loss is so great, particularly where there was also great love.

Because of how many veterans die each year at their own hand, affecting so many others in suicide's wake, we wanted to honor these relationships by asking a wonderful woman to tell the deeply true and deeply painful story of her own loss of her love to suicide. By telling the truth about these stories, and bringing this sadness into the light that truly so many share, we can embrace one another in the courage and compassion it takes to carry on. Marilyn has graciously shared her story, below. We are blessed to have her presence here.

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"The Language of Suffering and Healing: Lessons Learned from Loss and Life with a PTSD Vet"

Suffering has its own language.  Old words take on new powerful meanings, and some words that formerly brought up feelings of joy now are redefined with fear and terror.

When you live with and love someone with combat Post-Traumatic Stress Disorder, you develop a new vocabulary related to the disorder/the suffering.  The word “anniversary” used to be one associated with dressing up, going out to dinner, exchanging cards and gifts of love. Then it came to be associated with the anniversary dates of horrible, tragic events from the war -- i.e. the day a buddy was blown out of the air in his helicopter during a mission.  The word “trigger” has a common definition referring to a part of a gun -- now it referred to a smell, a sound, a sight, a verbal exchange, a situation that could set off rage, depression, anger, or isolating.

My late Vietnam vet husband, Denny, suffered with severe combat-related PTSD.  Truthfully, we both suffered from his PTSD.  Even though technically I wasn’t a soldier in Vietnam, it seems for a time, during the final ten years of our marriage, I became a prisoner of that war.

I feel I need to let you know right off that this story does not have a happy ending.  On December 9, 2009, my husband successfully completed suicide.   I say “successfully completed” because he had tried numerous times before in the last several years, but I had been able to save his life those other times.  Not so, this time. 

So now, in reality, I have my own set of “triggers” and “anniversaries” stemming from Denny’s PTSD behaviors and suicide.  I am sure these will be with me the rest of my life; but hopefully, with focused healing work they will hold less sway with my emotional well-being.

Countless articles, journals, blogs and books have been written about combat PTSD, each one with its own unique focus.  In this reflection piece, I can only do two things: I can share my own personal experience of living, loving a Vietnam vet who eventually committed suicide; and, I can share what I have learned from these experiences.  After all, isn’t that what it’s all about? What happened in your life, and what you learned from it.

Meeting Denny

The moment I met Denny, I knew my life had been forever changed.  I felt a connection with his soul I had never before experienced -- and I’m pretty sure, I never will again. 

He was a professional storyteller who came to my fifth grade classroom, to enhance the reading curriculum and increase the students‘ academic performance through an artistic approach.  He taught the students a love of story and characters through the sharing of folktales, fairytales, and the narratives of his own personal experiences.  And, oh, the personal experience narratives he had had in his life!  Denny told of sailing a boat during a Nor’easter, living in a tree house in Peru and hiking the Machu Pichu trail, fighting forest fires from a helicopter, hitchhiking across North America -- more adventures than most of us could ever dream of having.  And he told his adventures with a gleam in his eyes and a song in his heart.

But another story was being written during his time in my classroom, and that was our story. We fell in love, got married, and between the two of us raised seven children (from previous marriages) and four grandchildren.  Our marriage was far from fairytale perfect, even in the beginning.  We had both been married and many hearts were broken in our coming together.  But we endured and learned and clung to each other through the good and the bad times. 

PTSD Enters

At about the 12 year point in our relationship, a new entity/force entered the picture.  This was an uninvited presence, unrecognized at first – but the behaviors it produced and the unwanted consequences it set in motion seemed to have a life of their own.

On September 11, 2001, when the planes crashed into the towers in New York, and the war ensued with Iraq – for Denny, this was the final unleashing of his own, internal war. He had been battling this war privately for years, but now, his inner battles consumed him.  At this time, “our” war with PTSD began in earnest. PTSD was the new entity in our marriage, and 9/11 was the trigger.

Within two weeks after 9/11, Denny was in a mental hospital due to suicidal ideations.  I had never even heard that term, “suicidal ideations,” before, but my vocabulary education was just beginning.

Denny was depressed and despondent.  After his release from the first of many behavioral hospital stays, he felt somewhat better for a while and the depression meds seemed to help. 

But periods of happiness and calm were short-lived and mostly non-existent.  He began canceling his performances due to severe anxiety attacks.  Much of his time was spent on the couch under a sleeping bag watching certain movies over and over.  The movies -- Gladiator, Fly Away Home, and SeaBiscuit -- all had the same theme, personal triumph over adversity and challenge.  But they also had a lot of sadness and tragedy embedded within them.

It was also an extremely confusing time for me. 

Denny had been such a force of talent and admired by many.  He performed before audiences of thousands, but now, he was a shell of his former self.  He had also been my rock of strength, my touchstone for love and sanity in life.  Now, he struggled just to survive each day.  He once told me during his intense depression times, that he felt like he was walking through life with a heavy rubber suit on.  Very sad. 

Waiting for the diagnosis

Denny still had not been diagnosed with combat PTSD.  The doctors we were seeing were on the civilian side, and they missed the combat connection to his present day state of being.  His diagnosis was “severe chronic depression and anxiety.” Under their care, he received some therapy, numerous anxiety and depression meds, and even 15 rounds of electric shock therapy – at Denny’s own request.  He so desperately wanted to feel “normal” again.

Over the next several years, his behaviors escalated to include: alcohol abuse, drug abuse, repeated suicide attempts (always by taking meds), extramarital affairs, physical abuse, severe anxiety attacks, night tremors, rage, isolation, and flashbacks. 

Each of these were ongoing and extremely painful events to deal with and live through, for both of us. 

Eventually our local doctor suggested we take Denny to the VA, suspecting his combat experience was in play with his ever-increasing risky and damaging behaviors.  After a 45 minute intake interview, I learned the term that seemed to define our current situation and the outlook for our future: combat-related Post Traumatic Stress Disorder.  Denny had it and he had it bad.  His time in Vietnam as a helicopter pilot had damaged him mentally, emotionally and spiritually.  And it seemingly had returned to completely claim its victim.

The VA knew more about his PTSD, but for Denny their attempted therapies, meds, support groups, etc. did not work.  He was spiraling down and I knew if I did not get help for myself, I would go right down with him.

Starting to take care of myself

I had joined Al-Anon (a 12-step program for people who loved someone with addiction) when it originally seemed like Denny’s problems stemmed from alcohol and/or drug addiction. 

It was not easy to join a support group because I had always believed I could fix or handle any problem that came along in my life.  Only it was obvious my methods were not doing any good in this situation, and if anything, I was only getting into a depression myself.  In those Al-Anon meeting walls/rooms, with those other suffering people, my first ray of hope began to appear. 

I started to learn and accept some critical information to save my own sanity:  I did not cause Denny’s problems, I could not control his behaviors, and I could not cure him.  The people in my Al-Anon group, my sponsor, the readings, the meetings were the beginning of my effort to find my own peace - no matter what was happening with Denny and our marriage.  Before I felt hopeless, confused, angry, out-of-control, and frustrated trying to get him the help he needed and trying to fix him.  Now I was beginning to feel some peace.

Love and loss

I also learned in these meetings about loving detachment -- that I could still love Denny but detach myself personally from his actions.  In other words, his choices were not about me  -- no matter what he said or did.  It was never about me - it was always about him and his suffering.  His pain had begun long before I met him even though the drastic behavioral manifestations did not appear until much later in his life -- about 30 years after the war.

