On PTSD, or more properly, on Coming Home
Friday, November 16, 2007
Kat from Castle Donovan wanted us to talk seriously about the problem of what is fashionably called "PTSD." No one here needs an introduction to the topic. Kat's concern is that, in knocking down bad numbers on veterans' mental or spiritual health, we might ignore a real problem that needs to be dealt with.
She wants us to talk honestly about it, so I'm going to do that. There's quite a bit about myself I'm not going to tell you, now or ever. I will tell you some things you haven't heard before, to be sure, but I won't tell you why I know what I know. Just see if it seems right to you.
Professor Andrew Lubin and I talked to COL Sackett, of TSGLI, about the need for legislation to help make sure combat veterans can receive whatever treatment they want without wrecking their career. There is also the famous problem of the 'stigma' of asking for help, which is often seen as an admission that you're bent or broken or damaged. Young men, as combat soldiers tend to be, often don't want to show weakness. That is natural enough.
What you need to know, first and last, is that so-called PTSD is not an illness. It is a normal condition for people who have been through what you have been through. The instinct to kill and war is native to humanity. It is very deeply rooted in me, as it is in you. We have rules and customs to restrain it, so that sometimes we may have peace. What you are experiencing is not an illness, but the awareness of what human nature is like deep down. It is the awareness of what life is like without the walls that protect civilization.
Those who have never been outside those walls don't know: they can't see. The walls form their horizon. You know what lays beyond them, and can't forget it. What we're going to talk about today is how to come home, back inside those walls: how to learn to trust them again.
There is a sense that combat changes people, but it really doesn't. It brings out parts of yourself that were always there, but that you hadn't encountered directly. Those parts are in everyone else as well. No one has clean hands. No one is different from you. That is important, so let me repeat it. Everyone around you is just like you. They don't know it, but they are. You are not sick; you are not broken. Everyone else is just the same.
One of my friends is a combat veteran of fourteen years and four wars: Somalia, Haiti, Bosnia, and Iraq. He fought into Baghdad in OIF 1, and is here again on his third tour. He has a thing about indirect fire -- he walks to the DFAC from one bunker to another, along a route he has created specially so that he will never be more than a hundred feet from one.
Is that living your life in fear? No: it is experience. He has been in the blast radius of a mortar before. He carries the wounds. We get indirect fire here fairly regularly. He is the one who understands what it means. Those who do not behave the same way are the ones who are fools, not him. Here, that insinct is wise and will protect him. When he goes home, he will need to start learning to trust that the skies will not drop explosives. That will be hard, and I know he knows it. He is afraid, and man enough to tell me so.
Or take this story, to show that this is not just about combat, but about reality. That's important to know, because it reinforces the point that this isn't something in you that has broken. It's just that you've learned something others haven't realized. Those lessons come from the world we live in, and point to its real nature. As such, the lessons can come from any place, anywhere the walls break down -- it's just that combat often brings that about.
When I first started to ride horses, I would get up on them without any sense that it was a dangerous thing to do. We'd go running through the forest free and easy. The first time I was thrown wasn't enough to lose that sense; it took nearly being killed, not once but three times, before the reality of what I was doing set in. That shook me up, I am not afraid to tell you. There was a time, months, when I could hardly sit a horse at all -- and no matter what I did, no matter which horse, it would spook or bolt when I got on it.
I couldn't do the normal things that any little girl could do: get up on a horse and ride it. It wasn't that I was wrong: I knew something that the little girl doesn't know, because she is too young to realize she can die. I was right; I understood.
But it made me helpless. I had to learn, here as elsewhere, to ride in spite of the fear, in spite of that clear knowledge. You have to learn to sit deep.
So, let's say you're in the saddle. You're coming down a rocky trail -- steep, and maybe washed out. How do you sit the horse?
You lean back, to take some of your weight off her front legs, and you relax. You let your weight sit deep on her hips. In two minutes you could be starting the rest of a long life in a wheelchair, but you relax.
And when she stumbles? You relax, sit deep, calm her. If she spooks? Relax, sit deep, pull the reins. If she falls, you do your best to leap free -- but until then, relax and sit the horse deep.
Relaxing isn't just about attitude. If you stiffen up, your center of balance shifts. It's easy to get thrown. It's easy to fall yourself. You can throw the horse's balance off, which will make it more likely she'll fall.
Or she'll sense your fear, and spook.
