The War Within – Complete Series

Why We Won’t Talk to You

“He wouldn’t open up. I tried . . . I tried so hard it hurt. Now, he is gone forever. If he would’ve just talked to me, I could have helped him . . .”

Suicide survivors are left behind in a haze of shock and disbelief. In the many conversations I have with suicide survivors, I hear the guilt, shame, and regret in their voices. As someone who wouldn’t talk to his own wife, my very best friend in the world, about my emotional issues, anxiety, and night terrors, allow me to share the simple reason why . . .

Love

Seems counter intuitive, right? You are thinking that if they loved you, they would have shared their struggles and problems with you. They would have allowed you to help – especially when it starts to impact your relationship. In fact, their lack of willingness to open up is your proof that they don’t care about you or your relationship. In many relationships, that is simply not the case.

Let me share my perspective from the other side to help you understand. In my unit, protecting my Soldiers – my brothers and sisters in arms – provided the motivation to fight, to continue, to press-on. But those I love – family and my closest friends – have always been my greatest inspiration for service. In my most personal, vulnerable moments of loneliness, my family was my strength. My morale would soar with a letter, the sound of my wife’s voice, or hearing my son laugh. I would read a letter or gaze at a photo before I would drift off into sleep. I was committed to doing the hard work so they wouldn’t have to. They deserved a better world, and I was making my sacrifice to help give it to them. That was my reason for being in that hell in the first place. In return, you express with pride the nobility of what we do. I fight for my brothers and sisters, but I represent you – your hopes, your dreams, your Love.

When you join the warrior caste, you change. The military culture will help you realize your potential – to “be all that you can be.” You learn about yourself – the good . . . and the bad. In basic training, the stress from the novelty, separation, indoctrination, and assimilation changes you. When you deploy and head off to war, you change even more. The frequency, duration, and intensity of stress impacts how you view and interpret the world around you. You come face to face with the darkest parts of the human condition – and yourself. For me, I saw my own vulnerabilities. I saw the darkness inside me, and I was exposed to aspects of myself I didn’t like.

As I struggled to understand and gain control over what I was dealing with, my instinct was to shield – not share – what I was going through. The guilt, regret, and shame was a part of me, but a part I wanted to keep from my wife and kids. I didn’t know why things “felt” different. Because I didn’t understand it, I couldn’t talk about it with those people closest to me. My wife and kids were so proud of me, but underneath the veneer, I was struggling to reconcile these emotions inside me. You see me as a hero. I was afraid that if I shared my “weakness,” if they saw some of what I saw in myself, they wouldn’t recognize me anymore. To you, I would be less than what I was and undeserving of your love. If I couldn’t understand what I was feeling, how could I trust they would understand? The experiences, emotions, and memories made it hard for me to identify with the man I once was. No. Love of my family was all I had, and I couldn’t risk that they would see me as something less (the way I saw myself). I was losing myself, and I couldn’t lose them, too. I loved them too much.

When I struggle to control the negative, painful memories and emotions inside me, I become emotionally disconnected from you. You see me, but become increasingly frustrated because I am not there. I don’t express joy. I become hyper-vigilant to protect the most sacred part of my life. I worry. I don’t sleep well. I numb the pain with alcohol and other, reckless behaviors. Because my brothers and sisters in arms have seen these vulnerabilities, I long for a return to horror of war – so I can feel again. In the end, I harm the very thing I cherish the most – my relationship with you. All done under the initial premise of love.

Too many veterans who struggle and get to this point choose suicide as a way out. They want you to remember them as they were and not hate them for who they have become. They are hurting you, and they can’t bear to do that. They feel alone. They feel lost and frustrated with themselves. They want to release you from the burden they have become. They do it for Love.

Why We Respond This Way – The Body

The basic reason why service members and Veterans respond this way is actually very simple:

It is both expected and normal.