After Denny was diagnosed by the VA, I was asked to join a support group for women married to or living with a vet with combat PTSD.  This group met weekly at the VA and was facilitated by a woman counselor.  The other ladies that attended these meetings have become dear friends through the years.  Their marriages were practically cookie-cutter versions of my own.  The same issues, the same behaviors, the same frustrations, and ultimately the same sense of loss -- for that was the bottom line for us all.  We all felt that we had lost the man we fell in love with.  That man did not exist anymore.  It seemed we lived with a man/child made of ice -- frozen emotions, feelings frozen in a time and place inaccessible to any of us.  Ultimately, whether Denny could not heal or chose not to heal, I will never know.

The beginning of the end

In the first few days of November 2009, Denny and I had an argument that set off a trigger for him.  He went into a severe rage and physically attacked me.  I was lucky to get out alive.  I left our home of 20 years, as I had three times before when it was not safe, but this time felt eerily different.  It felt
“of the end,” somehow.

I moved into an apartment and after a few weeks passed, I began returning Denny’s almost hourly phone calls and innumerable texts and email messages.  He was not doing well, to say the least.

 He could not remember the attack fully but he did feel “shame” from it.  He begged me to come home but I told him I could not until he committed to serious long-term mental therapy and it was safe for me.  One of the last emails he sent me said, “I want to be loved so desperately, yet have no patience for love”.

On December 8, 2009, he called me two different times and threatened suicide as he had so many times before.  I called the VA suicide team and the sheriff’s department to tell them what he had said.  They checked on him twice that day, both times he was able to convince them he was fine – remember, he had been a professional storyteller. 

But sometime that night, he decided he had had enough suffering.  I cannot speak to what went through his mind at the end, but I know he swallowed many bottles of VA prescription meds and the next morning, he was gone.

It is too painful to describe seeing him in our bed that next morning, so I won’t .  I can tell you this, after the medical examiners took his body, they handed me gloves and bags and told me I had to dispose of the “hazardous waste” of our  bedding due to the contamination of his bodily fluids.  That scene, that experience is now one of the triggers/anniversaries that haunt me.  As I continue to choose to heal, I know the pain will be lessened, but that memory will never be erased.

Denny’s suffering ended that day – and mine took a new turn. Attempted suicide is horrible; completed suicide is devastating.

Turning to healing

But there is a new language and a new vocabulary I am learning now.  And that is the one of healing. 

During the worst times of his PTSD and my resultant confusion, I began to understand through support groups the difference between adjusting and adapting.  Whenever I had tried to “adjust” -- i.e., Denny’s behavior, circumstances -- my life only became more frustrating and out of control.  When I learned how to “adapt” -- I began to have more control over my life and emotions.  By learning how to adapt, I became proactive instead of reactive.  I sought out the help I needed through understanding friends, family, but most critically, through the hard work of consistent participation in support groups of my peers.

Through all of these experiences, I believe I have become a more compassionate person.  I have learned not to have expectations of others -- only of myself.  That does not mean I cannot have boundaries for acceptable and unacceptable behavior -- and I do.  However, I find I do best when my focus is on my own behaviors and setting realistic expectations for myself.

I have learned we are all on our journey together and alone.  When we are together, we must do all we can to love, support and help ease the suffering of those we are with; and when we are alone, we must find ways to do this for ourselves.

The most significant lesson I learned -- above all else -- is the importance of reaching out and accepting help.  We all need to be able to let go of our egos -- to realize we don’t have all the answers and that there are others out there who share in our suffering and trials.  When you can dedicate yourself to getting the help you need in these situations, there will still be pain, but you need not suffer.

My suggestions would be to find support groups in your area, through the VA or the Vet Centers.  Read related articles, books, online resources, blogs, websites that offer wisdom and support.  Whatever you do, remember you must take care of yourself before you can be of any good to others, and that includes your vet.

I am so grateful to have known and loved Denny.  I am so sorry for all the pain he endured and I am hopeful he has found the peace he could not find here on this earth, in this life.  And I miss him every day more than I could ever have imagined.

My wish for those reading this is the following: If you recognize yourself and your loved ones in any of this writing, that you will reach out, seek out, and accept the help that is available for you.

May you learn the lessons you need that will guide you on a journey of compassionate love for yourself and all those in your life.

Namasté.

-- Marilyn.

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Editor's note. In addition to being grateful to Marilyn for sharing her story so graciously and courageously, we also need to share some resources. The American Foundation for Suicide Prevention has a well-stocked website filled with resources, linked here, including a section on "Coping with Suicide Loss," linked here. Their website is well worth a look. There's also the "Fierce Goodbye" website, a faith-based perspective on suicide, based on a documentary (put together by the Mennonites), linked here. And on the military veteran side, the American Widow Project, most of whom have been widowed by war -- and yet a few by suicide -- is linked here, with the stories of suicide linked here. For more material from our website here on suicide, as it relates to veterans with PTSD, click here. Additionally, crisis and hotline phone numbers are listed here. With love to all concerned...

© 2010 by Healing Combat Trauma. All rights reserved. Use with attribution.

"Fighting Fair" vs. "Picking Your Battles" with a Combat Vet with PTSD

Everyone needs a friend like Kathie Costos. Kathie is my go-to person when I have questions about how to communicate with -- read, resolve conflicts with -- the combat vets with PTSD in my life. (She's also known as "Nam Guardian Angel" -- she's married to a Vietnam vet, Jack, with PTSD, and she's written a book about the experience, as well as created innumerable blog posts, videos which are widely disseminated on PTSD, and probably had enough conversations with spouses and family members to save a small army herself.)

Best of all, she's an absolute fount of wisdom, whose advice is spot-on, and comes from the trenches: 28 years of loving, and 26 years of being married to, a combat vet with PTSD herself. Very wise and compassionate lady, whose friendship and advice I treasure (and who I've been lucky enough to be able to meet in person). I thought I'd share her side of a recent email dialog we were having. As she puts it, she's giving advice to her younger self -- the advice she wishes she'd had, decades ago, but had to figure it out the hard way.

Her conversation is flecked with spirituality, but of a kind that even someone non-religious, or irreligious, can handle. It's golden-rule spirituality, and common sense heartfulness, that is so very rare indeed. Here she goes -- the context was "giving up" because "I can't win." She wisely responded:

"Winning depends on which battle you choose to fight.  Twenty years or so ago, I gave up on a lot of battles. My husband had changed from "best friend" to opposition and I was tired of giving up my life in all of this.

It was during a time when it didn't matter if I lost or gained 20 pounds, cut my hair shot or just let it grow, moved furniture around or let the apartment get dirty.  Nothing was noticed by him.  It was also the time I noticed that he was showing symptoms of OCD, focused on something's like a pit bull not letting go and basically worrying about not having anything to worry about.  It was one needless fight after another until I surrendered on certain things that had more to do with my ego than anything else.

I stopped letting my self worth be determined by his mood.  Not to say that I did any of this perfectly but what I couldn't "win" on was not a battle I was willing to fight anymore.  I got happier.

