Healing Combat Trauma

David Halberstam on "the Most Relentless of Forces, the Power of Memory"

In honor of the panel discussion on war correspondents and PTSD taking place at the National Press Club in Washington, DC today, some brief remarks by noted war correspondent David Halberstam, in the introduction to the coffee table book, Requiem, about the war photographers who died in Vietnam and Indochina:

"Our memories of Vietnam are too mixed, and there is altogether too much sadness in most of them; we have spent much of the last twenty to twenty-five year learning to forget or at least learning to soften those chapters in our lives. Saigon is mercifully distant, a place that belonged to the younger men and women we once were, the young, eager, scared journalists clad in Catinat fatigues, scrambling to get to Tan Son Nhut to get aboard the Hueys going into battle, terrified we might get there too late to get aboard, terrified we might get there in time to get aboard.

We are all older now, sedate men and women in our fifties and sixties living in civilized settings, leading ordinary, rather mundane lives. Yet for most of us, the memory is always there, just beneath the surface; when we open a book like Requiem and read it now in our handsome apartments in the Western cities in which we live, the past still lurks. And as we read, we are at first flooded by these images of the past, and then we are surrounded by a terrible stillness, a special silence produced by the most relentless of all forces, the power of memory. We are quiet as we turn the pages of this book, as befits a special act of homage to those we knew so well.

The silence stands in sharp contrast to the terrible noise that was a defining part of those days and accompanied so many of these very scenes: the racket of infantry weapons and artillery, the harsh clamor of the helicopters. We read it, of course, now safely distanced from our own terrible fear that was the constant of those days. But in some ways the remembrance of another time is more powerful than ever, not just because of the photos but, more important, because of the memory of the young men and women who women who took them, since they themselves, in the most final and terrible way, became part of what lay before them. Looking through Requiem, we remember not just what they did, but now we know, as well, the price they paid."

Happy Veterans Day 2011 -- Joe Galloway on the Experience of War

"War is about men who love their country but even more than that love each other. I left that battlefield knowing that they will continue to sacrifice for me. There are some events that are so overwhelming you can't simply be a witness. You can't be above it you can't be neutral you can't be untouched by it. You see it, you live it, you experience it and it will be with you all of your days." -- Joseph "Joe" Galloway, from "Vietnam in HD" on the History Channel. 

Editor's note: Longtime journalist Galloway, who served as a war correspondent in the battle of Ai Drang during the Vietnam War, has been decorated for his bravery under fire. He's also the author of "We Were Soldiers Once, and Young" with Lt. Gen. Harold Moore (Ret.), which has since been made into a movie; and he's featured in the excellent Michael Samstag documentary about war correspondents in the current era, called "War & Truth." 

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.

Advancing the Dialogue: Can Veterans and Civilians Really See Eye-to-Eye?

We've all heard the horror stories about what ignorant, impertinent questions strangers and even family members ask of veterans sometimes. "Didja kill anyone?" "How many people did you kill," etc.

It doesn't take much sophistication or awareness about the topic of veterans and PTSD before you realize, those questions aren't appropriate at all, ever; and in general, when it comes to questions about combat experience and what veterans suffered, very clearly let them lead in terms of the disclosure. Don't press. But if they want to talk, be able and willing to listen, if you're so inclined.

Apparently the word hasn't gotten out as far as it should have, though. The other night, I went to a screening of some films by a veteran about his experience, and certain questions by audience members afterwards just made me and many of the veterans in the audience squirm.

I share them because I think it shows how far we all have to go if we actually desire authentic dialogue between the two groups.

(An appropriate disclaimer would be, I'm a civilian too, but I've spent the last five years learning from veterans about what they experience in combat, and about how post-traumatic stress disorder affects them and their loved ones.)

The setting was a small community college auditorium, where members of the public gathered to watch a series of short films produced by an Iraq veteran about his experience reintegrating. The film showing was followed by a panel discussion with a handful of Iraq and Afghanistan veterans, both men and women, and a few who'd served earlier. The films were good, and portrayed the experience well, and afterwards, the panel took questions from the audience. Several of the (undoubtedly well-meaning) questioners make me wonder if it's possible for civilians to breach the gap with military on something so raw, personal and volatile as their war experience.

Certainly, when the Vietnam veterans returned, they were met with open hostility and outright neglect, both of which were a problem, and where those after-effects are felt even to this day. Many who were alive during those days, both veterans and civilians, regret those times. It's certainly true that veterans today are getting a different reception -- but is that reception necessarily better, particularly if it includes questions like these? 

One audience member, an older woman, said -- though she had a son who had gone to war and was on the panel -- that she herself was a pacificist. "So I'd like to know," she asked (I'm paraphrasing), "just why you would have joined the military?"

The filmmaker who was hosting the panel responded that the answers to that question would be as different as individuals, and that there was no one way to answer to it. To which a young audience member, referring to the woman's question, replied privately, "Just because you don't personally agree with someone else, isn't any reason to question their motivation for doing what they did."

"Spill your guts"

"Take this opportunity right now, you have it, we're listening," another older woman suggested to the panel of veterans, "and tell us, right now, what you would like us to know, about the worst of what you experienced in war."

The panel was, as a whole, taken aback, incredulous; it was the equivalent, of her saying, "here, right now, spill your guts -- on the most difficult memories you  have -- what's stopping you? We're listening." In an auditorium full of literal strangers, the question was absurd.

One young Marine, who was on a tour in Iraq where many of his brothers-in-arms died, and has since gone on to study social work, demurred that even when his mother asks him, there are questions about what he experienced that he just doesn't feel comfortable answering.

One teenage audience member, at 18 a few years younger than the youngest veteran on the panel, had a question he wanted to ask, which might have gone over much better than some of the more insensitive ones. What he wanted to know is when veterans self-identify as such, whether they feel that the "label" of veteran helps them to integrate better into the community, or whether they feel it sets them apart?

A question like this, which didn't get heard, would have been one of the more pivotal ones to address. Because while it's great that being a veteran has "come out of the woodwork" so to speak -- and the veteran experience is now one that seems to elicit some interest, versus during the Vietnam era -- that also cuts both ways. For veterans who want to be accepted again for who they are, not necessarily thought of primarily in terms of their war experience, however much it's changed them -- it's hard to say whether identifying publicly as a veteran helps this or hurts it.

And while 'm glad to see civilians embracing to some extent the veterans in their community -- and giving them the recognition and to some degree, attention that they didn't give their Vietnam veteran counterparts -- the reality is, it still needs to be done with compassion, understanding and empathy. And NOT the desire to put veterans on the spot and make them squirm under the spotlight of fairly ignorant questioning, no matter how "well-meaning" their interest.

Someday I hope we'll all find the right balance on this: respecting veterans for their service and their sacrifice, and letting the veterans lead the conversation about how much they really want to say about it. In the meantime, the appropriate posture for the rest of us -- both individually and as communities, is to wait, not press, and certainly not pressure -- veterans to talk about what they've gone through.

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

Intimate Survival: When the Veteran You Love Commits Suicide Anyway

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

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

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

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

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

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

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

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

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

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

Meeting Denny

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

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

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

PTSD Enters

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

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

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

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

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

It was also an extremely confusing time for me. 

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

Waiting for the diagnosis

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

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

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

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

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

Starting to take care of myself

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

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

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

Love and loss

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

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

The beginning of the end

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

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

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

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

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

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

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

Turning to healing

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

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

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

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

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

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

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

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

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

Namasté.

-- Marilyn.

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

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

The Hard -- But Necessary -- Work of Welcoming Veterans Finally HOME

With Veteran's Day approaching, it's time to think about an often-neglected theme, which is the "Welcome Home" that many veterans never had. The Vietnam veterans, who fought, died, and suffered -- not only on the battlefields of Southeast Asia, but also here at home. 

Talk to any group of Vietnam veterans, or even singly, and you find most still feel the pain and ache of no one welcoming them home -- with a parade, with open arms, with gratitude and appreciation for their sacrifice and service. It's an open wound that still smarts today' and it's also our national shame.

One Vietnam veteran, John, who served in the Army, was writing about how this indignity still rankles him today -- because it goes much deeper than the community at large not welcoming him home. His own family didn't even!

Here's his story:

"Time to bring my younger self home, back from combat? To be honored? In PERSON?

I'm sure this is a well intended idea - but, I don't know how to do that, and I'm not even sure I would -- if I even could.

Sometimes I think I left that young man there, on purpose, to keep fighting for the freedom of the South Vietnamese -- and, yet, I find him deep inside me -- still, surviving, struggling, striving for strength! He is the -- MY -- ultimate Warrior Within -- MY Primordial Personhood -- the very Soul of Soldiering! He's ME.

It's been 38 years - and no one in my family has ever cared enough to even ask about him! I remember finding my Grandmother crying over her kitchen sink one day, weeping out loud that "My Sweet Johnny has been lost to War!" And I recall, thinking "She's right - I'll never, ever be the same!" All I could do was hold her and let her cry for awhile...then, we said not a word between us - and I left my hometown behind forever!

A few years ago we did have a big "Welcome Home"-themed Veterans Day Parade dedicated to Vietnam vets - and I couldn't even get a single family member to attend (when I was one of many being specially honored) -- like most, they just want to forget it all, while we are obligated to remember and honor our fallen -- too many Americans don't even want to admit reality, let alone face the facts, or take responsibility in the slightest degree!

In fact, we're having a long-overdue family reunion, and one family member mentioned that "No one wants to even hear the "V" word! So, I'm going with the "What about those (insert sports team name here)?" and "Is it getting hotter (cooler)?" strategy of only safe-talk...oh, and there's to be no discussion of politics or religion either - you know, because they are all experts in these subjects - sad, Sad, SAD!

I suspect, after all these years, they are carrying the shame of knowing how they did not even lift a finger to get me the help I needed when I came home - even when I became homeless...and I want so much to tell them there's no rational reason for any such shame -- they didn't know what to do - no one knew what to do for combat vets back then, we didn't even have the diagnosis of PTSD back then!

I want them to know I do love them, and that I do take full responsibility for the decisions I've made in my life, and how I have forgiven their lack of effort long ago... I want them to know they too paid a price for peace in my volutarily sacrificing on their behalf -- that I went to war to protect their peace - and it's all O.K., Freedom is not FREE! But, I'm not sure how to say it, or when -- I'm not even sure they even care? Ideas anyone? "

(Reprinted with permission.) 

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

 

"The Vietnam Experience: A Soldier's Story" (Museum Exhibit)

The photo at left is of dog tags -- one for every local servicemember who died in combat during the Vietnam war -- hanging off the exhibition banner announcing a special show about the Vietnam War at the Petaluma Historical Museum in Petaluma, CA.

The exhibit, which is called "The Vietnam Experience: A Soldier's Story," opened mid-September and runs through Thanksgiving weekend. It features the personal stories and memorabilia of local veterans who served in the war.

According to the museum's website, "The exhibition includes historical artifacts, photographs, and documents interwoven with remarkable oral histories. Highlights of the exhibition include simulated living conditions, a Reflection wall, a speaker series, and film “The Vietnam War” which will air every Saturday at 1:30 p.m."

They add, "Over 278,000 Allied soldiers would die along with 1,470,000 Allied wounded in one of the most controversial wars in American history. Our goal is to honor the men and women of both the United States and Vietnam who served their countries in a common cause, and to educate our community about the sacrifices that they made."

The exhibit has been made possible with material from local US veterans, the collection of the Pacific Coast Air Museum, the Sonoma County Vietnamese Association, and the Petaluma Military Museum. General admission to the museum is $3, and free to any allied veteran.

For more on the Petaluma Historical Museum and the Vietnam war exhibition, click here. There's also quite an excellent, robust and extensive speaker series associated with the exhibit, linked here.

 

A Veteran Spouse Asks the Key Question: Will You Love Them Enough to Learn?

Longtime veterans advocate and ecumenical chaplain Kathie Costos is a hero of mine. On dealing with the spouses and the families, it's hard to find anyone wiser, having lived through the crucible of her own experience -- being married to a Vietnam vet for lo these many years (28, at last count), and raising a family with him, after he got back from the war.

In conversation, she admits she had to learn it all the hard way -- as many do. When she gives advice, she says it's like she's speaking to her 26-year-old self; giving out the advice she wishes she'd gotten at the time but had to learn on her own.

Here she is on a crucial question many folks should come to terms with: Do you care enough about them (veterans) to learn what they went through? She writes about some who do, and many who do not:

"My husband was married before we met. He was married soon after he came back from Vietnam. During their six years together, she didn't want to know about Vietnam, had no tolerance for his nightmares, flashbacks or short term memory loss. She didn't want to hear anything about Vietnam and they separated so many times he lost count. She just couldn't take it and this, this was when his PTSD was mild. 

His Dad, a WWII veteran with a Purple Heart and Bronze Star, didn't want to talk to him about war at all other than a few stories about some of his friends. His Mom didn't want to talk to him about anything other than what she wanted him to do for her.

Friends didn't want to listen and he never felt he could talk to any of them even if they were willing to listen. A few of them were also Vietnam veterans but they didn't talk about much either. There was no communication and no support. They had nothing to really connect. No emails with buddies back home in the states. No news reports from around the country. No books on PTSD with personal stories were written. There were only clinical books for me to read when we met and I wanted to find out why this veteran was so much different than everyone else in my family.

My Dad was a disabled Korean Vet and my uncles served in WWII. My husband was totally different.

Today there is the Internet, books, videos, media attention, sites like this one putting together news reports from around the country and more programs than I can remember, yet today there are still high numbers of divorce, suicides and attempted suicides with more and more veterans ending up homeless from Iraq and Afghanistan. Their families and friends are not perfect. Most of them have the same attitude my husband's inner circle did when they could have been trying to be supportive instead of telling him to "get over it" and stop.

Today wives like me are no longer left in the abyss trying to claw their way out alone because they have a lifeline to reach for, but too many never take hold of it. Their families, spouse and kids, suffer just as much as they do but they have the power to end the suffering and begin the healing. They have the power within their reach but they just won't take it.

Do they love their veteran enough to learn? Do they care enough to find out what they can do to help instead of judge and blame?

My husband's ex-wife didn't care enough to find out what she was facing and their marriage ended after six years. We've been married for 26 years and with all the heartache and struggles, I wouldn't have missed a day of it because in the process of learning what I could do for him, I discovered a more marvelous man under all the pain he carried.

All of us can discover the people they really are under all the pain when we care enough to learn and help them heal. In the process, we heal ourselves, forgive what caused us pain because we understand what is behind it and know how to respond to help them see the person they are under all of it."

Reprinted with permission. For Kathie Costos' blog, Wounded Times, click here.

