Healing Combat Trauma

Karl Menninger, M.D. on PTSD (Combat Stress) in WWII Veterans

We've briefly quoted Karl Menninger, M.D., before, here. But in scouring a book he wrote almost 50 years ago, we came across this extensive retelling of what he observed with World War II veterans and combat stress -- what we know today as PTSD.

It's interesting to read because there is both not much material readily available before the Vietnam War brought post-traumatic stress disorder into the common awareness, and also because the phenomenon of PTSD does seem to slightly "mutate" over time, perhaps because of the difference in the types of combat with each significant war. Menninger, a world-famous psychiatrist, brings up many important points in this passage -- and we wonder how many of them would still be considered true today.

(The context for the original work that he's citing here was performed when he was a member of a commision to study combat exhaustion in World War II veterans, appointed by the Surgeon General and his brother, Brigadier-General William C. Menninger.)

“In our studies of reactions to combat stress in World War II previously referred to, we were very much impressed with the way in which a set of forces began a phase of great stress and simultaneously aroused certain opposing forces which helped to maintain a balance. Then came more stress and more defense. Gradually the stresses seemed to become greater than the defenses, so that there occurred a lowering of achievement level, a partial retreat, the employment of emergency regulatory devices, evidences of threatened disorganization, and then, usually a recourse to medical aid.

With sedation and a few hours of rest many of these individuals were able to resume their former efficiency and return to the battle. Heroic and admirable as it was, this was not too difficult to explain. But other individuals had the same treatment and were not able to return to the front lines. Their symptoms persisted. This too we could understand. More time was required, more rest, more recuperation, further removal from the imminence of renewed combat stress.

But now comes the enigma. Many of these patients were sent back to the base hospital for care, nursing, protection, rest, and treatment. We saw some of them there, later. Many had improved or were improving; some had returned to duty (but usually not to combat duty). What impressed us most was that some of them were not better; they were under treatment of sorts, but they were worse. There was, for them, no more battle stress, no more physical exertion and prevail, no more threat of death. There was not even any considerable probability of further duty assignment. Bright, or at least safe and comfortable, situations lay ahead for them. Why did not the symptoms disappear?

In analyzing the nature of the stress they had undergone, we began to realize this was different from what would appear on the surface. In the beginning these men had experienced fear, fatigue, resentment, hunger, cold, and other things. But they were sustained, there, by many things, too: self-respect, pride-idealism, courage, devotion to duty, training, and habituation to routine. Moreover, there was a strong support from relations with comrades and officers and units. The sudden increment of stress which precipitated these symptoms was frequently the loss of one of these human supports by death or transfer. In other instances cumulative fatigue seemed to be the most important factor.

For these men, then, who did not respond to battalion aid-station treatment, the nature of the stress had changed; but it did not diminish quantitatively as the casual observer might have assumed. The threat of danger was gone, true, but so were the excitement and the routine activity. The weariness was gone, true, but so was the companionship of fellow soldiers. The unpleasant physical conditions were corrected, but in their place was the guilt feeling of abandoning one’s comrades and the fear of accusation of cowardice. Painfully disturbing was the dilemma that if one mastered his distress he would be sent back to duty, but if one admitted it he would be retired. A retirement could be cleared of all tincture of suspected cowardice only if it took the form of something called sickness. Efficient warfare and humane medical science are antithetical and sooner or later the antithesis shows up in the individual.”

-- Karl Menninger, M.D., “The Vital Balance: The Life Process in Mental Health and Illness.” New York: The Viking Press (1963).

Editor's note: The photo illustrates Polish soldiers involved in the Warsaw Uprising.

The House of Four Rooms: How Are Yours Doing?

I first learned about this concept from a fairly philosophical Marine officer who was serving in Ramadi in '05, while he was there. He shared the concept with me, and it's a great one -- one I need to return to more frequently for that all-important and oh-so-easy-to-lose balance in life.

The quote:

"There is an Indian belief that everyone is a house of four rooms: a physical, a mental, an emotional and a spiritual room. Most of us tend to live in one room most of the time, but unless we go into every room every day, even if only to keep it aired, we are not complete." -- Rumer Godden, "House of Four Rooms."

Quotable Quotes -- Chief Dan George on the Necessity of Love

It's not always easy to love a combat veteran with PTSD. Heck, it's not even easy to BE a combat veteran with PTSD and manage to love yourself, or those around you the way that you want to.

But part of healing is getting back in touch with how important love is, and even respecting its own form of therapeutic, healing power. Listen to these words from a very wise sage about just how important love is, in the natural order of things:

"Love is something you and I must have. We must have it because our spirit feeds upon it. We must have it because without it we become weak and faint. Without love our self-esteem weakens. Without it our courage fails. Without love we can no longer look out confidently at the world." -- Chief Dan George, Canadian First Nations chief, poet, author and Academy Award-winning actor.

Martin Luther King Jr Had a Dream for Combat Veterans, Too

Martin Luther King Jr., from a speech delivered exactly one year before he was assassinated in Memphis, Tenn.:

"This business of burning human beings with napalm, of filling our nation's homes with orphans and widows, of injecting poisonous drugs of hate into veins of peoples normally humane, of sending men home from dark and bloody battlefields physically handicapped and psychologically deranged, cannot be reconciled with wisdom, justice and love." -- Martin Luther King Jr, speech at Riverside Church in New York City, April 4, 1967. 

Editor's note: A link to the online text and audio of his full speech is here.

Finding -- and Keeping -- Your All-Important Balance

With the holiday season fully underway, here is a message that's foundationally true not just now but also every single day of the year.

It's vitally important to find -- and then maintain -- your personal balance, whatever that may be. We've spoken before about creating what's known as a "personal practice" -- be that meditation, qi gong, T'ai chi, yoga -- something that you can do daily that resets your own internal rythym and reminds you that you have substantial ability to affect your own mood, energy level, and emotional health.

Here's one thing we'd highly recommend be part of that, an attitude that is sadly missing from many people's lives, and also lacking expression in many others. It's a simple word that holds a universe of emotional health within it, and that simple word is GRATITUDE.

"Gratitude unlocks the fullness of life. It turns what we have into enough, and more. It turns denial into acceptance, chaos to order, confusion to clarity. It can turn a meal into a feast, a house into a home, a stranger into a friend. Gratitude makes sense of our past, brings peace for today and creates a vision for tomorrow." -- Melody Beattie.

Quotable Quotes -- Milton Erickson on the Indisputable Need for Joy

When it comes to worry and anxiety, the New Testament talks in Matthew 6:34 about a good reason for prayer being that "each day has enough trouble of its own" (all too true).

If you've watched the movie, "The Bucket List," with Morgan Freeman and Jack Nicholson, you've heard the conclusion that the two big questions that everyone needs to ask themselves before they die are these: "Have you found joy?" and "Has your life brought joy to others?" Provocative and essential; a "both/and" not an "either/or."

Then if you combine those two sentiments above, trouble and joy, you have the following quote from psychiatrist Milton Erickson, M.D., which goes to the heart of the matter:

“Life will bring you pain all by itself. Your responsibility is to create joy.” -- Milton Erickson

 We don't have to look very far to see the applications in the life of a veteran with combat-based PTSD or his or her loved ones. The pain is real; but the joy is completely necessary; and no one can create it but us. This holiday season, start "Joy to the world" much closer to home. Find and do the things that bring you -- even if only you -- some much-needed JOY. The pain doesn't need any more attention than it already draws to itself. Go find, and make, some joy to carry you through.

Quotable Quotes -- Ralph Waldo Emerson on Tomorrow a Fresh Start

It's not quite "New Year's Resolution" time -- but it's also true that the dawn of every new day provides a new opportunity to change what didn't work about the old one.

Hampering that often is our own unbelief / disbelief in our ability to improve. As Maxwell Maltz once wrote, "Your most important sale in life is to sell yourself to yourself." Why? Because you can be your harshest critic, and one area where that really shows itself is doubting your ability to change -- or being able to forgive yourself for falling short. 

With the caveat that it's not always possible to take the following advice, because we do wobble and fall regularly as human beings, it's nevertheless quite great advice -- from a well-known American sage:

"Finish each day and be done with it. You have done what you could. Some blunders and absurdities have crept in; forget them as soon as you can. Tomorrow is a new day. You shall begin in serenely and with too high a spirit to be encumbered with your old nonsense." -- Ralph Waldo Emerson.

Whether it's New Year's Eve tomorrow -- or just another day -- this remains good advice to heed, particularly as we try to put into place changes that will be for our and our loved ones' good.

Quotable Quotes -- Pema Chodron on Going into the Pain

"Bodhisattvas practice 'in the middle of the fire.' This means they enter into the suffering of the world; it also means they stay steady with the fire of their own painful emotions. They neither act them out nor repress them. They are willing to 'stay on the dot' and explore an emotion's ungraspable qualities and fluid energies -- and to let that experience link them to the pain and courage of others." -- Pema Chödrön, American Buddhist nun (Tibetan Buddhist tradition) and author.

Editor's note: The Bodhisattva Avalokitesvara (Guanshiyin, also known as Quan Yin or Kuan Yin) is pictured. Chinese, 11th or 12th century.

Also, for more on meditation, click here.

Bombshell Lily Burana, Author of "I Love a Man in Uniform," on PTSD

Lily Burana is a lovely force of nature, and at this time of year when we celebrate veterans, it seems only fitting to celebrate their often long-suffering spouses as well. Burana wrote a great book a while back called "I Love a Man in Uniform," about her marriage to an Army veteran who was deployed. 

"Love is great," she jokes among friends, "but it ain't no match for PTSD."

Last week, in honor of Veterans' Day, she wrote a typically light, humorous and reflective article for the New York Times about "The Quiet Side of Being the Soldier's Other Half," linked here.

She also wrote on her blog:

"I've been blessed with an adventure-filled life that has taken me many places and transformed me in many ways, but nothing has moved and transformed me more than my experience as a military wife. The grit, ritual, passion, dedication, resilience, and sacrifice have left an indelible mark on me.

This Modern Love column may be my final word on my experience as an Army wife--though you never can tell. When I saw it online, I started shaking and cried, mostly out of a deep gratitude for being part of the military family."

More germane to our purposes around here, though, what's particularly refreshing about Lily Burana -- on top of her smarts and humor -- is her delightful candor about how she and her husband each struggled with their own forms of PTSD. And how that experience challenged -- but ultimately did not extinguish -- their marriage.

Burana's book is smartly subtitled, "A Memoir of Love, War and Other Battles." And while "I Love a Man in Uniform" isn't technically "about" PTSD, as with many servicemembers' marriages, PTSD can turn out to be the elephant in the room. Marriage is difficult, deployment takes its toll on both partners, and trauma -- even from other sources -- tends to be cumulative.

In "I Love a Man in Uniform," Burana talks about her experiences with EMDR, therapy, medication, and Neuro-Emotional Technique, a form of chiropractic. In subsequent conversations with her, she credits EMDR with doing much of the "heavy lifting" where PTSD was concerned. EMDR "gave me the will to live," she says, "It significantly improved my quality of life."

"I know what it's like," she says. "I felt worthless." "My story has an encouraging ending, so I'm happy to share it. I'm going to put a face and a name to it" -- what so many others go through. "I went about as low as you can go," she said, before EMDR started turning her life around.

Like many military spouses, she talks of the pride of seeming "capable on the outside," but "dying on the inside." She also talks about how as her husband got his own PTSD from combat treated, "it served him beautifully." It became "a better life for him, too."

---

Editor's note: In addition to being an author, Lily Burana used her background as a burlesque dancer to create "Operation Bombshell," "the world's only burlesque school for military wives." (It doesn't involve nudity or a striptease.) According to the Operation Bombshell website, linked here, Burana started this light-hearted recreational program, "after enduring her own 'deployment blues'. 

"Burana's husband, then an Army Intelligence officer, was fighting in Operation Iraqi Freedom, and Burana longed for something to lift her spirits. Later, during a little "retail therapy" lingerie shopping, she found that the salesgirl was herself a sad, lonely military wife, and Burana wished she could offer her some cheer and healing distraction. In that instant, Operation Bombshell was born. The first Operation Bombshell class was held at Fort Hood, Texas in 2008."

For more about Operation Bombshell, click here. Or watch this endearing clip from Fox News about the program. (And for more on EMDR, click here.)

Photo credit: Laura Byrnes.

Quotable Quotes -- Carl Jung on Only the Wounded Physician Heals

"The doctor is effective only when he himself is affected. Only the wounded physician heals." -- Carl Jung.

Quotable Quotes -- Donna Eden on Illness and Healing

A provocative quote about taking responsibility where you can:

“Your illness is NOT your fault, but your healing IS your responsibility.” -- Donna Eden, author of "Energy Medicine."

The Toll of Veteran Suicide: Those Unnecessary Deaths

The poet T.S. Eliot called April "the cruelest month," but you know, this time of year, heading into the holidays, isn't that great either -- especially for those who are suffering from post-traumatic stress, when numbers of those who take their own lives actually climb. The numbers are already bad enough; and 'tis the season, so to speak, when they actually get worse.

Currently, 18 veterans a day(!!!) kill themselves; and one active duty servicemember every 36 hours(!!!).

Those are TERRIBLE numbers, because each one represents a life that can never come back, and plunges a family and a community into an often never-ending ordeal.

According to the website FierceGoodbye, material for survivors put together by the Mennonites, something we already know, but it's painful to hear the statistics again, and contemplate how far indeed the trauma reaches. They say: "Over four million people in the U.S. mourn the tragic suicides of family members. Suicide devastates family members for many years; family survivors are at greater risk of suicide themselves, and the pain ripples out to the entire community."

