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July 10, 2009

About Time

Hallelujah:

Regarding your new post on PTSD I'm glad that you posted the great link and, on a purely confidential basis, I believe the fairly common idea (certainly on the shrink side) that "PTSD...cannot be cured, only managed", may turn out to be a pile of horse manure in the long run.

How society defines its illnesses has a huge impact on their treatment.

Society is telling PTSD patients that they are marked for life and can never hope to cure themselves. That leaves no room for hope. And on what basis? We've barely got a handle on PTSD - have barely scratched the surface in terms of its effects on brain structure and avenues for treatment - and we're already calling quits on a cure? Why?

Recovery is possible. But as long as soldiers and Marines - often young, insufficiently skeptical, utterly reliant on authority - are told by everyone around them that the mind is like a bottle, and that once it breaks, you can piece it together again, but it'll never be as strong - as long as that's the social message, there's little hope for full recovery. But the mind isn't a bottle. It's a bone. Once it heals, it grows stronger, more resilient. We need to change the message to reflect the possibility of being strengthened by PTSD in the long run.

The timing of your blog post is very fortuitous. Last night, I received a call from one of the Marines who handled my medical discharge - for PTSD - and who's kept in touch with me since I left the Marines in '07.

He asked me to call another Marine who's been dealing with PTSD for years and is trying to move forward, because he wanted me to relate how I've not just come to terms with PTSD, but haven't had any symptoms since roughly three months after my discharge. I'm calmer, smarter, happier than I've ever been in my life -- and I've tested myself under very stressful circumstances. Next month I'm heading to [deleted] because I can still contribute as a civilian. And by next year I hope to be waived back into the military, as an officer; and I wouldn't do so unless I was 100% confident that I will not jeopardize the men under my future command by re-enlisting with persistent symptoms or delusions that I'm fully healthy.

I cannot be the only one, because there's nothing special about me. And I'm not going to dedicate my life to this issue because I just want to move on. But more prominent veterans can make a difference. Iris Adler made a documentary featuring your own Nate Fick talking about how he overcame PTSD, in so many words. I was about to email Nate to ask him whether he thinks he's overcome it. Please ask him. If he's symptom-free, it should mean he's cured, not that it's always just around the corner; because "you never know about tomorrow" isn't a scientific benchmark. It's a recipe for anxiety and fear.

Veterans and serving Marines need to finally hear success stories. They need hope, not life sentences. We just need to find and publicize these stories.

So, maybe one question worth looking into -- and I've never heard of a journalist doing so -- is whether veterans with PTSD ever re-enlist.

Surely, out of the tens of thousands with PTSD, there must be some who came back -- in every sense of the words -- to continue doing what they love, and inspire those around them to stare their demons in the face and walk away much stronger for it.

The answer to this question is: yes. In the 1980's I knew serving Marines who still battled PTSD, and those who were hardly ever troubled by symptoms. All were functioning, and functioning well.

This is not to minimize what those who have to deal with post traumatic stress go through, but somehow it's hard to see how treating them as permanently damaged goods helps, either?

This is, in large part, how we came up with the name for our tiny non-profit: Honor Their Service. Because that's what it's all about: recognizing that it's their service and not their wounds (visible or invisible) which define them. They're not victims.

They're survivors. Warriors.

Posted by Cassandra at July 10, 2009 04:54 PM

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Comments

But to investigate the issue of whether or not people can recover from PTSD would spoil the meme that all ex-service people are a) victims or b) not to be trusted.

Posted by: RonF at July 10, 2009 05:14 PM

Ron, you meany. How dare you dignify service to one's country!!?? I would tell you to punish yourself, but it is a loverly day here in the Atlanta Metro area, a gorgeous 78 degrees and no need for A/C.

Is the cookbook done yet?

Posted by: Cricket at July 10, 2009 05:39 PM

...it's hard to see how treating them as permanently damaged goods helps...

Your gift for understatement remains intact...