The "Moving Meditation" of Qi Gong -- One Veteran's Opinion on How it Helps

I asked a Vietnam combat vet, Marine, three purple hearts, shot five times and left for dead, star of the "Eyewitness to Combat" segment of this site, who's been doing Qi Gong lately, what he liked about it -- and how he would describe it to a fellow vet. Here's what he said, verbatim:

"Are you tired of feeling miserable every day and dragging your ass around? If you are, I've got something that takes 24-28 minutes, doesn't require any exertion/doesn't feel strenuous, will give you energy all day long and change your whole attitude!"

He's been doing it pretty faithfully lately, and losing weight -- possibly another of its many benefits, since it appears to work on metabolism. I asked him how he felt about having skipped a few days, unavoidably. "I missed it!" he said; adding, "I got lethargic, lazy, and listless; lacked energy; and my joints started hurting again. I missed the peace that it creates as well..." He also said, "I like Qi Gong because it gives me energy; it gives me a sense of well-being; it actually calms me down; and actually makes me feel good. It's almost like a narcotic, but a very pleasant one. It's not overwhelming; but it  has a very subtle calming -- and -- energizing effect. It gives me energy without psyching me up and getting me hyper. About halfway through, I start feeling really relaxed and good and then I don't want to stop."

Now that's what I call a ringing endorsement :-) Remember, YMMV -- "Your mileage may vary" -- and also, be sure to check with your healthcare practitioner before beginning any exercise program. That said, Qi Gong is probably one of the more mellow, but useful, exercises you could begin.

Last month, Jane Brody, who writes about health for the New York Times, had an article called "A Downside to T'ai Chi? None That I See" about a counterpart exercise to Qi Gong. (That article is linked here.) "After reviewing existing scientific evidence for its potential health benefits," she writes, "I’ve concluded that the proper question to ask yourself may not be why you should practice tai chi, but why not." (The rest of her article is well worth reading.)

Says Brody, "There is no question that tai chi can reduce stress. As the study authors described it, tai chi “combines meditation with slow, gentle, graceful movements, as well as deep breathing and relaxation to move vital energy (called qi by the Chinese) throughout the body.” She continues, "If nothing else, this kind of relaxing activity can lower blood pressure and heart rate, improve cardiovascular fitness and enhance mood. ... Regular practitioners of tai chi report that they sleep better, feel healthier and experience less pain and stiffness, though it cannot be said for certain that tai chi alone is responsible for such benefits."

So there are two choices, among several others, for "moving meditations" that provide health benefits and relaxation. I've been enjoying watching how much this combat vet has enjoyed Qi Gong, though, so I thought I'd ask him for his own opinion on it. As someone who's done both T'ai Chi and Qi Gong, I think Qi Gong is easier and more accessible; the vet seemed to agree, because he found it easier to learn and also required lower overall fitness, yet still produced benefits. The most important thing of all is finding an exercise that produces value that you can incorporate regularly. Like healthful eating, these practices don't help if you don't do them; so find one that works for you and make it a part of your lifestyle.

© 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.

 

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 -- 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.

The Sacred Brotherhood -- and Sisterhood -- of Those Who Understand

We read a few days ago Larry Heinemann's excellent quote about veterans after combat "carrying the darkness with us," linked here. And yesterday, in "War Creates Brothers," we learned about an historic gathering, a sacred ceremony of sorts, where Vietnam veterans like Heinemann met with Russian Afghansti veterans, at least a decade younger, and shared their stories with one another, bonding in the wet blood of brotherhood (and sisterhood, because it now applies to women veterans as well) from war. (That piece is linked here.) Now we synthesize the two together, with a quote from the article Heinemann wrote in 1989 in a national magazine, describing both the gathering mentioned above (lightly), and a much more extensive retelling of what the same Vietnam veterans' trip to Russia to meet with the Afghansti initially was like, a few months before.

Heinemann describes at great length the similarities and the bonds among the men that were formed, and tells the story of how the Russian veterans became involved in their own war in Afghanistan, leaving generally bruised and beaten "after nine years and 15,000 dead." Much of the article focuses on the stories of the Afghansti veterans they met in Russia, the grief of the devastated families of those who'd served, and the generalized indifference of the Russian government -- all of which he can compare, to one degree or another, to situations in our own country, after Vietnam. (As an aside, the bureaucracy of the VA seems to stand in for that of the Russian government in his analogy.)

As clearly as he paints the picture of the Russian veterans' suffering, and how it's mirrored in our own, one of the strongest descriptions he suggests is why the veterans on both sides of the conversation, separated by decades and culture, are nevertheless able to bond so strongly, through telling stories about their experiences, horrific and otherwise. This is the same principle we've been alluding to recently in the series about ritual, and the unburdening that can come from individual warriors when they meet up with one another, and have the safe "container" in which to share their suffering, confusion and grief. Here's Heinemann's remarkable quote:

"These stories and many others, came forward because the Afghansti finally had someone in their midst -- as we surely did not two decades ago [returning from Vietnam] -- who knew what they were talking about. We were fellow soldiers who could listen to the madness and know they were not mad; someone who could validate their worst blood-bath nightmares; someone who had an inkling of the brutality they had endured and inflicted; someone whom they could trust with stories about the deadest, darkest places in their hearts." -- Larry Heinemann.

Circling back around to Heinemann's earlier quote, mentioned a few days ago, we read in this article that it comes at the end of a longer declaration. As food for thought, I now include the full paragraph, in case it now adds fuller context, in light of the above.

"The Afghansti have caused a great many people a great deal of grief and have themselves suffered -- for a lie, let us not forget -- the same was we in the United States have caused much suffering in Southeast Asia, and have also suffered much in return, also for a lie. It was no small betrayal, no small lesson for a man to learn at the age of 19. Any soldier returning home must rediscover his humanity and establish a livable peace with the discovered, liberated, permanently dark places in his own heart --the darkness that is always with us."

Veterans Remember, Survivors Relive: Ken Jones on Vietnam, PTSD and Beyond

Ken Jones, @AKVet on Twitter, is a Vietnam veteran, Ph.D. psychologist, and trail runner, with much to say to our current generation of veterans, starting with "been there, done that" -- and come to terms with it. He's a joy to "follow" on Twitter, but recently he took the time to really spell out what a few of his combat experiences, and coming to terms with their resulting PTSD, had been like. (He's also the author of two free, downloadable e-books on combat and PTSD, which are mentioned in the piece, with hyperlinks that take you to them.)

Another Twitter fan, @BillNigh, took the time to collate some of Ken's recent stream-of-consciousness utterances about being a Vietnam veteran and his own experiences with PTSD into something we can all learn from. Thanks, Bill, and thanks, Ken. Here is Bill's condensing of what Ken wrote on the Web in early August:

"Ken Jones has several chapters in his life that relate to his military tour of service. He suffered battle wounds and PTSD. Now, from a healthy place, and a giving heart, he wants to help fellow, contemporary, vets return Stateside. He offers two free ebooks to anyone interested in the combat experience and in PTSD, "Life After Combat" and "When Our Troops Come Home". Listed below is a stream of consciousness set of posts that he did recently on Twitter on Friday August 6, 2010."

Herewith Ken's reflections:

"We have a "Support Our Troops" effort going on today to get the word out on the two free e-books I wrote about combat induced PTSD. I thought I'd give you a bit of background about how these books came to be.

I was a grunt with the 11 Cavalry in VN in 67-68. We operated in the Iron Triangle, Central I Corps, the Cambodian border, helped retake Bien Hoa in 68 Tet then the Triangle again. We worked with the 173rd, 25th Inf, 101st, 3rd Marines, Korean Marines, 196th Lt Inf, then with the 101st again during Tet. 

In "When Our Troops Come Home" there's a description of the first time I got blown up. This photo was taken after I had been dusted off to the Second Surgical Hospital. The people I talked with later said it looked like a booby-trapped 500 lb. bomb we detonated. What saved us was that most of the force of the blast exited out the side of the embankment we had just come over. 

During Tet 68 our mission was to retake Bien Hoa. We went in with the 101st and retook it. The last time I got blown up was 8 days before I was due to leave country. We got into a fight on our way out of the Triangle. I was a track commander on 32. We took a direct hit by an RPG through the front of the track. The blast blinded my driver and loaded me up with shrapnel. My driver was incredible. He was seriously wounded but did exactly what I told him on the intercom. Like we were in the motor pool.

I got my wounded off, picked up another driver and gunner and we went back in. Turned out to be a long day and night. "The Army sent my body back to Oakland in 1968. It took me years to understand that I died in Viet Nam." I turned 20 in Jan 68. on the Cambodian border. I came back to the world in March. I was 100 years old. 

I learned very quickly never to talk with a civilian about what I had seen, and heard, and smelled, and done in Viet Nam. There was no such thing as PTSD in 1968. There were just a bunch of crazy, whacked, dope-smokin' vets coming back. All the papers said so.

So I sucked it up. Got married. Eventually started a company at 23. Made it work. Looked "successful" to the community. I had an edge. I didn't sleep more than 3-4 hours. I filled my business life with frenetic activity so I didn't have time to "think." I remember driving alone from Salem to Portland on I-5 and screaming as loud as I could over and over to keep the memories away. 

I took up distance running thinking that if I ran far enough and fast enough that I wouldn't be able to think and maybe I could sleep. I was married to a wonderful woman who did everything in her power to try to understand what was happening. I wouldn't tell her anything. I'd wake up screaming in a cold sweat. All I ever said was it was a bad dream. Then I would get dressed for the office and leave for the day. It was usually about 0430. I'd drink coffee and have breakfast at an all-night restaurant. I read a lot: Ed Abbey, Alan Watts, DT Suzuki, others. Many others. 

By 1977 or so I felt like my chest was going to explode all the time. I couldn't run far enough or long enough to keep that "gripping fist" feeling out of my chest. I went to my doc. He looked for symptoms. I never said anything about being Viet Nam. My doc was a civilian. 

By 1980 it was very clear to me that something had to change. The choices I had were insanity or suicide. For some reason I began to write. At first it was poetry of a kind. Short, abrupt blasts of thought put to paper. Then a paragraph and a page. I found that I could get some relief from the grip on my chest if I sat and wrote something so, I kept writing - for three years. 

During that time I began to do business with clients in Anchorage, Alaska. And I wrote. But there was no let up in the constant chest grip. On a trip to Anchorage I heard a radio blurb about something called a Viet Nam Veterans Outreach Center that had opened. I took a chance. I kept a copy of my writing with me all the time. I took it with me to the Vet Center. 

It was a truly eerie sensation walking through the Vet Center door. I was pin-striped, button-down for business all the time. My civy camo. The vet at the desk took a look at me, then my eyes. He said, "Welcome" and got up and walked to an office in the back. 

The guy who came back with him looked like a cowboy, really. He asked me to come on back. His name was Farrell Udell. He was the team leader at the Vet Center. And he really had ben a cowboy in New Mexico before Viet Nam. Farrell was a Marine. He had been a door gunner on a Marine gunship in I Corp. He was the first combat vet I had met since 1968. I told him what it felt like in my chest and asked him to take a look at what I had written to see if it looked like I really was going crazy. 

He looked at the manuscript for awhile and said that, no I wasn't going crazy, and I had come to the right place. I believed him. Being able to look into another person's eyes who knew not only my words, but all the impacted feelings gave me hope again. 

That was in late 1980. At the time the only approach to treatment of PTSD was rap groups. Vets would meet once a week at the Vet Center and talk and listen and try to help each other with our pain. For some that brought relief. For me and others it just opened a massively infected wound, and we couldn't get the feelings to stop. 

In mid-1981, after several months of rap groups I went back to the team leader and told him we had to do something different. We talked for awhile and decided that we would co-facilitate a combat debriefing group. The purpose of the group was not going to be just to talk about what happened, but to find a way to bring some closure to our experience. We had no idea how we were going to do it, but we did know that it had to be done. 

Fareel went through his client list and identified the most serious PTSD cases he was working with. There were 20 of us. We put out the word that we were going to have a combat debriefing group, and what the intention was. There were 17 of us that formed that group. These were some hard-core folks. 
If I recall correctly in that group of 17 there were 28 Purple Hearts, 23 Bronze Stars, 4 Silver Stars, and a Congressional Medal of Honor. 

These were folks who had danced with the Banshee. 

The first night together everyone gave some background on their trigger time and how their life had been since. Basically it sucked to be us. We all got to look into each others' eyes. At the end of the evening we agreed that we were going to do this this thing, whatever it was. Farrell and I covered one wall of the conference room with butcher paper. Each week when the combat debriefing group met. I would read a short section from (what is now) "When Our Troops Come Home". Then we would go around and talk about how each of our experience was similar or different from what I had read. 

The stories began to be told. The anguish began to flow. Vets held vets while they wept their rage, and loss, and guilt for surviving. We kept a plastic trash can in the center of the circle. Sometimes a vet would need to puke to get through the rest of his story. At each session, before we closed, we went through a lessons learned, like an after action report. We made notes on the butcher paper we had taped to the wall. At first they were just notes about dates and times and events. 

Over the 15 months our combat debriefing group was together we realized that there were patterns in our experiences. There was a timeline from when we arrived in country to the point when we passed through the Acute Trauma Threshold and became survivors. 

We began to create a sort of map of our common experiences. Finally we had a physical diagram of the process of being traumatized in combat. It was an extraordinary accomplishment for this group of warriors. I was the scribe. I copied down what we learned together.

From that diagram we were able to flesh out and describe the process of going from an 18 yr old American kid to the initiation into the military that is basic training. "Then to Viet Nam and the "Immersion in Absurdity" of combat that nothing could actually prepare us for.

Then there was the one specific event that changed us forever. The day when feelings became more lethal than a Claymore mine. That was the day that we turned off all the breakers on all the feeling circuits. From then on "It don't mean nothin'" We became Survivors. The model that was developed by the group of Viet Nam Veterans in that combat debriefing group is what is described in the free e-book "Life After Combat".

So that's how it started, not just in our combat group in Anchorage, but all over the country. Vets helping Vets. It's why Viet Nam veterans, and those that lived through those years, are absolutely committed to today's warriors and their loved ones. 

We remember when there was no help. We remember the years of bitter, self-imposed isolation.  We remember the nightmares and the desperate need for the adrenalin fix to confirm that we were still alive. We remember the utter boredom of being away from combat and the fear of going back in. This is the difference between veterans and survivors: 

   Veterans remember.

   Survivors relive. 

There is all the same concern now as there was among my generation about being man enough to take the pain. How manly do you have to be to take the pain of an impacted tooth before you have a root canal done? A day. A week. 10 years. That's the thing about PTSD. It's impacted anguish. It rubs a blister on your soul. 

I refused to ask for help for 13 years. Many of my bros have waited longer than that. Some still wait. 