That's why optimizing mental health is so important. An unusual quote that a colleague just shared with me, from a writer who knows:

"Looking at suicide—the sheer numbers, the pain leading up to it, and the suffering left behind—is harrowing. For every moment of exuberance in the science, or in the success of governments, there is a matching and terrible reality of the deaths themselves: the young deaths, the violent deaths, the unnecessary deaths." -- Kay Redfield Jamison, mental illness sufferer, psychotherapist and author of "Night Falls Fast: Understanding Suicide."

For those of you who work with veterans, thank YOU for your service. Ideally, it honors the veterans' lives, loves, and their commitments to stay in the game, and helps get them the tools to do so.

Editor's note: If you're a veteran in trouble, please contact the hotline numbers linked here, or if you're truly in crisis, call 9-1-1. If you're someone who wants to learn more about suicide and veterans, there's a series of articles on the topic, linked here. And if you want to learn about a veteran overcoming his own struggle with suicide, click here.

Additionally, "Fierce Goodbye: Living in the Shadow of Suicide,' is a book, a website, and a DVD. It's also a video-on-demand at Amazon to rent (inexpensive) or to purchase.

Quotable Quotes -- Michel de Montaigne on Valor of the Soul

We usually think of "valor" according to its dictionary definition -- "strength of mind or spirit that enables a person to encounter danger with firmness; personal bravery" -- the word itself comes from the Latin word, "valere" -- to be of worth, to be strong, which ultimately became the Middle English word for worthiness or bravery. (We also get the word "value" from these origins.) And on a practical level, we associate the word with the combat action medal, which is given with or without the "V" for valor.

But here's an expanded definition from an influential, 16th century French Renaissance author and statesman. He wrote, more broadly:

"Valor is stability, not of legs and arms, but of courage; of the soul." -- Michel de Montaigne.

Isn't that something that every combat veteran with PTSD -- nay, even every family member, caregiver and loved one of a vet with PTSD -- finds they have to encounter at one time or another? (Rhetorical.) Here's a toast to you in that often-daily struggle to be whole again and to be well.

On Bended Knee: Forgiveness and Spirituality Also Help Heal Wounded Hearts

We don't spend much time talking about the benefits of mainstream religious-ity around here -- the dominant cultural paradigm doesn't need too much of an assist to get the word out about itself, after all -- but today there's an interview in Gaiam, a good source of health and wellness products and advice, with Larry Dossey, M.D., that's worth noting.

Dossey is the author of several books on the power of prayer and its effect on health (even among non-believers), including: "Healing Words: The Power of Prayer and the Practice of Medicine," Prayer is Good Medicine," and "Reinventing Medicine: Beyond Mind-Body to a New Era of Healing," among others.

He mentions several of the benefits...

 "For one thing, people who are attuned to spirituality often practice good health habits...(and) ...people who find a positive meaning in life tend to have better health profiles." Also, "people who belong to spiritually oriented groups have a built-in social network, and research shows that people who have a rich social life have a lower incidence of disease than those who are isolated and spend their lives alone."

In response to being asked whether there's any science behind this, he answers: "There are more than 1,200 studies published in mainstream medical journals that show a profound connection between spiritual practices and health and longevity. They indicate that spiritual people have a lower incidence of all the major diseases -- heart disease, cancer, diabetes, etc. -- and live an average of 7-13 years longer than those who don't follow any spiritual path."

At Stanford University, Frederic Luskin, Ph.D. leads a workshop and class series on "Learning to Forgive." Luskin is also the director of the Stanford Forgiveness Project, and the author of "Forgive for Good: A Proven Prescription for Health and Happiness," linked here. According to his bio:

"Dr. Luskin presents the forgiveness training methodology that has been validated through six successful research studies conducted through the Stanford Forgiveness Projects.

Prior to the current surge in research interest the importance of practicing forgiveness was extolled in both religious and psychological traditions.  Recently, Dr. Luskin’s and other’s research has confirmed its virtues in the promotion of psychological, relationship and physical health.  Forgiveness has been shown to reduce anger, hurt, depression and stress and lead to greater feelings of optimism, hope, compassion and self confidence.

Dr. Luskin’s work combines lecture with a hands-on approach to the ancient tradition of forgiveness.  Participants explore forgiveness with the goal of reducing hurt and helplessness, letting go of anger and increasing confidence and hope as they learn how to release unwanted hurts and grudges. His presentations explore the HEAL process of forgiveness that, when learned, can lead to enhanced well-being through self-care. In class practice may include guided imagery, journal writing and discussion all presented in a safe and nurturing environment. Dr. Luskin holds a Ph.D. in Counseling and Health Psychology from Stanford University."

For those interested in learning more about Dr. Luskin and the Stanford Forgiveness Project, click here. 

Editor's note: This beautiful stained-glass masterpiece by former Army medic John Knott is available as stretched canvas 11 x 14" prints, for $100 each. Email the artist at pappaknotts @ sbcglobal dot net to purchase.

"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.

 

 

The Secret Which Hides in Plain Sight

 Some wisdom for -- and from -- the ages:

"You could tell the secret of life ten times over, and it would still be safe. After all, the secret is only known when people make it real in their own lives, not when they simply hear it." -- The Tao.

"Do not merely listen to the word, and so deceive yourselves. Do what it says." -- James 1:22, New International Version.

"We dance round in a ring and suppose. But the Secret sits in the middle, and knows." -- Robert Frost.

Apropos of nothing in particular, these sayings have been on my mind today. Partly because much of what has been known about combat-based PTSD has been known since at least the 1970s, and partly because some of the behavioral modification techniques that frankly make life easier for the sufferers and their caregivers are also just that -- common sense. I think of how much collective wisdom the sufferers of PTSD and their spouses or significant others, family members, caregivers, etc., have -- and how little is probably put into practice.

What we know about how to improve lives with PTSD, whether through bodywork, mind-body medicine, CBT, PET, behavioral modification techniques, spirituality, consistent use of appropriate medication -- and successful combinations thereof -- still need to be APPLIED on a daily basis to bring any true relief at all. Not just thought about, contemplated, agreed with. In that regard, both the Tao and the Bible (above) are in agreement: merely hearing, or thinking about something, doesn't bring improvement. Doing it does. Go forth and conquer :-)

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

 

Quotable Quotes -- Thomas Dooley, III, M.D., on Spending Part of Your Life Serving Others

"Dedicate some of your life to others.  Your dedication will not be a sacrifice.  It will be an exhilarating experience because it is an intense effort applied toward a meaningful end." -- Thomas Dooley, III, M.D., U.S. Navy physician. (1927 - 1961.)

© 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.

 

Quotable Quotes -- Charles Dickens on Happiness Being a Gift

"In every life, no matter how full or empty one's purse, there is tragedy. It is the one promise life always fulfills. Thus, happiness is a gift and the trick is not to expect it, but to delight in it when it comes, and to add to other people's store of it." -- Charles Dickens, "Nicholas Nickelby" 

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

 

The Good Work of Talk: Healing the Wounded Heart Veterans Workshop

Practicing psychotherapist Allen L. Roland, Ph.D., tells the story of a group of veterans he's been working with in Northern California this past spring, along with Sal Ueda, M.S.W., counselor from the local Vets Center in Concord, CA. Roland writes (bolding is Roland's own emphasis):

"Five Vietnam veterans, all with PTSD, faced their fears and not only opened their hearts but found and began to heal themselves in the process.

The first meeting of the "Healing the Wounded Hearts Veterans Workshop" was on March 11, 2010 at 4 p.m.

They had never met me but they had been told about me, by their adjustment counselor Sal, and were prepared for an eight week commitment to face their fears and open their hearts in the process. They knew I was a Veteran and that made a big difference. 

I told them that this was an action based workshop and if they did their homework they would reach a place of not only another choice but would open their closed hearts in the process. They would also begin to see through different eyes ~ eyes unclouded by fear, resentment and unworthiness. I also explained through my Cycle Of Life chart how psychic pain will override Joy to the extent that most people have no idea that beneath their deepest pain and aloneness is love, joy and connectedness ~ the Unified Field. 

Of course, that first session I shared my own hearts journey to find a lost and alone little boy within myself who not only wanted to fly, and became a Navy Fighter pilot, but also to love as deeply as I loved my beloved grandfather before he was torn away from me at six years old. We didn't talk about the war ~ we all briefly shared our heart's journey and by the end of two hours ~ we became a band of brothers. Their homework was a life chart of the paths of their individual hearts. 

The second session, a week later, we all shared a childhood picture of ourselves and shared our life chart with the group describing our individual journeys to find love and acceptance as well as ourselves. We barely talked about the war ~ we all realized our commonality in that our lives had all been a quest to find meaning and that all of our love relationships had significant meaning. We were a band of brothers on an inner journey of the heart. 

The third session, a week later, they did the Vic/Acct exercise and had the chance to feel the lightness of being accountable versus the heaviness of being a victim. Their homework was to take the people they had resentment towards off the hook and realize that many of them they had deeply loved and were really gifts in their lives. 

Al felt it was the most meaningful aspect of the workshop ~ " I let my ex-wife off the hook ! I hadn't spoken to her in over four years. I was harboring extreme resentment. After the exercise, I was able to call her and let that resentment go. That alone has made a huge difference in how I feel today with her and my life." 

We barely talked about the war ~ we were a band of brothers on a common journey to find ourselves. 

The fourth session, a week later, they met the child within by means of a powerful guided visualization. Every one of them saw that long lost innocent child who told them what they needed to do to fully embrace him in their lives now. Their faces literally changed and became younger as they made that inner connection ~ it was like long dormant flowers suddenly blooming. I was moved almost to tears to see these Veterans suddenly claim their joy and innocence after years of self doubt and despair. For Tom it was the most meaningful aspect of the workshop ~ "Just seeing the look on the other Vets faces as they met the inner child." 

Their homework was to give that child a voice and hang out with him. 

The Fifth session, one week later, was all about gratefulness and thanking the people who have been there for them their whole life ~ with the help of a guided visualization. Many of them had not thanked anyone and certainly not themselves. Thomas shared his homework from the previous session and had 12 pages of notes on his experience. Here are some excerpts ~ " Once again, I was so surprised when it happened at the group meeting that I could hardly wait for it to happen again and again. Just the thought made me feel like a weight was lifting my shoulders and mind ... I meditated and saw him again. I asked him again ~ What do I need to do to fully embrace you in my life ? He immediately answered ~ Since birth, I have always been with you constantly. You just weren't looking for me. You just didn't see me or believe in me but I see a change in you now ~ more than any time since Vietnam." 

Thomas ended his notes by writing ~ " I can't believe that I have had this problem for some 40 years and I feel like a new born child. I'm still amazed that I had blocked out so much and yet this was the right key to change things for the better ~ and it was so simple to initiate ~ I feel good !!! " 

By now the Band of Brothers were inspiring each other on their common journey through fear ~ they were beyond the point of no return. Their homework was to thank at least 25 people who had touched them before the next session. We still barely talked about the war for there was no need to. They were already healing themselves by taking responsibility for love and coming from gratitude. 

The sixth session, one week later, was the Death Exercise where the group, through a visualization, were guided in a profound death exercise which helped them to experience the degree to which the people closest to them really knew them. The exercise actually simulates your death and the resultant shock of knowing that you did not truly share yourself with the people closest to you or that very few people really knew you.Obviously, it is a strong inner stimulus to open your heart with the people closest to you ~ and that was their homework to accomplish with the five people closest to them before the next session. 

Most of them enjoyed the element of the unknown that they were continually coming face to face with in these sessions, especially Al ~ " I enjoyed the element of surprise. It was hard to know week to week just what the activity would be and how it would effect me. Every week was different and unique but it all came together " 

The seventh session, one week later, reinforced that we are continually being called from within to the path of the heart, but few listen and fewer still respond. It is in this session that they understand that they have been called to the inner journey of the soul ( through Love) versus the outer journey of the ego ( through Fear ). This session ended with a visualization exercise in which they realize that the most precious gift they have always wanted is themselves ~ free from fear. 

For Barry, this was the most meaningful aspect of the workshop " For me, getting in touch with my inner child and having it pointed out to me that the key was just being myself and to trust myself without any fear or fears of the consequences." 

The Homework as well as ongoing homework was to share the gift of themselves with others but in the spirit of celebration ~ not deprivation. 

It was in that same spirit of celebration that we had our Eighth and final session where everyone acknowledged each others common journey through fear to the joy, love and light beneath. As George said, "Now, I truly know I have another choice and I can be loved for just being myself and I don't have to enable people to win their love.... I see the growth in my fellow members but also how we learned to love each other ~ a true Band of Brothers." 

It was also an incredible experience for both myself and Sal, a Veterans Readjustment counseling therapist (from the local Vets Center) who both formed the group and then fully participated in the sessions. 

Sal's most meaningful aspect of the workshop was "To witness and see the burden of fear, guilt and pain of each group participate lifted. To see the youthfulness return to their eyes, faces and demeanors. It is a blessed experience to see the joy return to these war veterans after years of despair. It is simply humbling and a beautiful sight." 

I was also humbled by this experience and validation of my empowering work as well as the receptivity of these veterans who obviously longed to be seen from the heart and not through eyes of fear. 

They had been trained many years ago to kill and I, in essence, jump started their hearts by re-training them to love and they began to heal themselves in the process by realizing that they indeed had another choice. 