The more you learn about what PTSD is and what it does, the more you will be able to adapt and find your own "life" in all of this.  I spend most of the time happy when we share parts of our individual lives together but not regretting when we do our own thing.  He's welcome to spend time in my world but I won't give it up anymore when doesn't want to go there.  He's welcome to come where I go but I don't change plans or let it hurt me that he isn't there.  There was so much that I gave up to stay with him but the things I need, I fight for and the rest really didn't matter enough to go to war with him over.

Mood swings, ambivalence and neglect should only be allowed to go so far and then it comes into unacceptable behavior and you have to let him know that.  If he wants you in his life, he has to open the door to let that happen.  There are still times when my husband gets the best of me because no one is perfect in this but spiritual healing took a lot of the anger/blame/shame away.  Much of coping skills with PTSD comes close to AA and allowing a "higher power" take over some things in order to live again.

As he healed it was important to let go of the past negative feelings, hurt, disappointment and regrets. Hanging onto them would have filled me up with so much junk that I wouldn't have had room for what was good being returned to our lives.  It took good old-fashioned faith and what Christ taught me so that I could forgive him as well as myself.  For others, they can turn to their own spiritual healing by turning it all over to their own "higher power" to let it go so they make room for the good stuff to come back into them."

-- Kathie Costos, Senior IFOC Chaplain, DAV Auxiliary Chapter 16, independent PTSD Consultant

Her blog, linked here.

Her website, linked here.

Her downloadable PDF book, "For the Love of Jack," about life with her husband, a Vietnam combat vet with PTSD, linked here.

© 2010 by Lily Casura / Healing Combat Trauma. All rights reserved. Use with attribution.

 

 

Bed and Breakfasts "Salute our Heroes" on November 10th

What are you and your significant other doing on November 10th? Here's an idea from the mailbag, today -- and certain gracious bed and breakfast owners across America:

"Hundreds of bed and breakfasts across the country are teaming up to offer a free night’s stay to veterans on Wednesday, November 10th, the night before Veteran's Day. Men and women currently serving or those who have previously served our country are eligible for a complimentary stay at a participating inn.

The program, started in 2009 by the West Virginia B&B Association has grown to include over 40 states and more than 600 inns. For a full list of participating bed and breakfasts visit www.bnbsforvets.org. The only requirement for these rooms is a valid military identification. Veterans can obtain an I.D. from the Veterans Administration.

Innkeepers’ appreciation for our men and women in uniform continues year round and packages honoring our heroes can be found by clicking here.  For example, the Andon-Reid Inn Bed and Breakfast in Waynesville, North Carolina has created a special promotion where two active military couples in need of a special getaway may send an email or letter and qualify to win an all-inclusive two day getaway (Sunday-Thursday, non-holiday) starting mid-March. The stay includes signature candlelit breakfasts, snacks throughout both days, and free use of the inn’s fitness studio and sauna, among other perks. All letters from interested participants must be received no later than February 1, 2011. One letter per person is allowed. (For more details visit Andon-Reid, linked here.)

• Andon-Reid is participating in the free night’s stay this November as well but the inn is now fully booked. In the meantime, BnBFinder.com has put together a sampling of inns that, at press time, still had availability for a free night for military service people on November 10^th:
• The Candlelite Inn in the heart of the scenic Lake Sunapee Region is offering a free night’s stay to men and women with heart – aka veterans and active military personnel. Located in historic Bradford, New Hampshire this Victorian inn features a parlor with a cozy fire, games, and complimentary apple cider. It’s also minutes to major ski areas, restaurants, and seasonal outdoor activities. The inn serves a full three-course breakfast daily, including homemade dessert, jellies and jams, and freshly baked muffins and pies. 
• The Huffman House at Creekside Farm in Newport, Virginia is offering a free night stay for active and retired military personnel to show its appreciation. The Huffman property features three historic buildings, including the inn, an early nineteenth century barn and a farmhouse built in the 1800s, which was remodeled in 1906. The inn, listed on the national register of historic places, is still a working farm. It sits on 61-acres of streams, ponds, and pastures, with abundant wildlife. Despite its old time appeal, Huffman is minutes from downtown Blacksburg and modern day conveniences.

For more inns participating in the B&Bs for vets program and those offering special deals, discounts, and add-ons for uniformed heroes visit the BnBFinder.com "Salute our Heroes" page, linked here. 

Editor's note: For a full list of which B&Bs are participating, and their vacancy status, by state, click here.

© 2010 by Lily Casura / Healing Combat Trauma. All rights reserved. Use with attribution.

When Is PTSD NOT PTSD? When Stubborn Pride Takes Control

Editor's note: We're not giving you medical or psychological advice here; consult with your own health care practitioner for that. What we are doing is sharing a longtime PTSD sufferer's opinion with you about his own situation, on the off-chance that it may instruct or enlighten. We have the feeling, now that he's outed himself, others may quite enjoy learning the distinctions he shares from his own life. And when we say "others," we mean spouses, significant others and family members...

From the subject of "Eyewitness to Combat," a Vietnam vet, Marine, with 40 years of "experience" on the subject:

"Post-Traumatic Stress Disorder has many faces and it sometimes masquerades as a behavioral problem; conversely, there are times when behavioral abnormalities masquerade as PTSD.  In other words, sometimes PTSD is mistaken for just stubborn Pride; and sometimes stubborn Pride is excused as PTSD.  There is also a third face, the one in which we appear completely “Normal.” So the “trick” becomes knowing which one is in control – the PTSD one; the PRIDEFUL one; or the NORMAL one. 

One of the most frustrating and difficult problems in sorting this out with traumatized MST or PTSD combat vets is that by their very nature, MST and PTSD sufferers are very complicated individuals, to say the least. It’s almost as if we are different people at different times.  And in fact we are.  My wife used to say she “never knew which one” of me “was coming home.” In other words: “PTSD really screws us up: mentally, emotionally, socially, personally, professionally and physically”.  However on many of the occasions that get blamed on PTSD, it is in fact our own personality “quirks” that have intervened, kidnapped and magnified the suffering from PTSD. And in the healing process, this habitual behavior must be sorted out before any true healing can “stick.” It’s true that we can be healed from our PTSD “disorder” but also allow our pride, habitual bad habits and negative attitude to completely mask any real improvement.

