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www.time.com/time/video/player/0,32068,597189043001_2014195,00.html

As thousands of troops return from Iraq, let us remember that for their families, the war is from over.  As the joy of homecoming gives way to daily routines, horrible memories surface, bringing depression, rage and isolation with them.

www.bbc.co.uk/news/world-us-canada-11131427

We must all  urge the government and the VA to provide essential resources to all family members of the troops.

When my husband asked me, four years ago, how I would feel about moving to Colorado where he would have the opportunity to realize a long held career goal, I told him, “Sure, let’s do it.”  We waited two years until our older son, Ray, finished high school, and then began packing up the home we had lived in for seventeen years in a town I had called home for thirty.

After packing one or two boxes, I became exhausted, my head pounding, and I would take a nap, avoiding any more packing that day.  My birthday came a month before our departure date, and when Ray, gave me a CD of music he had assembled for our drive to Colorado, I burst into tears, he and I crying together.  He had decided not to come with us, as he did not want to leave Austin.  Yet I never stopped to assess what I was undertaking.

The day my husband, younger son, and I drove off, leaving Ray behind, my heart broke.  For the next six hours of driving, I squeezed my eyes shut, and only the next day, as we drove through rain in eastern New Mexico, did tears stream down my cheeks.   When we got to the house in Colorado that we would be living in for at least a year, I dropped to the floor and curled into a ball, unwilling and unable to move.

Depression worse than any I had known since the days after my second son’s birth got a hold of me and wouldn’t let go, no matter how hard I fought back by volunteering for local campaigns, joining yoga classes, hiking.  When I returned to visit Austin and passed by my old house, sobs broke from me.  But being back in my beloved town brought me a flood of relief that felt like a drug, the joy punctured by having to leave again.

Over the next two years, through therapy I came to understand how much my home and town had become integral parts of  a life I had built to heal me from my childhood traumas.  My home sustained me just as my mothering healed me.  And when I left it and my older son at one and the same time, I knocked an enormous hole in the wall I had built between my present and my past pain.

What most amazed me about this whole experience was how ignorant I was of the importance of my home.  I couldn’t see what had sustained me in my adult years.  I did not foresee the consequence of moving away and leaving Ray behind. I did not see that because I had healed from my trauma I was not necessarily immune to falling back into its pain.

Trauma’s biggest consequence, I believe, is that it blinds us.  Initially, this is life-protecting, allowing us to react without being paralyzed by overwhelming terror.  But when the source of the terror is gone, when we manage to come to recognize that we are no longer in mortal danger,- a years long process in itself- a subtle blindness continues.   After all those years of looking away, we lost the ability to recognize we are not seeing the whole picture of our lives.  A sort of existential loss of peripheral vision.  When threatened to even a tiny degree, I get tunnel vision, using all my strength and determination to push through, to manage, to cope.  And lose the ability to ask: at what cost?  What will this mean for me?

My family returned to our Austin home a month ago.  My husband came to understand the importance it held for me, and so he is willing to do a lot of traveling.  I am lucky and grateful.  And I am whole again.  Ready to now have Ray be the one to leave, as he sets out for college.

The deep pain I went though in these last two years showed me I still has more healing to do, and for that I am thankful.  Times I wonder: do we ever end this journey of healing?

The Multigenerational Ripple of Post Traumatic Stress Disorder (PTSD)

The Obama Administration is changing a fundamental governmental position on what constitutes post-traumatic stress disorder (PTSD), and in so doing, signals a huge sea change in how the government sees its responsibility towards the women and men it sends to war.

Until now, the Department of Veteran Affairs required that to claim PTSD, veterans had to document specific events that might have caused it.  Such documentation has been, at the best, a huge bureaucratic process, and at the worse, made it all but impossible for those whose PTSD resulted from non-combat situations (such as witnessing atrocity) to find help from the VA for their suffering.

The new rule—which applies retroactively for veterans of all wars—allows compensation if a veteran can show that he or she served in a war zone and in a job consistent with the events the vet says caused the trauma.  No longer is coming under fire or witnessing a comrade’s death the only acceptable circumstances.  The new rule also allows compensation for having had good reason to fear traumatic events even if the vet did not ultimately experience such events.

Disability benefits include free physical and mental health care and a monthly stipend.

This change represents not only recognition that PTSD is a fundamental consequence of participating in war—in itself a monumental admission for a government to make.  It speaks that the government sees itself responsible to the people it sends off to war, responsible with deep commitment for the duration of that serviceperson’s life. Human beings with souls that war is all too able to wound,, service men and women will no longer be dispensable.  Government must be responsible for the healing of war’s wounds—without excuses, without short cuts, without budgetary concerns.

