PTSD: Supporting Our Troops Means Being On the Lookout For Symtoms

Despite the fact that we’re still fighting a war in Afghanistan, we’re presently losing more of our military to suicide than to combat. Among military veterans, we’re losing 22 a day to suicide. There are many reasons a person might choose to take their own life, but one I’d like to focus on is Post Traumatic Stress Disorder, often referred to as PTSD. For the past five years I have volunteered at Ft. Bragg, North Carolina, teaching soldiers how to use journaling as a tool to manage PTSD symptoms.

Some of you may know a veteran who came home from Vietnam or another conflict with issues no one could explain. When Vietnam vets sought help, they were often ridiculed because the mental-health professionals to whom they turned for help did not recognize their affliction as real.

In fact, PTSD has been with us for as long as we’ve had war. The first time there was a written reference to PTSD was in Homer’s Iliad (written around 762 B.C.), when the author describes Achilles’ behavior during the Trojan War.

Agamemnon betrayed Achilles by denying his claim on Briseis, the Trojan woman he had won and come to love. Achilles’ anger took the form of extreme violence enacted against his enemies. He became more fearless and disrespectful of his foes. It’s believed one of the main contributors to the PTSD cases from the Vietnam War was the betrayal of our warriors by the government.

Over the centuries PTSD has been known by many names: Soldiers Heart, Shell Shock, Battle Fatigue. Before our Civil War, people didn’t describe the disorder in terms of cause. All the symptoms were laid at the feet of the victim. They might acknowledge that “war has changed him,” or “he hasn’t been right.”

PTSD is not just a wartime phenomenon, though. It’s brought about by trauma. Victims of assault or abuse or even car accidents develop PTSD. It’s also not yet defined in a way that makes diagnosis clear or treatment standardized. Current treatments emphasize anti-anxiety drugs and talk therapy. PTSD was not defined or even acknowledged by the mental-health community until 1984, so there’s much to be learned.

Fort Bragg is home to the 82nd Airborne and Special Operations Forces, including the Green Berets and the elite counterterrorism unit known as Delta Force. When my youngest son was serving in the Army, I often spoke with him about PTSD and my fear that he could fall victim to it. I encouraged him to keep a journal during his nine combat deployments. Not to share, but to vent. To tell the stories as they happened so he didn’t have to lock them into the deep recesses of his brain. Once they’re stuck back there, it’s hard to get them out.

As Jason was nearing the end of his 10 years of military service, I moved to North Carolina to help get his house ready for sale while he served out his final deployment. I decided to use some of my time there to share with other soldiers the power of journaling as a tool to manage symptoms of PTSD. Working closely with chaplains, therapists, and family members, I connected with Ft. Bragg’s Warrior Transition Battalion, a unit whose 750 members include men and women who’ve been injured in combat. When Jason left the Army he moved to Washington, D.C. to attend grad school and is now a senior staff member at the Veterans Administration. I chose to stay in his house so that I could continue my work at Ft. Bragg.

My focus for the past five years has been on soldiers with PTSD and Traumatic Brain Injury, or TBI. I’ve heard many of their stories, though I’ve never asked them to tell me any. Our time together centers around how to use writing in general and journaling in particular to flesh out the stories that keep them awake at night, that drive them to drink too much, to isolate themselves and barricade their lives from the outside world.

Over the years I’ve been told by chaplains that I do what they do … but for soldiers who cannot seek a chaplain’s counsel. Many resist the availability of a chaplain, in part because they do not understand how non-judgmental chaplains are. I’ve met with many and they humble me with their understanding of their mission. Soldiers first, then God. Except for rabbinical chaplains who wear a camouflage yarmulke, in most cases you wouldn’t know their denomination unless you ask. They’re there to help, and if there’s time, to preach.

I’ve been told by therapists that I’m offering therapy to the suffering who cannot seek a therapist’s help. They’re not all happy about it, but the ones who get it are quick to refer soldiers to me. In a quirk of military necessity, soldiers who speak with an Army psychiatrist cannot rely on doctor-patient privilege as we civilians do. I hate it, but unfortunately it’s necessary. The soldiers see me as safe. I’m off the books and I don’t report to the Army. I do not charge the soldiers anything for my time and I give each one a copy of the journaling workbook I wrote. To the soldiers, the best part of this arrangement is that there is no record of our meetings. No referrals are necessary and nothing is documented.

When I have a chance to speak about my soldiers, I do so not to share their stories, but to share their plight. When you pass them on the street, you don’t see missing limbs or scarred faces, though you might. Chances are, if you see them, you’ll see a person who has a combat wound, an invisible wound that controls their life, preventing them from enjoying the day to day. I talk about them so you’ll know that PTSD is a combat injury that can be every bit as debilitating as a physical wound.

Among the problems that veterans have about opening up is simply the horrific nature of the things they’ve seen. They’re afraid that if they tell all their stories, they’ll be judged. Someone might say, “How could you do such a thing?” They can do such things because it’s their job. They don’t enjoy it, and know that you might recoil at the awful sights they’ve seen and the terrible things they’ve done. The safe thing is to just be silent. You and I might say, “Fine. I don’t want to have such visual images presented to me.” But when the soldier leaves those images locked up they eventually begin to creep out. We often think about the image of a soldier diving for cover when a car backfires. More likely though it is caused by images of a mother carrying an infant seconds before an IED explodes, juxtaposed against a mother carrying an infant in a grocery store back home. It can take the soldier back to combat in an instant.

PTSD is also not the private realm of male veterans anymore. I’ve worked with a number of females, and if you look at the way our military has changed, women are at risk every day. A hundred and thirty-nine females have been killed in Iraq and Afghanistan, and more than 800 have been injured. Contrast that with the eight females whose names appears as combat casualties on the Vietnam Memorial in Washington, D.C. and you begin to understand how much the military has changed. The Department of Defense recently lifted its ban on women in combat. Some saw that as a big deal, but all of the casualties I just mentioned happened before that change was announced. Women have been in combat since the beginning of these wars. And they carry the invisible wounds of PTSD just as much as the guys do.

When you read about PTSD, when you see it discussed on the news, know that it’s real, that it causes real pain and suffering. Support your vets in any way that you can to let them know you care. When you go to Memorial Day events, don’t just eat a hot dog and enjoy a refreshing beer. Take a minute to honor our fallen heroes, the ones we’ve lost and the ones we’re going to lose.

The families of the fallen want to know there are people who care about their loss. When you meet someone who has lost a family member, don’t dwell on how bad you feel for them, and for God’s sake don’t tell them what you think of the war. That ranks at the very top of the list of irrelevant data when you’re talking with someone who has lost a loved one. Ask them about their loved one. What kind of a person were they? What did they enjoy? Let them talk. Listen.

This article is an excerpt from a speech delivered in May 2013 at Northwest Unitarian Universalist Church.

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Michael Cain

Author, PTSD coach, highly opinionated.

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