I do know that true healing from the destructiveness of PTSD is possible and real. I know this because I lived with all three faces of it for forty years and I have been healed.  Not “cured” but healed to a point that I now have a mostly “normal” a life rather than a mostly PTSD, prideful, bad habit and negative attitude life.  From this very long journey to healing I am able to speak from wisdom and experience on behavioral abnormalities disguised as PTSD.  I have been there; done that; and, for the most part, “have gotten away clean with it.” Now looking back, I am embarrassed and ashamed of myself for falling into the “pity party” that “works for me” trap.  I allowed myself to become “victimized,” believing that I was “entitled” to feel sorry for myself and that everyone else should feel sorry for me as well.  My PTSD actually made me feel “special” as everyone was made to “tiptoe” around me like a king walking among his subjects, so as not to “set me off”.  Trust me when I say that “this gets very old very quick” to those who love you, care for and about you; and it should be of no surprise when they begin to get a little bitter and non-empathetic toward our behavior.  It just gets tiring!  Upon entering the 90 day VA in-house PTSD treatment program years ago, I came face-to-face with a sign over the door of our billet, made by one of the previous vet therapists, that said: “How long would YOU put up with YOU?!  Well, not very damn long, I can tell you that – and that sign made the point for all of us.  So why should we expect others to do so?!  And if that’s true, why do we resist healing? Suffering from PTSD for most of my life made me very familiar with all of its symptoms and destructive consequences, along with what it does to our own physical body.  I am well aware of how devastating it is upon the family, friends and employers of those suffering from this disorder.  Today though, when I’m substantially healed, (see “before and after” story, linked here) I find that I can still act like a full blown PTSD’er.  The only difference is that now it’s my choice when to move into that arena, or not.  As my youngest grown son would say, “I’m going with NOT!”.  So in going there now it’s a premeditated decision to do so, not one dictated by PTSD. It’s premeditated because I first think about it, usually when my feelings get hurt, and then I stop taking my meds, as in “I’ll show them”, followed by then I stop doing what I know to do to keep me grounded and clear of stress such as EFT or Qi Gong.  Then I isolate myself in my all-too-familiar bunker, and “Away I go!” But this time it’s stubborn, God-damned pride that is pushing my behavior and keeping it in play, NOT PTSD. It might look like PTSD, sound like PTSD, feel like PTSD – and I am enjoying the effects. My world is now totally miserable, and I am glad – because I am back in control! The poet John Dryden put the sequence this way, “We first make our habits, and then our habits make us”.  Relinquishing control to our Prideful self is a habit we simply cannot afford if we suffer from PTSD.  It will destroy us and everyone around us. Again, if it is so miserable and so devastating, why stay in it? They “why” is PRIDE: Stubborn God-dammed, destructive PRIDE, a shitty attitude and very bad habits.  How does this fit into having PTSD?  It doesn’t fit into HAVING PTSD at all, but it DOES fit into KEEPING it!  And why would we want to KEEP Post-Traumatic Stress Disorder going, when we have the tools to get rid of it? Because it’s comfortable; it’s normal to us; it gives us control whenever we want; it gives us an excuse for bad behavior; it gives us an identity; it’s amusing to “shock” others; it draws attention to us; we don’t have to follow the rules and get a pass for doing so; it gets us “stuff”; it makes us somebody special and we can even be “paid” to have it.   And if you are getting “paid” to have it, it makes you a professional PTSD’er.  Sooooo why not act like one and let the spouse go to work; you get paid not to! You can sit on the couch and own the friggin’ remote and when you want to watch something cool you can clear the room and get a beer delivered to you in the process.  All the while someone can give you the beer, the TV and the couch.  I also know this to be true because I have spent up to a month terrorizing everyone in my life with my fucking PRIDE disguised as PTSD.  And I enjoyed the whole experience! But eventually even my pride got to a point that I couldn’t stand it anymore.  I allowed myself to be ashamed of this childish behavior and to apologize and ask for forgiveness so that I could come out of the corner.  NOW I really am ashamed of myself because I hurt those I loved and they didn’t deserve it at all.  But now I know what it is and will not go there again. (Publishing this handy little guide to PTSD vs. PRIDE of course will help!) I’ll use the tools I have been given in healing and use them gladly.  I do not want my loved ones to suffer the fool that I could become.  Scripture puts it this way in 1 Corinthians 13:11: “When I was a child, I talked like a child; I thought like a child; I reasoned like a child. When I became a man, I put childish ways behind me”.  In other words “it’s time we grow up!” Understand I am NOT talking about what “reaction” PTSD compels us to do that is destructive.  What I am talking about is what keeps us continuing the destructive behavior AFTER our PTSD moment has PASSED.  The fact that we suffer from a trauma-induced survival skill does not make us “crazy” or “insane” or incapable of being aware of our surrounding and how our actions affect others.  We still have the ability to know right from wrong and we know when we hurt others and we know when we hurt ourselves.  PTSD also doesn’t change our “moral code”.  If you were a nice person before; you are generally still a nice person and that becomes your “Normal” face.  If you were a courteous person before; you are generally still a courteous person and “Normal”.  If you were a grateful person before; you are generally still a “Normally” grateful person.  If we are truly remorseful for our actions which harm others, as we should be when we are “Normal”, then the abnormal behavior will stop until triggered again. And in our “Normal” state we are ashamed, embarrassed and truly sorry.  If we are not at least remorseful and/or our misbehavior is enjoyable, then we are either a narcissistic “asshole” or we are pretending to continually have PTSD behavior for control and that is our “Prideful” face.  If we are ashamed, embarrassed and sorry but continue in bad behavior, then we are stubborn “Prideful” fools using the ole, “That’s my story and I’m stickin to it” crap.  It will lead to your destruction and that of your family.  And PRIDE becomes the driving force, not PTSD, and the NORMAL face is destroyed.    That was PTSD.  But then I would get embarrassed and mad when “corrected” and take the Prideful mental position of: “Well I sure fucked that one up; so screw them all” and I would then “dig my heels in” and really make everyone miserable.  And I enjoyed it.  I was “showing them” for getting justifiably upset at me for my action.  That was PRIDE.  “They would learn to leave me alone whenever I would go into one of my “Marine Corps Moods”, as my kids would call it.  Yep, goddamn Marine Corps PRIDE!  (In truth, I have three kinds of pride: Texas pride! Irish pride! And Marine Corps pride! And that is a whole giant bucket of PRIDE…) Understand that I DID have severe PTSD and those triggering events happened a bunch but the moment I realized I had screwed up, PTSD ended and PRIDE took over to magnify the damage.  I was too proud to admit that I was wrong and then ask for forgiveness or even to say I was sorry.  For a Marine to apologize was a “sign of weakness”.  To take this action with those who love you only adds INSULT to INJURY.  However for a father, a husband, a son, a partner, to apologize is essential and your “Normal” self and is a great sign of love, appreciation, humility, strength, self-confidence and courage. When scripture states that “the meek shall inherit the earth,” it is not talking about the weak but the gracious, strong, self-confidently humble who attempt to right the wrongs they have done to others. Our families and loved ones know when that moment of awareness happens, and they appreciate it and respond to it, but conversely, with no remorse on our part they start to lose empathy for our plight, and rightfully so.  If our prideful attitude and bad behavior keeps up, they become aloof, distant, uncaring and bitter – and here’s the thing, we’ve helped to make them that way through our actions. PTSD is what causes the hyper-vigilance and other survival reactions triggered by events in our lives, but PRIDE is what causes us to stay in the now habitual act of PTSD.  True healing can only come when we understand that we will have the tendency to move into survival mode for the rest of our lives and that there are things we can do to effectuate a smooth, peaceful, happy life.  AND it is essential that we do those things consistently for the rest of our lives. (Examples would be taking our medication, and using the tools we can do at home for our own self-care, such as meditation, deep breathing, qi gong, EFT, music therapy, aromatherapy, etc. -- and knowing when it's PRIDE that's taken control!) We also must learn to be grateful to those around us who put up with our “moments” and have enough respect for them to swallow our pride and say we are sorry and mean it; then sincerely ask for forgiveness in love.  If you are unwilling to do this, then you are not ready to be healed because you are enjoying being miserable and making others miserable too much.  And I really feel sorry for you.  When we realize we have just had one of those “moments”; STOP, regain your composure, look around at what you have effectuated and apologize and mean it.  But if you do nothing else, just STOP and go to your corner.  When you have calmed down, then correct it before PRIDE takes control and kills everyone around you or before it forces you back into the “bunker”.  Your families know when you are faking PTSD and when it is real; so grow up and get your shit together."Pride goeth before destruction, and a haughty spirit before a fall.” Proverbs 16:18. Even with PTSD!"

