It’s been one of those weeks, with days long and tiring enough to call for sleep at their end, rather than typing. In other words (as if you didn’t know already): I’ve been remiss.
But I’ll confess: one of the “one of those weeks” elements has been my finally succumbing to the Hunger Games trilogy. I just finished the second book last night, and I’m already well into the third and final one.
So go ahead. Say it. You’re right, you know. I should be embarrassed.
I’m not, though–especially since I’ll have at least one post come out of this. Who knows, maybe more.
On that note . . .
Brief side bar (a serious one): I would not recommend The Hunger Games willy-nilly to a combat veteran. The story has elements that are quite relevant to combat trauma and PTSD, and reading these books gives me a feel similar to one I often feel at my job every day. More on this later, but, truly, word to the wise: these books could prove quite distressing to men and women who have weathered the traumas of war.
I’ve had some very thoughtful comments this week, to all of which I plan to respond, One in particular I wish to address in this post, if only to remind myself why I do this blog and this work. A high school student, Stephanie Pieper, has created a Facebook page entitled Veterans With Post Traumatic Stress Disorder. It arose out of a class project, and she has created an excellent “deposit account” for information on all aspects of the challenges of living with and of finding hope for those living with PTSD. In her comment, which appears to have been sent out to a variety of individuals/organizations, she asked three very good questions–three very good questions that merit the following “letter.”
Thank you for your interest in my blog, and thank you for the work you are doing to increase the public’s understanding of the struggles that many combat veterans are facing. I especially commend you for your interest in making your peers more aware of these very difficult, very important issues. You asked me some questions, and I am glad to answer them as I can.
1. What drove you to start a blog?
First of all–though probably least noble of all–I enjoy writing. I enjoy entering inside a part of myself and seeing what words pop out. Sometimes I surprise myself. Sometimes I simply bore myself.
More importantly, though: as I say in the “About My Blog” section, I have had many combat veterans tell me that they can relate positively–even intensely–with the words I use to try to understand and describe their experiences. I claim no special knowledge. I just go to the same “place” inside me as I do when I write, searching for words to put to feelings that I can only barely comprehend–and never fully articulate. As long as the men and women whom I serve find these words useful, I will continue them.
Finally, there is a technical reason for the blog. Today there are many very effective psychotherapeutic (counseling) therapies for combat-related PTSD, and the VA, where I work, is at the forefront of promoting their widespread, competent use. These therapies arise out of a tradition that focuses on the importance of understanding what and how we think about our emotions, as well as on taking appropriate, helpful actions based on those thoughts.
I was, however, trained under a different tradition, one that focuses more on the stories we tell about ourselves, on the way we can make sense of our lives, and on the importance of powerful, personal relationships in bringing about a more coherent sense of ourselves. This has definitely become the “secondary” approach to the treatment of combat-related PTSD (and I’m not going to say for bad reasons, especially given the resources we have at hand). Still, I hope that this blog, the way that I talk, the way that I express my own experiences when I am with these veterans–all will give the next generation of professionals a taste of the wisdom I received from my teachers so that some of that wisdom can be effectively brought into some aspect of the care of veterans over the coming, many years.
2. What motivates you to work with veterans with PTSD on a daily basis?
To be truthful, I found my way to working with combat veterans quite unexpectedly. Like many individuals who work for themselves (I also have a private psychotherapy practice), I was looking for a part-time job that would provide health insurance for me and my family. I knew my current supervisor well, and one day (before she became my supervisor) I asked her about any availability of staff psychiatrist positions at the Indianapolis VA. And tah-dah: here I am.
That is only a small part of the story, however. I have long focused my psychotherapeutic practice on the treatment of men who are struggling with interpersonal issues. I like the intensity that many men bring into their counseling work–and certainly no one, in my experience, brings more intensity to any encounter they have than do combat veterans.
In addition, I am the age of the parents of most of these individuals. Thus I often find myself feeling a certain paternal enjoyment of the veterans. In my line of work, you have to be cautious about overdoing this: you don’t want to end up burdening veterans with your own needs. Yet similarly you cannot be “cool and distant” when you are sitting with persons who have been involved so closely with so much horror. My task hour by hour is to try to find the right emotional distance with the veterans: close enough to be affected by them, but not so close as to become overwhelmed or demanding myself.