Maybe you need to wait because of your career, or your security clearance, or nobody will understand, or until you get sober, or straight. We understand that. You can run, but you can't hide from an impacted tooth. Same Same with PTSD. Do what you have to do. But when the time comes know this: 

• There are thousands of us who understand what you and your loved ones are living through. We will help. 
• There are now trained counselors both in and out of the military. They will help.
• There are resources online, in your local community. Unlike 40 years ago. Help is right here, right now.
• By the same code that you live by: "No warrior left behind. Ever. Ever", we are all here. Waiting for you. It's your choice; it's your turn. 
• There are new warriors taking the field, filling the ranks every day. They will carry on the fight and the code. 
• At some point a warrior must choose to turn from the past and prepare to come back Home.
• Of course your guilt comes with you. That's part of the PTSD. 
• I can tell you from my experience that survivor guilt is also an easy excuse to avoid doing the really difficult work necessary to recover 

Consider this: There is a generation of warriors that we will not allow another generation of warrior to endure what we endured. Warriors are recovering and returning to their loved ones every day. Like everything else we do, undertaking the journey requires a decision 

Our mission is simple: Our mission is to Bring Our People Home. You are our mission. Semper Fidelis. 

Let Us Now Praise...Vietnam Veterans

Had an amazing "coffee" the other day with Gerald Nicosia, author of the exceptional "Home to War: A History of the Vietnam Veterans' Movement." What I thought would be a quick meet-and-greet with his signing my copy of his remarkable book turned out to be an almost four-hour marathon of information sharing and gathering about the players in his exhaustive, highly-readable record of what went on with the Vietnam veterans' movement. The book took him 12 years to write, went through four publishers, involved 600(!) interviews with participants, and still needed 800 pages cut before its current length, 800 pages in paperback. Remarkable. And it's put me very much in a "Vietnam" frame of mind ever since, following up on threads of what Nicosia talked about in person and remembering yet again how much the Vietnam veterans gave, for so little -- in the way of public acknowledgement and support for their contributions. I always get a little wistful -- even more than a little wistful -- wishing they had so much more recognition for their true generosity of spirit, and character...

So I've been chasing down Memory Lane here -- more Nicosia's than mine -- learning more about some of the Vietnam vets who had such worthwhile points of view, and made such a difference. Some are still alive, some sadly gone before their time.

Ironically, two of the ones who've captured my attention are, not surprisingly, Marines. Marines occupy more than their fair share of this site, maybe because in so many ways they embody the "tip of the spear." They see so much and do so much. Very often idealists, frequently combined with a balls-to-the-walls attitude, they come in for more than their fair share of difficulty. Is their incidence of PTSD higher than other branches? Perhaps. They've done so much for so long with so little they've just learned to live with it, but their numbers seem over-represented in both trying to get some help, and also in trying to do for their fellow veterans, both then and now. (I'll omit the examples here for now, but it's been true in my experience so far that this is the case.)

One of the Vietnam vets I've been trying to learn more about is National Book Award-winning Larry Heinemann, whose quote about war and the veteran's heart we highlighted the other day -- followed by a quote of his wife about the man she married, before and after war.

Another is Jack McCloskey, a Marine medic in Vietnam, who's talked about at length in Nicosia's book, but who died an untimely death at 53 from heart disease, perhaps brought on by both his exposure to Agent Orange and also his tireless work on behalf of other Vietnam vets, not to mention a few bad habits.

Photos of McCloskey are still on the Web, here and here, taken by his longtime friend, Eric Schwartz. And there's a wonderful obituary of him as well, here, though it doesn't talk about how he was shot on the street, and almost killed -- perhaps by someone trying to suppress his activism -- which is mentioned in Nicosia's book. I loved the obituary, and I loved the photos, but more than those, I loved the story conveyed in poetry about who McCloskey really was, and how deeply he loved his fellow veteran. When I read those words, they resonated not "just" about McCloskey -- who I never knew -- but also about another Vietnam vet, Marine, the subject of "Eyewitness to Combat," here -- who's also taken the guns out of the mouths of countless (hundreds? thousands?) of other Vietnam vets, over the years. He's been the one the wives have called, and he's gotten there, mostly, in time -- but not always. Sometimes he's gotten there too late. McCloskey knew that pain himself.

Allen Cohen wrote a poem, "Three Lines and Some Hippy Truths," about McCloskey's death and two others. It should resonate with us today because things aren't very different now. Only a few stand up for the many. "After the war," Cohen writes about McCloskey, "he learned the necessity of healing the mind that survived the broken bodies, and then the souls that were left helpless before the void of meaningless pain. In this way he gave his heart away to the veterans who needed it." From the poem:

Sometimes I get the feeling 
that I'm disappearing behind 
the glaring spotlight of media-
the political circus, TV, 
and Sports, and Movie heroes
In this world of 6 inch and 20 foot tall 
images who do nothing for humanity 
except sell sneakers or make empty speeches,
or appear in the dream world of sex and violence,
and get paid millions of dollars
despite their marginal and illusory existence,
in this world our own lives, 
the lives of those whose acts 
come within the scope of their talents,
their intelligent daily decisions,
their unrewarded kindness and love.
seem to dissolve in frustration and toil
against the silence of the calculus of history.

But look closely at those lives 
with their true heroism of every moment,
fulfilled through the sustenance of friendship,
the love of the children and one another.
For each other they become larger than life, 
far larger than movie screens,
in the singing of a song
the reaching out of a hand across the emptiness,
the drawing of a picture, the writing of a poem
even in the washing of a dish, the repairing 
of a fence or car, the sewing of a loose button.

I am sitting at the memorial for Jack McCloskey,
at the Family Dog Ballroom.
Jack was the Vietnam Veteran counselor
whose life starting in that war
that so defined our era,
was given to reaching out to others.
First to their bodies when as a front line 
unarmed medic, he gave aid to the wounded.
He would overcome the fear of witnessing 
death's witless massacres each time 
he hurled himself into the line of fire.
After the war, he learned
the necessity of healing the mind
that survived the broken bodies,
and then the souls that were left helpless
before the void of meaningless pain.
In this way he gave his heart away
to the veterans who needed it.

There was no People Magazine for Jack McCloskey
No "Jack McCloskey dies News at Eleven."
Country Joe McDonald is playing Sweet Lorraine.
The light show vibrates the air and his friends dance.

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

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

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

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

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

Quotable Quotes -- Larry Heinemann on War and the Veteran's Heart

"Any soldier returning home must rediscover his humanity and establish a livable peace with the discovered, liberated, permanently dark places in his own heart -- the darkness that is always with us." -- Larry Heinemann, Vietnam combat veteran (Marine) and author, winner of the National Book Award for Paco's Story.

On Healing: Is it "Too Late" for the Vietnam Vets?

"Throw in the towel, close the barn door, give up the ghost." It's too late for them...or us. Even the Tao expresses how it's more difficult to watch someone you love suffer than it is to have the same suffering happen to you; perhaps because you have to look on in empathy and concern, unable at last to save the person you love from the fate that surrounds them.

Two years ago last week, when I first started talking with the then-suicidal subject of "Eyewitness to Combat," a hardened Vietnam vet, Marine, with 40 years of severe, chronic PTSD, one of the harshest things he'd say was, in utter (but angry) defeat that it was "too late" for the Vietnam vets -- that they'd missed their chance to be healed. The country had passed them by, true, but what he was really alluding to was that they themselves -- starting with him -- had given up. So much has happened in the meantime, it's hard for me to remember all the specifics, but I know that this phrase went through my heart like a dagger. We'd struggle so hard to get him back on track and back into the fight, and then some setback would happen -- and always this refrain. "It's too late for us." In other words, just give up on us -- we've already given up on ourselves.

Fortunately, over the last two years and the progression towards healing that this vet has experienced, this phrase has come up less and less, to nowadays not at all. And I'm very thankful for the change. It's NOT too late for Vietnam vets. If anything, the process should start with them. They've been waiting...in neglect AND in humility the longest. We should support them in their hope for healing at long last...and not keep them at the back of the line, to which they've become accustomed. Vietnam veterans are and can be a total treasure...and a vital, vibrant element in pursuing healing for all combat veterans with PTSD. Let's just also make sure to include them as an important part: honoring those to whom honor is due.

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.

---

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

Kind Words from a Mentor and Friend about "Healing Combat Trauma"

Unsolicited feedback can be encouraging, especially when it's positive. Had a very nice surprise of that kind this past this past week when I received a lovely and unexpected email from Arthur Egendorf, Ph.D., a dear mentor and friend, whose own work with war veterans recovering from trauma gave me practical hope that good, heartfelt work could be done in this area.

(Egendorf is a Vietnam veteran [Army intelligence] with a Ph.D. in psychology from Harvard, and a lifelong interest in therapeutic healing modalities, beginning with talk therapy and branching out from there. He was one of the originators, in the 1970s, of the "rap groups," that allowed returning Vietnam veterans to have someplace to go and peers to talk with, when they weren't willing to take part in the services offered by the V.A. In any history of the Vietnam era that focuses on PTSD and veterans, such as Gerard Nicosia's encyclopedic "Home to War: A History of the Vietnam Veterans' Movement," Egendorf is one of a handful of experts from the time whose name keeps coming up.) 

I'll write more later in the month, as a certain anniversary date rolls around, about how much his award-winning book "Healing from the War: Trauma and Transformation after Vietnam," (sadly, now out of print) was put to constructive use with one veteran, whose life it helped to change. It's fair to say that my copy of his book is fairly well completely yellow from highlighting key passages, thoughts and inspirations, so it was especially gratifying to receive these unsolicited kind words from him.

Dear Lily,

In dedicating so much of yourself to the men and women who risk and give their lives for duty, honor, country you do all of us, this mostly sleep-walking America, a great service.  As tireless, fearless, noisy (when necessary) and deeply caring witness you give our soldiers and veterans what they deserve from this entire country but get from only very few.  As one who knows a bit of what it takes to love and care for bloodied and pained survivors who've fought for all of us and then have been mostly ignored, I salute and cheer you on to keep waking us up.  Keep shaking us, Lily.  Keeping making us see how much those who've served have given to us, and how much we owe our thanks, respect and unending care.  You go girl.  

Artie Egendorf 

Editor's note: For more of an introduction to Egendorf's work, here are a few posts that mention him, linked here, here, here (this one in particular, called "A Hand Across the Abyss: How Openness Helps Heal"), and here, among others.

Vietnam, Iraq and Afghanistan -- Suffering and Love

It's interesting to live a life that's been bracketed on either side by wars in Vietnam and now Iraq and Afghanistan. It certainly created an awareness of hardship and suffering, and the need and desire to offset that. And it brings to mind a favorite quote: "Suffering accompanies life, but love is affirmation." -- Everyday Tao, by Deng-Ming Tao.

Yoga for Veterans is Back in the News...

Yoga classes for veterans -- offered, in many cases, free of charge, at least initially, by practitioners nationally -- is back in the news.

(For a link to previous articles about the topic, including the work being done at Walter Reed, click here.)

"Yoga Warriors" is based in Central Massachusetts, and they offer classes to veterans but also train yoga teachers to work with veterans. From their website:

"The Yoga Warriors program was established at the Central Mass Yoga and Wellness in West Boylston, MA, and has been ongoing since 2005.  Yoga Warriors programs are being established in different parts of the country.  Interested vets can contact the Central Mass Yoga and Wellness at 508-835-1176 to put their name on the contact list.  Some of the classes are free to all vets. Registered yoga teachers that wish to become certified in the Yoga Warriors method can also call the above number to register for an upcoming teacher training workshop." (For a link to their website, click here.)

Paul Zipes, based in Florida, has a  "Yoga For Vets" program that he started a few years ago. We've written about it, here, and are about to again. His program connects yoga practitioners who want to offer a limited number of free classes to veterans of combat or conflict with the veterans who want to take them. For a link to Yoga for Vets, click here.

Former Marine Anuradha Bhagwati started Yoga for Vets NYC started in July, 2008 "as a service for NYC veterans." She says, "the program is designed specifically for veterans dealing with injuries or trauma, but every veteran is welcome, regardless of age, era or experience." For a link to this program, click here.

CBS News had a short segment today called "Yoga Soothes War Vets." Watch it below:

The video shows Vietnam veterans enjoying the experience, but one Vietnam veteran I know didn't take to yoga too enthusiastically. Too many aches and pains for him to enjoy it very much, he said. However, he's a much bigger fan of Qi Gong -- which is sometimes called "the Chinese yoga." For more information about Qi Gong, also called Qigong or Chi Kung, read two recent posts on the subject: here and here. Both yoga and qi gong offer demonstrable health benefits and encourage a more relaxed, calmer mind, and lowered anxiety and tension.

The Spouse's Point of View: "I Just Want It Over With, and Buried..."

Watched a great documentary last night, one hour long, originally broadcast on "The History Channel." The documentary was "Vietnam: Homecoming," and I rented it on Netflix, in their instantly-playable section. They describe it in the following manner:

"This moving documentary follows Pervis Crowe, Stanley Parker, John Hedrick and Mike Cook -- who suffer from post-traumatic stress disorder -- as they prepare to attend Operation Homecoming, a gathering in Branson, Mo., to help Vietnam veterans mend. Through poignant interviews, these anguished men share their personal stories of the pain and torment that scarred their psyches and forever changed their lives."

Good stuff. Because I've been privileged to have two years of in-depth, daily conversations with one suffering Vietnam vet, as well as having read his life story, mostly focusing around combat in Vietnam and its aftermath in his life as PTSD, which he sent me two years ago this week, I was astounded by the compelling similarities in what I heard on the screen with what I knew in real life.

Every veteran shared something meaningful. In the conversation illustrated above, a Vietnam vet and his wife exhibited typical conflict over, "you were only there for such a short time...how is it that you can't get over it yet?" frustration. As the wife said, pointedly,

"As your spouse, I don't want you to have to relive it. I want it buried. I just want it over with, and buried."

Unfortunately, that's not likely to be the case. She had "stuck by her man," -- whereas most of the wives in the documentary had not -- and yet, there were tremendous issues. In a suicide note this veteran had left, ironically with his combat brothers, he had mentioned how not only was he expecting to die, but also his wife and their daughter -- a fact that troubled his family members, not unexpectedly, quite a bit when they learned what he had said.

Another veteran, a black soldier, talked about how he managed to keep PTSD at bay until his daughter went off to college. Then his inborn conditioning that "if you get close to someone, they die" kicked in, and he became unrealistically fearful for her safety. At 50 years old, he checked in with what the VA had to offer, the first time he'd realized what an impact PTSD had made on his life, despite the decades of being afraid to get close to people or show his emotion.

Another Vietnam veteran, Marine, sat on his single bed in what looked like a hotel room, and grabbed his shaving kit of medications. This vet's "backstory" was that he was an entrepreneur, a businessman who created a company from scratch that went on to be worth millions. As he described it, he went from rags to riches, and then suddenly at age 50, he couldn't handle it anymore. The empire he built came crashing down, because his PTSD kicked in, and he couldn't run from it, couldn't keep it at bay anymore. And now he was single, marriage destroyed, dependent on pharmaceutical medications to keep his anxiety and sleepness at bay. As he sat on the bed, he took out large pill bottle after large pill bottle, filled with prescription medications, and described his dependence on each one, to help him sleep and help him cope.