And we never concentrated on the war for the real war had been waged within themselves ~ and they were now victorious."

-- Written by Allen L. Roland, Ph.D.  Used with permission.

Editor's note: The accompanying photo is of five other Vietnam veterans from a different gathering, not the ones described in the article.

Quotable Quotes -- Audie Murphy on Getting Over Combat

Audie Murphy, left, in his day, was the most decorated American soldier from World War II, winning the Medal of Honor, among 27 others. He also famously told a reporter, "You know, you never get over combat. I don't think you ever do." (Quoted in Chaim F. Shatan, M.D.'s famous text, "The Grief of Soldiers," from 1973.) He died at 45 years old.

We would wish for every Audie Murphy, and every other combat veteran, more relief from his struggles, and more healing, than Murphy himself was able to know. Let it be so.

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

 

The Way of the Snake -- Healing Combat Trauma

From the writer of the recent pieces on ritual and cultural healing for warriors, which we've all gotten to enjoy -- something I genuinely believe is the among the very best writing and thinking we've seen on this site this year. This is totally from the heart, and soul-level wisdom, soul to soul. He writes:

"Since writing these small pieces for your site, memories have come flooding back.I work hard at being detached and articulate, but when I get ready to send a piece, I get lost in a huge feeling of grief.

There are so many stories of love, even in the tragedy of combat, it brings me to tears. which I thought I would not have, trying to be objective in writing about combat and the soul. I am not sure I have ever had a muse, but if I do, she is kicking my ass today. I get so fucking lost in my feelings, working to objectify healing the soul.

I hope Mercury come out of retrograde soon. Just an attempt to ground myself.

Sitting here with tears, wondering WTF. You really are doing great work for warriors."

Then he quotes from a favorite poem, "The Way of the Snake" about combat trauma:

"I lost a year somewhere.

It must have been in Vietnam, I think.

The memories I have from there aren’t

real; they can’t be mine. I don’t know

whose they are, but I hope they

claim them soon—I’ve kept them

far too long.

-- Terry Hertzler, "The Way of the Snake and Other Poems: Writings from the War in Vietnam."

The writer continues:

I spent years looking for Terry, after finding his small book of poetry, and buying all six copies the San Diego store had, little knowing he lived in the same area. I used his writings with many men and women along my path. It as not until 2008, that I finally located Terry on the internet. I called him and we traded stories about his time In country, my use of his poetry, and his coming back stateside. I hope he will write about his “Achilles Tour” in coming back to America.

I write about Terry today, because he stays in my heart, as does his poems and recitations of the things he did after his return to the states. While I would love to recount stories Terry told, they are his stories, and he is the only one that has the right to tell them, however his poems show the effect of the trauma induced by combat.

I share some parts of poems, because he has given me personal permission to us his works. I am not so sure if I were as talented as he, I would be so generous.

I share these thoughts, because they reflect the view of a young warrior after war return, and know they reflect the feelings of many men and a few women I have talked with, in the reconciliation of my own deeds, and failure to understand what price my soul was paying, in all of my involvement in that war.

The fact, that I will carry some things until my death, and perhaps beyond has become less of a burden because I was seen, touched and loved by many people on my path of life. I have had, and still have, great teachers, and have been seen, as worth saving.

I have one picture of me when I was in Vietnam; it was a shock when I discovered it. It was when I began working toward understanding how I could help our returning warriors from these current wars. I could not accept how ragged, out of uniform I was. My mental picture was of a squared away sailor, not an uncovered. Shirt open to the belt, sleeves rolled up, and spiked uncut hair sticking out at angles a nineteen year old kid, standing on the bridge of our small converted LST.

That’s what happens to old veterans, the pictures are as they were, not as we like to recall. The exception is the agony of experience. A picture is perhaps in those days one sixtieth of a second. Memories are in the soul forever. As I was taught, the Huna belief is, the most powerful memories come unbidden in those unaware moments.

For one who has experienced the over pressurization of a M-2 fifty caliber machine gun, so well articulated by Colby Buzzell in his book “Killing Time In Iraq”, or the experience of thrown by the concussion of an explosion, the soul is never unaware.

It should come as no surprise that a returning warrior is hyper vigilant, startled by unexpected noise, people getting in their space, or nervous in crowds.

Returning warriors are evaluated by their chain of command with one purpose. Are they “good to go”. So basically, combat trauma is first observed and evaluated by the lowest ranking personnel in a supervisory position.  Of course highly scientific terms such as “Crazy as a fucking bed bug, but I need him” is the criteria for judgment of combat trauma. Does it qualify as a diagnosis, most assuredly yes! Is the troop mentally impaired? “Fuck No! He’s just like the rest of us!”   

Does obsessively disassembling, cleaning and reassembling a weapon represent a sign of combat trauma?  Who is to know? Perhaps the soul has given the body a function to eliminate physical or mental distress. “Has he got his shit together” “does she have her shit together”? Good to go!

Should we as a nation, or should congress, judge the effect of combat on a person eighteen years old, “Down Range”, when our learned specialists can not agree on what constitutes Combat Trauma. Perhaps we can rely on William Blake, when he wrote “You never know what is enough, until you know what is more than enough”

I return to Terry’s writing, a few excerpts from his writing, “A Vietnam Alphabet":

'D is for dead

E is for E-1, E-2, E-3, etc. those are army ranks. The higher the number, the less chance you will fall under D.

N is for nothing

O is for officers, they often knew nothing.

P is for piece it goes well with

Q which is for quiet. Sometimes too much peace and quiet makes me nervous

R is for R&R, rest and recuperation, rest and relaxation, rest and return.

S is for my friend Sam. Also for shrapnel. Sam stopped a piece of shrapnel with his heart one night.”

-- Terry Hertzler.

Combat trauma starts the first time one hears “Congratulations, you are now a member of the armed forces of the United States of America,” and it never goes away, after experiencing personal danger. It is with us day in, day out, the rest of our lives. The severity of actual personal participation can only be judged by a person’s Soul. To be given a pill, a shot, a cup of foul tasting goop, is not healing the soul. It may deaden, kill, alleviate, delay pain in the body, but it will never heal the soul. Only a person’s soul will know, what it will take to heal their soul, and many warriors are going to need soulful help, in finding comfort for their soul.

A final poem, "Year's End":

“When I was twenty, I lost

Christmas. Like Alice’s rabbit, down

Some dark hole, it disappeared.

I remember New Year’s well

enough. At midnight, the perimeter

Despite all orders to the contrary,

lit up with red, green and white

flares, as tracer rounds

from M-60 machine guns 

wove bright delicate patterns

through the sky.

But Christmas is gone and it frightens me

Christmas is gone—not veiled

in a mist of memory, or crouched

in some dark and secret corner

in my mind, but vanished, completely,

   like some Cheshire cat—leaving

   not even a smile behind

   not even a smile."

-- Terry Hertzler

And finally,

“we never asked to be put into this position

we never had high demands,

we never claimed to be on some kind of mission

like we had some kind of master plan,

it’s not as if we know exactly what we came for

so we settle for what comes our way,

we’re always unprepared for the final encore

what the fuck are we supposed to say.”

-- Clawfinger, "The Price We Pay."

In the Stillhouse of Dread after Combat

(From the ongoing series on ritual as cultural healing for the trauma suffered in combat. Written by a longtime Navy vet who was a leader in the mythopoetic men's movement.) He writes:

Combat Trauma -- The Stillhouse of Dread 

“Oh tear my stillhouse down 

Let it go to rust 

Don’t leave no trace of the hiding place 

Where I made that evil stuff 

For all my time and money 

No profit did I see 

That old copper kettle 

Was the death of me” -- Gillian Welch 

Trauma from combat is an evil brew indeed. It besots the mind, controls the body and absent self intervention can lead to death. The mind remembers, the mind’s eye sees, the body remembers and the soul exists, filled with anger and grief. Sometimes the mind swells inside the brain- which some learned people will deny. 

Nevertheless the mind expands, transcends time and physical bounds, leaves the body. Goes back in time. The taste of fury rises,and a gorge of power races through the body. Sounds, smells, vibrations and the pulsating wave of rapid fire exists, right here, right now. The aura of the body pulls in tight, the body reacts, the limbic of ancient humanity struggling for survival rise from the soul’s depths. The timelessness of intensity is maintained until overload occurs and blocks the mind from the soul, to enable the soul to survive. 

The soul remains to pull the body back from extinction. Unfortunately for some warriors, the soul’s power is greatly diminished and the body continues over the precipice into the solace of suicide. There is no suicide prevention short of physical restraint, which only exacerbates the mind’s disconnection with the Soul. "Talking the talk" helps strengthen the resolute soul, but the inability to change the past, to accept the nature of the soul, through scenes projected by the minds eye leads to the absolute cessation of the strength of the soul. The soul’s power is so depleted, the body mind demands the overload be negated by complete shutdown of all systems. Since the limbic soul fights to live, only an external force can quiet the internal strife that is maddening to the soul. The EVIL BREW of combat trauma prevails: 

“And somewhere a wind ready to find lost (souls) And cover their tracks We walk on, leaves blow past” William Stafford (souls substituted for men because we now have women in combat -- author.) 

Going back to the opening song, we can deconstruct the verse with combat trauma. “Oh tear my stillhouse down let it go to rust” (Eliminate the problems of my soul or psyche.) “Don’t leave no trace of the hiding place” ( No residual disturbance.) “Where I made that evil stuff” (What I did was against the laws of humanity.) “For all my time and money no profit did I see” (My youth, my life was wasted.) “That old copper kettle was the death of me” (The cauldron of warfare has killed my sense of righteousness, I must go underground to rectify my Soul.) 

Mircea Eliade in his work “Shamanism: Archaic Techniques of Ecstasy” discusses ideologies of the Indo—European ideas of life after death, the ecstasy of decent into Hades as an initiation and absorption into magical realm of fallen heroes. Without discussing religious beliefs in various churches and denominations, we can see through many complex civilizations there is a belief of life after death. Eliade also discusses the use of hemp and mushrooms in achievement of intoxication before or during séances. 

In the same discussion he notes the beginning of the use of alcohol and tobacco as the beginning of decadence in shamanic techniques. “Narcotic intoxication is called on to provide an imitation of a state that the shaman is no longer capable of attaining otherwise.” It is not a long step to the position of altering the state of mind through the use of mood or mind altering substances, to alleviate the pain in the mind and Soul. 

While intoxication or the use of mind or mood altering substances can influence conscious pain or confusion (suffering) in returning warriors with extreme mental or physical disturbance, the root of the disturbance lies in the soul. 

The Soul of a returning warrior must go through a metamorphosis to return to a different world, to ascend from Hades, as is indicated in myth and teachings of the ancient teachings of many civilizations. To understand the angst of combat trauma, one must learn the old myths and folklore, and learn to listen to the shadow of the returning warrior. 

If one is to look at military suicides, one must stop at simple interdictions with mood or mind altering substances and go to the interpersonal healing touch of hands and souls. The honest feeling of care and concern given freely. One cannot help but feel in awe of those souls that maintain the watch at suicide hotlines, Those are the last touchstone for many warriors and their families. Not only are they compassionate human beings, they are also warriors in combat with the daemons at war for souls. 

(This writing is meant in no way to impugn any religious belief or practice.)"

In the Dungeon -- Laying Down the Burden after War and Letting It Go

More from the longtime Navy vet and former leader in the mythopoetic men's movement:

“We tend to call it the real war. The rest of it’s just the show biz war. The real war involves getting down there and killing people. And being killed yourself or just barely escaping it. It gives you attitudes about life and death that are unobtainable anywhere else.” -- Paul Russel, "The War" on PBS.

---

"He had 80 weight of Spanish iron

Between his breast bone and his knee

But Billie broke locks

And Billie broke bolts

And Billie broke all that he came nigh

Until he came to the dungeon door

And that he broke most manful lie."

                                    -- Old Ballad.

How can one be free, with 80 weight of “Spanish Iron” trauma between the breast bone and the knee? Out of the combat zone, out of danger, but not out of the trauma, but still have 80 weight of trauma between our breastbone and the knee, that one must carry. Is there a place one can store that “Spanish Iron"?

 Is there a place one can lay down the burden, perhaps just for a while? Just long enough to get some rest, sleep without dreams of horror, not jump from noise, trust someone to touch the body with compassion. Some place where understanding does not get in the way of rest. A place the body can move freely, not tense with expatiation or anticipation... 

If that weight is on the soul, how does one remove it, leave it behind for a while, remember where it is, trust it will stay there forever? We may have to back and check on it, a lot at first, but learn to trust it is in safekeeping. So we can continue on our path toward a new life, unburdened with “80 weight of Spanish Iron”.

There are old ways of leaving heavy burdens borne by warriors, returning from bloody encounters of enemies. There are ways other warriors and community can show a sacred place to store the burdens of war, guarded by ancient spirits of warriors past.

Each warrior has a choice of the manner in which to leave their burden. Some have been washed in lamb's blood, others blessed by a holy man or holy woman, Some, though not many have left burdens to be watched by Fairies and Unicorns. Others have sent their burden into a drum, or flute, instruments taken down from walls, held as one would hold a small child, playing with abandon.

According to ancient warriors, only a ritual or mystical path, will lead one to the right place. The soul of the warrior will know the place none other. Each soul knows the best path to take, though sometimes the body will resist, out of respect to the memories contained in the warriors' Spanish Iron .