While we may or may not believe in the reasons President Obama continues to commit our country to war, he is revolutionizing our relationship to the people we send off in our names.  He is creating a true moral obligation to them, and that deserves our amens.

The Multigenerational Ripple of Post Traumatic Stress Disorder (PTSD)

The other night my husband and I were watching a movie a friend recommended, and by the end, it wasn’t a movie I was seeing but my own history, as if I were looking through a window into my family’s past and seeing my parents from a time I was too young to remember.

When my friend called to ask if I had seen Shutter Island, which is based on the novel by Dennis Lehane, I answered no, the preview indicated it was a scary movie about a man imprisoned in a Gothic-like insane asylum, not exactly inviting subject matter.  Yes, she said, it’s that but much more.  You need to see it.

The beginning confirmed the impression the preview created: a U.S. marshal visits a mental institution on an island to investigate the disappearance of a dangerous inmate, dangerous because she had killed her children.

Once inside the walls, the marshal begins having flashbacks—of the skeletal survivors and countless corpses he encountered when his WWII battalion liberated Dachau.  Hmm, this is interesting, I thought, and sank back into the couch, curious how this aspect of the marshal’s character would prove significant.  Then, halfway through the movie, the marshal’s wife appears and fades, the marshal’s memory giving her substance.  I sensed I should not trust his memory (as is true of the substance of my memories of my mother).  Something about the wife drew my back away from the couch and pulled in my stomach muscles.  I was suddenly not so sure I wanted to see the rest of the movie.

The clues begin coming faster and thicker: a young girl keeps reappearing, often soaking wet; sometimes she appears with a woman; the two of them lie among Dachau’s dead, but their eyes open, their flesh taking on color; the woman appears dripping wet; the girl says “you should have saved me.”

And I know before I know that the marshal’s wife has killed their children, that I’m watching my own family’s story, because when my brother was an adult our father told him that our mother tried to kill him when he was eleven.  Because my own mother was crazy and ended up, for a while, anyway, in an institution.  I’m seeing the story of my own family, but how can this be?  What I see is separate from me—from my memory.  What I see is the product of someone else’s imagination, and that fact both sickens and frees me.

Sickens because through the window of the movie I see that the mother’s illness and the father’s paralysis were much worse than I could ever allow myself to acknowledge.  Together, they were lethal.

Sickens because the window of the movie gives them a reality I never could allow myself to grant them.

Frees because now the illness and paralysis don’t belong to only me anymore.  Lehane’s imagination not only shows me that my theory about the causes of my family’s demise was correct, but that the devastation didn’t result from some flaws unique to my mother, my father, my brothers, and me.

Shutter Island symbolizes war’s devastation

But its truth is also literal.

The mother’s manic-depression, suicidal urges, filicide are as much the consequences of her husband’s war service as is his paralysis to intervene and save his children and wife.  A family is a system: what infects one disturbs and alters the others.  Shutter Island helped me see that my mother might easily have killed my brothers and me.  That she didn’t kill us wasn’t due to my father having had some better instincts or better character than the marshal.  My father had better luck in arriving home when he did, in time to save my brother from being suffocated by our mother.  Yet even then, when my father moved out, taking that brother with him, he left my other brother and me behind, still telling himself, perhaps, that there had been some reason why his wife targeted the child she did.  That my other brother and I were safe.

So I had luck as well that my instincts kept me on her good side until she was arrested for shoplifting and was given the choice of jail or committing herself to an institution.

Shutter Island answered the questions my travels across the country interviewing veteran liberators did not.  When I didn’t find a veteran who lost his wife as my father had lost his, whose children had lost their mother as I had lost mine, I thought my father must have had particularly bad luck in not only witnessing Nordhausen, but in marrying a woman with mental illness.

Now I understand that his luck could have been much worse.

To my knowledge, my father did not execute any German soldiers or cause their deaths outside the rules of engagement, but that the marshal did execute German guards at Dachau resulted from the trauma of entering Dachau and witnessing the endpoint of  Nazi ideology.  I believe that the trauma of any liberator, of any combat soldier has equally potent consequences.  Trauma incapacitates the serviceperson from anticipating, preventing, and then addressing the fallout from their trauma once they return to civilian life.  And then they all become overwhelmed by guilt.

