Category: Mental Strength

Why We Can’t Cure PTSD

What I am about to say is going to piss some people off.  I want you to know that nothing that follows is meant to diminish the very real struggle that some veterans are facing.  Unless we stop to talk about why we have a PTSD epidemic, we will never arrive at a solution.  The truth, however, doesn’t care about your feelings, so today we ruffle some feathers…

I am going to examine 3 main reasons why, despite the best efforts of seasoned psychological professionals, we are continuing to see a rise in PTSD cases and very few people are getting “cured”.

 

Reason #1 Life Stressors

Difficulties in the workplace or in your personal relationships can exacerbate the problems with PTSD.  Similar to the straw that broke the camel’s back analogy, there simply is only so much that the human mind can handle, and then it gives on everything.  Here at CONUS Battle Drills (CBD), we have talked at length about the challenges that veterans will face with their transition.  It is not an easy time, and you receive painfully little training on how to have a successful transition.  A week long course on transition when you’re two months out from ETS is NOT sufficient.

We believe the DOD’s transition process needs a massive overhaul.  Soldiers are getting guidance about the civilian world from a chain of command of people that have never been in it, and dangerously little of it is accurate.  This is the easiest problem to fix and the stop-gap that we are trying to fill here at CBD by training you how to transition. We seek to give you the tools necessary for personal success in corporate life, marriage, and parenthood and thus remove added stress in your life.  If we can help you get the majority of your shit together, then you can focus on wrestling your demons.

Reason #2 Feeling of Community

This one may come as a bit of a surprise, but for many veterans it is their trauma that connects them to their lost brothers.  Although it can be torturous to re-live an experience in a traumatic way, the thought of losing that connection acts as a barrier to healing.  Whether they feel like they would be losing their friends for a second time, or maybe they feel guilty for being alive, their PTSD represents their service and brings them closer to their brothers.

Our providers need to be aware that some patients may not want to lose their PTSD because of this and deal with that accordingly.  Sometimes this doesn’t manifest itself in any obvious way, but as a provider you need to pay attention to see if this is an inhibition to healing for your patient.

Reason #3 Financial Incentive

This is the hardest problem to fix, and really what I think has spawned the rise in PTSD claims since the GWOT began.

Some guys are out there getting 100% disability for their PTSD, if they get cured, that means taking a hit of thousands of dollars in their disability rating.  Basically, our government is paying these guys to stay sick, and if they’re not sick, to at least claim that they still are or lose thousands of dollars a month!  When you have such a powerful motivation to not get well, it should come as no surprise that they don’t, or even that other guys get sick too.

This leaves us with a choice:  Continue to pay guys even after they are healed or don’t pay disability for PTSD.  Neither is a great option, but unless something is done about this financial incentive, we will never cure PTSD and the rates will continue to go up.

-Spartan

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Never Surrender

Since I started CONUS Battle Drills I’ve had many people send me resume’s to review, ask me tips on handling headhunters and recruiters, and even helped proofread some college papers, but I was really unprepared for the conversation I had last night (even though I probably should have been).

A battle buddy of mine that I used to serve with gave me a call to talk about a friend of his that is getting out of the army (Let’s call him John).  John suffered a combat injury that has left him with chronic pain, and that pain has led to many more issues to include substance abuse, marital problems, and depression.  John is also getting out of the Army soon and doesn’t seem to have a plan for what he wants to do.  My battle buddy gave me an open-ended question asking for advice on how to handle this situation or what advice to give to his friend.

Now if you follow this page at all, you should have noted that John is on the path noted in Dark Night of the Soul and is exhibiting many of the risk factors for suicide.  If John doesn’t make some changes, there is a very good chance he is going to become another statistic and through his surrender, another family is going to be broken.

risk factors

 

If you’ve read the book, then you know that one of the objectives of CONUS Battle Drills is to prepare guys in such a way that they can address some of these risk factors and get on the path to healing and success.  I am not qualified to help John through many of his problems, and neither is my battle buddy, but together we are the first line of defense and can get him the real, professional help that he needs.

Surrender

My heart breaks for guys like John, but he is surrendering.  It’s easier to get up and ring the bell during hell week than to continue to suffer.  It’s easier to quit in mountain phase of ranger school than to endure another two months of pain.  It’s easier to drop out in selection than to continue to roll in the log pit filling your pockets with vomit.  The hard part, and the part that makes it all worthwhile, is to fight on, push past your limits and succeed in your goal.

Gentlemen, getting drunk and high, divorcing your wife, losing your job, that’s surrender.  You know what’s hard?  Fighting an addiction, repairing a marriage and building trust, getting promoted, even apologizing.  I’m not going to marginalize John’s problems, however, and just say that a change in attitude is going to fix everything because it’s not, but he needs to make a commitment mentally to get off the path of least resistance, get back on azimuth, and start working towards what is important in order to find healing and satisfaction.