I remember the second time I met with the Vietnam vet, Marine, who sought me out for help. He gave me his single-spaced, typewritten list of medications that he was on, 58 in a day, and I almost fainted. Some of them were just for the side-effects of other medications he was on! I was horrified, and sobered. No wonder he had an upset stomach all the time...

A year later, he was down to eight medications from the original 58. Gone was the pain patch, the Oxycodone, the night sweats, the nightmares, the muffled screams, the crappy sleep. Progress is possible. But it started, ironically, with listening to what the veteran went through. "No one wants to hear my story," he said. "They think I should be over it by now. I was only there for two years," he said, "they can't understand why it's the dominant experience in m life, and they're bored with it. Why can't I just move on?"

I heard echoes of that last night in the documentary, with the wife's question: "Why can't this just be buried?" I don't know if I have the stature to comment on this, but this is what I'd say. Honestly, he's not the same person you thought he was. War changed him; combat changed him. And if you can't accept that...you can't accept HIM. He's different now. And whether and how he chooses to show that, it's affected him to the core of his being. He can get better, and he can "improve," and be happier and healthier, by all external metrics...but seriously, if you don't value the core of what he experienced, and why it changed him...you are missing something very, very important. It's key to who he is. And if you wanted someone who wasn't affected by combat, well, that's not who you have right in front of you. It permanently expanded, and blew out, the boundaries of who you knew, and changed him into who he IS. And that is the veteran you can embrace, or not. The choice is yours. The experience was his (or hers). And he (or she) can share it with you, to the extent that you're open to accepting it. Be open. Work on it, if you're not. The payoff is immense. Because you will KNOW who the other person really IS.

A Veteran's Journey from Suffering and Despair to a "Happy and Productive Life..."

Had this conversation just now with a Vietnam combat veteran, who struggled for decades with severe and chronic PTSD. (Read about him in the "Eyewitness to Combat" section. It's gripping...)

It's been almost two years now since we first started talking, and I was looking back on how very much he'd changed. The most noticeable thing to me is how consistent he is now, along with the much lower intensity of the darkness and despair. Back then, when he was suicidal, it was a constant feature. I never knew from one conversation to the next whether that would be our last talk, so close to the edge he was. But that was a phase...and the phase changed, and the "mood" of that phase "lifted," and now I can look back and think how very long ago that seems, even though it was "just" two years ago.

In trying to find words to convey how much I'd seen him changed, I found the analogy of a staircase, maybe one with gigantic stone steps. It seemed that though he was still climbing -- we all are, of course -- he'd cleared those gigantic steps found at the absolute bottom and walked up a few more as well. Now when he slides back down, as we all do, also to some degree -- he no longer hits rock bottom --- so it might still be low, but it's much farther up from where he was, and that progress he made, he gets to keep.

He agreed, and said that it wasn't so much that the demon of despair wasn't there anymore, as that it was something he could now overcome. "Healing," he said, "is when you're able to use what you've been taught" from all those hard experiences. And one of the most key, is not to give up, but to do what you know to do. Whether it's to stay on the lowest dosage of the medications that keep you functional; or the healing techniques you know can help -- whether by going to a practitioner, or even the ones you can practice yourself. And ideally both: appropriate medication AND healing work. Together: an excellent, therapeutic combination. Singly? Not so much. It's like there's something missing...and there is. Synergy, for one thing.

St. Patrick's Day is this vet's "Alive Day," or as he used to call it, his "Kill Day." The day that everyone else was shot or killed, and he was shot and almost died, and barely didn't. Not a major celebration in his life; one with a whole lot of guilt for surviving, and one guy in particular who died who was a short-timer, and went into the fight with him because of their friendship.

St. Patrick's Day last year, this vet was doing great. On his medication AND doing healing work. Pleasant, engaged, out in public (even in crowded places), managing, letting his whole personality out, the bad as well as the substantial good. Major progress.

This year, St. Patrick's Day, not so much. Kinda "backslid," as the old churches would say. Had abruptly stopped his medication, because he wanted to "feel again," or "feel more." And what he felt wasn't so pleasant for him or anyone he was around. His personality was coming out then too: but it was the dark side, with only glimmers of the light.

That was a learning experience, for everyone. Get back on the meds, but don't stop the healing work either. They're BOTH important. They both produce the synergy necessary. With both, he says, he's able to stabilize; see the triggers and the red flags for what they are, but not react in the same way. Without the medication? As he describes it, "I'm looking for the switch..." to turn off the triggers "but there is no switch." Together, it works. And together with support from others: WE all work better too :-)

(Interestingly, though, he was still able to do one major thing THIS St. Patrick's Day. He told the story, in a powerful, moving and very public way, of the last seven days of his friend's life, leading up to his tragic death on that infamous "Kill Day." He said he'd never before had the strength to tell that story, and this time he did. Fellow combat vets eyed him nervously, preparing for the big crash...that never came. How well did he make it through? With an enormous sigh of relief. He went to bed and slept deeply, finally able to lay that burden down that had dogged him for 43 years. He was able to let the haunting memory go, without giving up the love of his friend. And that's what you'd call...healing. Bonus points were when the dead friend came to him in a dream that night, and they saluted one another. As though it were safe to let that memory go...but let the love remain.)

---

"Life for me ain't been no crystal stair," the great American poet Langston Hughes wrote in his poem, "Mother to Son."

It's had tacks in it,

And splinters,

And boards torn up,

And places with no carpet on the floor --

Bare.

But all the time

I'se been a-climbin' on,

And reachin' landin's,

And turnin' corners,

And sometimes goin' in the dark

Where there ain't been no light.

So, boy, don't you turn back.

Don't you set down on the steps.

'Cause you finds it's kinder hard.

-- "Mother to Son," by Langston Hughes.

The same could be said by so many veterans who suffer. But yet there is still hope, and it's in the climbing, not the "setting" down :-)

Returning to the conversation with the Vietnam vet, I told him how much I appreciate the consistency since he's been back on the low dose of medication he takes. Failing to find a better word, I said how much I appreciated getting to see his "charming" personality again, instead of the roller-coaster of pain, frustration, anger and despair. "ALL of these guys have charming personalities," he reminded me; "That's why their wives married them...And that's what we've got to help them return to."

"The Vast Majority of (Vietnam) Veterans Have Melted Back into Society..."

In reading a book tonight, "A War of Nerves: Soldiers and Psychiatrists in the Twentieth Century," by Ben Shephard, Cambridge: Harvard University Press (2001), I came across this interesting paragraph:

"Yet a Los Angeles Times survey of veterans in 1975 concluded that, overall, 'there is ample evidence to suggest that the vast majority of Vietnam veterans have melted back into society as successfully as any soldier from any war.' Vietnam veterans were joining the traditional veterans' organizations, using the GI Bill for education in greater numbers than any previous generation, and successfully getting off heroin. Only 2% of Vietnam veterans used narcotics in civilian life. The LA Times quoted a VA psychiatrist: 'Our society was scared by the image of the Vietnam veteran coming home and shooting up the community, of being a junkie. It was a distorted image that the veteran is still paying for.' There was, he believed, 'no evidence that Vietnam has produced a disproportionate share of people who are maladjusted to society and no evidence that the primary contributor to that maladjustment was military service.'"

I wonder if even Vietnam veterans would agree with that appraisal. It seems awfully rosy. There's a tendency when people first get back to want to fit back in, as though nothing ever happened. I wonder if they caught the respondents at that phase, before they had had significant adjustment issues. The old statistic was that it took veterans, including Vietnam veterans, 13 years to become  homeless, because it took that long for safety nets of family support and employment to fail. The statistics coming back from England with more recent wars is that it's taking three years, not 13, so the pace is escalating. A survey taken in 1975 would have been within that window. It's germane to note that the PTSD diagnosis did not become part of the DSM until 1980. Prior to that, according to "A War of Nerves," one prominent psychiatrist (Chaim Shatan) "argued in 1974 that there were probably one to one and half million men suffering from 'post-combat syndrome,'" while four years later, Arthur Egendorf, Ph.D., a psychologist and Army veteran himself, "(using looser criteria)" put the number at "over two million, a figure almost ten times as great." By 1982, the book says, "another article ... declared that 500,000-700,000 veterans were 'in need of emotional help at the present time.'"

A more common experience would seem to be that of a conversation I had with a friend today. She was talking about her uncle, who she never knew, who had served in Vietnam. According to his mother, she had "two" sons: the son who went off to war, and the one who returned. Her son's platoon was wiped out; only he survived; and he came back, and never really rejoined society. From the sounds of things, he got high, and stayed high, pretty much since he got back from Vietnam. And has never been able to have a job in which people contact is a requirement. Sad tale, and not an uncommon one from the era.

Quotable Quotes -- Arthur Egendorf on When Healing Happens

“Healing occurs as we develop the openness, care and vision to cast in a worthy light whatever appears before us." -- Arthur Egendorf, Ph.D., from "Healing from the War: Trauma and Transformation after Vietnam," coincidentally my very favorite book on the subject, although unfortunately it's also out of print.

Honoring Women Veterans Who Served and Suffered

October 12th through 16th is "Military Rape Awareness Week." In observation of that, the story of Colleen Mussolino, as retold by veterans advocate Susan Avila-Smith:

In Memory of Colleen Mussolino, Women Veteran Trailblazer

"I wanted to be an aviation engineer," Mussolino said.  "The recruiter said I could get into the program, but I found out that was closed to women." Instead she became a cook.  Soon the young WAC would find out just how differently women were regarded in the military.  On December 29, 1965, Colleen was raped by four men and left for dead.  She spent one night in the hospital and was sent right back to her barracks.  Colleen was treated like a prisoner of war, interrogated and was blackballed on the post trying to force her to sign a paper that she would not prosecute. Threatened with a dishonorable discharge, Mussolino signed the paper and was honorably discharged in March 1967.

For the next 20 years, Mussolino raised two sons, and lived her life.  But as time went by, the traumatic assault that was supposed to be covered up and forgotten began to take its toll.  "I was getting more and more short-tempered," Mussolino said. "My temper was just bad."  One day, while fishing with a World War II veteran, he told her she was entitled to veterans benefits.  She applied and began to receive benefits. She also joined a women's support group at the Brooklyn, N.Y. VA Medical Center.  "I was looking for other women who went through what I went through," Mussolino said. "Your civilian counterparts have no clue."

Women Veterans of America
With talk of the war breaking out in the Persian Gulf, she realized more women would be involved in combat than ever before.  In response, she co-founded Women Veterans of America to offer support and attention to the issues facing women in the military.  "The transition from military to civilian life is difficult," Mussolino said. "Once the uniform goes on, it never comes off." Their mission: Information and support for women veterans; liaision to government agencies; obtaining veterans' benefits and health care; advocacy in local and national isues affecting women veteran and women serving in the military. Pressure on Congress and the Department of Defense to cahnge the Uniform Code of Military Justice to include a fair avenue for victims of assault and rape to be able to report their cases and get their day in court. Punish those who perpetrate such crimes and offer protection from intimidation and threats for women who report the assaults. "The repercussions from the way the victims are treated only adds to the problem and can cause severe PTSD symptoms," the statement reads. "The UCMJ does not protect the victim, but instead rewards some perpetrators with promotion, and does not punish except with a slap on the wrist and a finger shaken in the face it continues.  It is difficult for many to fathom the emotional and physical turmoil that the men and women of the armed forces are put through.  To add sexual assault to the burden is unconscionable."

In November 1996, reports of sexual harrassment and sexual assault against women at the Army Proving Ground in Aberdeen, M.D., prompted "20/20" to put together an investigative piece on the military's handling of sexual assault.  A member of Women Veterans of America wrote to 20/20 about her own experience. "She was afraid to be interviewed because she had been given death threats," Mussolino said.  Instead, Mussolino agreed to share her own story of sexual assault and cover-up in the military with Peter Jennings. "I figured if anything came out of it, women would know they are not alone, and there is help," Mussolino said.  "Not only women are raped, but men are raped. The story seemed to validate them, too." During the show's airing, the Department of Veterans Affairs made a toll-free number available for women to call in for counseling.  "Over 3,000 women called that night from all diferent wars and branches of service," Mussolino said.  "The Department of Veterans Affairs realized more had to be done for women veterans." "A lot of Vietnam veteran women in this country don't come forward," said Mussolino.  They don't talk about it.  Those are the ones I want to reach. There is help. There is therapy by talking to a brother or a sister."

Despite her disabilities which have put her in a wheelchair, she would be at every significant event for MST and Vietnam vets, and was the primary point of contact for the media since the early 1970s.  Since Colleen's terminal illness, Women Veterans of America "decided that WVA is taking too much time on the issue of MST, and has dropped it from their services."

PTSD from Military Sexual Trauma (MST) is caused by sexual harrassment, rape and intimidation, or any improper sexual behavior.  Perpetrators often go unpunished, and have no "record" in an effort to play down the prevalence of assault and harrassment.

Editor's note: There's a "fan page" for Colleen Mussolino on Facebook, linked here.

"Not Victims, but Veterans": Max Cleland Writes an Open Letter to Other Combat Veterans

Max Cleland, decorated Vietnam war hero, triple amputee, head of the Department of Veterans Affairs under President Carter, and PTSD sufferer, who came to that knowledge in later life, decades after his military service, has written a new book, called Heart of a Patriot: How I Found the Courage to Survive Vietnam, Walter Reed and Karl Rove.

There was an interview with Cleland on NPR's Morning Edition yesterday, October 6, 2009, linked here.

But most interesting for our purposes -- since this blog is about combat veterans and PTSD -- is the "open letter" to other veterans that Cleland writes, and which is excerpted as part of the NPR piece.

"As combat veterans," he writes, "we have been through some of the most traumatic life experiences possible. War is as close to hell on earth as anything ever could be. That does make us different from our loved ones back home. War marks us all, some more deeply than others."

There's some wonderful, heart-felt expression in this letter:

"The soldier's lot is to be exposed to traumatic, life-threatening events — happenings that take us to places no bodies, minds, or souls should ever visit. It is a journey to the dark places of life — terror, fear, pain, death, wounding, loss, grief, despair, and hopelessness. We have been traumatized physically, mentally, emotionally, and spiritually. Some of us cope with exposure to hell better than others. Some are able to think of their combat experiences as but unpleasant vignettes in a long and wonderful life. It is not to those veterans I am speaking. I love them, but I am not afraid for them.

I am speaking to the rest of my brothers and sisters, those who find themselves trapped in the misery of memories as I was for so long. For them, I am afraid.To those veterans I say, you are not alone.