Posted by: BillT at July 10, 2009 07:04 PM

Good excerpt.

Today, too many people seem to forget we had an entire generation of men who saw horrific things in combat during WWII who went on to live full, normal lives. It wasn't "PTSD" back then. "PTSD", "Shell shock", whatever we chose to label it, has been around since forever. There's just a different focus on it now, and I think - as cited in the quote - how we choose to frame the issue makes a big difference. It may be harder for some, but we shouldn't view overcoming PTSD as impossible.

Posted by: Miss Ladybug at July 11, 2009 02:19 AM

PTSD is an odd thing. It can result from the duration of combat, the intensity of it, or it can be triggered by a single horrendous -- even if only in the eyes of that individual -- incident.

In WWII, the average *combat* infantry soldier spent 40 days in contact. The AAF recognized that a combat aircrew became pretty ineffective after 40 missions, so that was *their* limit.

In RVN, the average *combat* infantry soldier spent almost 200 days in actual contact. As far as flying goes, I flew roughly 80 combat assaults every month, and I didn't fly as often as some of the other pilots in our unit did.

Posted by: BillT at July 11, 2009 05:06 AM

Bill's first comment (and your comment) is right on--treating someone as a victim or as if you expect them to be permanently damaged is often disabling/repressive. It just gives them another thing they have to fight.

Posted by: FbL at July 11, 2009 09:53 AM

"it's hard to see how treating them as permanently damaged goods helps"

Well, it helps the liberal cause. The fact that it harms actual people doesn't matter. As usual.

Posted by: pst314 at July 11, 2009 11:33 AM

BillT, I have a valid question here: With regard to stress, you seem to be pretty mellow. You have mentioned that you are low maintenance, etc.
Here is the question: When you talk about PTSD being triggered by time spent in theatre or one incident, how do the coping mechanisms kick in to allow someone to keep doing their job in spite of the conditions?

I ask because I still get the jitters when I drive on the interstate.

Posted by: Cricket at July 11, 2009 12:05 PM

I don't cope -- I just keep going in spite of it.

I learned pretty early that I couldn't control the things that triggered flashbacks, because there wasn't any pattern to them -- except that my mind was idle when one kicked in.

One minute, I'd be taking the dog for a walk, the next minute there would be an exploding instrument panel in front of me in 3-D with SenSurround. I heard the radio chatter and felt metal and glass hitting my face.

I'd wake up sitting on the ground with a panicky collie jumping all over me.

After I figured I wasn't totally loony, it still took a while before I made the connection (*not* the sharpest brick in the hod), and I started consciously working to keep my mind occupied. If I was taking the dog for a walk, I'd mentally trace our route and look for new details to memorize. I worked the dog until she could have performed at Westminster. The flashbacks still came, but they came less frequently, and I taught myself to see *through* them to my actual surroundings.

I never got them when I was flying, because I kept my mind busy with navigation problems, and whenever I got behind the wheel of an automobile, I made a game of anticipating the moves of the other drivers around me and calculating how fast I'd be able to stop if I had to.

I'm a lousy driving companion, because I can't concentrate on driving and yakking at the same time -- but at least I don't see burning helicopters when I'm driving.

Lady Cricket, keep your mind occupied *safely* and the jitters will abate, little by little. They'll never entirely disappear, but with the passing of more time, they'll fade into a minor unease that you'll hardly notice.

I promise...

Posted by: BillT at July 11, 2009 02:16 PM

Bill...thank you. I think there is something to that in keeping my mind occupied (as if there wasn't enough fluff in there already), and engaged in productive activity. Is that why your garden is so lovely?

Your post has given me much to think about along the lines of Jesus Christ and Dr. Frankl. Losing one's self in service (your dogs are well-trained and obedient) and finding reasons to continue.

Be well and safe.

Posted by: Cricket at July 11, 2009 03:21 PM

BillT;

My experience is that they build cars better these days. No more backfires from a poorly tuned motor that found me sitting on the floor of McDonalds in a cold sweat.