All these years I thought anguish and unresolved grief created my father’s silence about my mother.  I never thought about guilt.  How huge his must have been.

The tragedy of Shutter Island isn’t that the marshal chooses to stay in his delusional fantasy rather than accept the reality of what has happened to his children and wife.  The tragedy is that he feels guilty for what happened, as if he could have, on his own, created a different outcome.

The Multigenerational Ripple of Post Traumatic Stress Disorder (PTSD)

A reporter recently asked me what the symptoms of PTSD are for children of veterans.  And I paused, because what basis do I have for answering that question other than my own experience?  I could not think of any books or research that specifically addresses that question; only in the last year has the National Center for PTSD recognized that children suffer from their veteran parents’ PTSD.  Their website says this:

Children of Veterans with PTSD are at higher risk for being depressed and anxious than children of non-combat Veterans. Children may start to have symptoms like the ones the parent has. For example, a child may have nightmares about the parent’s trauma. Children may have PTSD symptoms related to watching their parent’s symptoms. For example, a child might have trouble paying attention at school because she is thinking about her parent’s problems. The impact of a parent’s PTSD symptoms on a child is sometimes called ’secondary traumatization.’ Since violence occurs more often in the homes of Veterans with PTSD, the children may also develop their own PTSD symptoms.”

www.ptsd.va.gov/public/pages/children-of-vets-adults-ptsd.asp

While I agree with that, I do not agree with what the website says in a prior paragraph:

“Families of Veterans with PTSD experience more violence than those without PTSD. This includes violent behaviors in children. Children of Veterans with PTSD have more behavior, school, and relationship problems. They are more aggressive and hyperactive than children of Veterans who do not have PTSD.”

While it is true that many veterans with PTSD can behave violently at times, not all veterans with PTSD do.  Not all children of veterans of veterans with PTSD will be more aggressive or hyperactive.  Such sweeping generalizations do a disservice to families who need help but do not see themselves as falling within these categories.

I say this from personal experience. I never  showed aggression or hyperactivity; my father never once acted remotely violently.  Nor did the many WWII veterans I have met and interviewed over the last six years.  We need to consider that PTSD can take forms other than the one the media and governmental agencies highlight.  I believe a more common form of PTSD from war manifests itself in periodic depression, veiled melancholy, brooding, anxiety, suppressed memories, and nightmares.  The veteran is often highly successful in his or her professional life and does show to the outside world any indications of emotional pain.

One WII vet I met, who has never been able to speak of his war experience to his children, still wakes up from nightmares yelling and in a cold sweat.  He went to the VA recently for an evaluation after a VA physician who saw him for a sprained arm suggested,after questioning him about his daily routine, that he might have PTSD.  But the VA psychiatrist, after a twenty-minute evaluation, determined the vet did not have PTSD.

A determination of PTSD seems to involve more opinion than analysis of objective data.  What can a 20-minute observation reveal?  What if the psychiatrist her or himself devalues their emotions, a not uncommon characteristic of highly accomplished medical professionals?  (Much of the three years I spent in law school was a struggle to hold on to my emotional life as doing well on exams and in moot court trials seemed to depend on excising all emotions, to forcing myself to be dispassionate.  And if doctors allowed themselves to care about all their patients, they would soon be spent.)  So the meager signs a new patient might allow himself to reveal to a VA doctor could easily not pass a threshold of symptoms that doctor has established.

All of this is to say that if we have yet to nail down the qualities of PTSD itself, we are even further from defining the characteristics of secondary trauma.  I could speak from my own experience and identify my anxiety, which has increased over the years, my struggle with depression since I was 15, the way I go silent when I feel threatened or insecure, how I expect the worst and reflexively express a negative perspective (the quality that my husband finds most tiresome), how deep inside I see myself as unlovable, as having deserved the physical and emotional abandonment, so I can never rest from doing too much for those I love.

But such a profile becomes problematic, I learned when I first attended an Al-anon meeting two months ago.  My mother became an alcoholic sometime in the five years after my father returned from Germany.  As she left my life when I was five, I never considered the effects of her alcoholism on me (other than abandonment) until I sat through my first Alinon meeting.

Another child of a veteran had encouraged me to go after reading the manuscript of my forthcoming book, Gated Grief.  “Have you ever explored the significance for you of your mother’s alcoholism?” he asked.  At Alinon meetings people take turns speaking, and in my very first meeting as I listened to others speak, I felt like I was hearing my own characteristics described: going silent when people seem to ignore or dismiss me, constant worrying, being pessimistic, doing too much for people I care about.