Many of us have been overwhelmed by war. Many of us have been unable to cope on our own with what has happened to us or with what we have done. Many of us have been left hopeless, lost, and confused about ourselves and our lives in ways we never thought possible.

That does not make us victims. It makes us veterans."

The rest of the open letter is equally wonderful, and well worth reading. In it, Cleland talks about his own personal highs and lows, what he understands about PTSD and his own case, and what has helped him get through. It's clear the concern and caring he feels for other combat vets. The letter is linked here.

More Vietnam Veteran Suicides Than Combat Deaths -- Poem

Miles of Bones

"58,000 suicides
is a lot of bullets

wrecked car's
ruined veins

dead bottles
kids without fathers

American flags

& miles of dirt dug

58,000
the number of Vietnam

veteran suicides...
it equals the names

on the Wall
today: 7/09/91 8:10 p.m.

tomorrow
we'll exceed it

more suicide
than combat death

If you can't feel
this pain

you're already
dead

all these
bodies

floating
home."

-- by Bill Shields.  Anthologized in "From Both Sides Now: The Poetry of the Vietnam War and Its Aftermath," Edited by Philip Mahony.

Editor's note: Sadly, of course, since the time this poem was written, many more Vietnam veterans and other combat veterans have taken their own lives.

Barrenness of Survival

"I'd sooner be a fallen pine cone this winter
In a cradle of cold New England rock,
Less hurt in it than nineteen years.
What an exit! Stage left, fronds waving,
Cut down running my ass off at a tree line.
I'm thinking, as I hear my chest
Sucking air through its brand new nipple,
I bought the ticket, I hope I drown fast,
The pain is all in living."

-- Excerpt from "Morning -- A Death," by Basil T. Paquet. Anthologized in "Carrying the Darkness: American Indochina -- The Poetry of the Vietnam War," edited by W.D. Ehrhart.

In the Meantime: Between Combat and Death

"Listen:

Death is a goddamned disgrace.

It has no respect

for beauty or for wit

or for a lifetime

of survivor’s experience –

so why should I show

any respect for it?

          Death will catch me

          in due time,

          but until then

          the time is mine."

-- from "The Peace Monument," by Jan Barry. Anthologized in "From Both Sides Now: The Poetry of the Vietnam War and Its Aftermath," Edited by Philip Mahony.

Wry Reminscence of Combat Vet on His Peer Group

Peer Group

"me & the boys got the highest rate

of alcoholism & drug abuse & divorce

& mental illness & suicide

than any other group

in America.

It’s good to see us win

for a change."

-- by Bill Shields. Anthologized in "From Both Sides Now: The Poetry of the Vietnam War and Its Aftermath," Edited by Philip Mahony.

Trust and Mistrust -- One Combat Veteran (and Poet's) Point of View

"On all sides of the issues
on both sides of the ocean,
veterans mistrust anyone in a position to lie;
Wives, girlfriends, government officials,
salesmen, lawyers, and the rich.

Veterans trust dogs,
children under twelve,
masturbation,
the chair facing the door
and any weapon in the dark."

-- From "In Victory or Defeat," a poem by Steve Mason, Vietnam combat veteran, former Army captain, former "poet laureate" of the Vietnam Veterans of America. Mason passed away in May of 2005. (His obituary from the L.A. Times is linked here.)

For One Veteran, Writing His Story is "An Act of Spiritual Renewal"

If you're a combat veteran and in the Buffalo, NY area, you might enjoy checking out the writers group at the VA Western New York Healthcare System.  Led by a Vietnam vet, "participants can share their stories and offer each other suggestions to improve the readability of their experiences. The group meets on the first and third Monday of every month from 1:30 to 3:30 p. m. at 3495 Bailey Avenue, Room 422b, Buffalo, NY 14215." All veterans "interested in writing their story" are encouraged to attend.

---
We've talked about writing as catharsis before on this blog, many times, but the above item comes from an opinion piece called "Recording War Stories Allows Spiritual Renewal," published July 5 in the Buffalo News, and linked here.  In it, the unnamed veteran (maybe the print version of the story contains his name; the online version does not) says plainly, "We veterans should break our silence and write about the unspeakable events. I’ve written my stories and they’re more than just about me."

In the short opinion piece, he talks about the deaths of three of his friends in Vietnam, and how "documenting unspeakable memories" like these, "labeling those events and feelings with words and closing the cover" on those stories "is cathartic. The result is a spiritual renewal, a freedom that allows me to choose when to open and close the past while trying to live in the present."

Writing sounds like it's cathartic for this veteran, but it's also a concrete way for him to give honor to the lives of those he loved, and misses.

Virginia Not Just for Lovers This Summer: Also for Vietnam Veterans and Their Families

The Virginia Historical Society is pleased to offer free admission for everyone this summer! From June 6 to August 30, the VHS is displaying three exhibitions about the Vietnam era. The society is offering complimentary admission as a way to honor military personnel who served in the Vietnam War and their families.

On Display / Current Exhibitions:

• Soul Soldiers: African Americans and the Vietnam Era through August 30, 2009

Soul Soldiers: African Americans and the Vietnam Era explores the issues, actions, reactions, and expressions of life and culture of African Americans as they were affected by the Civil Rights Movement and the Vietnam War. Over 160 artifacts, photographs, audio recordings, songs, oral histories, and an original documentary on display in this award-winning exhibition show how events in the 1960s helped frame African American political and social perspectives that extended beyond civil rights. The roles of Dr. Martin Luther King, Jr., Colin Powell, Jimi Hendrix, and many others are explored, as well as the 9,000 women who served as nurses and in clerical and support positions during the war. Soul Soldiers was organized by the Senator John Heinz History Center in Pittsburgh, Pa.

• Marking Time: Voyage to Vietnam through August 30, 2009

Marking Time: Voyage to Vietnam features a cache of Vietnam War soldier art of striking importance and poignancy. Soldiers and Marines on the ship USNS General Nelson M. Walker, bound for Vietnam in 1967, inscribed graffiti phrases and images on the bottom sides of canvas bunks in the troop compartments. Men wrote their name and hometown, the date they expected to leave the service, and kept day-by-day calendars to mark the progress of the voyage. Original graffiti-covered canvases—discovered in the process of scrapping the vessel in 2005—display messages of patriotism, politics, humor, anxiety, and love. Marking Time was organized by the Vietnam Graffiti Project in Keswick, Va.

• A Vietnam POW's Story through August 30, 2009

Bring Paul Home: Phyllis Galanti and Vietnam War POWs is based on the collection given to the Virginia Historical Society by Richmond resident Phyllis Galanti. Her husband, Paul, was a lieutenant commander in the U.S. Navy when his plane was shot down over Vietnam on June 17, 1966. Mr. Galanti was a Prisoner of War (POW) until February 12, 1973. Pictures, letters, pamphlets, buttons, and posters from the donated collection show Mrs. Galanti's efforts, and those of the National League of Families of American Prisoners and Missing in Southeast Asia, to publicize the plight of their loved ones and to secure their release. "I think these exhibitions will be of interest to visitors, especially those who lived through the 1960s and 1970s, because they will be able to personally relate to the topics covered in all three shows," Levengood said. "It is the perfect opportunity for parents and grandparents to bring their children and grandchildren to learn about events that had a huge impact on American society, politics, and culture—and they can see it all for free!"

The Virginia Historical Society is located at 428 N. Boulevard, Richmond, VA 23220 Tel.: (804) 358.4901. The Museum is open from Tuesday–Saturday 10–5 and on Sunday 1–5 (galleries & shop only).

The Story of Virginia, An American Experience, a 10,000-square-foot exhibition with more than a thousand objects covering all of Virginia history from prehistoric times to the present is featured in the Robins Center for Virginia History. Hours: Tuesday–Saturday 10 am–5 pm and Sunday 1 pm–5pm (Museum Galleries and Shop only). Admission: $5/adults, $4/seniors 55+ ($2/Tuesdays–galleries only), $3/children and students, free/members. Admission to the galleries is free on Sundays. For group tour information, call (804) 342-9652. For more information, please call (804) 358-4901 or visit www.vahistorical.org.

Editor's note: For further information about these and other exhibits at the museum, please click here. (And thanks, Merri, for letting me know about this!)

"My Body's Intact, but Not My Soul"

Periodically we talk on this blog about the catharsis of poetry -- as a reader, as a writer. Here's a poem about Vietnam, in the form of a song called "Don't Go There," by S.L. Ponciroli, USN, quoted in Frederick Graham's "The Bamboo Chest," which we discussed recently, here:

Don't Go There

"Night in the bush in the drivin' rain
Heard the rockets burst then the screamin' pain
Feelin' pretty good 'cause I'm still whole
My body's intact but not my soul.

Don't go there is what my Mama said
You're gonna get hurt, wind up dead
But I had to go, stand and fight
'cause I didn't listen, I died that night.

My tour was over, I was done
The battles fought, but the war not won
I caught that bird, took me to the World
See my home, see my girl

Don't go there is what my Mama said
You're gonna get hurt, wind up dead
But I had to go, stand and fight
'cause I didn't listen, I died that night.

John Wayne told me to be a man
Defend my country the best I can
My home had changed, my girl didn't care
Made fun of my clothes, ridiculed my hair

Don't go there is what my Mama said
You're gonna get hurt, wind up dead
But I had to go, stand and fight
'cause I didn't listen, I died that night.

Nights at home in the drivin' rain
I hear rockets burst and the screamin' pain
Feelin' pretty good 'cause I'm still whole
My body's intact but not my soul."

-- Song by S.L. Ponciroli, USN, Danang '68-'69

Editor's note: In the photo used to illustrate this post, the handsome guy on the right, with the faraway cold expression, is headed back to Vietnam for his second tour.  He's already had the dream in which he dies, and he knows from experience that his comrades who've had that premonition, invariably do. The guy on the left, with the much less wary or apprehensive expression, is headed elsewhere. The man on the right's premonition came awfully close to coming true, as it turned out. Read more about that, in a post linked here.

Escaping from the Bamboo Chest

Every once in a while I come across a book about war and healing combat trauma that's new to me, and such was the case recently with one by Frederick Graham, called "The Bamboo Chest: An Adventure in Healing the Trauma of War," linked here. Unfortunately, the subtitle is a bit of a misnomer, unless you interpret it in a particularly specific way, in which case it works.  But while it's far afield from actual "healing combat trauma," the reality is, it's an amazing true-life adventure story by someone who understands he's very lucky to be able to tell it. 

For those of us who grew up reading books like Papillon, by Henri Charriere, who uses the opportunity of his captivity in and subsequent escapes from the notorious French prison, Devil's Island, to teach himself some things about himself, or any of the wonderful high-adventure historical novels by James Clavell -- Shogun, Tai-Pan, King Rat, Noble House, etc. -- Graham's book fits right in.  It's a remarkable story about a guy whose dad was a Marine, who grew up in and around Vietnam and Southeast Asia, and then finds himself imprisoned in a South Vietnamese jail in the 1980s, with an absolutely frustrating roommate who he'd been arrested with and grows to really detest, for all the right reasons.  Graham uses the opportunity of his imprisonment to reflect and make adjustments to his character, finds and nurtures his inner strength, and experiences several important insights from his childhood around the war in Vietnam that helps his adult self integrate itself more completely. 

Unfortunately, though Graham is plenty psychologically adept with his own experience, because he wasn't actually involved in the Vietnam war directly as a soldier, the "war" in the subtitle is at a slightly larger remove than it was for the actual participants.  However, as a story about man against the elements -- particularly man against society, and in some ways, man against himself -- it's really quite an exciting tale, and one worth reading.

"I Have PTSD," But "I Am Not PTSD"

This conversation goes back a while ago with a combat veteran of the Vietnam era, who has been trying various therapeutic methods for addressing his decades-long case of severe PTSD, and finding, by degrees, some actual and substantial relief.

Over the past few months, as his situation has greatly improved, aspects of his PSTD have fallen away, symptom-by-symptom.  But lest this lead you to believe that such progress, or success, is all "positive" -- the reality is, it doesn't always feel that way to the veteran, who has become habituated to seeing the world through the context of their having PTSD.  PTSD, of course, affects virtually every important aspect of their lives: from how social they are, to relations with their family, to how they can hold a job, how much pain they are in on a daily basis, how much stress they can manage, and how many medications (with their attendant side-effects) they take.  Psychological symptoms, physical symptoms, even "social" symptoms: they're all there.

And after a lifetime of identifying yourself as a "crazy, f*cked-up Vietnam vet," f'r instance, if that "identity" should start to fall away -- as you progress towards actual health and wholeness...mmmmnn, what do you replace it with?  Because there needs to be something.  Having relied on one identity for years (even decades) to manage life, and keep others at bay, suddenly that "crutch" or that "coping system" is no longer there.  And with all the other problematic pieces stripped away, piece by piece, what's actually left is a raw, brand new...baby. At least in terms of trying to cope with who you are in the world.  Amazing stuff.  And as great as it might be to get some symptom relief, and some ultra-positive life changes, at the same time...fear comes into play.  Who will I be without this shell I've learned to rest upon for so long?

Even the Bible talks about, in a slightly different context, how if you're going to sweep a place clean and remove all the demons, you have to immediately replace the empty space with something good, lest more demons come by (boy, the Bible is awful cheery; I'd forgotten...) and, finding the place vacant, immediately seek to fill it up with something "ten times worse" than what had been removed.  Mmmm. Lovely.  But the principle is a worthy one: If you're been relying on one thing, for a long, long time -- and you suddenly remove it -- you'd better find a way to be comfortable with the new self, because it's what's you have from here on out.

Having been privy to these struggles with one veteran as he walks his path, it's been surprising to me to see how "upsetting" the concept of healing can be -- initially upsetting, that is.  There's an old Tony Robbins line that human nature will do much more to avoid pain than they will to seek pleasure, and I think that comes in to play here, too. Change is painful; growth is painful; heck, even healing -- in that context only -- can be painful.  It's all new; it requires new skills; a new outlook; even new hope.  But ultimately, it's (obviously) the best way.  Most ironic of all is when the combat veteran, for example, has been the one to pursue the healing so radically -- and then when it starts to happen, in shock, he draws back, startled, as if realizing, ahhh, this is going to be my new life: how strange. I wonder if I recognize me in this at all.

Of course, over time, the progress coming in waves, as more methods are tried and proven useful, the experience gets better, and the veteran gets to be more at peace in his own skin.  Symptoms with which he has lived for decades start to abate, and be replaced by ... peace... and better experiences with himself, his family and loved ones. Overall, though the process is bumpy, the progress is sure.  There's no turning back: the combat veteran continues to WANT his healing, and his healing is happening.