"Supersize please....to go!"

Posted by: vet66 at July 11, 2009 03:23 PM

FbL, I can give you another reason why you don't treat someone as a victim or damaged goods; because you start to believe it and it delays or can stop any chance of recovery and function.

For the longest time, I had a non-union of my humerus. It finally healed after my third try at surgery. My injuries did not define me; how I dealt with them and the cause did.

Over two years ago, I ran out of my prescription painkillers, and no refills or new ones since.

Posted by: Cricket at July 11, 2009 03:34 PM

No more backfires from a poorly tuned motor that found me sitting on the floor of McDonalds in a cold sweat.

I got flagged from McDonald's.

In retrospect, it was a *good* thing.

Posted by: BillT at July 11, 2009 03:52 PM

I'm feelin' the love...! I was only banished to the drive-thru. Tell me you never told the newbie we can just "Autorotate down in an emergency?"

I can still vividly recall the smell of boiling fish heads, JP-4, and hot hydraulic fluid.

I'm Okay! Your'e Okay. I think we pioneered the E.S.T. school for Werner Erhard. Depends on what the meaning of the latin EST (it is) is. I wasn't invited to attend of course. My hair was too short.

Posted by: vet66 at July 11, 2009 05:00 PM

Tell me you never told the newbie we can just "Autorotate down in an emergency?"

Nup. It usually started out, "If we live through the crash..." and then got a bit more detailed.

I figured if he could hang tough on one of my briefings, he had a good chance of keeping his cool when the windshield turned into Swiss cheese. Although I *did* goof every so often -- I figured one guy was just being deadpan and he'd actually gone catatonic...

Posted by: BillT at July 11, 2009 05:19 PM

Only a professional can discern the difference between 'deadpan' and 'catatonic'. Wish I could have flown with you.

Posted by: vet66 at July 11, 2009 07:52 PM

Aw..isn't that just the cutest thing?!?!?!?

One more question and I promise I will pipe down.
Different triggers, then?

I promise I will keep the Precious tuned.

I saw 'Eragon' tonight. Sigh. The book was so much better, so I will not rename the Precious 'Saphira.' Besides, I am more of an Anne McCaffrey fan. Especially the Brainship series.

Nighty night.

Posted by: Cricket at July 11, 2009 11:31 PM

You guys never cease to amaze and inspire me.

Posted by: Donna B. at July 12, 2009 01:43 AM

Different triggers, definitely -- oddly enough, gunfire isn't one of them unless it's aimed directly at me.

Intense emotion is a definite factor, though I'm not positive it's a trigger or a byproduct, because the emotion occurs simultaneously with the show. About ten years ago, I began experimenting by trying to temper one by writing about it as it occurred, which is where the TINS! collection had its roots. The act of writing a TINS! while one is happening does seem to have decreased their overall frequency.

The annoying thing is that trying to compose a TINS! sometimes triggers the show. The good thing -- speaking objectively -- is that memory-faded details get...*refreshed*...

Makes the story more readable.

And it keeps me honest, 'cuz the guys who flew with me know what happened, too -- and the sneaky bastids *lurk*...

Posted by: BillT at July 12, 2009 06:52 AM

I am more of an Anne McCaffrey fan.

Moi, aussi.

Posted by: BillT at July 12, 2009 06:56 AM

I have no military experience, but the current thinking on PTSD echoes what the mental health and feminist community has done with rape victims. I worked with a rape prevention agency when I first graduated from college, and had to leave it because this kind of thinking started to consume me. While they insisted that being a victim of rape was nothing to be ashamed of, they also focused so much on the victim status that it would be difficult to put it behind you. And the constant focus on it makes you see a rapist in every man, making it almost impossible to move forward and have healty relationships. It's such a trap, and now they are treating PTSD the same way.