Yep. I know what you are thinking. What you are experiencing is nothing you ever expected, and there is no way you believe the way you feel or act is normal. I know I didn’t. Nobody ever told me I would have the stress responses I did. In fact, I always thought less of Soldiers like that – like they couldn’t hack it. Like they are not the hero they want and you envision them to be. My own beliefs perpetuated the stigma about behavioral health. Also, there is no way you could tell me that what I was experiencing was anything related to normal. I felt different. I was not the same, and that is the most important distinction. We equate expected and normal with same – and that is simply not the case. To help you understand, I am going to attempt to explain what happens to the body (and specifically the brain) through the stress inherent in the military journey.

Rational and Emotional Brain

Figure 1. Emotional & Rational Brain (Network for Good).

To understand the impact on the body, we must first understand the biological and physiological adaptations to stress. The brain processes stress response from the bottom-up. At the base the brain, the brain stem, we process sensory perception and activate hormones to prepare the body for action. Heart rate is elevated. Breathing rate increases. Our senses become more alert to process incoming information. It is a survival function – the fight or flight – common to reptiles and other animals.

Information is cycled through a part of the brain called the amygdala, where we process emotional response. We feel fear. We feel excitement. We experience anger. We respond through an accelerator (sympathetic) and brake (parasympathetic) systems. Together, these systems regulate the functions in the body based on our emotional responses. The sympathetic system – the accelerator – gets us “fired up,” and the parasympathetic system – the brake – calms us down again. Sights, sounds, or other perceptions cycle through the emotional elements before arriving to the top of the brain – where rational thought and judgment occur.

DIAGRAM-OF-THE-PARASYMPATHETIC-AND-SYMPATHETIC-BRANCHES-OF-THE-NERVOUS-SYTEM

Figure 2. Parasympathetic & Sympathetic Nervous Systems. (Khiron House)

The processing of emotions is far simpler and faster as part of our biological survival mechanism. It is far quicker and more efficient to immediately prepare the body for action than it is to determine, rationalize, assess, and weigh options (all functions of the top or rational part of the brain). Also, the frequency, duration, and intensity of sensory input will cause the brain to adapt and process information more efficiently. The connections become stronger and more dominant – analogous to the effect of strength conditioning a muscle in your body.

Here is the most important part: these responses and subsequent adaptations occur outside our awareness. They are expected and normal responses to repeated or extreme exposure to stress – such as a traumatic event in combat or repeated exposure through multiple, extended deployments.  A severe, traumatic event is a more acute condition that completely overwhelms the system. This emotional response shuts down the rational part of the brain because you are stuck in survival mode. The frequency, duration, and intensity of stress hard wires the emotional response system and illicits a behavioral reaction whether the situation requires it or not.

In my case, my panic attack occurred when driving through the mountains in Western Pennsylvania. The visual of open road and mountainous terrain triggered a response from flying in Afghanistan (something I had done over a period of 33 months). For some Veterans, it will occur during firework celebrations – the sounds of explosions triggers the hard wired stress response. For other Veterans, the sight of boxes or other trash on the road triggers a threat response to roadside bombs. When combat Veterans sit in a restaurant, they need to face the door because they need to see the access and exit to every room. The body jumps to conclusions of a threat response based on the similarities and memories etched in the brain.

These pervasive responses become automatic. Because the individual cannot anticipate or control the responses when they occur, they remain hyper-vigilant and anxious. They concentrate their energy on attempting to control what their conditioned physiological response is inhibiting them to do, and it significantly impacts their wellness and the quality of their relationships. The internal war of emotions isolates the member. They are alone in their suffering. They cannot nurture. They cannot feel joy because they are constantly mobilized for threats that reside in the depths of their mind. They become depressed. They become numb.

These responses should be expected because they are completely normal. The biology of our survival system responds exactly how it was intended to respond. It was designed to adapt in this manner. The good news is that the service member and Veteran can grow from this experience. They can experience joy, creativity, happiness, and love. The bad news is that – because it involves unconscious impulses – they cannot do it alone.