And suddenly, the revelation, at least in his mind: "I have PTSD," he declares, decades into the fight, "but I am NOT PTSD."  Previously, of course, the unspoken assumption was that there was no distinction.  PTSD so consumed his life than in fact he WAS PTSD.  Now, he can say that he has it -- increasingly, even better, that he HAD it -- but that it is not him.  Wow.

Who -- and What -- a Survivor Is

Quotable quotes:

"I define a survivor as one who has touched, witnessed, encountered or been immersed in death in a literal or symbolic way and has himself remained alive." -- Robert Jay Lifton.

LIfton, an American psychiatrist and pioneer in PTSD studies from the 1970s, is also the author of "Home from the War: Learning from Vietnam Veterans."

(Hat tip to Chris Lombardi, for pointing this one out.)

Helping Vets with PTSD: Rolling up Your Sleeves vs. Keeping an Arm's Length Distance

We've talked before on this blog about Paul Tillich's fabulous quote, that "the first duty of love is to listen." 

Here's a story that neatly conveys the polar opposite of that; or at least how someone, a VA provider, got actually PUNISHED for doing that (thanks to Ilona Meagher for noticing the story). But first, an aside.

I was at a dinner a while back that concluded a week's worth of focused training for health care providers, mostly psychologists, psychiatrists and social workers -- many of whom dealt with combat veterans.  Seated across the table from me was a VA provider, a Ph.D. psychologist who, to his credit, was of the Vietnam era but hadn't served, and who had gone into working with the VA so that he could "help" his generation of veterans, who he saw as being tremendously underserved.  True and good, so far.

As we sat at dinner, he told the private practice psychiatrist to one side of him, and the veterans service officer (and Iraq War combat vet/single mom) to the other side of him, about something "new" called "EMDR," that neither one had ever heard of, and that he had just learned about, and  was fairly enthusiastic about himself.  EMDR, for "Eye Movement Desensitization and Reprocessing," for one thing, is NOT new.  It's been in existence for years -- since the 80s, when it was developed by Francine Shapiro, Ph.D..  Something like 16 clinical trials have shown its efficacy. Heck, we've got several blog posts about it, from two years ago. So it's not really great news that the provider was "just learning about it" recently.  EMDR was one of the first quasi-"alternative" treatments offered in the psychological community for PTSD.  It's been widely studied and fairly widely recommended for PTSD ever since.  It's also something I've personally tried, so my ears perked up when I heard it.  "This stuff is so great," the VA psychologist enthused, warming to his true point: "You can treat people, and you don't even have to hear their stuff!"

Ohmigoodness.  If that isn't just the gold standard of what we want to be doing.  I'm holding out hope we'll find an arm's' length cure for healing combat trauma (kidding, absurd).

In this article, a VA provider who seems like a serious, intense, and concerned practitioner -- as well as a favorite among the veterans who were her patients -- gets fired and reprimanded for "talking an Iraqi vet down off the ledge," so to speak.  It's a pretty shocking story.  The provider has yet to be re-instated, and the OIF/OEF veteran who narrowly survived killing himself, thanks to her intervention, also has been left scarred by the situation, and more antisocial/less trusting than before.  Ugh.  Is this the kind of care we really want to be delivering?

The VA, particularly now (as in, these days) is supposed to be "very concerned" about its reputation, and really adamant about "no more bad PR."  If that's the case, maybe it's time to examine some of the decisions that get made, and why they get made -- from what happened in this story, to the psychologist above who was so thrilled to learn about a treatment mode that he could practice without having to get too involved.

Somehow, this seems to be the EXACT OPPOSITE of the care and concern and COMPASSION that someone like Sarah Haley exhibited, herself a VA psychiatrist, through whose landmark work the shame of My Lai was able to come forth and be addressed, etc. A true hero in the pantheon of those who addressed PTSD at its roots -- and, coincidentally, ALSO someone very well loved by her patients.  Hmmmn.  There might be a not-so-subliminal message in that. 

Here's what Gerald Nicosia, author of Home to War: A History of the Vietnam Veterans' Movement, says in part about Haley (to whom he devotes more than a dozen pages of narrative):

"The other horn of this troubling dilemma was that the traumatized person, especially if he was a Vietnam veteran, would almost never come in and spill his guts to a perfect stranger.  Trauma patients need to establish trust with a therapist, and the Vietnam veterans coming into the VA clinic were never being given the chance to do this.  It was by the merest lucky chance that the My Lai veteran had seen something in Sarah Haley that made him believe he could confide in her, thereby opening the door not only to his own dark secrets, but also to possible help for a whole generation of trauma victims."

 

And, separately:

 

"What Haley did not realize was that John [the aforementioned patient, who spilled the beans on My Lai] had come to her initially because he had been told she was trustworthy by his friend Mike, whom she had treated previously.  A year later, John showed up in her office again under the pretext of bringing Mike back for further counseling.  At this time, John confessed to her that "he had needed to believe that just one person cared, that one person could be trusted to know what he had done, and not reject him.""

 

Hmmmn.  Food for thought, all the way around: but most especially for the VA, and their apparently quite shabby treatment of psychologist Sidney Ornduff, and by extension, the other veterans whose lives she could have been helping.

 

Shocking Statistics and Veterans: When "9" Is Not So Lucky a Number...

Here's a shocking statistic I ran across today, in some material online provided by the veterans' charity, Swords to Plowshares:

"It took an average of 9 years post deployment for Vietnam and prior era veterans to fall into homelessness. Today, Swords to Plowshares and our homeless veteran service colleagues throughout the nation are seeing an alarming influx of homeless OIF/OEF veterans, sometimes just months after separating from the military..."

As you can well imagine, the 9 years must have involved a steady deterioration of resources and ability to cope.  Unfortunately, today the problem is taking place at an even more accelerated rate -- hence the need for more awareness and more care to be taken with the topic.

As the foundation says, "We prepared the following paper for the National Coalition for Homeless Veterans to help decipher why this new generation are becoming homeless so quickly in the hope that, by understanding the issues, we may prevent or at least mitigate the kind of long suffering our older clients have endured. The paper looks at bureaucratic, social, economic, and physical and mental health issues impacting our new veterans. It is up to us, as providers, as neighbors, and as citizens to prevent homelessness and truly support our military and veterans with the services and support they have earned."  The link to the presentation, in PDF form, is here.

Editor's note: For more posts where we've covered the topic of homelessness and veterans with PTSD, click here, which takes you to an index of posts on that subject.

Another Hidden Cost to Veterans: Decades of Suicide Watch for Your Peers with PTSD

I had an interesting conversation with a treasured Vietnam veteran the other day -- interesting in the sense that the Chinese mean it.  I thought he was planning on being one place and then when his plans changed at the last minute, I found out why.  He was, in his words, "taking the loaded gun out of the mouth" of one of his dearest friends, a Silver Star winner who also served in Vietnam -- and not for the first time, either. I've heard some of the other stories, too, as they were happening.

Just out of curiosity I asked him, having recently heard that although he's usually "successful" at this particular task -- a combination of skill and luck, I am sure, and I've heard how he does it, it's really pretty cool -- he's also "gotten there too late," in about five people's cases -- how many people has he actually tried to "rescue" over the years in the same way?  Literally "taking a loaded gun out of their mouths" (although that really amounts to persuading the fellow vet to lay it down, not physically trying to take it.)

"About 100," he said, and wasn't too happy to have to say it, either.

Just think of that for a minute.  His odds are probably pretty good.  I'm sure some of the 100 were actually different tries by the same people, but even so...five dying, 95 successfully averting...but 100 attempts?  From your peer group?  That would seriously suck.  And I know he's made a few himself.

So when we as a country try to estimate and analyze the "hidden costs" and the "lifetime costs" of struggling with PTSD, let's remember the psychic costs as well.  I'm not sure any of us are particularly well-suited to be taking loaded guns out of each other's mouths...for decades.  And the irony to me of this whole situation is that of course, he does what he does out of love: because he can't let them do it.  And yet...he's often not much more than a few steps ahead of where the other person is, at that moment.  Granted, he's sharing everything he's got.  But really: is this a solution?  I'm sure if he hadn't been there for those guys, the suicide toll among Vietnam combat veterans would be that much higher.  Which would be a tremendous loss, and a continuing disgrace (that they have to, not that they did.)  But at the same time -- think about it from a mental health standpoint.  How great would yours be, if decades after a war, you could also look forward to THIS grim duty?  Good grief...The poets and the politicians both agree, sometimes: War is Hell.  But so can the aftermath be, sadly. Even for those who survive.

Editor's note: For veterans in crisis, call the National Veterans Foundation.  Staffed with crisis counselors -- other vets, just like you.  As their website says, "The NVF is standing by to provide you with personal assistance and advice. We are staffed by veterans with experiences from Vietnam to Iraq.  We are trained not only in Veterans issues but also in crisis management for PTSD and suicide prevention. If there is anything we can do for you, please ... simply call us at (888) 777-4443."

The Double-Edged Sword Called "HOPE"

"Got hope?" the Obama bumper sticker asked.  (Hey, we're non-partisan here, it's just an illustration to make a point.)

The reality is, hope turns out to be VITAL, not optional, in someone's struggle to "heal."  And "healing," of course, is not specifically an end-result, a "one and done" event -- but a progress along a continuum. 

Even the Bible talks about how, "without vision, the people perish."  Emily Dickinson, who it's easy to imagine as a profoundly depressed, but nevertheless highly imaginative New England poet, referred in one of her more famous poems to hope "as a thing with feathers."  Meaning, pretty airy, light-weight, and able to fly away.  Hard to trap and catch, hard to hang onto.  If you put the two concepts together, though, hope is both necessary AND hard to hard to hang onto.  No wonder it's so important.

Over the last few months, I've been watching as a hardened combat veteran, with severe PTSD, has stepped out of his comfort zone, and put his "hope" to the test: Hope that there was a life for him outside the realms of severe combat trauma.  It's been incredibly interesting and refreshing to see what's happened to him since.  And hope shows up at every turn.  Without going into it in much depth here -- there'll be another time and place for that -- I've been able to see his physiology as well as his psychology change, in just a few short months -- and I've seen the renewal of "hope" this has caused within him.  For one thing, hope to be considered more than just another "crazy, effed-up combat veteran" -- the mask he's apparently worn for society for years (decades, in his case).  Hope that he can have an actual life and happiness beyond what he had been reconciled to, by virtue of "throwing off" some of what's hindered him (the Biblical wording here is purely incidental.)

The deal about having a mask that you wear, as a combat vet, because it's what society expects of you -- and it's also what allows you to keep other people at bay -- is a very interesting concept in its own right.  It helps, but it also hinders. It frees, but it also constrains.  And suddenly, with better health, comes the realization that it may be time to consider laying that mask down, at least part-time.

Whoa.  Strangely...that turns out to be a tad problematic.

Because there is comfort to be found behind that mask, and safety, and worst of all -- familiarity.  We all struggle with, "better the devil you know...than the devil you don't know."  And even a self-imposed mask offers a modicum of comfort, though at great cost (what you miss out on, wearing it).

The combat veteran and I had a conversation the last few days that mirrors several others we've had over time, as he's received extremely positive -- surprisingly positive -- news from his medical providers.  The sum of it is, he seems to feel he had an easier time picturing he was going to fade out and die...than actually revive and live.  Strange, isn't it -- the rest of us just want to get well.  But to the combat vet with PTSD, sometimes there's a fair amount of comfort (from the familiarity) of knowing things are bad...and likely to stay the same or keep getting worse.

What I've seen with this very courageous individual, as I've watched him fight to take this new hill, called health, is how hard it's been to reconcile himself to having hope now for an actual future, unmarred substantially by the PTSD that's dogged him so much from the past.  Not that he'll ever be "over" it completely -- but getting quite a bit better, and healing both on the outside and on the inside?  On the one hand, priceless. On the other hand, definitely scary.  Stay tuned...this has been an incredibly interesting journey to watch, and it will continue to be.

Vietnam Veteran Turns to Acupuncture, Qi Gong and Yoga for Relief from PTSD

We've been discussing various forms of Complementary and Alternative Medicine, or "CAM" for short, which seem to have potential therapeutic usefulnessness for treating PTSD.  Here's a mention in a recent article in the Salt Lake Tribune of March 14, 2008, of other Eastern methods, including the energetic medicine, "Qi Gong," which appear to have brought some relief to one Vietnam war-era nurse.  From an article by Matthew D. LaPlante:

Mary Jane Shipley is a 62-year-old former trauma nurse who was stationed at a mobile Army hospital in Vung Tau, Vietnam. 

Shipley's "eyes well with tears," LaPlante writes, at the recollection of the young men she watched die there, burnt and broken and missing pieces of their bodies as they faded away." 

He continues, "Shipley says she knew almost immediately after returning home there was something wrong with her. In part, it was the helicopters. She could hear them, even smell them, ferrying patients to the Salt Lake City hospital where she worked - sometimes minutes before any of her associates could."

Her other symptoms are hallmarks of PTSD: "She had trouble relating to other people. She was restless. She was constantly afraid. Perhaps to the eyes of today's doctors and nurses, Shipley's illness would have been obvious. But back then, no one reached out."

In Shipley's case, according to LaPlante, "It took her 30 years to realize she wasn't alone. Now in treatment for post-traumatic stress disorder, the Western-trained nurse has found Eastern therapies to be most helpful. She practices yoga and qigong. And at least twice a week, she undergoes acupuncture. "It took me so long to figure out what works for me," Shipley laments, "and I still have so much trouble."

News from Hell before Breakfast: Journalists, War Trauma and PTSD

"I hate newspapermen. They come into camp and pick up their camp rumors and print them as facts. I regard them as spies, which, in truth, they are. If I killed them all there would be news from Hell before breakfast." -- attributed, perhaps erroneously, to Civil War General William Tecumseh Sherman.

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A different quote:

"On Thursday, June 26th, I witnessed the immediate aftermath of an Al-Qaeda suicide bomb attack.  Several dozen people lost their lives... children, old men, civilians, police, and military men.  The scene was horrific beyond words, even for someone like me who has a fairly high threshold for such things.

I found it nearly impossible to look through the viewfinder.  What I saw was abhorrently graphic, yet far too important for the world to ignore.  I present images that provide an uncensored view of a terrible event, and some small measure of dignity to those who lost their lives."

-- Zoriah, international humanitarian photographer, whose gripping images from that event were later censored by the U.S. military, and he was evicted from his embed assignment with the Marines. (The link to the post where he talks about those images, and shows them, is here.)

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PTSD from being a combat journalist of photographer, embedded or otherwise:  Not everyone who's exposed to combat trauma develops PTSD, as we know.  Recently, Kimberly Dozier, CBS correspondent and author of Breathing the Fire, says she didn't develop it from her horrific near-death incident in Iraq in May of 2006, though ironically -- according to Dozier -- almost everyone she interacts with believes thatshe must have.  (See article to that effect by Dozier, linked here.)  However...many do; and for others, the signs and symptoms take time to manifest themselves. 