© 2010 by Lily Casura / Healing Combat Trauma. All rights reserved. Use with attribution.

 

Sometimes You Have to Choose to Love -- A Love Story after PTSD

Into the dearth of "good news" about combat veterans with PTSD and their partners comes the remarkable love story of Josh and Helen, who met and fell in love AFTER his service, his suicide attempts, and his PTSD diagnosis. While PTSD can seem like the "third partner" in a relationship -- the ever-present elephant in the room -- in Josh and Helen's story, it's what brought them together, and love, wisdom and maturity is what keeps their union intact.

I had the pleasure of getting to spend a few days recently with Josh and Helen, and was impressed by both of them, and the sheer fun of their relationship, which can be too rare among partners where one has PTSD. I was struck by Helen's clear-eyed, open-hearted approach -- the education she sought about PTSD, as she was falling in love with Josh -- and the way in which she's really becoming a wise "spokesperson" for how love is possible after PTSD. For all the broken relationships out there, and all the partners barely enduring and tolerating one another, I felt like Josh and Helen's story needed to be told, so I asked Helen to tell it. Just as a point of reference, Josh served in the U.S. Army from 2002 to 2008. He was honorably discharged in 2008, and served in Iraq from 2005 to 2006.

Here is Helen's story:

"I met my husband Josh on December 27th, 2008. That's about two years after he returned from Iraq and about two months after he tried to commit suicide for the second time. He was at my house attending an after-Christmas-before-New-Years party that my then roommate Chris was throwing, and he was there against the medical advice and wishes of the team of specialists overseeing his psychiatric care at a well-known men's inpatient program for PTSD.

He was home for the weekend to visit his family and in order to do so he was required to fill out a schedule of where he'd be, what he'd be doing, and with whom. If they'd known he'd be at that party, they more than likely wouldn't have let him go home. And if they knew he'd meet me, they'd probably have chained him to the wall. Of course I don't know that for certain because it's not the way things happened. He did come to the party, I was there even though I had other tentative plans that night, and we did meet each other.

Josh told me later that he wasn't looking for anything other than to feel normal for a few hours. He hadn't really expected to feel comfortable at all and certainly had no intention of telling me that he had PTSD. Again, not the way things happened. He started by telling me that he was a soldier which really intrigued me. In my head I can't help but equate military service with nobility, honor, and authority, probably because the only other people I knew that had been in the military were my grandfather -- who had served in the Navy in World War II -- and a family friend who took unfair advantage of my googly eyes at the tender age of 15, later dubbed "evil Army guy" though I never really associated the service with the man.

I had heard of PTSD and sort of knew what the letters in the acronym stood for. It was a pretty basic concept; formerly known as "shell shock" which Great Uncle Paul, Grandpa's brother had. I remember thinking when it became apparent that Josh and I were going to have a relationship that I should probably be concerned, but I wasn't. I don't know why. I had also heard that men with PTSD could be violent and do harm to the people they most loved. But then again, so can most of the people I know. I knew I'd have to educate myself on what exactly PTSD is, a fact that was compounded when I came up against some opposition from a friend of mine who thought Josh would kill me and then take his own life. She thought this because a friend of her grandmother's had been murdered by her husband, a veteran of either Korea or WWII. I started with the basics (the basics being the extraordinarily reliable source of Wikipedia....you can't tell, but that was written in a sarcastic voice) which actually gave me a pretty decent base.

From there I moved on to other sources including the VA, National Institutes of Mental Health, and last but not least, Josh's therapist. Josh took me to see him because, he said, "I want you to know what you're getting into". Among other things, what I learned was that, aside from the fact that Josh's PTSD was focused inwardly and therefore he wouldn't hurt me, he was being monitored by so many mental health professionals as well as regulating himself that he was the least likely person in the world to do so.

We got lucky. One of the most interesting things I learned was that PTSD is, for lack of a better word, normal. When a person is placed in an extremely traumatic and/or stressful environment, their mind enacts hyper-vigilance, paranoia, insomnia, etc. to enable survival. In a war zone, PTSD is useful. It's when the soldier comes home in time of peace that there are problems. Actually, many people with PTSD have it because of domestic violence. Some people get it from car accidents. The list goes on.What Josh told me really helped him was that I didn't push. When he told me about Iraq, I didn't launch questions at him that he probably wouldn't want to answer. I waited. I focused on him as best I could, I listened carefully.

Eventually he opened up to me, but the fact that I fostered an environment where he felt safe to talk about it, without judgment, without questions, without a sense of urgency helped him immensely. Communication is not our weak point because both of us took a chance at being safe with one another. At first it was scary, but it was completely worth it. One of the most important lessons I've ever learned thus far is that sometimes you have to choose to love. I took on the attitude (I was newly in love so it wasn't too hard for me...plus he's awesome) that he was (and is!) the most incredible, sexy, wonderful, manly man on Earth. I tell him frequently that he is an excellent provider, that he takes good care of his family, that he satisfies my basest urges (*giggle*), that I choose him and marry him every day and will have only him for the rest of my life, and most importantly that I love him so much and love him for who he is. I mean every syllable of it, it's completely true, and I stand by my bold statements and declarations. My heart melts every time because I see him sheepishly look down or puff his chest out, or I notice that he's walking just a little bit taller. He loves it, and his life is made easier and he is made happier knowing that I adore him and that I'm there for him (and he responds in kind).

This is not to say that it's always a cake walk. It isn't. Marriage is hard enough work without mental illness in the mix. His anxiety will act up, he'll get scared, he'll feel depressed and useless and insecure and jeez, we haven't even gone in to MY issues. But he knows that I'm always there for him. We made the conscious decision to put in the effort to speak, to care, to look out for one another, and to work through our arguments and disagreements. Sometimes that is damned hard. But in the end, loving him is easy because of it.

I know that our relationship is different than many other spouse-vet relationships for a variety of reasons. First, I met Josh after he came home from Iraq, after his suicide attempts, after he started treatment for PTSD. I never had to wait for him, never had to live away from him during deployment, never had to worry that the phone would ring or I'd get a knock on the door. I didn't have children to be both mother and father to while he was away, never had to experience my husband being a different man now than he was when he left me. I don't pretend to know what that must have been like.

But if there's anything that I can offer, anything that WE can offer, it's that there is hope. Josh was convinced once that the only good thing he could do was destroy himself; get rid of the burden. Find peace in death, in drinking, in drugs, ANYTHING. He had a plan in place to move to Seattle with just some basic gear with which to live on the streets, and he chose Seattle because their Department of Public Health has a clean needle exchange program. Almost two years later, he's married with a loving wife, a service dog who needs him, two cats who love to annoy him, a sound support system, and more and more he is learning that he's not alone. I am, and by choice always will be, his biggest fan, his cheering section, his advocate, his confidante, and his partner. As his wife, my job, my goal, my honor, my privilege and my pleasure is make sure he never feels otherwise."

Editor's note: The photo of Josh and Helen is used with their permission.