What is Important to You?

The second big question is to understand why you are getting out.  We have explored that extensively and even argued about whether that needs to be the first big question instead of the second.  Understanding what is important to you is very similar to the why because it becomes the overarching goal in which all other smaller goals will fall.

Using my earlier examples, the guys who eventually earn the SEAL Trident, Ranger Tab, or Special Forces Tab went to that school with the mental attitude that no matter what, they were going to achieve that goal, but they also compartmentalized their problems and challenges and created a series of small goals that were attainable that fed into the overall goal:  Pass the PT test, don’t fall out of the run, find the next point in land nav, get over this obstacle, don’t quit.  Even though surrender was an option at every turn, they avoided it because it didn’t fit into their overall goal.

So let me ask the question, What is most Important to You in Life?  Think about everything that you could lose, which of those things would be the absolute worst?  To me, it’s my family.  I can lose my job, my house, all my things, but all of those can be replaced, my family can’t.  Therefore every action I take, every decision I make, I ask myself whether or not that action or decision is helping to preserve that which matters most to me.  If the answer is “no” then I need to correct my course, get off the path to surrender, and move back towards my objective.

Paying the Small Debts First

I’m a big fan of Dave Ramsey and his Financial Peace University.  In many cases of soldiers that I work with, financial strife is the first problem that they face and things snowball from there.  Dave Ramsey gives counseling every day to people sometimes hundreds of thousands of dollars in debt, and his advice always starts with paying the small debts first.  This gives us the opportunity to take some weight out of our rucksacks a little at a time, develop good habits, and prepare us to take on the biggest monsters because the ankle biters have been taken care of and we can laser focus on the bigger issues.

In John’s case, however, finances have become a symptom or a consequence of his initial injury that drove his addiction.  Now he’s facing a major life change by getting out with no job, no career goals, and no focus.  This is compounding problems in his marriage, making him want to quit.  In John’s case, finding a job is his smallest debt.

Let me put it this way:  John isn’t going to wake up tomorrow and not have pain.  He isn’t going to wake up and not have an addiction.  He isn’t going to wake up and not have any problems in his marriage.  There is no action he can take today to make those problems go away.  In fact, he will be fighting those battles for many years to come, BUT he can wake up tomorrow and have a job!  He can take a single action this afternoon and tomorrow wake up with a career; it’s a small victory and one he certainly needs in his life right now.

John also needs to get off the path of surrender and do the hard task of asking for professional help with his addiction, managing his pain, and repairing his marriage.  Gentlemen, going to a mental health professional doesn’t make you weak.  It’s hard to admit that you need help, the mistake is thinking you can do it alone.

Conclusion

I know a lot of you are suffering like John is, and too many of our brothers out there are quitting life because they can’t handle the enormity of their problems.  I want you to know that there is help, there is healing, and you are not alone.  One of the pillars of my strength come from God, and I encourage you to seek Him out.  Even if you don’t believe, joining a men’s group where you can talk openly with other men facing the same problems will give you great strength just like your battle buddy did in combat.  Please don’t surrender, there are people in this world that are counting on you, and to them what you have done in your life makes you their hero.  You can do this and there are people that can help.

God Bless every one of you!

-LJF

Getting out of the military is hard!  Don’t make it harder on yourself by not being prepared!  Buy CONUS Battle Drills:  A Guide for Combat Veterans to Corporate Life, Parenthood, and Caging the Beast Inside!

The Power of Perspective

This is my friend Steve.  He’s one of my favorite people in the office:

steve

Steve is one of our test engineers here at John Deere, and an integral member of our team.  He is hardworking, honest, and always has a positive attitude.

I first met Steve about a year ago when I moved cross-country and started working in North Carolina.  We shared a corner of a large cubical farm and both of us being early risers meant that we generally had some time to chat each day before most people showed up to work. I looked forward to those morning conversations, learning about him and his interests, but most of all, I loved his perspective on life.

I remember the first time he told me about Muscular Dystrophy, it was in passing, and it seemed to me he was determined to not let a disease define who he was.  As the months went by, I noticed a wheelchair brought into our cubical and asked him about it.  It was there in case of an emergency evacuation; he can’t move as fast as others.  Then he said something that I doubt he even remembers, “I’m blessed that I still can…” and then went on to list a bunch of things that he still could do.

BLESSED?!

Here is a guy that has every reason to be angry at God and his response is faithfulness and thankfulness that he “still can”!  I thought it was amazing and inspiring, and it was an affirmation for me to continue to focus on my own blessings and stop zeroing in on every problem I have.  I needed to really consider my own perspective.