Some bodies follow an unknown path, and find solace in a poor storage container. Sometimes these paths promise to be easy. They lead to containers of spirit smoke, and drink, and false intensity which is so familiar to the body, the voice of the Soul is muted.

The correct path for the warrior may also be his or her most difficult one. Many have words that describe this path. One spirit of courage left this saying for those who choose their path:

 “to be nobody but yourself in a world which is doing its best day and night to make you like everybody else means to fight the hardest battle which any human being can fight and never stop fighting.”

 “let it go-the

smashed word broken

open vow or

the oath cracked length

wise-let it go it

was sworn to

                     go

let them go-the

truthful liars and

the false fair friends

and the boths and

neithers-you must let them go they

were born

                to go

let all go-the

big small middling

tall bigger really

the biggest and all

things-let all go

dear

       so comes love”

 -- e.e. cummings, U.S. poet (1894 - 1962). 

Quotable Quotes -- Transformation and Metamorphosis for the Returning Warrior

"The soul of a returning warrior must go through a metamorphosis to return to a different world, to ascend from Hades, as is indicated in myth and teachings of the ancient teachings of many civilizations. To understand the angst of combat trauma, one must learn the old myths and folklore, and learn to listen to the shadow of the returning warrior." -- A concerned veteran.

Editor's note: "Metamorphosis" comes from Greek, by way of Latin -- to change one's form.

(For more on ritual and the returning warrior, please see our recent series, linked here.)

After Combat, Healing the Sin-Sick Warrior Soul with Ritual

Periodically we have the honor here of running someone else's writing/thinking with their permission. In this case, it's a longtime Navy vet who also served as a leader in the mythopoetic men's movement in the 80s and 90s, writing about warrior despair, suicide and the culturally healing power of ritual. This is the first of several pieces on the subject. Look for the others, which will appear shortly. Here goes:

"Perhaps only those who have been to the "Arena of the Gods" -- and have been capable, like the gods, of delivering death and destruction -- can understand the true costs of warfare on the soul.

Jonathan Shay, M.D., Ph.D. writes: 

“Acts of war generate a profound gulf between the combatant and the community he left behind. The veteran carries the taint of a killer, of blood pollution...that many cultures respond to with purification rituals. Our culture today denies the need for purification and provides none, even though in the past it has done so.... In the medieval Christian church, everyone who shed blood in war had to do penance. If you committed atrocities, you had to do more penance, but even if you wore a white hat and were a perfect model of proper conduct, you had to do penance. Most warrior societies, as well as many not dominated by warfare, have historically had communal rites of purification of the returning fighter after battle...” 

An Israeli psychiatrist comments:

"It's important to understand the long-term consequences of war and to minimize them," says Dr. Zahava Solomon, a professor of Psychiatric Epidemiology and Social Work and head of the Adler Research Center for Child Welfare And Protection in Israel. 

“While people tend to perceive war as only taking place on the battlefield," she says, " for many the effects linger long after the battle is over.” "War does not end for a considerable portion of these individuals," she continues, "and relatively high rates of combatants continue to suffer from post-traumatic stress syndrome (PTSD) [an anxiety disorder that can occur following the experience or witnessing of a traumatic life-threatening event]. They continue to experience the war in nightmares and flashbacks. We pretty much liken it to cancer of the soul," she said.

And finally, from a Christian leader's perspective:

 “The reality of war is that everyone gets wounded. Some wounds heal rapidly, but some last for a lifetime. The reality is that the wounds of heart, soul and spirit have a spiritual component that is not being adequately addressed. Despite the valiant efforts of many organizations and the commitment of billions of dollars to address these issues, there remains a serious gap – the faith gap.” -- Major General Robert F. Dees, US Army (Retired), Executive Director, Military Ministry, from his introduction to "The Combat Trauma Healing Manual: Christ-Centered Solutions for Combat Trauma," by Chris Adsit.

A recent article by Barbara Barrett covered the work done by a Defense Department task force "devoted to preventing suicide in the military." According to the article, the task force presented 76 recommendations in four primary areas, and additionally made 13 "foundational" recommendations "considered vital to developing a comprehensive Defense suicide prevention model." But none of these recommendations made any mention of the spirit or the soul, or more importantly, how to heal the souls of our returning warriors. Though our currency may say "In God We Trust," the military makes no acknowledgment of the soul of its warriors, and no provisions for their spiritual healing. 

(Ironically, though, it does send warriors off with ceremony. Troops go into battle often accompanied by a chaplain, priest, or other "holy" person, who invokes a "spirit" to bless them in their mission - which in its own way is usurping their opponents' right to life and death.)  

We lament as a nation that so many of our warriors are committing suicide. But at the same time, we ignore the need for any healing rituals for our returning warriors. There is no balm in Gilead for the sin-sick souls. If we can't look to VA or DOD for methods that embrace ritual, perhaps we need to take a look at indigenous peoples in other cultures, or even a few years back in our own.

In the 80s and 90s in this country, men came together in “mythopoetic gatherings,” doing ritual to help veterans and others heal the soul wounds of the Vietnam war. A sacred space was established and the men used storytelling, poetry, music and movement to explore their path to healing. These gatherings were led by Robert Bly, James Hillman, Michael Meade and others, and I was privileged to be a part of them as an elder.

In some of the gatherings, Meade would tell what was known as a "dilemma story." The men would then choose sides and state their case for the correctness of their positions in an attempt to resolve the dilemma.  The ebb and flow of discussion often became heated. The ritual of the dilemma story became a container to hold the anger and angst of the discussion. Even though there was anger, sadness and confusion, the dilemma story remained in the Sacred Space, a container within a container, which guaranteed safety.

According to Meade, when a large group of men gather, there are two questions that reside in the limbic brain (commonly called the lizard brain). “Is someone going to be killed?” and “Is that someone me?” When the lizard brain is able to resolve these questions in the affirmative, the man could begin to participate in the gathering.

In 1992, Native American medicine men traveled from East coast tribes, Midwest tribes and Western tribes to San Francisco to hold a gathering of men. Those men, many of them veterans, participated in ritual alongside these medicine men, using rituals the medicine men brought from their tribal cultures. During this time as well, there were stories of an increasing number of veterans committing suicide. 

The returning warriors from the Vietnam war had fought in combat as a tribe, but then were returned "unceremoniously" stateside, rotated out individually, when their service was ended or when they were discharged -- to no fanfare whatsoever, and to a land that had become different since they left. Little if any attention was paid toward establishing a ceremony, much less a ritual, to help the souls of these warriors, women and men. And the results of this neglectful in-action are still evident in our society. The Vietnam war is a gaping wound in our collective consciousness, and the residual guilt has become one of the reasons why returning OIF/OEF warriors are being welcomed slightly more warmly than their Vietnam war fathers were.

One of the prominent medicine men who helped to establish sacred space and ritualize a healing process was Malidoma Somé. In his book, “Ritual: Power, Healing and Community,” he recounts a ritual done specifically for healing the internal wounds of Vietnam.

As a participant in that ritual, I recently revisited Malidoma’s writings, and the grief that was expressed. While as one of the Elders of the Gathering, I can say that is was one of the most powerful moments in my life. It is my feeling now, that those of us in a leadership role, did not realize the depth of grief men had about the war, and it transferred into the ritual. I believe every man in that gathering went away with a deep knowledge of how powerful ritual is."

Quotable Quotes -- Sarah Haley, M.S.W., on Combat's Effect on the Veteran

"Combat veterans may play down or embellish their 'war stories,' but initially their reports should be taken at face value. The only report that should not be accepted at face value, although one may choose not to challenge it initially, is the patient's report that combat in Vietnam had no effect on him." -- Sarah Haley, M.S.W., "When the Patient Reports Atrocities: Specific Treatment Considerations of the Vietnam Veteran," published in Archives of General Psychiatry, Vol. 30, Feb. 1974.

Quotable Quotes -- Carl Jung on Integration

"Would you rather be whole or good?" -- Carl Jung, Swiss psychotherapist and author.

Self-Image in Veterans with PTSD after Combat: Same as Before, or Different?

We wrote an article on this site more than a year ago that was read very heavily, entitled "A Combat Veteran Asks Himself, Who Am I, on the Inside?" linked here. His response at the time to the question, "What's your greatest problem right now?" was very direct, raw and hard to hear: "I'm an exploding ball of hate," he said.

As tough as that "conversation" was to absorb, it might be time for a rematch, but on a slightly different topic. How does -- or does it actually -- a combat veteran with PTSD's self-image change, after combat, from what it was before combat? (Or before and after PTSD. Really, either question would produce interesting results.) 

It does seem that even in the literature, very little attention is paid to how servicemembers and veterans view themselves after combat. What was their self-image before -- and then did it change, or HOW did it change, after combat?

(By way of definition, "self-image" is different from "self-esteem." Self-image is basically how you look at yourself, pros and cons -- your sense of yourself and who you "are." It can be as simple as, I'm so tall and weigh such and such; I'm a good student or I'm good at sports; I'm social or I'm a loner, etc. Self-esteem has more to do with how highly you regard yourself (e.g., belief in yourself and/or self-confidence). It's also not the same as "self-worth," which is the value with which we regard ourselves. It's more purely "just"" how we see ourselves: bad, good or indifferent.)

Our self-image is who we see ourselves are -- how we would describe ourselves to others. "I'm fundamentally a good person." "I'm fun to be around." "I'm responsible." Ways we describe ourselves to differentiate ourselves from others. 

The illustration at left may help. It's a drawing a combat veteran with PTSD made based on an instruction to "draw himself as he saw himself, right now." Meaning, at this point in his life, not necessarily right after combat. He drew what amounts to a split personality, a "bad" and a "good" self, about equally weighted. He saw himself as both, at the same time. 

(Example from non-combat-related psychology, to further define what self-image is, by taking a look at what distorted self-image is: When an anorexic woman looks at herself in the mirror and "sees" herself as overweight, though she is underweight, we say that she has a "distorted" self-image. In other words, her correct self-image would be accurately that she is too thin. Instead, she projects onto the accurate image the distorted image she carries of herself, and she is able to see herself, wrongly, as not thin enough.)

I'm torn about including several quotes about war and the warrior, to get the discussion going...but I don't want to tip the scales one way or the other here. It's probably best to just think of the actual question: How did I view myself before combat/PTSD, and how do I view myself now, after combat/PTSD -- and have those two views of myself changed?

Quotable Quotes -- Suffering from What We Keep Silent within Us

"What is the source of our first suffering?" wrote philosopher Gaston Bachelard. "It lies in the fact that we hesitated to speak. It was born in the moment when we accumulated silent things within us."

(With thanks to Rob Breszny for highlighting a really cool quote.)

Embracing the Warrior Spirit: Native Americans and Storytelling for Healing

Did you know that "large numbers of Native Americans enlist for military service and represent the highest per capita enlistment of any ethnic group in the United States?" It's true. 

According to the U.S. Department of Health and Human Service's Administration for Native Americans, "Tribes view service, sacrifice, and courage as important values and part of an individual’s journey to becoming a leader, protector, and agent of change for his/her family or tribe."

I'd heard through the grapevine that a national museum devoted to Native American culture had a special exhibit about warrior veterans telling their stories. The Smithsonian exhibit, "Native Words, Native Warriors," is still on tour, through 2011. (In January through July of 2011, it will be at the National Museum of the Marine Corps.) Find out more about the exhibit, here.

In the meantime, I've uncovered some good resources about Native American warriors as veterans, and the extent to which their culture celebrates them and welcomes them home.

From the National Museum of the American Indian (part of the Smithsonian), a "workbook" online called "Coming Home: Strength through Culture."

From a segment entitled, "Healing after the War": 

"According to American Indian traditional beliefs, war affects a soldier’s well being, and makes it difficult for him to live in the everyday world. For American Indians, returning home means returning to a place — a land, a community, a family, and a culture — that you are part of, a place that you have a special relationship with. Participating in war interferes with your ability to be part of this place. It upsets the balance of life. This is why American Indian cultures have special ceremonies to help bring the soldier’s life back into balance — to make it possible for the soldier to once again live in peace and to be physically, spiritually, emotionally, and mentally healthy."

From a segment entitled, "Giving Honor to Veterans":

"American Indian communities remember their veterans’ sacrifices forever. Veterans are always respected and honored. Sometimes they are remembered in special songs that are sung in their honor. Native people often go to veterans for advice because they have strong mental abilities as a result of their many experiences. Depending on the community, veterans are given special prominence at different kinds of tribal events. For example, at powwows veterans always lead the grand entry of dancers. They carry the American Indian Eagle Staff, the flag of the United States, their tribal flag, and other important banners. Veterans are recognized and honored on special occasions with ceremonies and dances that relate their sacrifices to the community. For example, the Comanche Gourd Dance honors veterans. Sometimes a family member or a friend might hold a special dance or ceremony to honor a veteran. These are the lasting traditions that show respect to veterans for what they have done for the people."

In another section it describes how a Native American Marine Corps veteran of World War II, Navajo Code Talker Carl Gorman, experienced a ceremony upon returning home that helped allow him to put the past behind him and move on with his life:

"After the war, Carl Gorman returned home to Arizona for a short time. Even though he had been raised as a Christian, he talked about how the traditional Navajo ceremonies for warriors became important to him: "I didn't have a ceremony when I came home," he said. "I didn't quite believe in it anymore. A medicine man that was an old friend suggested that I have one, but I didn't have the money to pay him to perform it. He agreed to do a one-night sing over me for free. I participated in the sing and felt a great weight leave my mind and body. I felt very rested afterwards. I realized then that I needed to make peace with what I had experienced during the war." (Navajo Weapon by Sally McClain, 2001)

And from the U.S. Department of Health and Human Service's Administration for Native Americans, an entire resource guide online about storytelling for Native American veterans. Segments include:  

• The healing power of stories;
• Tips on using storytelling for healing (with facilitation questions);
• Native American service in the U.S. military;
• Resources for Native veterans; and a
• Native American Veterans: Storytelling for Healing DVD that can be ordered, here.