Finally, though, I do work with these veterans out of a definite sense of duty–although I need to clarify that word carefully. The duty is not a patriotic one or a civic one, for I’m not one to feel a strong affinity toward the “nation” in the abstract. Instead I feel it to be a human duty, arising out of who I am and what I value. To me, it doesn’t matter whether or not this current conflict is a justified one. These men and women believed that the honorable task for them was to protect those of us who are not willing (or able) to take up that task. They do what they do so that we can do what we do. You may or may not believe that this current conflict is such a task. No matter: these men and women agreed to protect us by doing well what they are led to do, wherever, whenever. They gave their youth–and some of them, their lives–for us, whether we wanted them to or not. I believe strongly that all of us owe them our best efforts to make home “home” for them once again.
3. What is one thing you would like my generation to know about PTSD?
If I may be so bold, I’d like to suggest two things: one about military life in general and one about PTSD in particular.
As a father of teenagers, I am well aware that most high schoolers these days have no thoughts whatsoever about entering military life. I do ask, though, that your generation embrace from the start those of your peers who indeed believe that military life offers them the best hope for a meaningful career.
I know that some younger people think that people go into the military only because they lack structure or seek education. Others think that people go into the military only because they are foolhardy.
Remember, though, as I’ve said in previous posts: some individuals have always been intense by their very nature, “warriors-in-spirit” as I have called them. For these individuals, the military is not just a fall-back option. It is the option, a chance for them to focus their energy into activities that can be meaningful and worthwhile. Granted, combat often complicates–if not obliterates–that meaningfulness. That’s where the PTSD comes in. Nevertheless, they still feel the honor of protecting even those who don’t want (or at least say they don’t want) their protection! Therefore I urge your generation to make combat veterans’ return to civilian life–both now and in the years to come–as seamless and rewarding as it can be.
As to PTSD, though: never forget that the traumas these men and women endured will be with them–and thus with your generation–for the remainder of your lives. Your generation will never be free from these challenges, and thus I strongly urge each of you to begin preparing for these challenges right away, no matter what professional or personal choices you might end up making. Learn what you can about the consequences of trauma. Understand personally and professionally how you can help veterans come to grips with those consequences in ways that are both realistic, yet still hope-filled.
I am fifty-four, and I have about fifteen more good years to help prepare your generation for the work ahead. Currently I treat men and women who are in their mid-twenties to their mid-thirties. In fifteen years, they will only be in their forties–and there will be younger ones still, the ages of your generation. The job of my generation is to transmit to your generation all the wisdom, the hope, and the patience our mentors have instilled in us. The job of your generation is to make it work for these veterans–for a lifetime.
Again, I thank you for your energy and for your willingness to learn and to share. If your generation has many like you–and I know it does–the futures of these combat veterans will be all the better. Good for them. And good for you. All of you.
My best to you in your future,
Rod, Stephanie contacted me for the same reasons. What an amazing young lady. I sent her some advice but I also responded to her questions as well. It’s is always heartening to see the next generation take a vested interest in learning from the generations preceding them.
Thank you, but again, as I always say: you are truly the one to be admired. Thank you for your continued willingness to share your life (www.combatveteranswithptsd.com) and your continued commitment to living your life, for your wife, your daughter, your family–for you!
Dr. Deaton, Thanks so much for the Blog, and for this letter. I’ve just discovered it today thanks to an email heads up from Dr. Wilson, PhD, at VANIHCS-FW. As a Social Worker (now with the VA), a grateful non-combat Viet Nam era draftee undoubtedly experiencing some degree of survivor guilt, the father of children ages 24 to 30, and a human being, I also feel a need to understand, and share, the burden of others: just as I hope that there are be others to help me with my burdens. It seems, though, that need becomes duty when those burdens are suffering that is the result of the use of some in the service of others- use that has knowingly placed the “some” in harms way. The motives (to serve their country, or themselves) of those who serve, or the preferences (for, or against the war(s)) of those being served seem irrelevant: they have suffered, and suffer, in service to others, whether intentionally or not.
I hope that your blog might help my children, none of whom served in the military (with my strong blessing), have a greater understanding of, and empathy with, their peers-in the interest of the greater well-being of all. If the experience of death changes us all, how can the experience of violent and intentional death not change us fundamentally? And how can that not then change us all?
Thank you so much. I cannot even imagine how I could respond in any way that could add to the beauty and intensity of what you’ve said. With every day, with every pair of eyes that looks at me, hoping against hope that somehow it can get better, I find my passion growing. As my colleague Sheri Bell-O’Gara has said, we are indeed so fortunate that these men and women trust us with their very souls. I can’t conceive of any more meaningful work.