They won’t get help for the same reasons I would not seek help. I feared that I was broken. I was going insane, or worse yet, I was weak. I suffered for a long time. I had sleepless nights. I had moments when I would shake. Those feelings were awful, but I couldn’t accept that this was something beyond my control. I was supposed to be a leader, and I was afraid of being seen as a coward. Furthermore, I was a pilot, and I was afraid that this condition would end my career. Who would I become? Who was I now?

I share this to tell you that what you or your loved on is experiencing is completely normal. Conversations with my trusted mentors and friends convinced me of this. I admired and respected these warriors – and they shared that they too were experiencing many of the same challenges. I studied the physiology and stress and the neurological response. Stigma prevents us from talking about it and accepting this as normal. The knowledge and awareness gave me the courage to get help, and I hope it does the same for you.

The tragedy of wartime service is that you will never be same, but different can also meanbetter. Growth is one option from this experience, but it requires assistance to re-calibrate the brain. This is the first, most important step to discover your post-military path to empowerment, and it is both expected and normal.

Why We Respond The Way We Do – The Mind

“I hate war as only a soldier who has lived it can, only as one who has seen its brutality, its futility, its stupidity.”

Dwight D. Eisenhower

One day in particular stays with me . . .

I did not routinely fly MEDEVAC missions, but I did on my third deployment. MEDEVAC (short for Medical Evacuation) was the highest risk mission for an aviation in Afghanistan. I was the Executive Officer and the only member of the brigade senior staff who flew the Blackhawk. The other officers were AH64 Apache “gun” pilots, so I flew on these missions to help my commander monitor the condition of the crews and offer feedback for risk mitigation. On a personal level, I flew these missions because – by the third deployment – I needed to find some purpose to what was happening all around me. Maybe if I convinced myself that I was saving lives, I could make sense of what we were doing.

“MEDEVAC! MEDEVAC! MEDEVAC!”

That was the call we would receive on our hand held radios to let us know that we needed to rescue a casualty. I would run, often very clumsily, to the aircraft and, for the most part, watch the crew work with precision to get the aircraft off the ground in under 10 minutes. Because I didn’t routinely fly – and the MEDEVAC mission in particular – my contributions to this point probably did more to get in the way than they did to help. I was typically the pilot on the controls for no other reason but that job was easier than the combined duties of navigating airspace, communicating, and preparing the systems on the aircraft to treat the casualty. To be honest, my greatest fear was that I was getting the way of these Soldiers doing their noble work.

During surge in 2010, there were a lot of MEDEVAC missions. We labeled missions alphabetically starting with “A.” Some days the fighting was so intense that we went through the alphabet at “Z” and started all over again at “AA.” Normally, we would receive some basic information about the number and condition of the casualties, but for some reason, on this day in particular, we got a lot more information.

The mission was a child, an 8 year old Afghan boy. He had been wounded by one of the Improvised Explosive Devices (IED’s) somewhere in Zhari Panjawai region. His father had carried his dying son to the Coalition Forward Operating Base at Azi Zullah in the middle of the desert to try and save his life. He probably walked at least several miles with his child dying in his arms. We flew to the limit of what the helicopter engines would give us. The crew was magnificent – coordinating actions in the aircraft with operating room precision to prepare to receive the child and save his life, and me – not getting in their way.

The flight was short, maybe 15 no more than 20 minutes. I had the landing point in site when we received the fateful call from the unit that the boy had “died of wounds.” I didn’t fly MEDEVAC much at all, but I flew enough to know that when you hear that over the radio about the condition of the casualty, you exhale – not just with your breath, but with a part of your soul. For us, on this mission, we wouldn’t save a life. We were only going to transport the remains (as we called the dead) back to Kandahar. 

Every landing in Afghanistan is a dust landing, they just vary by degree. This one was no different. As you approach the ground, the cloud of dust consumes the aircraft. As a habit, I would always be looking out perpendicular to the nose to see what was happening around us. On this day, on this mission, when the dust cleared, I locked eyes with him. On the edge of the HESCO built barriers, I saw the eyes of man whose child we could not save. 

