Tag Archives: grief

Low D

On a topographic map, there is a symbol marked by a closed loop representing a contour of equal elevation with hash marks inside. This is a depression, an area of land lower than all the land surrounding it.

One in ten older American Veterans suffers from depression (VA)http://www.va.gov/health/NewsFeatures/20110624a.asp

Last week at Dr. Hart’s Combat Veteran Aftercare Group, I heard him tell a brother that most Veterans with PTSD also have another condition and that his was depression.

Depression is like being lost in a cedar swamp on a moonless night in the fog. Pitfalls surround you between the roots of tall trees that shade you even from starlight. One wrong step could drop you into a hole in the bog, into cold, dark water. You know there is higher ground somewhere, but even your imagination has lost sight of it. There is no light, not even in your mind. Darkness enveopes you; purpose escapes you; hope echoes like a cruel joke.

NOTE: This blog series investigates twelve attributes I see as conducive to recovery from PTSD and other past stresses. May aspires to Hope.

Eleven (11) percent of our older Veterans suffer from depression. The number seems low to me, but I expect that is because a lot of Veterans do not live to be old. On an average day, twenty two (22) American Veterans commit suicide.

Depression kills.

It lies there, waiting, between the anger and acceptance of a grieving process.

But, there is Hope.

“Hope is a good thing, maybe the best of things…” (Shawshank Redemption)

A line from a movie, yes, a story written by an author of horror. I find that amusing in a way.

If you are a Veteran, or if you love a Veteran, please recognize anger as an alternative to depression. Anger is a lifeline to higher ground, to life, to rescue from depression.

Yes, acceptance is a goal, the state of conclusion of grief. Yes, acceptance is possible and desireable. But, it is over there, on the other side of that chasm or swamp of depression. Will we survive the journey?

Some of us will. Many, too many, of us will not. Like combat, itself, even the survival of PTSD carries a sense of survivor’s guilt. Now, ain’t that depressing?

Anger management in the customary sense is dangerous for combat Veterans because it makes us vulnerable to depression. It strips us of our lifeline. It casts us into the swamp of despair.

So, where is the Hope, already?

Here it is: Brotherhood. Nothing helps a Veteran like another Veteran. We don’t need to sit around and talk about our PTSD. We do need to sit around and talk. We need each other. I don’t know why, the psychology of it, but I know it works. And at some point one brother shares with another an experience of Hope, an improvement in conditions through application of strategies, a psychologist that can be trusted. Trusted, yeah, that’s it.

And service. There is a blessing to feeling useful in service to your brothers. You feel a purpose, again, to share your experience with the Veteran in pain. I have witnessed it, experienced it.

If there are tracks of depression in your heart, get help. Reach out to a brother and ask him how he does it. You will find them at Veteran’s organizations, VA hospital or clinic waiting rooms, or VA Centers dedicated to serving combat Veterans and their families.

May your tracks follow you to help.

Desperate Dates

Note: This blog series investigates twelve attributes I see as conducive to recovery from PTSD (and other past stress) which has become part of our ethos or basic belief system. November investigates gratitude.

One of the happiest anniversary dates of my life is DEROS, my Date Eligible to Return from Over Seas. I left Vietnam on 1 November 1970. It has been on my mind, especially since I planned this blog series and I have been helping organize Military and Veteran Appreciation Week on campus. This should be a joyous time, right?

“Some of the reactions those affected may experience as the anniversary date nears include difficulty concentrating, loss of appetite, irritable outbursts, nightmares, difficulty falling or staying asleep, and feeling detachment from others.” (APA)

Except for the loss of appetite, I have had all of those symptoms the past couple of weeks, including this morning. First, I looked for physical causes such as a virus, heart problems, or worse. Then, I blamed it on work.

I had been confused.

Time generates anxiety. All I had to do in Vietnam was stay alive for 362 days and I could go home. The closer I came to that date, the more I worried about getting shot down as I visited A-Team camps by helicopter, or a rocket attack on our compound (one hit my building about three weeks after I left). I was holding my breath. Maybe that was what I was feeling on my DEROS anniversary.

Sunday, November 2nd, after I expressed gratitude for getting home forty four years earlier, I had an epiphany. Since my deployment had been for one calendar year, this was also the anniversary of the day I patted my baby in her crib, hugged my wife, said goodbye to my parents, and went to war. The dual nature of this anniversary date had eluded me all these years.

I am grateful that my baby did not have to grow up without her dad. I am grateful that my second daughter was conceived almost a year after I got home. After decades of guilt, remorse, and anger, I am grateful to be alive.

“The highest tribute to the dead is not grief but gratitude.” (Thornton Wilder)

Perhaps there is no more compelling feeling among survivors than a need to make something of the life spared, a life of gratitude, as expressed at the end of the movie, Saving Private Ryan.

My first visit to “The Wall” was an unplanned escape from pain. I came away knowing that it was okay that my name was not there. Knowing it deep down, inside. I had been told.

When my friend went to Vietnam to be an airborne brigade recon patrol team member, he was still a teenager. He has never been to the Vietnam War Memorial. I suggested, once, that he should go, but he told me that he couldn’t until he had made something of his life.