Quotable Quotes -- A Spouse's View on How War Changes the Veteran

We wrote about Vietnam veteran, Marine and National Book Award-winning author and poet Larry Heinemann yesterday, and his quote about "War and the Veteran's Heart," linked here. And we've certainly written quite a bit -- as in very often -- about the spouse or partner's point of view, of living with the combat veteran with PTSD. Those articles are linked here. Today we bring those both together, with an excerpt from Larry Heinemann's wife, Edie, about how war and combat changed him. We're sure that many spouses and family members can relate. From a long article about his writing:

"They met at a college dance almost 26 years ago, six months before Heinemann left Fort Knox, Kentucky, for Vietnam. Edie Smith, from Long Island, New York, was doing her undergraduate work at Nazareth College in nearby Bardstown. "He was a clown, very funny and very easygoing," Edie says. "He told some good stories, about his family, about his grandfather." Edie Heinemann says everything about her husband Larry, including his complicated relationships with women, his moods, his present sense of humor, and why he became a writer, was forged by Vietnam.

 "I don't think I've ever told this to anybody on the record, but I married a completely different man than the one I met. Larry had a warmth, a genuineness, a humor about him, even a naivete that was completely stripped away when he was in Vietnam. When he came home all I saw was the bitterness and the edge and the distance. For so long he held so much of this inside, and I don't think I ever fully realized how much pivoted on his experiences in Vietnam. Only recently, with the work he's done, the writing and the other things, has he begun to shed what happened to him, revealing more humor and everything else that was taken away in Vietnam."

Source: "Heinemann's New Style," by Patrick Z. McGavin in the Chicago Reader, (date unknown, but possibly July 23, 1992), linked here.

An American Veteran -- After Combat, Unlucky in Love

"Ann," Eddie Livingston, the subject of our "An American Veteran" series writes to Ann Landers in the summer of '65, "you cannot possibly know how the help and comfort your column brings to people like myself. Many times I have found things in your column that seemed to apply to me, specifically." In characteristic Eddie fashion he adds, "I hope you are never alone, or lonely, Ann."

(Click on the photo to read the letter in its entirety.)

A comment like that stands out because being alone and loneliness are clearly important to Eddie as well.

His niece, who's brought his writings to light, comments that Eddie believed "because of all of his problems stemming from the war and his POW experience [both creating his PTSD] that no one could ever love him."

Fortunately he found someone later who did, but in this letter you can clearly read the pain and frustration of the 41-year-old Eddie at striking out too many times in the same way, where other men with less baggage from the war are clearly succeeding. Eddie was 41 at the time but a recent combat veteran I ran into the other day, in his 30s, was able to use the experience of having several women break up with him in a row as his "wake-up call" -- that it was no longer all of their problems but it was his PTSD as the common denominator, and he started to go get help so that he could change his future. I commend his efforts but also Eddie's plaintive authenticity on this front. I'm no "Robert Taylor," he bemoans, citing a celebrity of the day, but knows that he's still worth loving. Veterans with PTSD may have rocky relationships (see the divorce rates) and plenty of alone time (see the series on living in the bunker), and these problems with others may stem from the difficulty they find in loving or accepting themselves. It's certainly true that I've recently seen spouses not have the easiest time with the experience, either. Difficult or hard to love? Yes, probably. Worth the effort? We believe so. Stay tuned for a very positive story on just this topic...

Editor's note: For a set of articles about the fuller topic of sexuality and intimacy in the combat veteran with PTSD's life, click here.

A Cheerful Heart Does Good Like a Medicine: The Struggles of Living with PTSD...in Your Spouse

I went to a retreat recently for combat veterans and their families. The retreat is in its third or fourth year of existence, and did a fine job with its core mission, which was providing community for veterans who had lost the camaraderie they'd experienced with other vets in combat. In theory it would also have been a supportive experience for family members who ordinarily might not find anyone else to talk with about living with and loving a combat veteran. PTSD wasn't the focus by any means -- it rarely came up -- but of course because of the demographic, many of the people at the retreat were struggling with the experience of having, or living with, someone with combat-based PTSD. And since the focus of the retreat was building community, not therapeutic counseling, the PTSD topic was somewhat of the elephant in the room, at least to me. So many people experiencing it, on one side of the aisle or another (veteran or spouse), yet few addressing it directly and certainly no one officially. 

Here are a few observations, based on the experience of spending almost five days with the group. The observations are my own; your mileage may vary. 

In addition to the things done well -- community-building, family support (particularly for the children), recreation opportunities, good food, and neat opportunities for bonding among the participants and creative expression -- there were some difficulties, which I think speak to the topic as a whole these days, or the state of affairs on PTSD and the military. Despite the numerous initiatives addressing the topic of PTSD and the military, based on what I saw and experienced, I questioned how much was really getting through. Family members seemed to be living in the midst of PTSD but not being really aware of what PTSD was or how it could affect their relationship. 

Civilian spouses, predominantly women, talked about their husband's unpredictable violent tendencies, unwillingness to communicate, or withdrawal, sleeping and crying, without being aware that those were elements of the PTSD he suffered from combat. 

Younger spouses appeared justifiably frightened and unsure of how to "read' the signals -- often fearing that they were now bookended by two violent men in their lives -- the father they'd grown up with and left young to marry their husband, and now their husband, returned from combat but without enough progress under his belt in addressing his own PTSD, either through medication or therapy or any other means. The experience was highly raw, and still unfolding. The dominant theme among these young women seemed to be FEAR and CONFUSION, as well as a certain amount of co-dependency. Fear over not understanding their husband's PTSD and confusion over how to interpret the signals or how best to manage the chaos. And co-dependency in contributing their reaction as part of the problem. Their best solutions? My guess: love, support, and EDUCATION -- primarily about the main topics of concern to them. What PTSD is, and issues around co-dependency and safety (domestic violence, safety planning, communication skills, etc.)

Older, theoretically more "mature" spouses, who had endured decades of their husbands' military service and repeated deployments, were sadly not much to look up to for the younger women. The primary theme of their communication seemed to be RESENTMENT. And a pronounced tendency to locate all their problems externally: the slacker husband, his terrible family, the town they lived in to be close to his family, etc. If you were looking for a genuine sense of love and appreciation for the combat vet, despite his shortcomings, well, that appeared to be in short supply. (Which is not to gloss over the exceptional difficulties of living, for years, with someone unpredictable, violent, or withdrawn -- or having to cope single-handedly with the considerable demands of keeping the family on track by yourself. However...)

The trouble with resentment is that it festers, and is a good emotion/reaction to address/move through/and move on -- not a great place to camp out, somewhat indefinitely. It's a short hop from resentment to bitterness, and neither of those are about communication and growth. Prescription? A growing focus, daily, on GRATITUDE -- things to be thankful for and appreciative of, not things to pick apart. Wherever your focus is...that's what you get more of. So why tempt fate with only criticism, when gratitude is also an option? Even the book of Proverbs talks about a "cheerful" (or joyful) heart being "good medicine," but a "crushed spirit dries up the bones..." (Proverbs 17:22.)

(Years ago, when Oprah was doing her "Remembering Our Spirit" segment, one of her consistent tools was the gratitude journal...and the challenge to every day, before bed, find one, two or three things to be grateful for. Many people found the (corrective) experience had the power to change their lives. That on top of addressing the legitimate issues and concerns? Much more positive...Here's a link to what's involved in keeping a Gratitude Journal.) 

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I remember two years ago when the subject of the "Eyewitness to Combat" series contacted me through this site, and shared that his own family (in his opinion) were frustrated with him and his search for healing, and basically tired of listening to him on the subject. I remember him saying a version of this, that in their opinion, "You were only in combat for two years...how is it possible that you're not OVER it yet...how has it dogged you all these years?" But the reality is, it had. It's not what we want, sometimes, it's the hand that we're actually dealt. And that was his hand...and that was theirs. The same is true today.