I didn’t see anger. I didn’t see blame. I saw, in the glowing whites of his eyes only emptiness. With all the technology, power, and might we brought to these people, we couldn’t save this boy – a child about the age of my own son. Prior to this, I had seen death. I had sifted through remains at the morgue. I remember the haunting smell of charred flesh, but I think I always wanted to believe that we could bring a better peace. But in the face of that man, on that day, I saw the only purest nature of war.

. . . there are moments in my mind I still feel his eyes upon me, piercing into my soul. 

The greatest casualty to the fighting man and woman is that of the soul. War is an expression of the absolute human condition. It embraces the limits of good and evil inherent to our nature. Preparation for and exposure to our collective, unconscious nature leaves an elephant sized footprint on the entire psyche. We feel this pain through guilt, regret, and shame. We unlocked some of the horror of our nature, and we struggle to heal, atone, and reconcile the deep pain in our hearts and minds. Loved ones become collateral damage as you attempt to connect with someone who no longer recognizes themselves.

How can this not affect our relationships? How does this not change how we view the world? The person you once thought you were is no more. Too often, Veterans struggle because they try to recover what they once were – which is not possible. You can never be the same again. There is no rewind. You can’t move backwards.

Healing means that you must release what you were and embrace what you are to become. Here is the good news – you can actually become a better form of yourself. There is a process to heal. There is opportunity to discover happiness and joy in life. There are ways to find purpose and empowerment to achieve the highest potential for yourself and those you love . . . and you don’t have to struggle trying to do it alone.

Finding The Way Home

odyssey

Figure 3. The Journey. The return home from war is always longer than the path to war

 

Perhaps one of the greatest metaphors for the return from military service is also one of the oldest. The Greek Hero Odysseus was returning from war in Troy home to Ithaca in Greece. As depicted in the map, the most direct journey would have been less than 600 nautical miles and probably would have taken no more than a month to complete. The actual journey home took over 10 years and spanned thousands of miles. Becoming a part of the warrior culture and entering the domain of war is much quicker and easier than the path home. Coming home is a process, each warrior’s journey is unique to that person, and the path is hardly ever direct. In order to rediscover life beyond the compression of military service requires preparation, humility, and community.

Preparation

The greatest challenge to healing and discovering a post-military life is ignorance. Service members do not know what it means to transition back to society. Because we don’t know how to come home, we assume we can simply backtrack to recover and restore the life we once knew. Retrace our steps. Pick up where we left off. Too many Veterans discover that they cannot return to the way things were only when it is too late. Exposure to combat impacts the entire psyche in a lasting way. They, like Odysseus, are tormented and lost across the seas trying to find their way back home.

2000px-Heroesjourney.svg

Figure 4. The Monomyth provides a process for discovering purpose after combat

Here’s the riddle: The journey home is forward, not backward. We achieve peace through transformative growth. During the middle of the last century, Joseph Campbell combined the themes across time, culture and religion to create the Hero’s Journey to describe the process of entering into war and how to come home again (Figure 4). When you become a warrior you feel different because you are different. Military service and war plunges your psyche into an abyss bound by the haunting anxiety from trauma, guilt, shame, and regret. Like a parasite, war invades your body and mind and feeds on the soul. Left unresolved, it will continue to metastasize throughout the course of your life. Understanding that you will require a process of renewal is the first and most important step to begin healing Ignorance about the process of rediscovery leaves too many Veterans to wallow in despair, and knowledge about the process unleashes the opportunity for growth.

Embrace Humility

Preparation helps the service member or Veteran understand what is to come, and humility allows the healing process to permeate the mind, body, and spirit. Humility means nothing more than honest self-awareness. You have to acknowledge that you need healing by acknowledging how you have changed through your military journey. Unfortunately, humility is an attribute that runs counter to the warrior culture. We want our Soldiers to be assertive, decisive, aggressive, and dominating. Winning in war means imposing your will upon your adversary. We demand our leaders project a presence of strength and confidence. When you see me in my uniform, you feel the sense of pride, honor, and courage. Humility? Humility has no place in our military formations. Unfortunately, it is a virtue essential to start the healing process.