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Journalists bear witness, both to some of the most savage atrocities of wartime, though without the training and the mindset of combatants, and also to the suffering of the survivors, military and civilian.  Says one photographer who served in Vietnam:

It has been very difficult for me [to recount some of his memories from the past] as it has brought back many of the horrible nightmares that I had thought that I had finally put away. It did get them out in the open and off my chest so to speak and now my family now knows why I sometimes have to take those walks out into the woods alone to just get away. Hard to explain. I do have severe survival guilt as I have lost far to many friends in combat in up close and personal confrontations. I have many photos of me smiling and yes there were many good times. However; there were enough bad times to more than compensate for the good ones. I have learned to cope with this new world that I came home to only because I still feel a great need to help my fellow veterans. We 'Nam veterans are all but forgotten in my eyes.

Two significant resources: Dr. Anthony Feinstein's work, and the Dart Center for Journalism and Trauma.

Two excellent books:

Dangerous Lives: War, and the Men and Women Who Report It, by Anthony Feinstein (2002); and Journalists under Fire: The Psychological Hazards of Covering War, by Anthony Feinstein. (2006).  (Recommended by Jonathan Shay, M.D., Ph.D., noted PTSD expert.)  Shay wrote: "the first and only book about the occupational [psychological] hazards of being a war correspondent.  Published in Canada, will come out in the US next year from Johns Hopkins UP with a new chapter on embeds."

Dr. Anthony Feinstein is a professor of psychiatry at the University of Toronto and a neuropsychiatrist at Sunnybrook and Women's College Health Sciences Centre in Toronto. He is an expert on Post-Traumatic Stress Disorder in war journalists. Feinstein received a 2001 Guggenheim Fellowship to pursue his research. Dr. Anthony Feinstein's bio is linked here.  Much better bio, linked here.

For reporters: War, Journalism and Stress: The Self-Assessment Test, linked here. (General description of the test, linked here.)

What Feinstein has to say:

More than anything, says Feinstein, he’s learned that, “War is not good for journalists. They suffer from it.”

Specifically, they suffer post-traumatic stress disorder, substance abuse and anxiety disorders. One in five journalists, over the course of a long (15-plus-year) career, endures significant PTSD, says Feinstein. That means, among other things, bad dreams, flashbacks, numbness, an overly sensitive startle response and an inability to get close to others emotionally. One in four experiences depression. “And a number drink very heavily as well,” says Feinstein, “but I don’t know how many, because I never know for sure what they’re telling me.”

The most surprising revelation of the research for Feinstein? “I didn’t realize that the journalists were in such great danger. You see them when they report the news: cool, collected, with everything seemingly going on behind them. But these people are really right in the middle of it all.”

He is particularly sympathetic to still photographers. More than anyone, he says, these professionals have no choice but to get into the thick of things to do their jobs well.

The Dart Center for Journalism and Trauma, located on the campus of the University of Washington in Seattle, is a particularly good, targeted resource for journalists about reporting and trauma: both externally reporting, and internally experiencing trauma from reporting in war zones.  Click here to look through their extensive offerings, which are really superb.

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Who's the handsome young man in the photo? 

That's Robert W. "Grif" Griffin.  Griffin says, "I was a combat photographer with the 1st Cavalry Division Airmobile from 1966 to 1968 and 1970. I was in country [in Vietnam] as a photographer from 1966 to 1968, and back again in 1970."  (He was shot down near Quan Loi in 1970.)  He adds that he "spent 20 years in the Army mostly as a photojournalist/motion picture and still photographer."

According to Griffin, "the photographer who took the photo is Jere L. Smith, a fellow combat photographer and a Specialist E5 at the time. We were both assigned to the 13th Signal Battalion, which was part of the 1st Cavalry Division Airmobile."  At the time the photo was taken, Griffin was duplicating some slides for his Command for a Division briefing that was to take place in several locations at the same time: hence, the dupes.

A Hand across the Abyss - How Openness Helps Heal - A Therapist Talks with His Patient, both Vets

I've recently started reading a very interesting book from the Vietnam era, by Arthur Egendorf, a Ph.D. psychologist who was first a veteran - and later tried to piece together what he had experienced in a way that could also help others. Egendorf's in-depth work at the time with veterans, and his motivation behind it, really seem exceptional. 

Gerald Nicosia writes about him, too, in the excellent "Home to War: A History of the Vietnam Veterans Movement," because Egendorf was instrumental in establishing the veterans' "rap groups" which were an early feature of attempts made to cope with the combat trauma and PTSD Vietnam vets experienced. 

This passage, from Egendorf's book, is remarkable to me for several reasons: Egendorf's own intuitions about healing; his humility, openness and vulnerability with his patient (and friend); their nuanced dance together; and of course, best of all, the effects it actually had on the Marine he helped.  Egendorf's book is out of print, but here and there copies are available used, including on Amazon.  Here's what he wrote:

“If you look, it’s not hard to find veterans who are engaged in healing.  I met one of them eight years ago while visiting a VA hospital.  His name was Jim, an ex-Marine from the Bronx recovering from his latest breakdown, back for another of the hospital visits that began a year after he returned from Vietnam.  I introduced myself as a fellow vet, now a psychologist, who wanted to interview him for a study that would help Vietnam vets.

 
“You want to help me?” he asked.  “For six years I’ve been in and out of this hospital, and I’ve heard enough of shrink talk.  I want to know how you made it.  That’s how to help me.  Tell me how did you get it together?”

 
I responded by making him an offer.  If he would let me interview him, he could ask me anything he wanted.  He accepted and spent ten hours telling me his story.  Before the war he was the kind of youngster teachers like.  He behaved well in class and worked part-time after school.  During his teens he had seen a psychiatrist for “nerves,” but generally had held his own.  In 1969, when he was eighteen, Jim was drafted and goaded into “volunteering” for the Marines, then sent to combat duty in Vietnam.  He saw action in I Corps, in the north of South Vietnam.

 
Ever since he came back, his mother and his wife had been trying to tell him that something was wrong,  For the first year all he did was stay in the apartment, smoke dope, and listen to music.  Then one day while looking out the window he saw a junkie trying to steal the radio from his car.  Jim grabbed a baseball bat, ran after him, and started pounding the guy so fiercely it took three people to tear him away.  After that he knew he was out of control and went for help.

 
Seven years after coming back, Jim described his burdens this way: “Before I went, I worked for six years.  I was the best assistant manager Martin’s Bargain Store ever had.  I can’t work now.  They messed up my head.  How the hell are you supposed to concentrate after all I’ve been through?  Reality sucks.  It’s not what you know, it’s who you know.  That’s why a nineteen-year-old acidhead or college guy gets out of it.  Who do I know?  My shrink from before the war said I was fine.  Now the VA says I was always cuckoo and my problem’s got nothing to do with the war.  My wife is scared of me.  My family thinks I’m nuts.  We were supposed to be over there fighting for freedom, killing people who never did us any harm.  What are you supposed to do after that?

 
I listened, particularly to what was left unsaid.  He had just started to find some direction in life when the war crashed in.  Then it was “pussy,” as his drill instructors called him, and thirteen months of being constantly threatened with death, and seeing a dozen guys he knew pulverized into heaps of bloody flesh.  Others made fun of him, mocking a grunt from New York who resented the practice of calling Vietnamese “slopes” or “dinks” or “gooks.” When the time came to go home and he looked forward to leaving the mess behind, he found that things didn’t work as he expected.  After coming back he wasn’t anybody’s hero, the afterimages of shattering brutality stayed fixed in his mind, and the business-as-usual reality at home had no room for what he carried inside.

For Jim and many like him, it was not them but the world that was crazy.  What was keeping all of it from blowing up, just like the people and placed he had seen “wasted”?  Presidents give the orders and people die.  It’s like a primitive ritual with human sacrifices to bloodthirsty gods.  Jim was sure about only one thing: The people pulling the strings didn’t care what happened to him.

 
“How’d you get it together? That’s what I want to know,” he kept asking.  Our backgrounds were different, but the war gave us a common bond.  Jim was a ghetto kid who didn’t finish high school before entering the service, whereas I had gone to private school, Harvard, and then Europe for a year of postgraduate study before my draft board notified me.  Unlike him, I never saw a psychotherapist while growing up and was never seriously upset until after I came back, and then never so bad that I couldn’t go to school and hold a job, too.  All the same, he knew.  “Something got to you too, huh?”

 
He tested me to see if I’d open up with him. “People like you go into psychology to straighten themselves out, right?”  Yes, I told him, he was right about that.  After years of taking pills and hearing therapists interpret his past and try to modify his behavior, Jim wanted to “relate.”  It was the same hunger that led a dozen of us to form the veteran rap groups that began meeting in New York City in 1970.  In these groups we asked each other and the therapists who volunteered to assist us in gaining the same openness Jim now wanted.

 
After a few meetings Jim asked to be a regular client.  At the beginning he couldn’t take much – he would miss appointments and “forget” to return my phone calls. Eventually, though, we met more regularly, and he began to thrive on the questions I raised.

What had gotten to him?  What was so troubling?  What made him so vulnerable?  What was he going to do about it now?  How was he going to handle his life?  I didn’t intend for him to answer my questions the way elementary pupils answer their teacher’s drill.  Rather, the idea was for him to use the questions to orient himself, to direct his energies where the questioning pointed.  It was time for Jim to stop telling the same story over and over and to begin living out a new one.

 
The more we worked together, the more he saw opportunities to make himself useful – a gesture that would help his wife, an odd job to pick up some cash, a game he could play with his kids.  He studied enough to distinguish his sensitive reactions from his deluded flights of fancy.  And when he was ready, he acknowledged that his suffering would never make sense o its own.  It would only be valuable if he took it as a lesson, something he could use to remind himself that how he handles his life is up to him.

 
After a few months of groundwork, Jim was out of the VA for good.  Then he got off tranquilizers and stayed away from pot.  In the next year, he and his wife stopped fighting and started talking, and soon after that he was holding a job for the first time since he left the Marines.  Two years after we began meeting he bought his own house and was holding down two jobs.  Instead of complaining about his two kids, which is all he had done when we first met, he’d brag about them.

 
The time came when he raised a more ambitious question.  Given his suffering, and what he’d learned, what purpose would he devote himself to?  “People, I want to do something for people,” he’d say.  One of his dreams was to save enough money to start a summer camp for ghetto kids.  In the meantime, he began seeing the people in his daily lives as the ones to serve.

 
Jim still has bad days and times when his kids get to him, but he no longer doubts that his life is workable, which gives him a certainty that makes him proud.  He’s especially happy about the way men who live on his street now listen to him.  “They figure I must know something after I’ve been through.  They ask me how they can straighten themselves out.”  He volunteers at the local Outreach office for veterans, run by the Veterans Administration. “If a high school dropout ex-cuckoo like me can do it, anybody can.”

As powerful as that is, here's something I like just as much: Egendorf's own description of his participation in the dance between patient and practitioner:

“How did you do it?” was the question Jim kept asking.  I knew he wouldn’t be satisfied with some formula or set of rules.  He wanted me to open up, to make it safer for him to open up to himself and to me.  And so I told him about myself, but not to give him know-how.  I simply related bits of my story as they became relevant.  For example, I told him how sensitive I was when I came back.  At first, little things would get to me. I’d be overwhelmed by seeing a dead dog lying on a highway, or the picture of a mourning woman in a magazine, or newspaper listings of the soldiers just killed. Strangers halfway around the world, especially dead ones, seemed closer to me than anyone had ever been except my family and one or two lovers.

 
I also told him about how I threw myself into issues connected with the war.  Before Vietnam I had read newspapers casually.  In the months and first years after coming back I would tear into the pages to see what new horrors I needed to absorb and to find out which people in high places I would cheer that day and which ones I would scream at during the hours I spent raging in my head.  I was more deeply moved by tenderness than at any time in my life, and I was also more easily angered. I’d write scathing letters to editors, congressmen, and the President.  I’d blurt out slogans to old friends and family, who didn’t know how to talk with me anymore.

 
I didn’t tell Jim only about matters that weighed me down.  I made sure to tell him some things that were hard to admit to myself at first, things I needed guts to say, but once said would leave me feeling lighter. I told him it wasn’t just the pain that had surprised me; I had also begun to catch glimmers of some secret joy.  I was happy I had made it through the war when others didn’t, which was hard to acknowledge.  But something else delighted me even more.  Strangely, I was glad to feel so much hurt, as if having allowed something to tear me open meant one day I would give birth to something I might treasure.

 
Jim would compare himself to me and decide that I was so much better off that I had to know something that made life easy. So I also let him know about my awkwardness – the many times I flip-flopped back and forth, from wallowing in my distress to trying to hide from it.  But I also told him I learned more from my mistakes and weaknesses than from anything else.  In fact, my about-faces, in which neither wallowing in the pain nor turning my back on it satisfied me, eventually led me to the realization that I was searching for the third way.  I couldn’t say what it was at first, but I figured somebody had to know or there wouldn’t be such people as counselors and therapists.  They must know, I thought, and so, hungering to find out what they knew and daring to think I’d know too once I joined their ranks, I took a job as a crisis counselor.

 
Jim grasped the irony of my story.  Contrary to what he had initially thought, I wasn’t useful to him because of any information I had.  What I had to offer lay in my willingness to admit that I don’t have anything in particular to tell people until I hear them talk.  I’m willing to be with them without answers, so that I can assist them with their own search.  I told Jim that I’m as surprised as anyone when this works.  The moment when someone trusts me enough to tell  me his troubles a change takes place in me.  I suddenly have more wisdom for them than I usually have for myself. I listen, make comments, and without having to think or plan in advance, ask questions they find helpful.

 
In the end, what Jim accomplished by being with me wasn’t new information to pass along, something he could go out and tell someone else.  He developed an approach to life that transformed his experience of the war from a burden to an opportunity for healing.  The shift happened as a result of our being together, and by our pursuing a joint quest that fostered trust, respect, appreciation and the openness that is healing in itself.

Most crucial is the openness.  I’ve noticed this not only with Jim but also with hundreds of others I’ve worked with since, and with dozens of therapists I’ve trained.  In this book I intend to convey what I mean by openness, in such a way that healing from war dawns as a possibility for you.”

 
-- Source: Healing from the War: Trauma & Transformation after Vietnam, by Arthur Egendorf.  Boston: Shambhala Press (1986)

(Shambhala Press is what published Claude Anshin Thomas’ excellent book, At Hell’s Gate: A Soldier’s Journey from War to Peace, which we have mentioned frequently on this blog.)

 

Getting the Better Picture: Major Causes of Death and Injury for Vietnam Veterans from the War

(Well, other than suicide, that is...which certainly became more prevalent later on, after their return from the war; and still, unfortunately, goes on to this day.)