What I wish for these spouses is comfort, understanding, good communication, and ultimately JOY. I think of the great women I know, like Kathie Costos, who DO get what it's like to be married to a combat vet with PTSD, and who have excelled, not crumpled, under the strain, and who do what they do with LOVE. (Here's a link to her downloadable book about living with and loving her husband, "For the Love of Jack.") I think of the woman spouse who wrote the post several years ago, linked here, and used with her permission, which absolutely taught some truths about being married to a vet who you still LOVE and BELIEVE IN, but who is suffering on his own path with PTSD. I think of Britta Reque-Dragicevic, who I've written about before on this site, who wrote the wonderful (and real) book, "Close to Home: A Soldier's Guide to Returning from War," available here. I think also of the great resources in Patience Mason's work and Aphrodite Matsakis', and how their work has helped all of us to understand the dilemma of what a combat veteran struggles with, from the spouse's perspective, so much better. I think of the ongoing guidance I get from people like Kathie Costos (mentioned above), who has such a great understanding of the communication skills needed to interact with a combat vet with PTSD, but from the important perspective of loving them for who they are. And don't forget the resources on this site: communication skills, caring for the caregivers, sexual intimacy, and a fabulous resource list of books and articles for military spouses and family, broken down by topic, linked here.

Going to the Bunker: A Combat Veteran with PTSD on the Purpose of Protective Isolation

Every combat veteran with PTSD knows what is meant by their "bunker," or what "going to their bunker" means. It's a walled-off, isolated situation that allows them to get some space to themselves, away from other people (including family and friends), when they feel particularly triggered, and they need to stay in there for, well, as long as they're going to. They come out when they're ready, and not a moment before. Obviously this situation can be very frustrating to others in the vet's life, but for the vet it affords him or her some very necessary, protective isolation.

The rest of us who aren't combat vets with PTSD I suppose could think of it as the vet putting himself or herself in a time-out from the world, by taking themselves out of the mix, and away from people and stimulation, both bad and good. And the time-out will be over when it's over, because they decide when it's up.

The recent Fourth of July with its fireworks that remind many vets of combat was a classic bunker situation. Many, many vets were making plans before the Fourth for how to protect and insulate themselves from being triggered by the fireworks (noise, smoke, crowds). One Gulf War vet with PTSD who had already isolated himself, wrote of putting a pillow over his head and just wanting it to be over, so that he didn't have to experience it. The next day, fireworks all exploded, he was better. But during, he had to be in the bunker. Another combat vet with PTSD, from the Iraq war this time, talked about staying in her bunker for days, making brief provision runs, every fourth day or so, to the grocery store and then...back to her bunker. When she needed to be in her bunker...

The bunker concept/construct is so typical to combat vets with PTSD that I thought I'd ask one who I know fairly well how he'd describe it. He has decades of PTSD "experience" under his belt, and I've also seen him retreat to his bunker at various times. A month one time, a week another time, the last time, a day. Sometimes even a few hours. But however long the episode lasts, during that time: totally unreachable. And realistically, you better not even try...because it just makes the situation worse. 

The more chances I've had to experience this with him, the more certain I can be that, short time or long, he'll emerge from his bunker, when he's good and ready, and with a new and improved outlook on why he went in the bunker in the first place. (For those who don't know, the bunker can be anywhere...a shed, a garage, a spot in the woods, a room in a house, even a chair. But it's sacred, inviolate, untouchable space...and the vet goes there in retreat, partly to spare those around him, but also strongly to get control over what he's feeling. (He or she, obviously.) So I figured he'd be able to offer his personal/expert advice on this.

Here's how the conversation went.

Me: "What typically sends vets to their bunkers?"

Him: "Any situation -– losing a job, losing their cool, a fight with their kid -- that makes them lose control sends them back to their bunker, so they can regain control. It may not be much, but while they're there, at least they have control over that little room they're in."

Me: "What's the longest time you've ever spent in your bunker?"

Him: "A year."

Me:  "!!!"

And then he clarified. (Remember, this is just his opinion, but it's worth sharing, because of the number of vets he knows and has observed, as well as what he knows about himself.) "Each time a vet goes into their bunker, they go in for a longer period of time. Until one time they go in and they don’t come out." (He does know an awful lot of other vets who have sadly killed themselves. That happens in bunkers, too. No wonder families and friends are justifiably concerned.)

The progression he just mentioned...vets spending longer and longer times each time in their bunkers...is actually the opposite of what he's been doing, since I've known him (which coincides with his getting better). Each time he goes to his bunker, it's both less frequent, and for shorter and shorter times each time, to the point that the last "bunker" episode I observed him in was actually only about half an hour.

In the middle of a frustrating conversation, not quite an argument, but one where emotions were high and we weren't communicating smoothly, he "withdrew" to his bunker of self-enclosed, protective space -- without moving from the couch he'd been sitting on. I saw him cross his arms, very agitated, close his eyes, and start doing something that looked like huffing and puffing. Even on an animal instinct level I knew, give this person his space. All the body language was daggers. I stepped away, and a short while later, he bounced back, and resumed where things left off, able to manage the conflict without any undue strain. Turns out what he'd been doing during the huffing and puffing phase was actually deep breathing, to calm himself down and regain control. Very smart. On the outside, he looked furious. On the inside, he was doing what he could to get back under control. As a result, he was able to "emerge" from his bunker in record time -- which speaks to the tremendous benefits of learning coping skills and stress-reduction techniques, as he has.

When I first knew this vet, he talked about what he'd learned at an inpatient PTSD program at the VA years ago. It was the cutting-edge program at the time, and he speaks of it with great appreciation, even though many of the guys he went through the program with sadly did not make it. ("Did not make it" is euphemistic code for "sadly, later killed themselves.") One of the biggest things he learned in the program, according to him, was about "red flags" and "triggers," and how to get away before you make things worse. Heading for the bunker, just like in the description of the vet with the pillow over his head,  is one way to keep things from getting worse. For the vet, that is -- for the family or loved ones, it's very difficult to experience, and hard to ignore, though one of the secrets seems to be, going on with your own life, while maintaining a compassionate (but not nagging) concern for how they're doing.

One of the distinctions he likes to make, though, between what he learned from the behavioral modification skills, above, in the VA program, and what he's learned since then, following more of a healing path, is that now he has some ability to not just "avoid" triggers but also "deal with" situations as they come up. The red flags still show that the problem is coming, but instead of being ONLY triggered, there are now new ways to deal with it that don't only involve avoiding or isolating.

The situation above, of being in conflict but being able to "be" with it, and breathe through it, meant that the conflict didn't have to explode into a multi-day saga or a physical exit to an actual bunker, which could last for weeks or months -- or even a year(!) Ahhh, progress is a beautiful thing...

Editor's note: For Part II, "Busting Out of the Bunker at Last," go here.

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© 2010 by Lily Casura / Healing Combat Trauma. All rights reserved. Use with attribution.

Quotable Quotes -- the Oft-Neglected Role of the Caregiver in Illness

"As little as we know of illness, we know even less of care. As much as the ill person's experience is denied, the caregiver's experience is denied more completely." -- Arthur Frank, "At the Will of the Body."

Editor's note: We have a section entitled, "Caring for the Caregivers." Click on this link to expand.