My Inspiration

Steve is no longer my cube mate, he had to move closer to the entry door to the factory, and just a few weeks ago I noticed he had a powered chair.  We spoke a bit and he opened up about some of the difficulty he was facing: how tired he was, how he couldn’t play with his beautiful daughter, and how this chair was changing all of that for him.  I found out that although the health insurance paid for the chair, they wouldn’t pay for the new, specially modified vehicle he had to buy to transport it.  When I expressed shock at that, he merely responded,  “It’s cool, I had this planned for a while.”

It’s cool?!

Here is a guy having to buy a car worth almost as much as a house due to his medical condition, getting no financial support to do so, and he can only talk about how it’s great that he was prepared and had enough income to take it on.

He told me another joke, we laughed for a bit, and I drove home.  On my drive I began to think of how I would deal with what Steve is going through right now, and realized that I have a lot to learn from him.  I also realized that I am wasting the blessing of good health.  If i was unable to run, I’d probably complain about it, even though I rarely do it now. So I got back into the gym the next day.

Perspective

I was on the elliptical one morning not long after my decision to work out more when it hit me that a healthy body wasn’t the only blessing that so many people take for granted.  We’re so preoccupied on having more, that we rarely stop to appreciate what we currently have.  Our homes, our familes, our cars, a full belly.  I’m not cold, wet, hungry, or tired.  I’m not getting shot at, and i’m sleeping in a comfy bed with air conditioning.  I have a comfortable pair of shoes and new clothes.  I shower every day and have furniture in my house.  I own several televisions, I have internet, a phone.  The list goes on.

I have seen and lived among people that pray every day to be exactly where I am right now; am I thankful enough?  Are you?

My friend is going through a tough time.  This is the card he has been dealt, but instead of wallowing, he is inspiring.  Instead of faltering, he is ever more faithful.  Instead of depression, he spreads an infectious smile.  I need to be more like Steve, and in the age of the victim, I think we ALL need to be more like Steve.

What’s your perspective?

-LJF

Getting out of the military is hard!  Don’t make it harder on yourself by not being prepared!  Buy CONUS Battle Drills:  A Guide for Combat Veterans to Corporate Life, Parenthood, and Caging the Beast Inside!

The Dark Night of the Soul- Part 2

In this second part of our topic on suicide (click here for part 1), I would like to discuss the more intimate factors associated with suicide. Perhaps we could reframe it by asking, “Why people kill themselves”?

The answer, as I mentioned in the first posting, is complex. There is no one single answer that would explain that tragic behavior. However, in my many years working with very distressed and hurting people as well as reading and thinking on this subject, I have come to see four factors, which seem to be present in one way or another in the mind of those who are contemplating suicide.

The Four Factors

 

