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Guest Post - Coming Back and Moving Forward - PTSD and the Military

(Today's post is a guest post by longtime reader Chris C. He is a member of Iraq Veterans Against the War. This post was written before the recent Ft. Hood incident.

If you would like to guest write for us, please check out our guest post guidelines.)

I myself have never had a traumatic experience in Iraq that would lead to Post Traumatic Stress Disorder (PTSD), but over the course of working in a notable, anti-war veterans organization (IVAW), I've worked with several people who have. I've seen the worst possible emotional breakdowns one can possibly imagine in police stations and hosiptals, homes and bars, and even just on the street.

Regardless of your views or stance on one particular war or another it is an inevitable result that some people return traumatized. In 21st century warfare the survivabilty of the average soldier is much higher than in the past. This means that a combat soldier today often survives injuries that would have meant certain death on a battlefield 50 years ago, and comes out of it supposedly "unscathed," meaning there is no noticeable physical wound or lasting physical handicap.

In Iraq and Afghanistan there is a blurry often indeterminable line between a civilian and an enemy combatant, often creating a feeling of paranoia, constant vigilance, and various circumstances where civilians do get killed after being mistaken for enemy combatants.

US soldiers are exposed to danger for a prolonged period of time, up to 15 months as it currently stands, as opposed to say someone in a car accident whose traumatic experience takes place within one day and their mental recovery process may start the next day.

One of the best works on PTSD is LTC Dave Grossmann's book On Killing. On Killing identifies the US military as using operant conditioning to train its soldiers to help overcome their natural reluctance to kill, and he interprets PTSD as a byproduct of what can come about when the military uses this operant conditioning. Soldiers and veterans have to adjust and come to terms with the fact that they have committed what is in most religions and societies considered to be the ultimate sin: to take the life of another human being. Sympathy with the motivations of the enemy combatants, acknowledgement of the humanity of the enemy combatants, and the uncertainty of the combatant status of the person they have come into conflict with can compound these results.

Surviving traumatic experiences and losing peers can also lead to PTSD. Here is the story of a friend of mine here and here.

It's important to note that PTSD is a long term affliction that can resurface later on in someone's life, even after its been treated. PTSD is not "cured“ but rather people have to learn to adjust to living with it, and move on with their lives. For many people the intense emotional loss experienced in combat is short term, equivalent to the emotional pain someone might feel in breaking up with a loved significant other, or the death of somebody very close. There is a period of intense emotion but afterwards life goes on. The difference between a short term "adjustment“ and long term PTSD may be an adequate and comfortable support network. PTSD is what happens when life doesn't go on, and people encounter difficulties of varying degrees with every day life from a feeling of uneasiness in crowds, depression, aggression, substance abuse, suicidal tendencies, violent streaks, the well known "flashbacks“ that everyone thinks of when they hear PTSD, uncontrollable anxiety, and the nightmares that come to torment their sleep and remind them of their trauma there to.

PTSD is a massive problem. In January this year suicides among US Forces exceeded the number of combat deaths, the number of veterans who kill themself will probably exceed the number of soldiers killed in Iraq and Afghanistan, as it did in Vietnam. It has become such a startling trend within the military itself that Ft. Campbell was shut down for 3 days. Caught between not wanting to reduce the number of seasoned soldiers out of the deployment rotation and wanting to be able to address the problem the Army has taken a gamble with a new resiliency training program.

I know nothing about this resiliency training program, but in my experience the Army's way of examining this issue was to give you a questionnaire upon returning from theater (and if you answered that you were experiencing difficulties it would be that much longer until they let you free). They had a suicide prevention program that basically consisted of "if your friend starts talking about suicide narc on him, so that we can put him by the CQ desk 24 hours a day with no shoelaces and a roadguard vest to isolate him, humiliate him, turn him into a pariah, and make him more depressed." Army culture still has a long ways to go to deal with this problem effectively; it will have to learn to put the machismo aside when helping those suffering from PTSD.

For veterans getting out of the military, many of them feel like they have been kicked to the curb. Army programs like ACAP are woefully inadequate for reintegrating soldiers into a constructive civilian career, and the VA's coverage and capabilites vary in different areas of the country (here in Germany there is absolutely no VA office or VSO with which to consult for those that have chosen to remain here). Worst off and perhaps most inefficiently of all, the US military doesn´t help or even suggest personnel register with the VA as they are outprocessing to ETS.  Many who leave the Army either quickly reenlist soon after leaving or go to one military contractor or another. The VA estimates there are some 131,000 homeless veterans on any given night, a vastly disproportionate number relative to the general population.

With the quality of care from the VA varying wildly from one region to the next and months long waiting lists for claims from the VA, many veterans commit suicide before they even get help. Most VA treatments for PTSD consist of a large number of perscriptions that may treat symptoms but not the core problem (and have severe side effects as well), and group therapy meetings since often times the caseload the VA has exceeds their capacity. If this trend continues Iraq and Afghanistan veterans are set to follow the beaten path Vietnam veterans have followed.

As I said earlier, regardless of what you may feel about the conflicts in Iraq and Afghanistan, it is important to realize it is being done in your name and supported by your taxpayer dollars. It is the responsibility of society as a whole to take responsibility for these wars and their side effects, not just the responsibility of a small ineffective government bureaucracy. The burden veterans carry can be partially alleviated by a functioning VA system, but it requires a more active involvement from our society to fully address the problem and prevent an "adjustment period" from developing into full blown PTSD.