We'll be developing this segment more in the weeks and months ahead, but for now this should provide some useful resources to start thinking about Native Americans and ceremony -- particularly storytelling -- for healing in community.

Editor's note: The painting at top is "First Furlough," by Native American artist Quincy Tahoma.

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.

Transpersonal Psychology, PTSD and Spirituality: A Therapeutic Approach

From a brochure about a now-past seminar given by Dr. Marius Koga, a look at the transpersonal therapeutic approach to PTSD and spirituality. I shared his comments with a friend, an Iraq veteran with PTSD, and she affirmed how completely his remarks fit with her impression of her situation. In her words: "He explained the exact reasons why I thought God hated me and was punishing me and why I turned to drugs. I always thought I was the only one who thought that way, and so it was nice to hear that from him."

In Dr. Koga's words:

"It is common for PTSD clients to seek religion and spirituality as part of their healing process. However, most psychotherapies are focused on the ego and personality constructs, while religious or spiritual considerations have been traditionally ignored. It is only in recent years that a therapeutic modality known as “transpersonal psychology “ has emerged which reintegrates psychology and the personality with the soul. The client is encouraged to actively maintain his/her individual self-concept in order to participate actively in his/her recovery. Concurrently, the client is guided to incorporate his/her individuality into the larger plane of the collective identity (including family, community, and religious and spiritual helping resources) to undergo personal transformation and growth. Our military especially, coming home from Afghanistan and Iraq, are seeking answers to painful questions about the gruesome realities of warfare, the value of personal faith, and the worth of human life itself. Many find that their faith in a God that is always available to respond to one’s personal tragedy can be utterly shattered. Soldiers and others who are unable to resolve such challenges find themselves lost in a spiritual flatland, which can take many nightmarish forms. They may feel abandoned by God, they reject or curse God, and they feel that God was powerless to help or even non-existent. They may even rationalize that their body mutilation, PTSD, or Traumatic Brain Injury was deserved punishment from God, or, in extreme, believe that their eternal damnation is God’s ultimate punishment. All too often, they feel they have no recourse but to numb their pain with drugs and alcohol. Their families suffer with them. By providing the opportunity for introspection about the meaning of trauma for the client’s life, transpersonal psychology helps soldiers, their families and friends, and others who have experienced PTSD and other traumatic events, to renegotiate the passive and silent state of the sick role and regain a sense of journeying, integrating, and healing." Marius Koga, MD, MPH, is a Diplomate of the American Academy of Experts in Traumatic Stress and an Associate Clinical Professor of Public Health at UC Davis School of Medicine. He is also a Professor at the Institute of Transpersonal Psychology in Palo Alto where he is directing a pilot center for trauma studies. Dr. Koga has developed courses in mental health and spirituality for Chapman University and has been the Course Director for Transcultural Mental Health and Spirituality at Tulane Medical School. A former political prisoner, torture survivor, and refugee from communist Romania, Dr. Koga’s interest is on PTSD in refugee populations and US military who are Afghan and Iraq war veterans. He has given numerous presentations, and workshops on spiritual dimensions of trauma in US and Europe.

Patrick Marius Koga, M.D., M.P.H.

Dr. Patrick Marius Koga is an Associate Clinical Professor of International Health at UCD School of Medicine, Dept. of Public Health and the President of the Veteran, Immigrant, & Trauma Institute of Sacramento (VIRTIS ). Dr. Koga was trained in Romania and at Tulane and his work in the past 20 years has focused on cultural and spiritual modulators of posttraumatic stress disorder due to armed conflict, complex emergencies, forced displacement, and immigration. His current international research work includes a cross-cultural psychometric evaluation of the reliability and validity of the Civilian Version of the Mississippi Scale for Combat-Related PTSD in the present Kyrgyz-Uzbek conflict in Kyrgyzstan, and a resilience study of the Iranian refugees in Turkey. At UC Davis Center for Healthcare Policy and Research, Dr. Koga is focused on needs assessments and epidemiological surveys of the psychosocial reintegration of OIF/OEF veterans with PTSD and of the disparity gap in mental health services available to Eastern European, Afghan, and Iranian refugees in the Greater Sacramento Metropolitan Area.

More about Dr. Koga, from his bio at the Institute of Transpersonal Psychology in Palo Alto, CA:

Patrick Marius Koga, MD, MPH

• MD, University of Timisoara, Faculty of Medicine, Romania, 1984. Specialization: Adult Psychiatry, 1988 
• MPH, International Health & Development, specialization in Cross-Cultural Mental Health & Medical Anthropology, Tulane School of Public Health & Tropical Medicine in New Orleans, Louisiana, 1999
• Board certified and Diplomate of American Academy of Experts in Traumatic Stress, 2006.

Marius is a Professor at the Institute of Transpersonal Psychology. A psychiatrist and a former political prisoner, torture survivor, and refugee from communist Romania, Marius’ professional interest focuses on the cultural, religious, and spiritual dimensions of PTSD in war refugees from Eastern Europe and the Middle East who have resettled in California. His spiritual path unfolds out of over two decades of practice of Advaita Vedanta, Zen Buddhism, martial arts (5th degree black belt in Karate-Do, 4th degree black belt in Judo and Jujutsu) and out of several years of monastic living as an initiated disciple of the Ramakrishna Order of India.

For the past ten years Marius has also been promoting cultural, religious, and spiritual competencies in medical student education in various capacities such as Dean of International Medicine & Development, Cambridge Overseas Medical Training Programme, Cambridge, UK, Course Director for Transcultural Mental Health and Spirituality at Tulane School of Medicine in New Orleans, and currently as an Associate Clinical Professor of International Health at the UC Davis School of Medicine. 

Marius believes that in an increasingly globalized world, ridden with disparities, conflicts, and violence, ITP has a unique opportunity to partner its expertise and leadership in transpersonal psychology with public health, medicine, government, policy makers, donors, educators, and factors of social change to reduce suffering and mental illness, and to promote individual and collective growth and well-being. 

Editor's note: For more on Dr. Koga's work with VIRTIS, which also focuses on veterans, click here.

One Very Easy, Doable Meditation Exercise: Soft-Belly Breathing

There's a very simple, straight-forward meditation that those of us who attended the "Healing the Troops" program as part of the Center for Mind-Body Medicine's practitioner training and advanced training sessions learned. It's called "Soft Belly Breathing," and in a few minutes you can master it. All meditation helps with stress reduction, so whether you want to pursue learning meditation more thoroughly as a practice, or whether you just want a simple tool you can use to reduce anxiety and stress, this meditation is worth trying...if only to see how simple it is. The instructions are linked here. 

Editor's note: The Center for Mind-Body Medicine's "Healing the Troops" program is linked here.

Busting Out of the Bunker at Last...Made to Be Social Beings, We Die in Isolation

Following up on the "Bunker" post of the other day, about the protective isolation of the bunker for the combat vet with PTSD, it seemed high time to write "the rest of the story," about what the subject of "Eyewitness to Combat" sees now about the bunker mentality, and how and whether it's possible ever to overcome it. (So here's a picture of his bunker in Vietnam, to illustrate it.)

What follows are direct remarks from the vet, from a few weeks ago, about this exact topic. I'll add a few words where I have to, to keep the flow going, but the thoughts and the wording are his:

On the problem of the bunker:

"We are made to be social beings. We die in isolation. And that’s why when we withdraw into a hole, we are withdrawing into a grave -– just one that isn’t covered up yet.

With me I wanted to get out and I wanted to be with people. I wanted to enjoy my surroundings. I wanted to go to parties. I really did. I wanted to do that. But I had this deep ingrained fear that if I was around too many people, too long I would talk too much, say too much, and they would figure out who I really was, and not like me. And every place I went, it seemed that I was always pissing somebody off. Making somebody angry at me, and that rejection was more than I could handle. So it was easier for me to decide that I just hate everybody, and don’t want anybody around me but animals. And crawl back in my bunker, and hide. But then I would die there. Because what I really wanted to do was go back and be with people who cared about me, somebody who would love and accept me and who I could have fun with. Every time that something would draw me out of the bunker, I would do something stupid, have my PTSD moment, and have everyone around me direct me back to my hole.

We are supposed to be social; we are supposed to belong. For those of us who are Marines, we belong to one another, we belong to the Corps, we belong to the men who came before us, and the men who will come after us. We belong to something bigger than ourselves, and that’s what makes us Marines for life. This is not unique to the Marine Corps however; for we all have an innate, ingrained need to belong to something bigger than ourselves; to something that accepts our faults, that builds upon our good deeds, good qualities, that involves people. Be it religion, be it Indian culture, be it motorcycle clubs, be it national associations. We all have a need to belong. The problem arises in our isolation creating a void that is filled with the wrong associations/influences. For we WILL belong to something, good or bad; harmful or helpful. Churches prey on that need to belong. (We've both had bad experiences with churches, so we give the secret fist-bump to each other at this point.)  

Now, all veterans belong to one another. Their bond is in their service, that transcends the specific branches and time.

People go back in the bunker to heal, to hide from being hurt; or to hide from hurting others. They stay there and depression sets in; and they cannot get out by themselves. Someone has to physically go in and bring them out, just like (my guy friend, a Navy seal) did with me; just like you did with me.

He encouraged me; he listened to me; he understood me; he had been where I was. He said, "I don’t know how to help you; I love you; I care for you. But I know if you don’t want to do something, you wouldn’t do it. So what I want to do is share a dream with you that I’ve had since I got out of the Navy. Reasonable or not. But I need your help to do this. And when you feel like you can come out, call me. And he left a stack of papers about a foot high. I spent a week staring at them, and it interrupted my depression! And he'd put one of the most interesting articles on the very top. He had made me a part of what he was doing. I just wanted to be and do something that people wouldn’t hate me for; wouldn’t criticize me for. Because the aftereffect of ‘Nam was so bad, because we gave so much; and received so little. And we had done MORE than we could do over there. I just wanted to do something where people didn’t hate me."

(That Navy Seal friend is someone he'd previously helped himself; stood up for him so he wouldn't go to prison for his third arrest.) "I’m the one who walked in there and walked him out of his depression. Blood brothers, combat vets. He was a friend."

I mention the name of another friend of his, who he served with in Vietnam, who was injured on his same kill day/alive day, and who used to call him up to see if they could go be mercenaries in South America together. It all sounded like an elaborate, not so cleverly-disguised death wish. Very Butch Cassidy and the Sundance Kid. When I first knew him, there was a real pull to that. Now, further down the healing path, not so much. I ask him about that guy. A lot more reasonable now, he reflects, though he knows the allure, "That’s not the way to go; it’s not the way to make you happy. It’s just another way to get yourself killed. Problem is, sometimes it works; sometimes it doesn’t."

How much time has he spent in his bunker over the years?

"Years. Probably spent 20% of my life in a bunker, hiding, wanting to die, not having the nerve to shoot myself; hoping that the diseases and the meds would finally do me in.

I just didn’t know how to be happy. There was no joy in my life. There’s no reason to live. My family used to ask me, 'How can you look at what you’ve done, and tell me that you have no purpose in life? You don’t understand.' Problem was, I didn’t understand. I did not know why I didn’t have the capacity to have joy, to love anyone or to have fun. I just know I’d tried religion, I’d tried everything the VA could throw at me, in-house therapy, group therapy, self-help, medication, I tried working myself to death, I tried getting rich, I tried doing stupid things to harm myself (go back into combat situations), where maybe if I revisited it; I tried going to The Wall; and something would just not allow to want to live, or be happy, or enjoy being in my life. I couldn’t look around and see the flowers, let alone smell them. All the roses in my life were wilted; not because they were, but because of my vision of them was wilted."

My self-esteem, my sense of self-worth, my self-pity, and sense of total uselessness overwhelmed everything else. No matter how hard I tried, everything I touched was going to turn to shit. I heard it from my dad, and then I began to believe it was a generational curse. A curse is only a curse if you decide it’s going to be a curse. I understand the Universe. I understand me and the necessity of believing in yourself and believing in others. Politically the world may seem like a shitty place; but it’s always seemed like a shitty place. World’s always been a bad place, and it’s always been full of good people, and bad ones. And we have the right to choose the ones that we’re with. And we have the right to choose whether we’re going to be happy or sad, or doing something that’s worthwhile or not. Money is essential but money’s not the end. Money is only the means to an end, and yet we lose that perspective.

I’m no longer willing to let other people and their misery dictate whether I’m happy or sad. It’s up to them to walk through that door. Sick and tired of being sick and tired, that they’d rather die than continue on. Then they’ll walk through that door and want help and accept it. As long as they have one ability to resist, they will."

We talk about two guys we know, combat vets from different eras -- Gulf War and Vietnam. Neither one seems to really "get" where they need to go with this recovery stuff. When they're doing well, they're broadcasting their healing to the world; when they're down, they're completely off the grid, hospitalized for suicidal ideation and attempts. My mind reels from this. I wish when they were doing better they'd put more time into actually finding a way out; not just broadcasting it, so their lows wouldn't have to be so low, since their highs seem...unnaturally, or at least unsustainably high. It reminds me of a friend who says, about people who complain but do not attempt to solve, "It must not be bad enough for them yet." 