  • Hopelessness. Many years ago, a very prominent American Psychiatrist, Dr Aaron Beck, who is also known as the ‘father” of Cognitive Therapy, noticed that an item in his depression questionnaire highly correlated with likelihood for self-harm, including completed suicides. This item dealt with a sense of hopelessness. Later, he developed a whole questionnaire known as the Beck’s Hopelessness Scales to evaluate this very important construct. The person who is at high risk for suicide is the person who has lost the sense of the future, who develops strong pessimistic attitudes, has very low motivation to do anything, and has limited expectations regarding life and others. In working with very depressed people over the years, I have seen repeatedly that it is not the degree of adversity in the person’s life, but the loss of hope that is critical. It reminds me of the quote from Nietzsche “give a person a why and he can deal with any how”. No matter how much pain and suffering a person experiences, if hope exists, if there is a point to everything (a “why”) then he can deal with the greatest of difficulties. On the other hand, once hope is lost, life tends to go the same way. The beautiful, courageous and tragic story of Ann Frank reminds us of this principle. This young Jewish adolescent hid with her family is an attic of a house in Amsterdam during WWII. Her diary shows despite her precarious situation, she was hopeful and joyful. She kept hoping for the day of liberation, and her future life. Sadly, they were betrayed and the Nazis sent them to concentration camps, and there she fought on, resisted this evil with all her might, until her older sister died. Ann, who had so gallantly and courageously battled fear, horror, hunger, and disease, felt there was no more hope and let go of life; she stopped fighting and surrendered herself to despair. Just four weeks later, the allied forces liberated her concentration camp.
Otto Frank visits the attic
  • Pain. Edwin Shneidman, in his seminal work on suicide, created the term “psychache” to describe the depths of psychological pain, hurt, and anguish a person experiences when contemplating suicide. While in sadness and depression, we always feel a level of pain, this is a more intense, despairing and alienating type of pain. As a Psychologist dealing with people in this state, I always felt this huge emotional divide when trying to reach out, to succor, and to bring hope. This is not only a hurtful pain, but also an alienating type of pain, which cuts people off from others. A person who suffers this type of pain, feels no one understands or can understand. This person feels alone, desperate and hopeless.
  • Anger. Sigmund Freud in his pioneering work in Psychoanalysis theorized that one prominent reason why people developed depression was through an unconscious mechanism in which anger, initially felt against other people, is introjected (turned inward) against the self. This is possible because we carry within ourselves our histories and the image of important people in our lives, even those who have hurt us. Therefore, the anger we feel towards them we direct it to their internal representations in our minds. At some point, this anger, or better-said “rage” is let loose and becomes murderous rage against the self. When I was in training I had a supervisor who used to say that suicide was the ultimate “fuck you”, referring to this concept in which the act of killing oneself is a defiance, a message, towards others whom have hurt us and whom we hate. Independently of the veracity of this theory, the person who is suicidal is typically very angry as well, although as frequently, this anger is not acknowledged.
  • Guilt. The final horseman of this apocalyptic self-destruction is guilt. This emotion, as all emotions, carries within itself, a set of consequences. A person who is guilty feels the need to be punished. It is only through punishment that guilt can be released, paid for, and the emotional debt, be once for all, finally settled. When guilt is unbearable and the hope for forgiveness is not available, suicide becomes the ultimate and proper method of paying that debt. A common misconception in PTSD is that people develop symptoms due to witnessing or living through horrific images of horror or destruction. While it is true that witnessing experiences of this nature will affect us in emotional ways, most people will, with time, feel better and return to normal functioning. In most severe cases of PTSD, the dynamics are very often consistent with feelings of guilt regarding what the soldier did or failed to do, which resulted in pain, suffering or loss of life. Now this guilt does not have to be “logical, real” so to speak, it only needs to exist in the person’s psyche as a constant reality and accuser of his actions. Sometimes this guilt takes unusual form such as the well-known “survivor guilt” in which the soldier feels guilty not because his actions (or lack of) but just because he survived and the common expression of this existential dilemma is “why me, why was I spared”? Another interesting twist to this guilt is the man who becomes horrified to find he had the capacity to enjoy killing and destroying the lives of other people. I have seen variations of these themes in almost all of the cases I have treated with severe PTSD, and this is a very difficult obstacle to overcome.

Where do we go from here?

There is very little doubt that the person experiencing these kinds of emotions, needs to find professional help. The good news in this tragic story is that people do recover and hope flourishes again in the desert of our hearts. War changes people, but beyond the horrific consequences of battle, the person you become is not dependent on the events themselves but on the choices you make, in the face of those events. Who you are at any given time in your life, is not the sum total of all your experiences, although those are indeed primordial. Who you are and who you become is who you choose to be; we are our existential choices.  An old priest told me of his experiences counseling those who were about to die in a firing squad (this was right after a revolution in a Latin American country). Some men had to be dragged and tied to the post, while they cried and begged for their lives, while others walked to their deaths with defiance, refused the blindfold and died yelling at their executioners or praying and singing to God; same fate, different attitude. I was a young adolescent when I heard this story, and throughout my life I always wondered if placed on that situation how would I die. Most importantly, this story always reminded me that I am and I become my choices, even when those choices may just only be the choice of my attitude.  

If you or someone you know is facing these demons, seek out help. The very first step in any type of recovery is the acknowledgment of the problem and the decision to do something about it. The road to recovery may not be easy, but good and wonderful things do not come easy, they take work and commitment. You need to realize the need to open up the old wounds and face them, talk about them, tell them to another human being who will be there for you. You need to find in your heart to forgive yourself for real or imaginal wrongs you did or for the failure to act; to forgive others, to let go of the guilt and the anger you have been harboring for years. You need to find new purposes and goals, new meaning, to renew hope, to heal the pain and to find the path you will walk for the rest of your life. You will not forget your memories, those will always be there, but your understanding of them, your relationship to them and your reaction to them, that will change, and that change will make you free.

Many aspects of this process are not only psychological but spiritual as well. Long before we had psychiatrists and psychologists, people would come to their parishes and spiritual leaders for healing and guidance; it worked for them and it can work for you as well. Confession, forgiveness, and renewal, ancient practices that are never too old or outdated for us to use them.

Galgano Guidotti was a knight who fought bravely in the Crusades and upon his return, he carried with him the invisible wounds of the soul. The story is told that in his despair, he stuck his sword in a rock and turned to God for healing, changing his life forever. Today there is a small chapel in the Galgano Monastery in Montesiepi in Tuscany, Italy where that sword can be seen. It still stands as a reminder of a warrior who found peace and a new purpose in his life; if he did it, you can also do it.

-Spartan

 


Getting out of the military is hard!  Don’t make it harder on yourself by not being prepared!  Buy CONUS Battle Drills:  A Guide for Combat Veterans to Corporate Life, Parenthood, and Caging the Beast Inside!