The attitude this breeds with practice has a direct parallel with warfighting and diplomacy alike. Both deal with genuinely dangerous situations. Likewise, in both cases, there are many times when the worst thing you can do is show fear. Sometimes, the best thing in the world is to show that -- no matter what -- you're feeling relaxed.
So here you are, where we've all been. You are suddenly aware of something your upbringing didn't prepare you for, and your society doesn't grasp. You know it's real, because you've seen it; and the fear and anger echoes deep into your core, because you have the same instincts that propelled us successfully through ten thousand years of war.
Yet now we have a society full of people who have never looked death in the eye, and never felt what it feels like to want to kill, or the guilt that comes from having wanted it. You have to come home and live among them, but to them you seem strange. You are afraid of what they will think of you, of how terrified they would be if they could see in your heart. You have thought how you might kill them. You don't intend to kill them; you just do that now. It scares you that you do, but it just happens, like breathing.
I know what that's like, and there are plenty of us who do. You can come home. You can learn to sit deep.
In fact, horseback riding may be one of the best things you can do. If there is a place where you can take lessons, I would strongly suggest that you consider them. It will focus your mind, and the discipline you will learn there is exactly the one you need elsewhere. You have to learn to trust the horse, even though really horses can't be trusted; just like you have to learn to trust the walls that hold up society, even though you know what lies beyond them.
Another thing that you can do is find a martial arts group that is composed of combat veterans like yourself. Here again, you will find a situation where you can train yourself in a discipline that will build just the qualities you need to deal with the world. Look for a group that teaches real fighting techniques, not sport techniques; and one that is filled with fighting men, not sportsmen. They will understand you. Anyone can -- you are normal. All of us are like this to a greater or lesser degree. It's just a question of whether or not they've had the experiences that let them see beyond the walls.
These tools will help you learn to do what you have to do. They will not be enough. More than anything else, you need love. Love cannot heal you: it cannot make you trust the walls. The training is what will do that. Love is what will give you the reason to push through the hard times, until the training can take hold. You must find someone who loves you, a mother or a wife or a friend, and trust them with your fear and your pain. You must be honest with them, especially because you fear it will scare them and drive them away.
Let them see. If they love you, they will stay with you. If they do, you will know you can rely on them. That will give you time, and strength, to train.
A few last words on what are called 'the helping professions.' There are three of these: psychologists, psychiatrists, and chaplains.
Psychology is a form of magic, not a science -- its fundamental models of the human mind are not falsifiable. That's a technical matter -- if you're interested in the question, I've written about the dangers of taking psychology seriously on occasion -- but it is important. We should never allow any of our veterans to be stigmatized, or have their careers in any way harmed, because of the opinion of a psychologist. They mean well, but they aren't doing science -- their readings of your psyche should impact your career neither more nor less than the chaplain's, who also isn't doing science, but is at least honest enough to admit it.
That said, psychiatry is a medical science. If you find that friends and chaplains aren't enough to drive off your demons, a psychaitrist can treat underlying chemical problems that may be adding to your difficulties. This can buy you some time to sort things out within your soul.
We tend to try to do this with alcohol. I've done plenty of that myself, so don't think I'm preaching here -- there are just some problems that booze won't fix, and might make worse. The right pill can turn off the parts of your brain that cause problems. Sometimes the right medicine might make the difference between learning to love and trust again, or not making it home. If you're thinking you may need that, and want to talk to someone you can trust, I'd suggest you try Doc Russia. He is a medical doctor, not a psychiatrist, but he knows about this stuff. More importantly, he's a Marine. You can talk to him without worry.
As for Chaplains, I have a lot of respect for men of God. That said, not all of them can be trusted, and not every religion is right for you -- and indeed, not everyone seems to be right for religion. You've got to sort that one out for yourself. A lot of men have found a fortress in God. You might be one of them, and finds walls there that you need not fear to trust. You might not.
The worst thing, though, is to trust someone who betrays you -- whether a chaplain, a psychologist, or a wife. Sadly, there are those who will. I told you that you should show yourself to those who love you, so you would know whom you could trust to love you while you train. It's different with 'helpers' -- they don't love you. Trust them if they come well recommended. Reach out to other fighting men to find the ones you can trust. They are out there.
At this time in my life, I feel very peaceful and easy. I have a wife who loves me and whom I know completely I can trust. I have a child who reminds me of the joy that is just as much a part of our nature as are wrath and murder. I have friends and family, and things are all right.
You can have that too. You can come home. It may seem like you will never know joy again; you may feel like all positive emotions are washed out, empty, or shadows of what they used to be.
That will not always be so. You can come home.