He weighs in: "They haven’t lost ALL their resistance. One of two things happen when people reach that level: they either commit suicide, or they get help. What makes the difference? A friend. A friend who can walk in under that and take them by the hand and walk them out. Just like in combat, if you get wounded, you can’t walk yourself out. Someone to grab you by the nape of your neck and drag your ass out of there. You can’t do it by yourself."

He continues: "If vets who have been healed don’t go and get vets who haven’t, then no one else will. In this situation the Marine Corps phrase of “we take care of our own” is literal; if we don’t, no one else will: not the vet’s family, not his relatives; no one. Only a vet can walk out a vet."

But yet, I helped you...and I'm not a vet. But you came looking for the help, too. He replies, "But you were a friend, a sincere, concerned friend. A friend like that, another vet; not the government...."

Editor's note: The photo above is of the "Eyewitness to Combat" Marine with two of his buddies, very Three Musketeer-y, circa 1966 or 1967.

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

Victimology -- The Temptation to Stay Stuck

Every behavior has a potential payoff, or we wouldn't engage in it. This is particularly applicable to people who have suffered for years, not months, with their situation, and where the groove has most definitely become a rut.The subject of "Eyewitness to Combat" talks about how being a "f*cked-up Vietnam vet" was a mask he could wear at times -- not that those times were always under his control -- in order to get other people to back off or keep their distance. Carolyn Myss, author of the New Age classic, "Why People Don't Heal and How They Can," talks about how attached people can get to their "wounds" -- to the point that they introduce them almost immediately into conversations with strangers, or overly bond with their friends and companions over them, with the ultimate experience being that it becomes very difficult for them to move on. "Love me, love my wounds" seems to be an unspoken demand of those too attached to their victim-hood.

This isn't to say that everyone who suffers becomes a victim -- nothing of the sort. Or that everyone who flaunts their wounds, so to speak, is doing so intentionally. But for any of us who have suffered, it's important to examine the unconscious temptations behind victim-hood, lest we accidentally fall into the quicksand and get stuck. 

Bev Smallwood, Ph.D., has a book called, "This Wasn't Supposed to Happen to Me: 10 Make-or-Break Choices When Life Steals Your Dreams and Rocks Your World." She talks about how different survivors of the same experience (say, Hurricane Katrina) might all suffer, but won't all adopt the same attitudes of victim, surviver or thriver. In a chapter entitled, "Poor me," she mentions several of the potential payoffs for over-identifying with the "victim" point of view: "'Victims' don't have to be responsible for their attitudes and actions;" "'Victims' get others' sympathy and support...for a while;" and "'Victims' feel self-righteous and justified." There's even a short quiz: "After all I've been through, I've learned that you just can't trust people;" "I admit that I have a tendency to blame others when things go wrong in my life;" "I often have pity parties;" "People have told me that I complain too much;" and "I feel angry when people try to get me to make personal changes and begin to move on. They just don't understand."

Contrast those self-defeating sentiments with those in the "Survivor's Pledge," which we wrote about several years ago, here: 

The Survivor's Pledge:

I will not be a victim.

I will rise above.

I will give back.

I will change the world.

There's also an ultra-fabulous chart comparing and contrasting the states of "victim," "survivor," and "thriver" -- with "thriver" being obviously the most desirable state, linked here. A wonderful OIF vet, with MST and PTSD, shared it with me a few months ago, and it's a keeper. When I shared it with the subject of "Eyewitness to Combat," another overcomer, he loved it too, and said, "PTSD is on the left, surviving is in the middle, and healing is on the right." As someone who's experienced all three states, that's how he chose to describe them... Not everyone is at the same place in their healing trajectory, but at the very least, it could serve as some inspiration for what improvement would look like, and how to get there...incrementally.

Quotable Quotes -- The Dalai Lama on Life Purpose and Satisfaction

That Dalai Lama -- he's amazing! If "personal outlook" were a software package, I'd ask for the Dalai Lama upgrade: because I like how he thinks. So compassionate and kind and reasonable, but not afraid of science. A fascinating, compelling combination. 

Some of his great quotes lately:

"We can't be useful to ourselves unless we're useful to others. Whether we like it or not, we're all connected, and it is unthinkable to be happy all by oneself. Anyone concerned only with his own well-being will suffer eventually. Anyone concerned with the well-being of others takes care of himself without even thinking about it. Even if we decide to remain selfish, let us be intelligently selfish -- let us help others." -- The Dalai Lama.

And another:

"Once you shift your focus from yourself to others and extend your concern to others, this will have the immediate effect of opening up your life and helping you to reach out. The practice of cultivating altruism has a beneficial effect not only from a religious point of view but also from a mundane point of view; not only for long-term spiritual development but even in terms of immediate rewards."

And another:

"The world's major religious traditions all give the development of compassion a key role. Because it is both the source and the result of patience, tolerance, forgiveness and all good qualities, its importance is felt to extend from the beginning to the end of spiritual practice. Even without a religious perspective, love and compassion are clearly of fundamental importance to us all."

And another:

"Satisfaction is characterized by inner peace. It arises from generosity, honesty and what I call ethical conduct, a way of behaving that respects others' rights to be happy."

---

Bringing this all back around to veterans with combat-based PTSD and their families, think how crucial what he's expressing are. Eighteen veterans a day kill themselves -- a shocking statistic -- and we seem to be at the beginning, not the middle or the end -- of that particular trend. Army and Marine suicides -- they see the bulk of the action, after all, in these wars -- are both up, despite the "best of intentions" on the part of the services to bring down the numbers. Pep talks on prevention and more prescriptions aren't solving the problem, nor are they likely to. Because, as one combat vet with PTSD said, "pep talks are hard to take seriously because that is for the normal life of a normal person, not for a veteran contemplating suicide because of combat trauma." True, that.

It's coming up on two years, shortly, of my first phone conversation with the combat vet, a Vietnam vet, Marine, with 40 years(!) of severe, chronic PTSD, which plagued his life, despite "all the best" of what the VA threw at him (his words, not mine), including an inpatient, residential PTSD program that was cutting-edge at the time. (Would it surprise you to know that most of his classmates in that program, according to him, are now dead, also from suicide?) After our first conversation, which seemed relatively pleasant and positive, he followed up with an email about wanting to drink and put a gun in his mouth to end it all, because he was sure God hated him; after all, he himself did. Sparkly stuff. Lots of unicorns and rainbows and fluffy clouds there...not one bit.

Of course, the end of his story is quite a bit more positive, mostly because it didn't end. He's made the transition from bleak, grim and grisly to mostly inspirational and awesome. And it took a while, a solid footing, a hand reaching across the abyss and pulling him up and out -- a hand which he importantly grabbed (it doesn't work if you don't ;-). It took some specific therapeutic treatments to help remove trauma from the body. We tried a few, intentionally, and they worked; there are others that might as well. And it took a huge motivation on his part to reach out -- however ugly his mess at the time -- to get some help and be real about where he was really at. For years, decades really, he'd been the one other vets' wives called to take the gun out of the mouths of their husbands. Now he finally had some hope to offer others. But it took commitment on his part, believing that the hope was out there, and going after it with all he had. Not always pretty, but effective :-)

(He's the veteran in the "Eyewitness to Combat" series on the site. Here are two items about his turnaround, linked here and here. The second is in his own words.)

Anyway, the upshot of the whole experience is wanting to build a program to bring other combat veterans with PTSD through, and help their families as well, who are often left holding the bag (of misery) but not really getting the help they need either. Combat veterans with PTSD have often lost their life purpose completely, and as we've been talking about lately, purpose is key.

The "eyewitness to combat" veteran, described above -- he and I share a purpose. It's helping others overcome. It's possible. And as the Dalai Lama says, that's being intelligently selfish -- taking care of those 18 vets a day who'll be killing themselves, BEFORE it happens. So it doesn't HAVE to happen. That's the best use that you and I could put our time and energy and compassion to. Please join in helping others so that they don't have to suffer so intensely, when there is a way out.

Editor's Note: A California-based psychology grad student is doing a Ph.D. thesis on Iraq vets with PTSD and life purpose. If you qualify based on the above criteria, he'd like to talk to you, and will pay you $50 for your efforts if you participate. Here's the link to his study. His brother is a combat vet. 

Additionally, you can "follow" the Dalai Lama on Twitter -- @DalaiLama -- and you can follow us on Twitter as well @HealingPTSD.

Prevention Talk and Prescriptions Apparently Not Doing It: Army and Marine Suicides Both Up

"The grand essentials of happiness," Allan Chalmers wrote, "are something to do, something to love, and something to hope for." Those words echoed in my mind yesterday when I met a remarkable woman vet in Seattle, who ten years ago was homeless, suffering from MST and PTSD. (Today she's a vital, contributing member of her community, solving problems for herself and other veterans in need, on a large scale.) 

We were talking about suicide prevention, a cause close to her heart, because she'd lost a daughter to suicide, and recently a friend as well (Orrin McClellan, who we wrote about recently on this site.) We were talking about suicide, and how Army and Marine numbers are still up, despite prevention strategies. She said, pointedly, that she'd learned that veterans (and others) who are struggling with suicide need "three things" in their lives to keep from killing themselves. What they need are: "a reason to live, a way to live, and a purpose to live for."

Salon magazine had an excellent but gut-wrenching article earlier this week by Mark Benjamin called "A Predictable Suicide at Camp Lejeune," subtitled, "A doctor warned that mental health care for violent, disturbed Marines was inadequate. Sgt. Tom Bagosy proved it." The story profiled the violent death of Marine Sgt. Tom Bagosy, 25, on the way out of the Deployment Health Center. (Bagosy leaves a wife and two children.) Less than a year ago, Salon had run another article by Mark Benjamin about a Marine Corps psychiatrist, Dr. Kernan Manion, and his specific, whistle-blowing warnings about the inadequacy of mental health care at Camp Lejeune -- warnings he took all the way to the president, and seemingly for which he was fired a few days after voicing them. (Here's the link to that earlier article, including his warnings.)

Marines initiated a new suicide prevention program last year; but suicides have only increased. They lead the services at this point. Army numbers are up as well. According to a report released Thursday, and carried on CNN, 32 soldiers killed themselves in June, "the highest number in a single month" since Vietnam. Twenty-one of of the soldiers were active duty, 11 were inactive Guard or Reserve; and seven of them killed themselves while deployed. A quote from the article, "Army officials admit they still haven't answered the question of why troops are committing suicide at a record rate."

While Marines sometimes mock the Army's slogan of an "Army of One" -- preferring instead to focus on the group -- the reality is, both branches are seeing heavy combat and neither one is excelling at helping troops not commit suicide. New programs get trotted out, new initiatives, new videos. But none of them are getting the job done: not alone, not together. Troubled troops and veterans are simply not listening; or not hearing what they need to hear. And what would that be?

Well, Mass. General Hospital is having their second annual conference right now on the "Complexities and Challenges of PTSD and TBI," and they're doing a great job "Tweeting" the speakers' points in real time. Here are a few excerpts of note, starting with a crucial one: "Only 30% of troops self-identify as needing help before committing suicide -- despite all the proactive intervention points." And again: Only 42% of troops who screened positive for mental health problem actually sought help from doc or spiritual advisor." PTSD is initially difficult to distinguish in troops because upon their return home, "initial relief and euphoria" at being back can mask it. But over time,"After 8-10 weeks and adjusting to a different life schedule at home, symptoms start to present."

This fits right in with the stories you hear from people coming back, that they don't want to talk about it or think about it (PTSD); they just want to get on with their lives, and fit right back in to where they were before. It's later on, when this adjustment doesn't work, that things get more stressful. High unemployment can't help: veterans' unemployment is significantly higher, in the recession, even that the national average. And troops have gone from being highly focused on the battlefield and engaged in their warrior purpose to losing that and perhaps not being able to replace it immediately with another. They've also gone from a high level of camaraderie with their buddies often to being quite geographically separated from those they were close to when deployed. Marriages and family life can be rocky as well. The relationship they were dying to get back to on the battlefield may have evaporated by the time they got home; or not make the adjustment intact. Again from the MGH conference: "78% of marriages end in divorce for first-time deployment troops."

Against all these backdrops of difficulty -- and an awareness that the "gold standard" of treatment is still talk therapy and psychopharmaceuticals -- the problem persists, compounded by sleeping pills that can be dangerous, and the ever-present self-medication strategies of alcohol and street drugs. It's hard to get the formula right for the correct medication(s) at the correct dosage(s), and until that happens, veterans frequently talk about feeling numb, in a stupor, not feeling like themselves, etc. Vets don't necessarily want to talk about what they've been through -- except perhaps with one another, and even then, not that much -- and ignorant questioning about how many people they've killed while they were over there, etc., just exacerbates the problem. So enough of the bad news...of which there is plenty...what can vets possibly do to increase their chances of surviving and adjusting? Because I highly doubt it's gonna be another prevention video or poster that does the trick, however well-meaning.

If everyone wants an easy answer, maybe they won't like this. But it seems to be that it's time to return to replacing one purpose (warrior) with another (warrior on the homefront), and putting some time and thought, effort and resources into what that will be. One veteran who made the transition from serving to the fire department, felt he literally replaced his one purpose, and one set of buddies with another; and that "substitution of purpose," as it were, was what helped him survive. But not every vet will be so lucky, or have or make that opportunity. 