It can be difficult to feel grateful for something we do not believe we deserve, something we have not earned.

The bad news is that like other PTSD symptoms, date reactions will never go away. The good news is that as long as we are still alive, we have opportunities to turn from habits of grief to practice of gratitude.

May you find the embers of gratitude in your heart, and may humility fan them into flames. Gratitude is in you—you just have to find it.

Happy Tracking.

Back Fire

Tragedy behind bullets shattered many lives on a Texas firing range last week. Tragedy is a teacher of love—if, and only if, we open our minds and hearts to the lessons. Is it worth the pain?

We may never know what really happened on that range or what led up to that irreversible act in time. Just a thought from a natural and life-long skeptic: Maybe it is not for us to know or to pretend we know. Maybe it is the not knowing which allows us to accept the lessons of love. Maybe.

Chris Kyle died that day, a man who survived bullets and other wounds, a man who took many lives in honor of his team and country, a husband and father, a mentor to other warriors with invisible wounds, a friend and neighbor to Chad Littlefield who also died that day. Two lives ended and many were twisted into torment, including brothers in services present and past who identify with Chris and Chad, Combat Veterans who still feel the sting of invisible wounds aggravated by this tragedy, triggered into PTSD symptoms of their own.

Families were shattered that day in ways that can never be repaired.

Let the grieving begin.

But, wait. Eddie Ray Routh met a fate that day, also, the man accused of killing his two mentors on the range. Shall we grieve for him? For his friends and family?

Whom shall we judge worthy of our grief?

And, how will we grieve our loss—the shattering of our fragile feelings of security that temporarily suspend our sense of vulnerability, the peril of all with PTSD?

Is there love in our anger? Am I angry at Eddie Ray for killing an American hero? Am I angry at Chris Kyle for exposing himself to the dangers of firearms in the hands of Veterans suffering the symptoms of combat PTSD? Am I angry at Ron Paul for comments about guns and PTSD treatment?

Perhaps I am angry at those who are angry at Eddie or Chris or Ron. Maybe in my grief for my loss, I am angry at those I see responsible, and in my anger, I may be selfish.

We may never know what happened on that Texas firing range that day or why it happened, but we still feel the loss. And, we are angry. That is not a good thing, the anger, but it may be a necessary thing (temporarily). The anger may be required as a protection from depression; however, we do not need to act on that anger.

Many Combat Veterans find solace in shooting. Perhaps it relieves feelings of vulnerability that trigger PTSD episodes including rants and rages. Perhaps is takes them back to their pre-trauma training and a more innocent time. Maybe it just takes them back to a place where they feel more comfortable, more alive, or more relevant.

That is not for me to judge.

To an outsider, Combat Veterans using the firing range as treatment for PTSD may seem contra-indicated, especially to a health care professional.

That is not for me to judge.

To a wounded trauma survivor, media treatment of this tragedy may seem like a superficial invasion, the ramblings of the ignorant, an exploitation of a tragedy of our brother(s).

That is not for me to judge.

For those who would use this event to promote a political or an ideological position, I can understand disdain, but that is not for me to judge.

Sure, I have the right to judge. We all do. But, today at least, it feels as though the judgment is fueling my anger—even the judgment of the others’ judgment—and fueling my anger is stealing my strength. Judgment feels like it protects me from my vulnerability.

It is an illusion.

Protection from my vulnerability is cradled within love.

That is my judgment.

But, I would really love to read your comments.

Sad Sorry

…A man carries one of these into battle and by the grace of God comes out in one piece; he carries a strange sense of guilt the rest of his life.   (Paraphrase of John Wayne in The Green Berets.)

This is from memory as I couldn’t find the quote, but I have seen the movie several times including 1969 before I had earned my own Green Beret. Perhaps one of you can post a quote and source.

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

“Frequently, combat veterans feel guilty about having survived their combat experience, and this affects their sense of self-esteem and self-worth.” (Hart, 2000, p. 141)

The first thing I did when I walked up to “The Wall” (Vietnam Memorial) was to read the first name. The second thing was to wonder where my name should be. The third thing was to find the panels of names of those killed during my tour in 69-70.

This is a healing wall and I felt the acceptance of my life and, unbelievably, of the loss of theirs. It is a spiritual place.

After my experience, I tried to encourage a good friend and fellow Vietnam combat Veteran to go to The Wall. He said he couldn’t do that until he had done something with his life.

We lost something in combat, too. My first wife said she always thought I had lost my soul. When another friend was asked by his psychologist what part of him died in Vietnam, he went after his doctor.

This is another dilemma of Post Traumatic Stress. We feel a sense of loss but deny it because we feel guilty for surviving. We didn’t lose as much as others so we have no right to feel that loss. We never grieved our own loss.

Psychologists describe several stages of grief (usually five or seven depending upon the source). When we refuse to allow ourselves to grieve (because we feel unworthy of the feeling), we get stuck, mired in the past and caught in unresolved grief.

