Tag Archives: dilemma

Resolution

“How few there are who have courage enough to own their faults, or resolution enough to mend them.” (Benjamin Franklin)

Resolution 1: the act or process of resolving: as
a: the act of analyzing a complex notion into simpler ones
b: the act of answering : solving
c: the act of determining

My resolution for 2013 is the commitment to finding simple solutions to the complex problems of Combat PTSD. This blog series is titled Beyond Eros because I have already learned that one important component of the solution is an unconditional form of love for our Veterans from families and communities, a form of love far beyond the physical and romantic. My intent is to explore the nature of such love in its various forms and effects.

The first lesson in this kind of courage comes from Maj. Gen. John Cantwell of Australia. His story is neither unique nor special, but it does illuminate a concept for me. It helps me begin to understand the nature of moral trauma.

We do not all react to the horrors of war in the same way; however, many of us share some tendencies, and the collection of these tendencies is called a disorder or mental illness.

It is not.

It is the equivalent of a moral fever.

A fever is a desperate attempt to right a wrong, to attack an intruder, to restore health. It is the body’s way of protecting itself from something dangerous.

A fever is not a disease. It is a symptom of physical disequilibrium and an attempt to re-establish that equilibrium, a process referred to as homeostasis. The disease is some bacteria, virus, fungus, or substance such as a protein interpreted as threatening.

Post Traumatic Stress is not a disease. It is a symptom of moral disequilibrium and an attempt to re-establish that equilibrium.

War is the disease.

My psychologist (Ashley B. Hart II, PhD) tells us, “Only good people feel guilty.” PTS, the term now preferred by the U.S. Army, is a condition shared by good people.

General Cantwell is a good man. I know this because he feels guilty. His moral equilibrium has been disrupted by the atrocities of war, images and events that cannot make sense within his personal moral code.

We can treat a physical fever with anti-inflammatory drugs, but health is not established until the invader is repelled. We treat both symptoms and causes.

PTSD (I use the D to refer to Dilemma as in the unresolved moral disequilibrium) is not a disease. It is a desperate attempt to resolve a moral dilemma. It is the courage to own our faults (as participants in morally unacceptable events). It happens only to brave, good people, people who struggle to accept the reality of an unacceptable reality.

Physical fever can lead to delirium.

Moral fever can lead to a kind of moral delirium. We become, on occasion, what we despise. We get lost.

Instead of hating the delirium, can you love us back home?

Depths of Dilemma

“Many times veterans begin receiving care when their world has fallen down upon them like a house of cards, and everything one has worked for and strived for has been threatened, challenged, or has been lost.” (Hart, 2000, pp. 98-99)

Reminder: For the next few weeks, this blog is dedicated to my reflections on a book by Ashley B. Hart II, PhD, called An Operators Manual for Combat PTSD: Essays for Coping.

It seems the Pentagon has removed the D from PTSD in hopes of inviting more veterans to seek help without the stigma of “Disorder”. The American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders is currently in the process of revision from DSM-VI to DSM-5 and will include changes to PTSD criteria. In the meantime, I have chosen to begin referring to Post Traumatic Stress as a Dilemma.

Stress that follows months, years, or even decades after trauma presents a dilemmatic condition. Choices seem limited and equally unpleasant.

Is it me or is it them?

Shall I get help or tough it out?

Fear or isolation?

Learned helplessness or constant conflict?

Depression or jail?

Misery or death?

By 1990, one quarter of the more than three million Vietnam Veterans were reporting combat PTSD symptoms (Hart, 2000). Many more sought help much later. Too many others have never reached out.

We each learn (by operant conditioning) to cope with our feelings. Unfortunately, many of our techniques are unhealthy. In the long run, they fail us and/or destroy us. We sink into a dark valley that seems to have no way out. We despair, and that leads to homicidal and suicidal ideation. Combat Veterans tend to choose suicide over homicide, but not always.

Traumatic stress is cumulative. Childhood abuse predisposes one to combat PTSD. I would suggest our individual temperaments makes some of us more susceptible, but I have no diagnostic or statistical evidence.