Pulling the Pin: Combat Vets, PTSD and Troubled Personal Relationships

Combat veterans with PTSD often have tremendous difficulty with their closest personal relationships: marriages and families.  Divorces, multiple marriages, and short-term relationships that end unhappily are very common: All situations that compound the pain and suffering that already exists with PTSD.

While there are a few books out there that provide some helpful advice about the difficulty of combat vets with PTSD sustaining good relationships, some insight is also in order.  While many obstacles could be mentioned, we'll stick to just a few important ones.

1.    Needing to have a constant enemy. Combat veterans will tell you that their training requires a constant enemy for alertness, vigilance, what amounts to staying alive. Once combat ends -- or between episodes of combat -- that "role" needs to be filled by somebody.  The most obvious candidate to fill that role?  The combat veteran's usually unwitting, and unwilling, partner. If the spouse or partner isn't available, the next best candidate is a child. The combat veteran is often unaware that he or she is using this tactic at all, and the one victimized by it can often tell "something is wrong," but isn't always clear on exactly what that is.

2.    Pestering and teasing doesn't feel like love, but it does feel like irritation. Let's say the coast is clear.  It's a sunny day, everything seems (temporarily) all right in the combat veteran's world. But he or she teases and pesters a spouse, partner or family member (e.g., a child) incessantly, until that person gets fed up and walks away.  "But I was just teasing!" says the combat veteran.  Yes, but the frictional nature of the allegedly good-natured teasing has a predictable effect: it drives close others away, much like bad behavior also does. Now the combat veteran can be left alone: But is that what he or she really wanted?  Perhaps.  Perhaps not.  The main thing, combat vets say informally, that inspires this strategy, even on an unconscious level, is that too much peace and calm is off-putting, and creating (or re-creating) a little "chaos" in interpersonal relationships puts the combat vet with PTSD back where he or she is more likely to be comfortable.

Now factor either (or both) of these two behavioral patterns (among several others that could have been discussed) with the combat veteran's periodic desire for intimacy -- and imagine the realistic toll that such behavior, even if unintentional, takes on the spouse or partner's desire for intimacy.  More likely, either one or both of these behaviors is more likely to shut down or numb the spouse or partner, who then is more tempted to resist attempts at intimacy.  Is turning down intimacy the problem?  Is it the only problem, or even the central problem?  Probably not, if either of these fairly typical behaviors are an issue.

Combat Veterans, PTSD and Domestic Violence - A Sometimes Deadly Combination

Domestic Violence a Growing Problem for Veterans

“The increasing number of veterans with posttraumatic stress disorder [PTSD] raises the risk of domestic violence and its consequences on families and children in communities across the United States,” says Monica Matthieu, Ph.D., an expert on veteran mental health and an assistant professor of social work at Washington University in St. Louis. “Treatments for domestic violence are very different than those for PTSD. The Department of Veterans Affairs [VA] has mental health services and treatments for PTSD, yet these services need to be combined with the specialized domestic violence intervention programs offered by community agencies for those veterans engaging in battering behavior against intimate partners and families.”

Matthieu and Peter Hovmand, Ph.D., a domestic violence expert and an assistant professor of social work at Washington University, are merging their research interests and working to design community prevention strategies to address this emerging public health problem.

“The increasing prevalence of traumatic brain injury and substance use disorders along with PTSD among veterans poses some unique challenges to existing community responses to domestic violence,” says Hovmand. “Community responses to domestic violence must be adapted to respond to the increasing number of veterans with PTSD. This includes veterans with young families and older veterans with chronic mental health issues.”

VA research shows that male veterans with PTSD are two to three times more likely than veterans without PTSD to engage in intimate partner violence and more likely to be involved in the legal system.

— Source: Washington University in St. Louis

Avoiding Intimacy: Passion is Frozen Out, Along with Every Other Good Emotion

In our on-again, off-again series on "healthy sexuality and the combat veteran," here are these words of wisdom from someone involved in a healing profession, who's been married to a combat veteran for more than 25 years now.  Together, they are the parent of one child.

The veterans' aversion to intimacy, she believes, can be traced to one thing, most of all:

"It's the wall," she says -- not meaning the "Vietnam wall," that's for sure; although they may have some inadvertent relationship (poor attempt at humor, I know."  Veterans, she says, "build this emotional wall: the body, mind and spirit join together to "protect" the person [the combat veteran].  Much like the immune system kicks in to fight off illness, the mind sets off a red alert to fight off and keep bad feelings from invading.  Unfortunately this also fights off good feelings. 

Passion is frozen out along with every other good emotion.  Joy, love, hope, excitement, all trapped out.  They can act as if they have all of them but they are unable to really feel any of them. 

 

Men will have one-night stands and visit hookers for the act of having sex, but they also do it because it is safe. There is no chance of emotional involvement.  In their minds, they know there isn't supposed to be one [the chance of getting emotionally involved].  But if they decide to have sex with someone they are supposed to be connected to, it's a letdown because they are not really attached to them. 

 

When you make love to someone you really care about, you feel the passion between you because all of the "human" is participating in it.  With PTSD, the wall stops the unity between the two people.  Physically they are there but the rest of them is not.  When they touch you, it's as if there is no psychic energy in their hands.  When they hold you, their muscles are there, but there is no heat from their embrace.  When they kiss, it's a kiss of a stranger.

 

A lot of this has to do with their age at the time they were wounded by trauma.  Most were under 20 at the time the rest of us were finding ourselves, developing the "unity" of the elements that make us who we are.  Practicing and forming of development of the "unity" comes with experience and if that is subjected to emotional disconnect, it is broken off.  Usually it does not mend.

 

When they are older and trauma hits, they have already developed the connections of the unity and they tend to not have as much of an issue, using the other parts of "them" to compensate for their lack of unity.  Even with age as a factor, there are still the missing elements trapped behind the wall."

In future posts, we will continue to explore this topic further.

When Two Are Better Than One: A Relationship That Can Save You

Although at first glance, we should really save ourselves -- not be saved by others -- there's something wrong with looking externally for something that should come ultimately from within -- still, relationships can exert powerful forces for good in our lives.  It's painful reading about the Vietnam veterans, for example, who are "unable to touch intimacy," or who still clearly keep intimate relationships at a distance, because they're afraid of the weight of failure, among other things. 

There's a nice segment of a poem from T.S. Eliot that speaks to this.  Eliot was a famous Modernist poet, from the school that developed around World War I, and while he wasn't sensational about this in his own life -- his first wife, Vivien, to whom the words "My nerves are bad to-night.  Yes, bad.  Stay with me." are attributed in Eliot's famous poem, The Waste Land, is also a woman he institutionalized; still, he is able to write these comforting words, which perhaps he practiced himself, and perhaps did not.  (They could also be about his marriage to his second wife, which was apparently much happier, though shorter-lived.  He was married to her at the time he wrote these lines.)  In any case, they can still serve to inspire us with their truth:

"If a man has one person, just one in his life,
To whom he is willing to confess everything --
And that includes, mind you, not only things criminal,
Not only turpitude, meanness and cowardice,
But also situations which are simply ridiculous,
When he has played the fool (as who has not?) --
Then he loves that person, and his love will save him."

-- T.S. Eliot, The Elder Statesman (1958).

Editor's note: For our ongoing series on "healthy sexuality and the combat veteran," go here.