So what of myself was the consequence of those five years with my mother and what resulted from my father’s repressed trauma?  I thought about what a therapist had told me years before: A family is a system, so when one member of a family has a serious problem, other members will manifest anger in a myriad number of possible behaviors, alcoholism being one of them.  Wine and then scotch enabled my mother to escape her husband’s coldness and absence- both physical and emotional.

We think that the trauma of war flows through the veteran-parent, but we need to also look at the non-veteran spouse, because often their means of coping has as serious consequences for the children as does the veteran’s detachment or rage.

I have not answered the question the reporter raised.  I do not feel that I can speak for any one but myself.  And it is terribly painful to acknowledge the toll of my father’s war on our family, on my brothers and me.  We are not a family.  One brother does not speak to my other brother and myself and has never told us his reasons.  My other brother and I have distance between us, as though hearing the other person’s difficulties stimulates too much pain.  My children have no sense of an extended family on my side.  The lives of my brothers and myself have been warped, so much energy consumed by resisting our sorrow and negativity, by developing strategies to cope.   If that is true of other children of veterans, how much treasure have we lost from our wars?

The Multigenerational Ripple of Post Traumatic Stress Disorder (PTSD)

As a former student of mine, Matt Campbell, posted on his Facebook page today, Americans seem to have little clue of the significance of Memorial Day.  It began in 1868 to honor those who died in the American Civil War by placing flowers on their graves. After the bloodshed of World War I, all soldiers who died in the line of duty were honored.  As Matt notes, most people see Memorial Day as the start of summer and a nice three-day weekend, and very few of us “take the time to remember our fallen soldiers.”

The Denver Post carried an article today about the pain of parents who have lost sons and daughters to war.  Twenty-four year old Staff Sgt. Jacob Frazier of the Illinois National Guard, was killed in Afghanistan in 2003.  “Don’t ever use the word ‘closure’ with me,” his father Jim Frazier said. “I once threw a reporter out who used that word. It’s simply a hole in your heart that is always there . . . and you learn to live with it.” On Memorial Day in 2003, just two months after burying his son, Mr. Frazier agreed to go on a parade float through Chicago. He found the disconnect between his grief and the happy, smiling crowds excruciating.

Another parent, Sandra Miller, mother of Army Pvt. De Wayne White, 27, who died in Iraq in 2007, is “baffled that so many Americans do not recognize or even think about sacrifice, especially on Memorial Day.” “It’s not about having a barbecue. It’s a day for remembering . . . . And what’s up with all the sales?  If one TV channel could just put up the photos of all the fallen for just one day, that would make a huge difference.”   Mr. Frazier is quoted as saying that what we can do is ask family members about their son, daughter, husband or wife.   “The kindest thing you can do is just say, ‘Tell me about him,’ because if you don’t talk, you get sick.”

The words of these bereaved parents gave me an idea.  What if instead of parades, we had, in every single town across this country, a public role call of all the service men and women from that town who have died in war- not just our current ones but all our wars– from the Revolution, to the War of 1812 to the Civil War to the Spanish-American, World War I, World War II, Korea, Vietnam, the Gulf War. And all of us took turns reading the names.  And all of us were present to hear the names, to acknowledge that life and loss. We need to take the losses of our wars personally.  Because even if no one in our family ever died in the line of duty, even if we opposed each and every one of these wars, the fallen soldiers died in our names.    And until we remember the cost of war, we have no chance of realizing how we allow the suffering of war to continue.

Please consider going to the movies on the evening on Tuesday, May 18th to show support for military families who have lost loved ones in Iraq or Afghanistan.   On Tuesday, May 18 at 8:00 p.m. ET / 7:00 p.m. CT / 6:00 p.m. MT / 8:00 p.m. PT (tape delayed) in select movie theaters nationwide, audiences will be taken on an inspiring and compelling journey to a picturesque Rocky Mountain camp where 25 boys gather for a week of camp to honor the memories of their fathers who made the ultimate sacrifice while serving our country in Iraq and Afghanistan. Get your group together to hear their stories, be inspired and take action!

To help you share information about this touching, one night in-theater tribute to our Military and their families with your community, we have created tools such as e-cards, social media badges, a trailer, flyer and online banners for you to use which you may find on the event website,

www.sonsofthefallenonthebigscreen.com.