Committing the act of war goes against our nature and exposure to its horror tests the limit of our sanity. Emotional fatigue, trauma, guilt, and regret are the residue left from combat service to both the mind and body. Veterans will expend all their conscious energy trying to suppress unwanted, unhealthy, and unconscious impulses and feelings. This is where we need self-awareness that only comes from the admission that war has left behind its brand on your mind and body. Regardless of the moral justification for war, we need to forgive ourselves for the things we had done while in the Temple of Mars. We need to shed that burden, and we cannot do it alone. If we don’t, we stay in the abyss – we remain in hell. The greatest act of courage comes from expressing our own vulnerability, but to do that, we must first see ourselves as we truly are. We must first be humble.

Community: The Same Journey on Different Paths

One of the reasons we reject humility and the opportunity to heal is because we fear isolation from the very team, the very brotherhood essential for our survival. Our brothers and sisters see some of the darkest parts of our nature – the shadow of our soul – during combat. They are counting on us as we are on them to get through the abyss. I want to be strong for them because I need them to be strong for me. We perpetuate this facade long after we return from the field combat. We need to accept that we are not alone but rather a community of veterans simply seeking a post-military path to a new life. Once we admit, see, and share the pain from our experience among the community of Veterans, we release the shackles holding us in the hell within our mind.

We imagine that everyone around us is doing okay and if they can “suck it up” then so can I. After all, I am not going to be the odd man out. We don’t realize that our brothers and sisters share in similar struggles. We presume they are in control, when they too are struggling to find their own way. Trust me. My greatest comfort to address my anxiety was knowing that what was happening to me was completely normal, and if I ever felt overwhelmed, I only needed to look up and see the many Soldiers still standing beside me. My mentors and fellow Veterans convinced me that I wasn’t broken. I wasn’t weak. I was amazed when I started to talk openly about my problems how many of my fellow Soldiers admitted to many of the same challenges. The weight of these problems diminished. The journey home is personal, but as a community, none of us are left on that path alone. Understanding that you all share a need for transformation, atonement and healing to return provides the light of community in the darkness of despair.

Finding our way home and discovering life beyond combat requires a combination of preparation, humility, and community. We need to understand the process forward to return to civilian society. In order to seek assistance to re-calibrate, atone, and heal the body and mind, we need the humility to accept our vulnerabilities and see ourselves as who we really are. Finally, we need to acknowledge that no warrior is left unscathed from the compression of military service, we can share in the comfort that our journey may be personal, but the challenges to returning home are not unique. They are expected. They are normal. Although your path may not require 10 years as it did for Odysseus, these factors enable the process for you to come home.

Finding Hope

“Warriors deal with death. They take life away from others. This is normally the role of God. Asking young warriors to take on that role without adequate psychological and spiritual preparation can lead to damaging consequences. It can also lead to killing and the infliction of pain in excess of what is required to accomplish the mission. If warriors are returned home having had better psychological and spiritual preparation, they will integrate into civilian life faster and they and their families will suffer less. But the more blurred the boundary is between the world where they are acting in the role of God and the world where they are acting in an ordinary societal role, the more problematical the reintegration becomes.”

Karl Marlantes, USMC, Vietnam Veteran

Suicide is a symptom of the broader condition of the Veteran population. Our service members volunteer to protect our values and our nation, and in turn, we owe it to serve them when their duty is done. So, what kinds of things can we do? We can help guide our Veterans to discover a post-military path of empowerment. Even though some struggle, ALL Veterans can find hope.