When I returned from Iraq and went back to the US there were flags flying high all over the place, and yellow ribbons on every other car. When old friends asked what Iraq was like, I told them, "it sucked." There was no deeper probing and I perceived absolutely no feeling of interest, empathy, or curiosity; they just expected me to come back and return to my old ways. The dichotomy is fascinating and I've always wondered how a nation that so proudly proclaims it supports their troops can fail their veterans so miserably. If a PTSD epidemic is ever going to be stemmed that needs to change, the war cannot be a hobby for the government that everyone just cheers for from a distance as if it was a sporting event, people have to realize that it might mean much much more for their neighbor or their coworker. What would it take for those people who put yellow ribbons on their cars to actually hire veterans? I don't want to see other veterans of my generation fall through the cracks and forgotten as Vietnam veterans were, and I will fight to prevent that as hard as possible.

One of the best groups that really really takes care of vets is Swords to Plowshares in San Francisco. They will take homeless veterans off the street, help them get job training, and set them straight with the VA. Even if people aren´t that desperate or homeless they are probably the best VSO there is. Vets for Vets is good as well, though thats more for good peer support than just having a top quality professional VSO. The Coalition for Iraq and Afghanistan veterans, is a committee of some non-partisan organizations who take these problems very seriously and do their best to help.

There are medical professionals who have offered help to returning veterans outside the VA, if you are a veteran and ever in need of help please don´t hesitate to contact me, there are places for help if you know where to turn. Remember if you are having a hard time its not because you are crazy; PTSD is a sane reaction to an insane situation.

eight comments

I think this post touches on a lot of powerful emotions, but the thing I noticed most, reading every war memoir and news issue, is that in the rough and tumble tough army, PTSD is considered“not tough”, or weakness. People don’t want to have it.

The last line said it all, it is a sane reaction to an insane situation. I just look at people on 15 month tours of fear, and I’m amazed more people don’t come back needing to talk about it.

Great guest post.

People don´t want to talk about it, and thats not just because of the stigma inside the military attached to PTSD although that plays a factor to. The social stigma and the disciplinary or career consequences often attached to admitting to having adjustment problems inside the military are real however. Once people get out though they are free of the military and free to talk about what happened, but normally they still dont. Why?

This problem isn´t unique to Iraq or Afghanistan. My wife´s grandfather was actual cavalry (with a horse) in the Wehrmacht at Stalingrad, he deserted there, walked by foot all the way back to Germany (he ate his horse on the way), and hid in the Black Forest by Freiburg until the Americans came. That would be very interesting dinner conversation to say the least. He almost NEVER talked about what happened in Stalingrad or going into hiding afterwards to my wife or her family. I think it has something to do with the fact that it can be painful to talk about and that traumatising events are often repressed and buried as best as possible as a self defense mechanism. It showed itself in other ways, from what I´ve heard he was cruel to my wife´s uncle, drank like a demon, was physically and mentally abusive to people close to him, and calling him a cynic would´ve been like calling the Antarctic a bit nippy.

Studying what happened here in Germany after WWII uncovers a lot of interesting social phenomena. German (and often American) WWII soldiers normally never talked in great detail about what happened during the war, nobody here will ever admit their grandparents were nazis, nearly every family has some story of some small resistance to the third reich (which are usually questionable to say the least), and you will notice everybody over 70 here will always turn all the lights off in their house after dark as if they still had to black out their house to hide it from night time bombings. What I´m trying to say with that is that war can influence societies, and it can have greater even more life changing effects on the actual participants.

It has atleast a small effect on everybody involved, even for me coming from a safe zone in Iraq, for a few weeks afterwards I panicked for a split second when I checked for my M16 and it wasn´t there. It felt like I had walked out of my house without my wallet or my cell phone (embarassingly enough a couple of times I even went back into rooms I had just come out of and nearly started look for it before I realized I didn´t have it anymore). It was nothing bad or traumatic but just a deeply ingrained habit from having my M16 within arms reach for a year.

I really agree with what you say, Chris C, about having reflexes ingrained. I was used to leading men downrange, and changing some of those habits, and learning that I don’t lead my family, was the biggest change I had to make.

What I love most about your post is the fact that it says that the whole country must solve the problem. Right now only the Army and VA are shouldering the entire burden, and it is a heavy burden.

Chris, great post. You’re right, people don’t want to talk about it, mostly because they don’t understand or want to talk about it. It’s sad that the very same conditioning used to preserve a soldier’s life can so negatively affect him when he leaves combat. And there’s a point you mentioned that I really appreciated that tends to go unmentioned with PTSD. Namely that not just undergoing situations where one might be killed can be the cause, but taking life is a major cause too.

That is too true about taking a life as a major cause of PTSD. It is also more of an ethical challenge than many give it credit for. We train to risk or sacrifice our own lives, but pretend like killing someone else is not a big deal.

I remember walking home with my dad one night when I was about 12. We had our dog with us. We passed a poorly lit alcove. He looked at it and warned me, “Always be aware. If someone wanted to get us, that’s the type of place they’d hide in.” It sounded strange to me at the time, but when I read above about reaching for the M16 and it not being there, it made sense that he was trained to think in such a way and survived because he thinks in such a way.

It is almost strange to think about WWII and PTSD, because people treat that war as so black and white, you almost can’t imganie it would create trauma. But of course it did.

In a way, the stoic father of fifties television is the defining characteristic of how that generation handled PTSD. Although, that probably wasn’t a good way to do so.