We deny our loss and our right to feel the loss for a generation or two. When denial fails at a subconscious level, we proceed to bargaining. We try to relive the time and experiences, if only in our dreams, desperate to make it come out different, to finish this unfinished business. In our dreams, death is undone—our friends are still alive, a thing we regret did not happen.

More about sleep issues next week.

We spend our lives in denial and bargaining for so long, going back and forth between the two, that we sometimes forget it is not normal. We wonder what is wrong with the rest of the world.

And, the next stage is anger. Yes, this is about as far as most of us ever get. We are angry at ourselves for surviving but we do the sensible thing to protect ourselves. We focus our anger on others. You make the list. We blame. I’ll attempt to move past that stage.

Anger causes all kinds of physical and mental illness, family and social problems, even legal and moral issues. It is a tragedy, a genuine waste of life.

So, why do we not move on, into the light of acceptance? Of resolution? Of healing recovery?

Because there is a hazard between anger and acceptance. (Ooh, that would be a good title, “Between Anger and Acceptance”.)  The hazard is a gulf, a chasm, a gauntlet, and it kills (quickly or slowly) almost as many Veterans as combat. It is much more dangerous than anger.

Depression. We cannot get from anger to acceptance without depression. That is why Dr. Hart counsels us to hold a low level of anger, to hold onto that “Edge” as we walk our recovery into acceptance. Few of us can survive the journey without help. So, we stay angry.

Are you depressed, now? Feeling guilty? “It is important to remember only good people feel guilty.” Thank you, Dr. Hart, for that reminder.

 

Good Grief

“Any war is testament to the proposition that human life is expendable.” (Barnes, 2011, p. 2 in Beyond the Blood Chit) We each leave a part of us on the battlefield and grief is the consequence. The quality of life after combat depends upon how that grief is resolved.

Reminder: For the next few months, 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.

When my first wife told me she thought I lost my soul in Vietnam, she was not completely wrong, for a part of my self did die in the jungle—not my soul, however, but an important part of me, nevertheless: my innocence. Recovery is a process of healthy grieving.

I expect most of us have some acquaintance with stages of the grieving process, perhaps five or seven steps. This may suggest that recovery is inevitable, that we naturally progress through the steps to a positive outcome. Sadly, no. Many times, we get stuck and may stay stuck. PTSD is like that.

We begin with a stage of denial, a form of disbelief that a loss has even occurred. Even if we know subconsciously that something died, we fail to articulate the loss cognitively. The idea that our experience has changed us or has taken something from us is so shocking that we reject it as not possibly true.

At some point, at least a part of our psyche develops an irritation, often in the form of a focused anger. We blame Nixon, Kissinger, Congress, North Vietnam, Russia, Jane Fonda…. Is it any wonder so many Vietnam Veterans hold anti-government or anti-liberal sentiments? We get stuck in this stage. Why?

We may progress, at least off and on at times, to a bargaining stage, especially subconsciously. We replay (or, relive) events of our past, ever trying to make things come out differently. We trick ourselves into living an illusion in which our comrades, and our own youthful innocence, still live.

Stage four is the reason we get stuck. Depression sucks. As the loss becomes clearer, it gets more difficult to deny the reality of our grief. We sink into a rut of learned helplessness, a feeling of being forever doomed, damned to suffer through eternity. Anger is preferable.

Anger is the alternative to depression, and many Combat Veterans become fixated at this stage of grief. We fail or refuse to struggle through the stage of our depression. My personal opinion is that the helplessness of step four makes us feel vulnerable, and vulnerability is not healthy for us—it threatens our survival. So, we stay angry.

If you learned five stages of grief, you might expect acceptance, now. If you learned seven steps, you might expect an upward turn at this point. That would be a good grief outcome. It’s not that simple.

If there is a key to healthy grief for battlefield losses, and it might be the key to all of Combat PTSD, it is right here. We may make some kind of turn toward reconstruction and acceptance (what I call recovery) or not.

We do get stuck. It is sort of like a broken thermostat, a positive feedback loop in homeostasis terms, or a do loop in computer vernacular. Depression leads not to an upward turn but back to anger—again and again—frequently for forty or fifty years.

The good news is that people do recover. We learn coping skills (BREATHE) that help lower the level of anger to a socially acceptable edge. That potentiates the journey through the depression toward acceptance.

I would like to offer two cautions, here. First, the journey into the stage of depression is dangerous and demands professional help. Certain conditions such as addiction will require resolution, and the issues of combat memories that encourage the journey also trigger major limbic system dysregulation (dinosaur dumps). It is also a lot of hard work for the Veteran. It takes commitment.

Here is where you come in. You can help a Veteran you love, even those you do not know. Validation of our experiences, our losses, and our emotional conditions can provide support for this commitment of hard work. We can all help our Veterans by learning about Combat PTSD, supporting treatment programs and VA services, and caring for the Veterans. It all starts with social awareness.

I do not have the answers. But, I do have some questions. Are you willing to participate with groups in your community to Support Troops After Return? I am willing to speak to community groups on behalf of Combat Veterans. See http://www.ErvBarnes.com for details.