If we take a look back at the Chalmers quote that opened this discussion, what are the three "grand essentials" for happiness (i.e., well-adjustment) that he cites? Something to do, love and hope for. And what are the three things that help a vet prevent suicide, according to the suicide counselor vet? Three very similar things: a reason to live, a way to live, and a purpose to live for. Veterans are warriors...and cast aside from their purpose, without an effective way to replace that immediately, it's possible they flounder. As a society, as those who "support" our troops -- whether professionally or personally -- what can we do to make sure that they have all three? With a little reflection, we can see where they had them in combat. Something to do (be a warrior); something to love (family, country, buddies, the mission); and something to hope for (winning; getting back home alive; reuniting with family and friends; keeping your buddies alive). What I suspect, sadly, is that from those adrenaline-charged heights, life on the home front, potentially unemployed, over-medicated, and disconnected from family and friends, there can become a time when there's not enough "reason" to live; there's not enough way to live; and there's definitely a loss of purpose to live for.

A better use of resources than more videos, etc., though would be: focusing on what would it take to give veterans their purpose back? And not entirely how could be do it for them, but how could they join in that mission themselves? Every veteran affects the lives of 50 other people, minimum; so whatever happens with them back on the home front is a ripple effect. Let's focus some energy on the topic of continuing life with a purpose; versus watching on with sadness and despair the continuing tragedy of young vets (and older) taking their own lives. They've given too much; and they deserve so much better. So while pep talks on prevention and prescription pharmaceuticals don't seem to be doing the total job when it comes to suicide prevention, maybe it's time to bring back talk about purpose -- and how to continue that successfully, after the deployment is over and the uniform is hung up for the time being.

In a related side note, apparently mental health plummets when distressed individuals can't "do" to solve their situations with personal effort. There's been talk in the news lately about mental health issues soaring in the Gulf states after the BP eco-disaster, and that money needs to be set aside to help with those; but in that, there's also discussion of what happened after Hurricane Katrina. Apparently, after the hurricane hit, those affected started immediately to do what they could to restore their lives. (Think of all the news footage we've seen of residents after large-scale disasters, sawing up downed trees, hauling lumber to shore up makeshift housing, etc.) What's now surfacing anecdotally are stories about while this busy-ness after the disaster was therapeutic for people -- helped them to get their minds off the tragedy by putting themselves back to work -- when FEMA came through and made everything grind to a halt while they inventoried the situation -- people's grief and despair rose up in waves, with nothing to "do" to distract them.

Much is made of the "adrenaline rush" of combat, and how it's very hard (hmmn, likely impossible) to match that in civilian life -- but at the same time, there's also definite "purpose" -- of getting the job done, of keeping your buddies alive, etc. After combat...it's suddenly very quiet, and boring by comparison. "War is hell, but peace is boring!" some veterans joke. Cast adrift without the shared common and energizing purpose of combat, in their early 20s, veterans need quickly to find something to "do" that matters to them -- something they can live for, love and enjoy, that satisfies them and makes life worth living. Sadly, far too many people are checking out when they can no longer find a reason to live, and in tragic stories like that of Marine Sgt. Tom Bagosy, or Orrin McClellan, you get the impression they don't feel like they had any other choice. Tragic. Not just for them, but for the people they left behind, whose lives will also forever be marked by this experience. Such a tremendous loss...and possibly, preventable: If not for them, at least for some others. Let's try.

Quotable Quotes -- Rob Brezsny on What Qualifies as "Information" on a Subject, Even PTSD

Here's a great quote from American free thinker Rob Brezsny. I like it because it goes to the heart of what we're trying to do on this site. It's not the "same 'ol, same 'ol" -- it's an attempt to get people thinking differently about a topic that ruins many people's lives, yet within which there is still to be found a certain amount of hope.

This website has been going on for almost five years now. Tens of thousands of hours worth of researching, reading, interviewing experts, thinking and composing the almost 800 articles on the site, 200 recommended books, and dozens of experts. We when started, back in very early 2006, there really wasn't anything out there about PTSD and veterans on the Web, for troops coming back from the wars in Iraq and Afghanistan and their families. I Googled it plenty to make sure I wasn't intruding on someone else's "space." In fact, Ilona Meagher was starting her work at about the same time, but Google hadn't picked up either of us yet. A few months later, when I found her site, I made a point not to read it, so that we could each keep to our original point of view, and not be accused of overlap.

I even chose the name, "Healing Combat Trauma," in a fit of inspiration -- because it was expressly intended to give people HOPE, who might be lacking it, or beaten down by the sheer overwhelming nature of what they had, that they could still get better. Something to cling to, that might help move them out of a state of despair, discouragement and demoralization into a sense that there was something still worth looking for, not to mention living for. "Without hope, the people perish" -- the Bible says. It's a very true statement. And there's nothing like illness to make people give up hope, because of feeling poorly in body, mind and spirit.

Today, almost five years later, the "landscape" surrounding this topic has changed quite a bit, but it's also heartening that people are beginning to find that we're out there and like what they see. The need is greater than it ever was. At least 18 veterans a day kill themselves because they've frankly given up, or feel too miserable to carry on, with the "best" of what they've been offered from the status quo (which fortunately is also improving, but maybe not fast enough, or in enough flexible directions to satisfy the need.) I made a decision early on that I didn't want to "just" report the news -- "misery everywhere! report at 11" -- because that was too easy to do, and didn't require any original thought. We're not cutting and pasting here; we're reading, analyzing, thinking, and talking to people who know -- and then sharing that information with you. 

And there's a certain amount of resistance. On Facebook, where there's a fan page for this site, linked here, with approximately 2,500 members, people occasionally recoil in horror when they read the title. "Healing" Combat Trauma? Why, they sputter, you can't HEAL combat trauma -- my doctor said so! And I just saw him. Of course, we've covered that topic, ad infinitum, but the basic interpretation is, there's a difference between "healing" and "curing" -- and healing is a nice continuum of improvement from bad to better that anyone can jump right on, at any given time -- especially when they're ready to, and not a moment before. "Healing" isn't something you want to drag unwilling people into; but it's also something that is available for those who want it, at whatever degree they can access it. (Even the VA, at least at the level of the National Center for PTSD, and their clinical training which I got to attend in May, is talking about switching the emphasis from a focus on "symptomology" to "functionality" with PTSD -- a needed improvement.)

I had the "healing versus curing" conversation many times with the subject of "Eyewitness to Combat," whose own story of great improvement is highlighted here, in his own words. After going to one treatment or another that appeared to improve him, he would be excited about thinking that he was now "cured" -- despite 40 years of chronic, severe PTSD, and having tried most of what VA had to offer, including a stint in an inpatient, residential treatment program for PTSD that was cutting edge at the time. I tried to explain to him, patiently and not always successfully, that healing wasn't a toggle switch between "ill" and "well," but a path from one to the other, which he was now on, and which he'd continue to be on, through the various things that we'd try and the progress that he'd make. It's also something that doesn't always need a practitioner to facilitate. Practitioners are important, but there are also things that a person can do for him or herself, to improve their overall health and well-being. And sometimes it's important to wedge people's minds open just a little tiny bit...in order that they can encounter something new, that might change their world view, which might (ultimately) help change their lives. Worth it.

Which brings us to the quote of the hour. It's an interesting one, because Rob Brezsny hones in on how something people aren't used to -- the idea that you can "heal" PTSD, for instance -- ruffles some feathers, and shakes some people up. But if they already knew it, what would be the point of hearing it again? Sometimes we have to step away from our preconceived ideas about what "can" and "can't" happen to enter the realm of the possible. In sickness, which is so laden with discouragement and guilt -- as well as hype and manipulation, sometimes -- that's no different from any other area. So let's see what Brezsny has to say about what qualifies as "information" on a topic:

"Let's define information as data and ideas that are new to you. If it's something you already know, then it's trivia or propoganda or dogma, not information. In fact, let's be tempted to use the terms "information" and "novelty" interchangeably. If you're not surprised, if your curiousity isn't piqued, then the message streaming your way may not qualify as information." -- Rob Brezsny.

Quotable Quotes -- Rumi on "There Is Another View..."

We haven't shared any more quotes about the Tao of Healing lately, although there is a whole series of them on this site, linked here. However, this one, by 13th century Persian mystic philosopher Rumi, while not strictly "about" healing -- nevertheless speaks directly to the change in "vision" that's necessary in order to rise above the discouragement and defeat that sickness or disorder can imply. 

There's a famous Einstein quote that (paraphrased) says no problem can be solved at the same level at which it was created; it always needs a view ones step higher. This quote from Rumi reinforces Einstein's point, but I choose to look at it as how to view illness and health...

"Are you searching for your soul? Then come out of your own prison. Leave the little stream and join the river that flows to the ocean. Like an ox, don't pull the wheel of this world on your back. Take off the burden. Whirl and circle. Rise above the wheel of the world. There is another view." -- Rumi 

Too Long a Sacrifice Can Make a Stone of the Heart: The Tao of Self-Care

"Too long a sacrifice can make a stone of the heart," wrote Irish poet William Butler Yeats. He wasn't necessarily a caregiver to anyone, like a veteran, with PTSD -- but he sure seems to understand the predicament. 

The "365 Tao" book that I'm so fond of -- what's not to love about an item at Amazon that has 65 ratings, and they're ALL five stars?! -- had a wonderful item today about how caring for another appropriately is wonderful, but that there is "too much" of a good thing, and it can backfire terribly on the caregiver. Read what it says:

CARING

"Don't go out looking for good deeds to do

But if one comes your way, do not refuse.

If you meet someone who is suffering, you must help them."

And then, importantly:

"Those who follow Tao believe in using sixteen attributes on behalf of others : mercy, gentleness, patience, nonattachment, control, skill, joy, spiritual love, humility, reflection, restfulness, seriousness, effort, controlled emotion, magnanimity, and concentration. Whenever you need to help another, draw upon these qualities. Notice that self-sacrifice is not included in this list. You do not need to destroy yourself to help another. Your overall obligation is to complete your own journey along your personal Tao. As long as you can offer solace to others on your same path, you have done the best that you can."

It's so crucial to note what the author says about "notice that self-sacrifice is not included in this list." (And, previously, that non-attachment was.) So many people on this path or journey, trying to help vets with PTSD, in their own families, their brothers and sisters they served with, etc., are bound to follow the completely self-sacrificing path. We understand that impulse...but see where it leads? It leads to personal disaster. Please take better care of yourself than that. It's not necessary to give your complete and entire all to do your best, to give your best. There has to be a "you" left at the end of the day, or the night. Please find and treasure that self...and don't let it be destroyed, even in the guise of being...the care-giver. 

What can you do for yourself today to improve your health and stress level? What nurtures you and gives you peace of mind? Is it exercise, spending time with friends, having alone time -- what is it? There are many things you can do for yourself that are inexpensive and take good care of you. Please make a list for yourself of what those are, and find a way to bring them back into your life. It will make a world of difference. Some of the very same recommendations or suggestions for veterans with PTSD are ones you might like yourself. A simple exercise like Qi Gong, which creates a feeling of being "relaxed, balanced and energized" -- is just one example of positive self-care, and there are many others.

At the opposite extreme, of not taking care of yourself, what can we guess happens with too long a sacrifice, for others, no matter how worthy, needy or deserving? According to the poet, it can "make a stone of the heart." And following this along...what happens to a stone heart? It shatters and breaks. Keep a soft heart...take care of yourself first...so you can continue to care for others. Not instead of yourself. Importantly, after yourself. So that you can give the best care of all...and not be depleted, broken or crushed. 

More Praise for "Healing Combat Trauma"

Belleruth Naparstek, Ph.D. is a psychotherapist, author, and guided imagery pioneer who is also the author of Invisible Heroes : Survivors of Trauma and How They Heal, and Health Journeys: A Guided Meditation for Healing Trauma (PTSD), two items that have helped many veterans interested in healing to make definite forward progress.

This past year, Naparstek published an important and educational article in the Huffington Post in May called "Note to Colleagues: Please Stop Saying Post Traumatic Stress is Incurable," linked here, as well as one in February called "Returning Troops from Iraq and Afghanistan are Different From Our Vietnam Vets," linked here, both of which are "required reading" for those who want to understand what obstacles face veterans and clinicians alike in treating combat-based post-traumatic stress.

Just the other day I happened to read an article on Naparstek's own HealthJourneys site where she mentioned our very own Healing Combat Trauma as "an excellent site" and referred readers to it. Very gratifying praise indeed from a someone who's a true pioneer in thinking about and working with trauma survivors.

Week-long Clinical Training Program at the National Center for PTSD

Just back from the week-long and yes, truly fabulous, "clinical training program" at the National Center for PTSD, held on the campus of the VA in Menlo Park, CA. Here's a link to the program. It could not have been better.

We learned so much -- classes ran from 8:00 a.m. to 5:00 p.m. daily, and the stack of handouts, double-sided, ran to 14 lbs. of material. One of the best parts of the program, and there were so many, was the opportunity to observe the men's inpatient residential treatment program for PTSD. That was outstanding. It was hard not to want to follow those guys' progress through the rest of the 60-90 day program. They were working hard at getting better, and it was inspiring.

There'll be more to share about the experiences in the program and what we learned as time goes by, but for right now I just wanted to mention it. It was outstanding...

The Tao of Healing

We've collected the quotes we've been posting lately on health, healing and the wisdom of the body into a series called "The Tao of Healing," along with relevant articles from this site over the last few years. To access that collection as a whole, click here.