Posted by: April at July 12, 2009 08:29 AM

...the current thinking on PTSD echoes what the mental health and feminist community has done with rape victims.

An Army psychiatrist lived with us for a month while he did research on the cumulative effects of being shot at roughly 24 hours each day.

He came to the conclusion that none of us could possibly be sane.

We, in turn, considered him to be a total fruitcake.

Posted by: BillT at July 12, 2009 09:06 AM

To quote Cervantes: "Who knows where madness lies?"

OhMYGAIA Bill, I laughed so hard I started to hiccup.

I love reading your TINS! Some of the technical whirlybird stuff is beyond me, but the prose is fantastic.

I found writing to be a catharsis as well. For two years after our event, I wrote a journal. Even though I still post entries to it, it helped take that sharp edge off, leaving me with the jitters, which is the next thing to be dealt with.

I simply Do Not Have the Time to be in a Time Stop (obscure Artemis Fowl reference; the books are fantastic), because I have people who depend on me. It doesn't stop the even being played out in the back of my head every single day, but it does help me help me keep focused, hence the Dr. Frankl reference.

Posted by: Cricket at July 12, 2009 09:56 AM

I really need to quit staying up and contemplating the demise of my accounting book...

Posted by: Cricket at July 12, 2009 09:58 AM

Did the army psychiatrist who lived with you ever realize that he was part of the problem being researched? They remind me of the guy who studies only the pee in his boot and not how it got there.

They are like music critics. Never wrote a symphony but make a career out of chasing sour notes. I hope he took some time to study the 12 step program from AA. I would recommend that wonderful program to all regardless of their personal demons. It is a lesson in survivability.

Posted by: vet66 at July 12, 2009 11:31 AM

Did the army psychiatrist who lived with you ever realize that he was part of the problem being researched?

He may have gotten an inkling when he decided to watch the pretty fireworks one night and climbed on to of our bunker.

I drew the short straw and had to run out, grab his ankles, and drag him inside.

Posted by: BillT at July 12, 2009 02:58 PM

Too funny! A real boost to his ego that you drew straws and the loser had to save his butt. Reminds me of the writer in one of the Dirty Harry movies. A military guy was demonstrating the Laws Rocket and Callahan had to pull his partner played by Tyne Daley in the clear as the back blast almost put an end to her short career.

Good job. That could have had a real Looney Tunes ending. I lost track of the number of times the hair on the back of my neck stood up in the dark leaving me to wonder what I had just missed or just missed me. I had images of some representative of the nether regions passing me by on icy wings because he/she had orders for someone else.

Personally, I believe HELL is run better than our government at times.

Posted by: vet66 at July 12, 2009 07:46 PM

Hell has laws you know, despite *who* rules it.

Posted by: Cricket at July 12, 2009 08:20 PM

Let's leave the IRS out of this, shall we?

Posted by: vet66 at July 12, 2009 08:38 PM

...the hair on the back of my neck stood up in the dark leaving me to wonder what I had just missed or just missed me.

When a tracer goes past you on the left and another goes past you on the right, you *know what just missed you -- the four rounds that weren't tracer.

That's when you wonder *why* they missed...

...or start looking for holes in case they didn't, but the adrenalin just kept you from noticing.

Posted by: BillT at July 13, 2009 02:02 AM

That's when you wonder *why* they missed...

The answer to that is pretty simple, really. It is all part of the grand plan that says, according to the big script, it wasn't our time to go. Call it luck, fate, joss, or whatever, but the exquisite difference between life and death is immeasurable. When we read of the exploits of the typical MOH hero, indeed, the typical warrior engaged in his/her one minute of total chaos after 59 minutes of abject boredom, the unseen hand of the "big plan" is apparent.

Somebody must remain to carry on. That, my friend, is why we were spared. I try very hard not to take that gift for granted. Time is precious, is it not?!

Posted by: vet66 at July 13, 2009 09:21 AM

Yup. That it is...