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It's true that my hero, Mark Twain, once said that "there are only three kinds of lies: lies, damned lies, and statistics."  A very funny line, but statistics still do have their place.  For one thing, even if they're slightly in error, they still manage to paint us a "bigger picture" of what's really going on.  War statistics are no different.

If you want some great current ones, by someone who loves statistics, check out my friend Ilona's blog, and in particular, this recent post.  However, what I'm hoping to do here is contribute to the "bigger picture" on injury in the Vietnam war.  I came across this passage earlier today, and it's remarkable in its ability to demonstrate who was killed by what, and who was injured by what, on the American side.  There's going to be a different distribution from the OEF/OIF conflicts in Afghanistan and Iraq -- and we already know what the signature wounds of those wars are: TBI, PTSD, and eardrum damage from the blasts.  But if you want to look back and better understand what Vietnam was like for our veterans, check this out.  I don't think I've ever seen a better list to give us a "picture" of what combatants went through and suffered, albeit externally:

"There were three major causes of American combat deaths during the Vietnam war.  Fifty-one percent were killed by small-arms fire; thirty-six percent by fragments from artillery fire; and eleven percent by booby traps and mines.  The percentage killed by small arms during Vietnam fighting was a substantial increase over that of earlier U.S. wars.  During both the Second World War, and the Korean War, only thirty-three percent were killed by small arms. 

The Vietnam percentage was much greater, because of both the fact that ambush was a major tactic of the Vietnamese Communists, and the Communists’ use of a Russian-supplied rifle, which was high-velocity, rapid-fire, light and extremely effective.  American soldiers suffered wounds from four major sources: sixty-five percent from artillery fire; sixteen percent from small-arms fire; fifteen percent from booby traps and mines; and two percent from punji sticks.

Of those soldiers killed in action, thirty-nine percent were hit in the head; nineteen percent in the chest; eighteen percent in the stomach or groin area; seventeen percent in the legs; and one percent in the shoulder or arms; with sixteen percent suffering multiple location wounds.  The percentage that died due to head wounds is considered high, and is attributed to the reluctance of many GIs to wear a helmet because of the heat; quite a large number wore floppy cloth hats instead.

 

Americans who survived their wounds were hit in the following locations: thirty-six percent in the legs, eighteen percent in the arms or shoulders, fourteen percent in the head, seven percent in the chest, and five percent in the stomach or groin; twenty percent suffered multilocation wounds.

 

Many who were wounded during Vietnam fighting survived because of both the helicopter and improvements in medical treatment.  In Vietnam, only 2.6 of those who survived long enough to reach field hospitals died; during the Second World War, almost twice that many died on hospital tables – 4.5 percent."

-- Source: Vietnam: The Valor and the Sorrow, by Thomas D. Boettcher.

Editor's note: Hope you don't mind the sick humor of the beef diagram, above, but it comes from years of working in law firms, where personal injuries are graded according to worth of the body part harmed, and the age (and therefore future life expectancy/earning power) of the injured.  Speaking of lists that need to be revised...

Books Fall Open, We Fall In: Reading to Better Understand the Vietnam War and Its Veterans

The kindly and indulgent boyfriend, GuvBoy, left for the local library book sale with instructions to purchase anything that looked good about the Vietnam war and several other blog-related topics. As a former journalist and all-around smart person, he knows how to figure that out, so I knew I was in good hands.  As it turns out, he returned with some good ones, that seem to have been lost to history.  So I thought I would point them out here, in case they help anyone else who's interested in digging deeper into what went on and what the combatants experienced. 

(In case it's never been clear what orientation the categories of books in the various columns flanking this blog have, here's the breakdown:

The column to the right here on this blog lists various books of poetry about war, any war; followed by a section of all sorts of excellent first-person narratives about various wars, the better to give us an understanding of what veterans went through.  Those first-person narratives are organized by war, to make it more self-explanatory.  The column to the left here lists therapeutic resources for dealing with combat trauma up on top; and various miscellaneous things that get mentioned on the blog further down).

For Vietnam-era veterans who want their families (i.e., children and grandchildren) to better understand what the war was like, I'm still recommending "Home to War: A History of the Vietnam Veterans Movement," by Gerald Nicosia, because while he's talking about the veterans movement, in 700 pages, he's capturing all sorts of history of the era and feelings for and against.  The book is actually pretty neutrally, historically written, and it's a very good resource.  I've blogged about it earlier, here.  Except for its oversight of the extremely impressive (to me, anyway) Lawrence Kolb, M.D., I can't say enough good things about Nicosia's book.  There's a fascinating wealth of information about the legitimization of the PTSD diagnosis in the book as well.

Here are a few others:

Stanley Karnow's Vietnam: A History, is also good.  The cover calls it "The first complete account of Vietnam at war" -- maybe it should actually say, the first complete account of Americans at war in Vietnam -- so it has its place.  It was written as the companion to the long-ago PBS series of the same name.

Plus three new finds, though, thanks to the pleasantly-disposed boyfriend and his handful of small bills:

"Long Time Passing: Vietnam and the Haunted Generation," by Myra McPherson; "Healing from the War: Trauma and Transformation after Vietnam," by Arthur Egendorf; and "Vietnam: the Valor and the Sorrow" (from the home front to the front lines in words and pictures), by Thomas D. Boettcher.

Each of these books has a particular reason why it's good and worth perusing.  McPherson was a Washington Post and New York Times reporter who carried on 500 interviews with veterans and others to get her material; Egendorf, who Nicosia writes about in his history, was a Harvard graduate, Vietnam vet and psychologist who became one of the founders of the first rap groups to help veterans deal with the personal fallout from the war; and Boettcher was a graduate of the U.S. Air Force Academy who served in Vietnam in the press corps.  His book has more than 500 photographers, many never before published, which adds greatly to its interest (it's also very well-written and well-paced, not deadly.) 

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Additionally, we've already blogged about Lori Sekala's great bibliography on PTSD and war in the blog post entitled, "A Good Librarian is a Wonderful Resource," linked here.  (Sekala is the collection management librarian at the U.S. Army War College library).  But here's something we haven't talked about yet -- possibly THE definitive bibliography on books about the Vietnam war, to better understand the experience.  It's linked here.  Enjoy :-)

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

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

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

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

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

 

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

 

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

 

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

 

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

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

Vietnam Veteran: "Most Of Us Are Afraid to Love" - A Profound and Generalized Sense of Distrust

As part of our ongoing series on "healthy sexuality and the combat veteran," here are some fascinating excerpts from Yale-trained psychiatrist Robert Jay Lifton's work with Vietnam veterans in "rap groups" in the 60s and 70s. 

It's also interesting, in light of the extraordinary closeness and love that combatants feel for one another, how very little of that appears to be transferred successfully to relationships with intimate partners.  Combat seems to develop a closer bond than often even marriage; and the reasons for that are both various and fairly obscure -- not to mention, hardly ever even broached.  We have some ideas, and in the forthcoming months we will be discussing those.  But for now, we're setting the stage with more "raw material" from the veterans themselves about the difficulties they have touching love.

There are very few works that even mention sexuality and intimacy and the combat veteran -- literally, even mention the concept -- so it's interesting how many aspects of it he is able to cover here.  Quite thought-provoking.  "The word on the street" is that, among Vietnam veterans at least, this situation also hasn't changed in the decades since.  They're still pretty much stuck in the same patterns, for the same reasons, that Lifton talks about here:

(In Vietnam,) … even authentic intimacy and love had to be in some degree contaminated by the counterfeit universe, had to be a little distrusted.  Just as men felt that “Whenever you tried to be human you got screwed,” so one of them added, “If you got close you got burned.”

 

Vietnam had absolutized (or totalized) the whole question of intimacy for the American survivors.  Having experienced a particularly poisonous version of the “end of the world” image that characterizes extreme situations, they distrusted, feared, and could not believe in, the renewed human ties they so desperately craved as a psychological basis for reconstituting that world.  The death-dominated imagery they retained had to do with disintegration, stasis and separation.  The overall sense of disintegration (physical, psychic, moral) associated with the Vietnam environment is internally maintained in approaching the environment back home. 

 

The stasis or cessation of feeling derived from extreme psychic numbing in Vietnam leaves one with an image of a world that neither lives nor moves.  Vietnam’s extreme elements of separation – from familiar landscapes of any kind and especially from purposeful or visible images and symbols – results in an ability to find or catch hold of anything with which one can authentically connect.

 

Toward potentially intimate relationships the men at first brought a sense that any such promise of renewed life was counterfeit.  This intense suspicion of counterfeit nurturance – a form of “tainted dependency” in which love and help are equally strongly sought as a personal need, and resented as a sign of weakness – also had direct origins in the counterfeit universe of Vietnam.  There, as the men recalled all too readily, any form of help, nurturing or love was equated not only with weakness of the blind-helpless giant, but with the corruption of the executioner-victim.  To be sure, the men brought to Vietnam earlier imagery of a similar kind involving suspicion and doubt concerning love and nurturing they craved.  But that negative imagery, present from all childhoods, ordinarily combines with alternative images of trust involving one to respond to love and care with the mixed capacities characteristic of all adult life. 

 

In Vietnam, however, the negative inclination – the image of the counterfeit – is likely to be aggravated to the point of dominating one’s entire psychic life – which is why we can speak of the totalizing of conflicts around intimacy, love and nurturing.

 

The men revealed their sense of the importance of these issues in their energetic criticism of one another for maneuvers of any kind that seemed to be flights from intimacy – whether these took the form of shifting the discussion toward safely distant matters, telling shallow war stories, or suddenly shifting into revolutionary diatribes or leaden silences.  Adept as they were at exposing these maneuvers, none was free of profound individual conflict concerning intimacy.

 

Associating Vietnam as they did with their parents’ generation, ultimately with the whole of American society, their sense was something like, “After Vietnam, what could you trust of anything?”

 

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A man with unusually profound difficulties with intimacy (exceeding but touching upon those of the others), he seemed to lapse into puzzling understatement when he went on to conclude: “People aren’t perfect,” and “People are fallible.”  But what he really meant, as his subsequent behavior revealed, was that unless people (and all relationships with them) were “perfect,” they were threatening, untrustworthy betrayers.

 

An engaging person with a certain talent for human relationships, his pattern of keeping people at a considerable emotional distance was interrupted by his falling in love with an attractive young married woman.  He enthusiastically described to the group their plans to save money in order to buy a Volkswagen bus and drive around the country together.  But at subsequent meetings he seemed much less certain and talked of going south alone for a couple of months in order to earn the money for the trip.  He also said that he wanted to “test the relationship” in various ways in order to find out “whether two people can really get along when they are with each other twenty-four hours a day.”

 

It was he who had the garbage-dump dream, and in it he was expressing (in addition to the themes already described) his fearful sense that all claim to love and intimacy was counterfeit, filthy, “garbage.”  Others in the rap group pointed out that he was being hopelessly absolute about the relationship, that nobody could stand anybody for twenty-four hours a day, that he was “manipulating” arrangements with the girl, “preparing a time bomb,” and “setting things up for a break.” 

 

He denied none of this, and was even willing to explore sources of his mistrust, but nonetheless insisted on doing things his way.  He went further and said, “If I can’t love her, then I don’t think I’ll be able to love anyone.”  And when one of the [other] men gently commented, “Most of us are afraid to love,” he answered with a poignant question, “How do you tell when you feel love?”

 

He was soon to prove the men right: before long the relationship dissolved.  But he went on insisting upon “complete independence – being able to get along without needing anybody.”  His all-or-nothing approach to relationships – the totalism we spoke of before – was discussed extensively. both in connection with the Vietnam experience and his own psychological development.  He did not, during the six months or so I knew him, overcome either this totalism or his profound and generalized sense of distrust.  But he did open himself a bit to his own feelings and to glimmerings of insight; and the rest of the group seemed to benefit greatly from what they learned about themselves through him.

 

Falling in love, or feeling oneself close to that state, could be especially excruciating – an exciting glimpse of a world beyond withdrawal and numbing, but also a terrifying prospect.  A typical feeling, when growing fond of a girl was “You’re getting close – watch out!”  The most extreme emotion of this kind expressed was:

 

“If I’m fucking, and a girl says I love you, then I want to kill her [because] if you get close…you get hurt.”

 

Love or intimacy, in other words, posed the threat of still another form of corruption and disillusionment, of still another ‘death.’[1]  It was much easier to avoid that risk and stay numb (remain in an evenly deadened state) – “I feel like hiding out in my own head,” was the way the same man expressed it.

 

But the men did of course fall in love.  When that happened, especially if soon after returning from Vietnam, they would find themselves breaking off relationships because “I couldn’t go through with it,” or “I didn’t want to be tied down to anything.” What they meant was that their psychological work as survivors was so demanding as to preclude, at least for a certain period of time, sustained intimacy or long-range personal commitment.

 

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The general dilemma of these veterans had to do with the extraordinary intensity of both their need for and difficulty with sustained intimacy.  Breaking off relationships was as painful as it was necessary.  On many occasions, entire rap groups were devoted to such closely related themes as: the general problem of fidelity, notably sexual fidelity,[2] the hunger for love and nurturing, and the sense of being chained by sustained intimacy in a relationship; and the powerful influences of Vietnam corruptions – with their residual fear and guilt of great magnitude – extending backward and forward into old and anticipated corruptions that touch virtually all aspects of existence. 

 

This entire pattern of holding on and breaking off contained a continuing dialectic between persistent death imagery and imagery of life renewed.  But they came to realize that the equation was never simple: holding on could take the form either of revitalizing intimacy (life renewed) or of numbed distanced in proximity (a new death), and breaking off could be a pathetic need to reject the intimacy one craved (a self-inflicted death) or a liberating opening out to deep experience and greater self-knowledge (renewed life).  Over the course of time most of the men increased their capacity for intimacy, but that dialectic would simply not go away.

 

-- Source: Home from the War: Vietnam Veterans – Neither Victims nor Executioners, by Robert Jay Lifton, M.D. (Yale-trained psychiatrist).  New York: Simon and Schuster (1973).

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[1] It is possible that he and many others continue to associated the nakedness of sex with Vietnam images of grotesque bodily disintegration – as did Guy Sajer, with memories from the German Army experience of World War II: “As soon as I saw naked flesh [in a beginning sexual encounter] I braced myself for a torrent of entrails, remembering countless wartime scenes, with smoking, stinking corpses pouring out their vitals.

 

[2] I use the term fidelity here to suggest more than loyalty, though loyalty itself was of great importance.   Also involved was authenticity – in sexual matters, for instance, the genuineness of an impulse to find a new partner at precisely the time that an existing relationship showed promise of deepening intimacy.  Fidelity thus involved being true to, having faith in, the animating principle of the new self being formed.  It included overcoming fears that one’s residual destructiveness and death taint would not harm or contaminate others.