This website has connected me with people all over the country who dedicate themselves to helping veterans and their families heal from war’s traumas. Veterans Heart Georgia (VHG), based in Atlanta, is among the pioneers creating programs and assembling resources.  I envy Atlantans for being able to participate in VHG’s monthly Listening Circles where people speak their pain and struggles and find support and understanding.  Community is invaluable to healing PTSD.

One of VHG’s programs is the Children and Families of Veterans Initiative. As part of that VHG is partnering with the Counseling Certificate Program at Mercer University to gather data for a research proposal that seeks to understand intergenerational trauma.

VHG’s first step in gathering data for a pilot study is creating a blog. From the stories they can bring together from the blog, they will look at common threads and see how frequently those commonalities (qualitative data) occur.  Then they will form small focus groups (via conference calls, probably), followed by a smaller number of interviews. This data will form the basis for a proposal to study the prevalence of negative effects of war on adult children and families, as well as to develop an “intervention” or method to help end people’s suffering.

If you go to VHG’s website, www.veteransheartgeorgia.org, you will see the blog on the far right of the navigation bar.  Click on that and then register so you can leave your story.  This will increase the chances that families of veterans, as well as the veterans themselves, will have resources available to them for healing.

You can create a nickname when you register that will keep you anonymous, our use your own name.

Let us all help to create a groundswell of awareness and healing.

The Multigenerational Ripple of Post Traumatic Stress Disorder (PTSD)

Who wouldn’t want a soldier suffering PTSD to get the help he or she needs?  Our attitudes and awareness have evolved light years since World War II when we saw “battle fatigue” as an excuse for cowardice and treated it with either Thorazine or an ice pick to the brain.  Today the term “PTSD” is universally familiar, and the success of movies like “The Hurt Locker” and “Brothers” reveals a deep vein of sympathy and compassion towards our soldiers who suffer from war’s traumas.

So how is it that soldiers like Eric Jasinski cannot get the mental health care they need?  Rather than treating his severe PTSD, the Army courtmartialed him for refusing to go back to Iraq, and he spent twenty-five days of this month in Bell County Jail near Fort Hood in Texas.

Eric enlisted in 2005 and was deployed to Iraq in 2006 where he collected intelligence that helped determine the location of air strikes. “What I saw and what I did in Iraq caused my PTSD,” he told reporters before his trial.  “I went to get help and had an eight hour wait to see one of five doctors.  I ended up getting a letter that instructed me to go see a civilian doctor, and she diagnosed me with PTSD.  I began taking the medications (Zoloft, Seraquil, Periactim, and Ambien), and they were helping, because I thought I was to get out of the Army in February 2009 when my contract expired.” 



But in late 2008 the Army extended his service and gave him a 90-day supply of meds to get him back to Iraq.  (As if the meds alone could take care of his PTSD, let alone enable him to return to Iraq.)  When he told a counselor “I don’t know what I’m going to do if I go back to Iraq,” the counselor asked if he was suicidal.   When Jasinski responded, “I’m not planning on going home and blowing my brains out,” the counselor told him he was then good to go to Iraq.

“There was no way I could go back with my untreated PTSD.  I needed more help.”  He went AWOL during his pre-deployment leave break, and on December 11, 2009 turned himself in to authorities at Fort Hood, in Killeen, Texas. 



His civilian lawyer, James Branum, believes that Jasinski’s case highlights the need of the military to provide better mental health care for its soldiers.
 Even while the Army has seen a record number of suicides since 2006 and an escalation of soldier-on-soldier violence, it still does not provide its veterans meaningful mental health treatment. Practitioners are overwhelmed, the demand far outstripping the supply of qualified professionals.

Eric Jasinski is not an isolated individual.  He represents countless service men and women returning from Iraq and Afghanistan who see no choice but to go AWOL when the military does not provide them meaningful mental health care treatment for their PTSD. 
According to a 2008 Rand Corporation report, at least 300,000 veterans returning from both wars have been diagnosed with severe depression or PTSD. 



Eric Jasinski offers advice to his fellow service members: “Do not, do not let a 5-10 minute review by a military doctor determine if you go to Iraq.  Even if you have to pay out of pocket, go to a civilian doctor.  Even then I’m not sure that will help… but you have to take that chance.” 

He believes we need a total overhaul of the military’s mental health care and more experienced psychiatrists– ones who are first and foremost dedicated to the well-being of their patients rather than the “good ole boy” system of their superiors.

We civilians must open our eyes to the treatment our combat vets are receiving.  In our names they have served, and because of that service, they are suffering.  We are all implicated in their suffering.

The Multigenerational Ripple of Post Traumatic Stress Disorder (PTSD)