Posted by: BillT at July 13, 2009 11:51 AM

I wasn't shot at (it was a knife on the other side of an open window) or raped (simple assault the first time, the second time they settled for throwing me down two flights of steps. And people wondered why I hated high school?), but it was ten years before I could be around 20ish year old men with dark hair and attractive features without breaking out in a sweat and edging towards the closest door. I still make darn sure I know where the doors and windows are, and I don't like people getting close behind me, but I'm darn sure not a victim to be petted and cosseted. Wasn't back then, either!

Posted by: LittleRed1 at July 13, 2009 02:20 PM

Good on ya, Lady Red!

Posted by: BillT at July 13, 2009 02:42 PM

they also focused so much on the victim status that it would be difficult to put it behind you.

My daughter in law and I had an interesting conversation several years ago re: training for cops who are stressed.

I understand the focus on "making it OK to seek help". Really, I do.

But at the same time I also wonder sometimes if that isn't harmful in some cases - the constant urging to get in touch with your feelings, not to hold anything in, to almost obsess about it, etc. Sometimes it's just that ability to (as Bill said) stop thinking about something and keep your mind occupied that allows you to cope.

I think there's a lot to be said for the role of determination and self-discipline in managing your feelings about something you can't necessarily change? I can't speak to PTSD but with other situations in my life, I've been happier and felt more in control by learning to manage my thoughts and feelings than by "understanding" or dwelling on them.

I'm not convinced there's a one-size-fits-all solution to any of this.

Posted by: Cassandra at July 13, 2009 02:52 PM

Given how the medical community has given an entire generation of school children the make believe illness of ADHD, it is not surprising to me it they would abdicate any responsbility for its inability to improve those with PTSD. All shrinks want to know is what drug to give you. Forget helping anyone overcome anything.

Posted by: Mrs. Tingle at July 13, 2009 03:42 PM

I had ADHD as a child -- but back then, the term for it was KLOWWHWOPILCSAB -- "Kid Looking Out the Window Wishing He Was Outside Playing Instead of Listening to Chalk Screech Across the Blackboard."

It's been a long, hard road to recovery, and to this very day, the screech of chalk on a blackboard makes me cringe.

The horror. The horror...

Posted by: BillT at July 13, 2009 04:05 PM

I'm a firm believer in ADHDE. (Alcohol Deficiency Has Deleterious Effects) I would fall victim to it every spring no matter what I was attending....high school, college, MWR Empowerment seminars.....
0>:~}

Posted by: DL Sly at July 13, 2009 04:57 PM

Seeking help does a couple of things. It doesn't get you in touch with your emoticons until you have a breakthrough. After that, it is using techniques to get through the day. From what I have read here, pretty much everyone figured out how what the triggers were and then went from there. Counseling might be needed if reactions are harmful or if meds are needed.

Posted by: Cricket at July 13, 2009 05:40 PM

As a recovering patient of the medical/pharmaceutical industry post spinal cord injuries and taken with my history of rants on drug [over]usage, I would like to say, for the record, that I was not channeling through Mrs. Tingle in the

Posted by: Mrs. Tingle at July 13, 2009 03:42 PM
comment. But I do agree with that thought.

Regarding PTSD, as a former squid who spent most of his time on a flight deck, I can't claim any knowledge of or insight into this topic. I've had a few confrontations with people in my life. Those that were beyond the fist-ta-cuff variety consisted of having a pistol shoved into my face on two different occasions. Twas not real quick to recognize the flash-card that related to avoiding dangerous areas/situations in an early phase of my misspent youth. And maybe it's due to an incredibly thick and slow cognitive unit with which I'm equipped, but I did not dwell on the incident, once it was past. Learn from my close calls? Eventually. Moderate my behavior, increase my situational awareness? Yeah, absolutely. Otherwise... pfffff. What me worry? I've been incredibly lucky in my life. As they say, babies and <insert appropriate descriptor here>.