Here are some of my thoughts on how we can help in this process:

Change the Premise For Mental Health Care

Combat impacts the functioning and the physiology of the brain. I spoke about the neurology in Part 2and described the conflict of the mind in Part 3.  For me and all Veterans, the response is both normal and expected. Because we know the mind works this way and understand the neurology behind the science, then why do we wait for service members to self-select receiving mental health care? Why do we rely on a survey to assess their level of behavioral wellness? The frequency, duration, and intensity of stress can alter the functioning of the brain, and therefore, behavioral health evaluations should be part of the core program for combat Veterans, not an elective program.

Mandatory evaluations can assess the level of support necessary along a continuum of programs that includes counseling, group therapy, alternative therapies, and mindfulness. Our systems wait to provide care based on achieving the threshold for the medical definition of Post-Traumatic Stress Disorder, and that constraint excludes too many Veterans from the interventions they require to re-calibrate themselves after military service. Given the conscious and unconscious conflict inherent from participation in war, all Veterans will require some level of assistance. It is only a question of degree. We can answer this question proactively and eliminate the stigma of self-selection by requiring our service members complete these evaluations.

Train the Competencies of Emotional Intelligence

If we need self-awareness to enable the healing process, then why don’t we teach them the competencies of emotional intelligence. Emotional intelligence enables self-awareness and monitoring of the emotional state for the individual and the team. Emotional intelligence is about optimizing team performance, reducing toxic behaviors in organizations, and – as some studies have shown – providing the resiliency necessary to prevent stress related disorders like PTSD. This skill trains the conscious mind to become more aware of the unconscious, emotional impulses that occur beneath the surface of our awareness. It provides the conduit for the humility necessary to help re-calibrate the brain after trauma or other related combat stress related conditions.

Implement a Formal Transition Program

If only a small percentage (less than 25%) of Americans qualify for military service, and we put them into the very best military in the history of the world, why has the Veteran population become such a liability? Why are we talking about things like suicide and not talking about how Veterans transform our communities as the distinguished leaders in business and across our society?  Transition from military service is not a task or a checklist, it is a transformative process of renewal. It needs to include a program of initiation that educates the service member on the process – the Hero’s Journey to discover their post-military path.The weak link in the chain is the transition process. We need a Reverse Boot Camp.

The Reverse Boot Camp should have continuity between the Department of Defense and the Department of Veteran Affairs. We need a program of initiation to begin the process and it should culminate with the new role the Veteran has in their post-military life. We ask service members to leave the familiarity of their military installation and ask them to navigate an entirely new bureaucracy in the Department of Veteran Affairs on their own. Why are we surprised when they become frustrated and opt-out of valuable programs that could help them? We need to better set them up for success.

For Veterans: Share Your Story

One of the most therapeutic activities I had after my panic attacks was the simple act of communication. By expressing what is deep inside has helped me master my issues. I am fairly confident that if you start to talk to a fellow Veteran about your experiences you will discover that you are not alone. I am not proud of everything I have done through the deployments, none of us will be, but I have learned to forgive myself. I have gained a deeper understanding. If you told me that I would have this level of control over my anxiety 5 years ago, I would have never believed you – but this is where I am today, and you can overcome too.

For Loved Ones: Connect

If your son, wife, husband, or friend is “different,” I would encourage you to connect with us, and we can help both you and them. Know that different can lead to better. I would encourage you to connect with Veterans in their trusted circle. Their brothers and sisters from their unit are closer to these issues than you are, and therefore, they are the best asset you have to help them discover hope. Understand that they are not broken. Allow me to give you hope by telling you that beyond these struggles, your friend or loved one can grow and become a better version of themselves.

If you are or know of a Veteran who is struggling, I wanted to share this series with you to offer you encouragement and hope. I wanted to help you understand. I know it is difficult because it was for me. Our organization is working on a White Paper, petition, and legislation for the Reverse Boot Camp. We are committed to solving the problem of military related suicide, because we believe we can accomplish this goal. We are more than an awareness campaign, and we need your help. We need you to be active in this campaign to help us implement real change. Our military protects us, and together, we can help each of them achieve the post-military life they deserve!

JER

 

 

 

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Author: Stop Soldier Suicide
Date: June 29, 2016
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