The quotes are intended to be opportunities for reflection about what health and healing mean to you, what hope you can have, and what wisdom you may already bring to addressing your own condition. So often, we're quick to forget that we have any wisdom at all about ourselves as individuals, and yet, typically we know -- or ought to know -- ourselves better than anyone else can or would.

As Harvard-trained physician and integrative medicine pioneer Andrew Weil, M.D., tellingly writes in "Health and Healing," "...My training and background as a physician have made me reluctant to go to doctors or hospitals except for real emergencies. I have practiced paying attention to my body, diagnosing my own problems, and treating them myself whenever I can. As a result of this practice, I have become a sharp observer of changes in my body, usually detecting illnesses at very early stages and having a good sense of their nature."

While his method might not work for everyone -- since laypeople are probably less aware of the risks they might be overlooking than a trained physician might be -- still, it points out that quintessential "theme" of the Tao of healing...to observe one's self in sickness and in health, and figure out if there are any life lessons encoded in the experience, or wisdom to be gained from the observation of same. Not always, but sometimes, or frequently enough if you practice it, there's quite a lot to be gained from looking within and contemplating what the message of illness and difficulty is -- while not ignoring the outward signs that may need treatment.

The concept many of us have grown up with, of there being a distinct "Mind-Body" split, is actually one that only goes back to the 17th century, and mathematician/philosopher Rene Descartes. Both earlier and later, this "split" or "dualism" between the body and the mind has been rejected as "artificial." Whether or not you want to get into this abstract philosophical detour, it's interesting to contemplate that if there is no split, the body and the mind work in concert to share their sometimes quite enlightening wisdom with us, if we're open to hearing it.

Belleruth Naparstek to Mental Health Colleagues: "Please Stop Saying PTSD is Incurable."

Note to mental health colleagues: "You can recover from posttraumatic stress. Certainly, you can significantly reduce - not just manage - its symptoms. But - and here's the thing - not with traditional treatment. The problem is, a lot of my colleagues don't know this yet. So they go about it in traditional ways and pronounce the condition incurable, based on the results they get." -- Belleruth Naparstek, from her article "Note to Colleagues: Please Stop Saying Post-Traumatic Stress is Incurable," just published in The Huffington Post on May 1, 2010, and linked here. The whole article is excellent; please give it a read and a think as well...

Editor's note: We've written about Naparstek before on this site, here. Her guided imagery tapes, CDs and DVDs, including "Health Journeys: A Guided Meditation for Healing Trauma (PTSD)," and her book, "Invisible Heroes : Survivors of Trauma and How They Heal," are loved by many.

Understanding Post-Traumatic Stress as a Mental "Illness" without Judgment: A Sufferer Clears Things Up

Periodically we come across something great that a PTSD sufferer has written about what it's like to live that experience, not just read about it. The following post is uniquely compelling and articulate, and it's written by Joan Esnayra, Ph.D., founder of the Psychiatric Service Dog Society. Read more about Joan's organization here. But for her wonderful letter, reprinted with permission, keep on reading below:

Dear Veterans,  

Here is what I wrote in response to one of [name redacted's] posts the other day about whether or not PTSD is a mental illness.   It comes from the heart and it is offered with respect, (if not a little tough love, too).

Dear [Name Redacted],

I know that a lot of veterans are not happy hearing PTSD referred to as a mental illness.  Perhaps this is because of some latent fears about what mental illness really is.   Mental illness is quite simply abnormal brain function in the domains of speech, cognition, behavior, and/or sensory capacities.   Not all abnormal brain function is a mental illness, but all mental illnesses are characterized by abnormal brain function.  Does this make sense?

PTSD is described extensively in the DSM-IV. This is the 'Diagnostic and Statistical Manual of Mental Disorders.'   It is the bible of Psychiatry. You don't go to a podiatrist or an audiologist for PTSD treatment.  You go to a mental health professional. This is because it is a mental illness. There is no value judgment, here. It's just a fact.

I've been diagnosed for so many years that sometimes I forget how scary it was for me when I received my first mental health diagnosis at the age of 25 (Major Depression & PTSD). Having grown up with a mother who attempted suicide with some regularity throughout my childhood years, the last thing I wanted to receive was a mental health diagnosis. Voila! There it was staring me in the face. And, despite the fact that I should have been hospitalized (indeed hospitalization was offered to me), I declined the invitation, swearing to myself that I would not become my mother!  he idea of psychiatric hospitalization was absolutely frightening to me at the time.  

Since then, I have "been there, and done that". I've seen what psychiatry and neuroscience have to offer people like me (and people like you). Did you know that Bipolar Disorder is believed by some researchers to be a dysregulation of the circadian rhythm circuitry of the brain? Where is the mental illness in that?   How can a genetic malfunction of the brain's day/night &  sleep/wake cycle cause people to suicide to the tune of 25%? To say that something is a mental illness, is not personal.  There is no value judgment in the statement. It is just the category of pathology that each of these mental disorders falls under.   It is logical and nothing else.

One of the things that veterans with PTSD have to reckon with is that they do have a mental illness. For some of you, this is a no-brainer, no big deal, like "Duh, that's pretty obvious, Joan." For others, especially the newly diagnosed, this prospect is exceedingly frightening. Allow me to proffer that the fear is not in the classification, rather, it is in our own assumptions about mental illness. When I give public presentations on PSD, sometimes people assume that I am a non-mentally ill psychologist, because I come across professionally, and because I know my subject matter, and I'm articulate. I couldn't possibly be a knife-wielding psycho, right?  I mean, isn't that what mentally ill people are really like?

Of course not!  Mentally ill people are as diverse as any other group of people. You have the high functioning, the low functioning, the assertive self-starter entrepreneurial types, and the passive, quiet, stay at home types.  The whole gamut of humanity is represented on the spectrum of mental illness. There is no "type" among those who live with mental illnesses. As a result, there is no judgment, either. 

The mental health consumer community has been pioneering PSD for 13 years.   We have an intervention that the veterans community wants and needs.  Thus, we need to be building bridges to communication so that we can benefit one another over the long term. Disparaging the characteristics of persons living with mental illness is not going to get us there. So, I'm asking you to re-think your assumptions about mental illnesses and the people who live with them.  

Someone in this group recently disparaged others' talk of suicidal ideation and self-injury. This is incredibly disrespectful to our community members.  Unless you have walked a mile in someone else's moccasins, it is inappropriate to disparage a legitimate feature of their disability. To do so is tantamount to making fun of someone who wears a colostomy bag.  "Hey Poopy Boy, You Stink!" That would be terribly rude. Don't you think?

One of the assumptions that people who are not comfortable with the concept of mental illness make is that people with mental illnesses are victims. This strikes our community as a completely bizarre attribution. What is a victim? Ostensibly, it is someone who, through no fault of their own, is harmed, used, or taken advantage by some force that is more powerful than they are. Using this definition, one might conclude that persons living with mental illnesses are indeed victims to the same extent that anyone is a victim,...of their own genetics!

But, there is another way of using the term 'victim' that disparages the sufferer. In this instance, there is implicit judgment that the person is weak, cowardly, ineffectual, and quite frankly, worthless in the eyes of society.This is the version of 'victim' that I was responding to when I read the term in your previous post. It offended me. I am not weak or cowardly or ineffectual, or worthless, and I AM mentally ill. I have no shame about saying to the world, "I live with mental illness". If I did have a problem with this, then, it would be more so a problem of self-acceptance. The fact is, I am mentally ill. Underestimate my abilities and I will prove you wrong.   Call me mentally ill, and I will agree with you.   Do you see the challenge, here, to familiar assumptions?

The veterans community needs the PSD community, and the PSD community needs the veterans community. We are like newly reunited cousins.  My side of the tracks has never gained societal acceptance because we could never hide the fact that we live with mental illnesses.  (We've been symptomatic our entire lives). Your side of the tracks has experienced societal acceptance in your role as non-mentally ill soldiers. Importantly, your side of the tracks (your peer group) has accepted you on the condition that you are not mentally ill.   

Well, guess what? Living with PTSD means that you ARE mentally ill.  So, do you go into the proverbial closet (a lot of people do), or, do you establish a separatist agenda ("we are not like those people"), or are you going to challenge society's fundamental assumptions about mental illnesses?  It is my sincere hope that you will choose the more enlightened path and look for ways to challenge societal assumptions about persons living with mental illnesses with an eye towards growing a more equitable society for all of us.

Joan

Quotable Quotes -- On Reaching the Actual Breaking Point, Where Change Happens

"People come to the consulting room and lay out a collision of values with great embarrassment and agony. They want resolution but would have something even greater if they could ask for the consciousness to bear the paradox. A friend went for her hour with Dr. Meyer in Zurich who was famous for commenting with the single word 'ja' to anything he was told. In good English style my friend bravely laid out the complexity of her life. She burst into tears and cried out that she could stand it no longer. 'Ja, gut,' replied Dr. Meyer. "Now something will happen." This is stark medicine but it is correct for one who has the strength to bear it." -- Robert A. Johnson, Jungian analyst and author of "Owning Your Own Shadow: Understanding the Dark Side of the Psyche."

The Beneficial "Moving Meditation" of Qi Gong

When April Fool's Day rolled around, one world-famous T'ai Chi teacher had this as his status update: "April 24th is 'World T'ai Chi and Qi Gong Day. (It is, by the way.) Brazil has declared it a national holiday, Utah has recognized it, and [name of giant pharmaceutical company] has filed a preliminary injunction against it."

(Anyone who's ever observed the battle between Western medicine and Complementary and Alternative medicine or "CAM" would get that joke... We've come to expect peace of mind in a pill, not in a lifestyle practice or an exercise that can reduce stress and improve immunity.)

T'ai Chi and Qi Gong are both ancient Chinese practices. T'ai Chi is more correctly a type of martial arts, and Qi Gong is often termed "a moving meditation." "Qi" is the word for what the Chinese see as the "life-force energy." This same Qi (or Chi) is what acupuncture moves along energy meridians. Qi Gong is one of several practices, including T'ai Chi and Yoga, that are effective at relaxing "body, mind and spirit." Unlike the other two, however, Qi Gong is less demanding physically, so can be done by a broader range of people, including seniors and the disabled.

In "The Complete Illustrated Guide to Chinese Medicine," Tom Williams, Ph.D., writes about these arts, "In many ways Qi Gong and T'ai Chi represent the paradox that is central to the whole way of thinking in Chinese medicine. These practices are so gentle and apparently effortless, yet they are in fact inordinately powerful and bring tremendous benefit to anyone who adopts them as part of a regular healthcare strategy."

As the Wall Street Journal reported last year, "Alternative medicine is mainstream. The evidence is mounting that diet and lifestyle (including practices such as Qi Gong, T'ai Chi and Yoga) are the best cures for the worst afflictions."

There's much to be said on behalf of this multi-thousand-year-old practice, which 100 million Chinese who practice it daily in parks, both morning and evening. It's a low-cost "health care system" that's available to all. Unlike the more rigorous T'ai Chi, Qi Gong can be done standing, or even sitting in a chair. It can be learned in a class, or at home with a DVD. There is a selection of DVDs likely to be found at your local library; and online at Amazon.com, at Gaiam.com, and at ExerciseToHeal.com. 

Lee Holden, who had a show on PBS about Qi Gong, talks about how Qi Gong leaves you "relaxed, balanced and energized." When I asked Holden which of his dozen or more DVDs he would suggest for people struggling with PTSD, he recommended "Stress Relief Qi Gong," among others. (His DVDs are available on his website, linked here.) 

Why would Qi Gong practice be particularly beneficial for veterans with PTSD? Holden clarifies:

"Qi Gong switches the nervous system from the stress related ‘fight or flight’ mode to the restorative healing mode of the parasympathetic branch. EEG shows that, in people practicing Qi Gong, the cerebral cortex enters a state of calm that few people experience, even in sleep."

(Holden is also the author of "Seven Minutes of Magic: Recharge Your Body Each Day with Qi Gong," linked here.)

Here's a sample from that DVD:

Aspects of Qi Gong, especially its less rigorous nature, combined with its health benefits, including stress reduction, make it a good fit for veterans. Leading a Vietnam combat veteran through some a Qi Gong routine, as we both followed along with a Lee Holden DVD, I asked him how he felt afterwards: "Great!" was his response. He had tried T'ai Chi, but found that he and other vets could not adapt quickly enough to it.

In my own battle with chronic fatigue syndrome years ago, after trying the best of Western and Eastern medicine, I found that it was T'ai Chi and Qi Gong that "built energy" and "moved energy" that allowed me finally to recover.I had the good fortune to take instruction in person from a wonderful instructor who adapted her instruction to even those in chronic pain, and I remember that we could do the Qi Gong exercises sitting down, and yet still experience the benefits. If you're in the Seattle, Wash. area and you can go in person to a class, I recommend Kim Ivy at Embrace the Moon, because I know her work. But if you have to get your instruction from a DVD, Lee Holden and Francisco Garripoli are highly recommended.

For more information about Qi Gong and its health benefits, there's one website in particular that's a treasure trove of information: the Qigong Institute, and it's linked here. I would also suggest reading what Lee Holden has written about it, linked here.

(Note that you may find Qi Gong spelled several different ways, including "Qigong" and "Chi Kung.")

Finally, here are two informational videos that describe a little bit more about what Qi Gong is and what the experience of practicing it is like:

and

Quotable Quotes -- Jung on the Crucible of Personal Change

"Find out what a person fears most and that is where he will develop next." -- Carl Jung, Swiss psychiatrist and the father of analytical psychology. (1875-1961)