But it seems to me that there are answers to the trauma borne by so many to be found in people, like Bill and Vet66, along with so many others who get on with their lives.

And I can't help but think that another source of priceless insight might be gleaned from those WWII and Korea combat vets who are still with us. Those men who came from an age when the post trauma of battle was not a subject for concern, much less analysis or help/support. They had to sort through their after-battle battles on their own. Much like any other pioneer/survivor who gets on in spite of damages, injuries, and setbacks. Knowing of no other alternative, they charted their own difficult course and pushed on. I would think they would be valuable fonts of information and examples of coping with, managing and conquering the demons. Information that might help our warriors who face the same battles today.

I only wish my pop had been able to read about and converse with all of you folks. He would come out of deep sleeps screaming, hitting the floor in mom and dads bedroom, thinking he was still fighting in the Pacific up to 40 years after the fact.

I can only recall a few episodes during the first 15 years of my life. Those episodes were very, very rare. Dad maintained that it was not worth talking about, so he wouldn't. He got on with his life in spite of it. But he would be visibly shaken for varying periods after waking up from one of those nightmares.

Looking back on his episodes from my current perspective, I realize that even while he coped, he never let anyone down. I am not so sure that we, those close to him, can say the same. We did not, nor could we at that time, understand. Has much changed between then and now? I hope so.

"They're not victims.


They're survivors. Warriors."

And inspirations to those who are paying attention. Yep, our men and women in the armed forces are inspirations. Warriors. The best of us.

Posted by: bt-the resident-curmudgeon_hun at July 13, 2009 06:40 PM

Cricket~

I agree about "Eragon" the book vs. "Eragon" the movie. Have you read any of the other books? I've read "Eldest", but not the third one, yet - waiting for it to come out in paperback, so I'll have a matching set, and I'm behind on reading the books I already have...

Posted by: Miss Ladybug at July 14, 2009 12:41 AM

I am reading Brisingr now. So far, it is pretty good. I enjoy his prose and the working through of the ethical and moral dilemmas in the books.

Have you discovered the 'Fablehaven' series? Imagine a preserve where the occupants are good and evil fairies, demons, sprites, and other assorted creatures, and the caretakers have to...heh.

There is also the Michael Scott series about Nicholas Flamel; the Alchemyst. I have mixed feelings about it, but it is not bad.

My son and I were discussing Lloyd Alexander's books. He was totally spooked by the movie 'The Black Cauldron.' I, being a concerned and caring parent, proceeded to tell him that the Voldemort comeback scene with the cauldron was right out of the Mabinogian, which Rowling and Alexander both borrowed from.

He nearly choked.

heh.

Never let it be said I neglect the teaching of young minds.

Funny, though, as much as I love the Celtic myths and legends, as well as the Norse legends, I absolutely detest horror books and films.

Posted by: Cricket at July 14, 2009 01:00 AM

I think of the genre as "comic relief"...

Posted by: BillT at July 14, 2009 09:30 AM

Not familiar with "Fablehaven"... Haven't heard of Michael Scott, and don't know Lloyd Alexander, either...

After college, my best friend got me interested in the Valdemar books by Mercedes Lackey. Really like those. Think Alberich in Exile's Honor & Exile's Valor would have made a damn good Marine... I've read some of her other stuff, too, but the Valdemar ones are my favorites... Not for kids, though.

Posted by: Miss Ladybug at July 14, 2009 10:59 AM

Mercedes Lackey writes wonderfully. 'The Ship who Searched' is one she authored with Anne McCaffrey and is part of the 'Ship who Sang' series.

Artemis Fowl is brilliant. The first three books are very well written. The fourth book is also good, but might be intense for younger children; I would give that a 14 year old level.

Brandon Mull is the author of the 'Fablehaven' series. These are not books for squeamish readers. They aren't gory, just deals with demons, fairies and the ethics/morals of having to manage magical creatures.

Posted by: Cricket at July 16, 2009 01:06 AM

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