Combat Veterans who suffer post traumatic stress and seek out professions of vulnerability (police, fire, prison guard, etc.) accumulate more stress, becoming more likely to experience a full-blown disorder.

“Veterans often begin the search for compensation as well as assistance when they have managed to discover themselves at the bottom of this trough, and it is a slow process finding a way out.” (Hart, 2000, p. 99)

Looking for some good news?

People do get better. We do learn new, healthy coping skills. Recovery is possible.

This is my purpose, to reach out a hand to others. The only reason I sought help was because a friend already on PTSD disability from the VA asked me to. The only reason I continued was because of another friend who had recently sought help and was showing improvement. The reason I continue is because my family smiles more.

If you love a Vet, or you love someone who does, you have work to do. You may find it difficult to convince a Veteran to get help, but a trusted friend who is a Veteran, and who has accepted help, may be successful. We must work together as communities to connect our resources with our Veterans.

We must Support Troops After Return (S.T.A.R.). Here is the work for you to do. I don’t know how to do this. You and I must begin to cooperate, to work together, to find ways for our families and communities to invite our Veterans home from their dilemmas.

It will be difficult, frustrating, and rewarding. Care to help? Share a comment.

Why Write What We Do Not Know?

Say, what? How can I write what I don’t know? I always heard the advice, “Write what you know.”

Absolutely. Do write what you know, but if that is all you write, you aren’t going to learn much, and learning is one very important reason for writing.

I came to this conclusion with disarming lack of speed. I have written and graded more essays and term papers than the IRS could count. Okay, that’s hyperbole. The reason I wrote and assigned literary composition was that I believed it was a powerful learning process. I was right, it is.

Even though I believed in the value of writing as a learning tool at a cognitive level, I never grasped it emotionally until last week. My writing group, Write on the Edge (.org) asked me to speak and sign my books, Beyond the Blood Chit. My premise was that writing this novel became a part of my combat PTSD recovery process through learning.

The idea isn’t new. We can find quotes by famous authors referring to writing as an adventure in exploring uncertainty. No, I’m not going to give references, but I would love for you to provide some in comments on this blog.

We can only write what we know. If we try to write what we don’t know, we fail. Is this a paradox?

No.

We begin to write what we know in an effort to explore what we don’t know, and this may be conscious or subconscious. It is a valid inquiry process. We start with the known and use it to illuminate the unknown. Writing is the tool through which we view and learn, or at least flirt with the possibility of learning.

Somewhere during the experience of writing this novel, originally called, “LG”, I recognized that it was about combat PTSD recovery. I admit that this recognition was empowered through a VA recovery program including individual and group counseling. It was also potentiated and developed by personal friends willing to discuss their own experiences and views.  

Like other activities of life, learning is a dance. We learn, use what we learn to inquire, learn more, and continue to inquire, constantly changing our minds. Sometimes we add new knowledge to old. Other times we modify what we believe to accommodate new tenets. Occasionally we reject old, dear, beliefs to acquire new and conflicting ideas. Writing helps us to do all of these.

So, I started writing a story called “LG” about a Vietnam Veteran, like me, who was trapped in some kind of internal dilemma. Blood Chit emerged as an icon for part of that confusion, the perceived duty to serve, help, and even rescue others. My friend’s tattoo of a daggaboy (retired cape buffalo bull) became the symbol for the other part, the longing for escape from this duty to my private water hole of safety. None of this was in my mind when I began writing, and some only emerged well into the rewriting process.

Because of this writing, only because I finished the novel and tried to market it, did I find out what the real story is about. That’s a lot for this old man to learn.

Finally, by agreeing to discuss the writing process with my colleagues, I have come to understand another piece of the mystery. What we learn depends upon our willingness to doubt, wonder, and work the processes of inquiry. It depends upon a commitment to write what we do not know.

Inquiry is not for the feint of faith or those convinced of their own certainty, but for those who want to know more.

For all people with a longing need to know, I personally recommend writing. Enjoy the journey.