Combat Veterans and “Closure”

A few days ago, Max Harris wrote the third of his blog posts (from Every Day Is a New Day) about his losing to death his therapist, Dr. Joseph Casagrande.  In my two previous posts, I shared Max’s frustrations and anger.  Today I share his grief, just he shared it with all of us:

I went out to the cemetery today.  I had learned late Thursday night that Doc does have a final resting place and it was less than a half hour from my house.  Needless to say, after spending Friday getting everything sorted out with the VA (that’s another post for another day), I was exhausted and couldn’t make it out to the cemetery yesterday.

So I went this morning.  Talk about surreal.  There I was, not a soul in sight anywhere.  I was standing in front of his grave marker, solemn and contemplative, head down.  No cars drove by the cemetery in that moment and the snow started to come down very heavily.  It felt like one of those moments you read about in books or in serious dramas.  Yet this was real life.  This was MY life and, for some reason, it just felt right that I should have solitude and quiet in that moment.

And then it passed and the emotional pain hit like someone ripping off a Band-Aid.  Intense, searing, yet short lived.  I was left with the dull throb of missing someone I would never see again, but being there – seeing Doc in his final resting place – gave me the closure I needed desperately to fully move on.  I didn’t realize how badly I needed it until that moment.  It made me wonder why I needed that closure, that finality, so keenly.

I thought about it on my walk back to the car, on the ride home and a good portion of the early afternoon.  And then, it hit me.  I needed this because I never got closure for all of the death and violence I experienced over in Iraq.  It made me think about all of the other veterans with PTSD that were suffering just like me and it made me realize:  If there is ONE THING that can trigger us and bring it all back into our consciousness, it’s having someone close to us die and not getting the closure we need to move on.

In retrospect, I recognize now that a lot of the anger I have felt for the past few days was not anger felt but, rather, anger remembered.  Grief.  Not felt, but remembered.  Helplessness, intensely remembered.  I recognize now that this event, the unfortunate circumstances surrounding Doc’s passing and the way in which I was informed, has been a blessing in disguise.  It may take it a while for me to fully accept that, but I know I eventually will.  What I have gained from this experience is how losing someone I care about will affect me in the future.  It also equips me to support my fellow veterans if they find themselves in the same position.

So take heed.  If it is in your power, do everything you can to provide adequate closure for veterans with PTSD.  Don’t blindside them.  Do what you can to be compassionate and try to leave them feeling like they are in control of the situation and how they choose to grieve.

VA Admin, ARE YOU LISTENING?

The combat veterans whom I serve often ask me “When will it end? When will I be able to move on?” They—and I—often struggle to understand what, at any particular point, that “it” is: the emotional instability, the nightmares, the flashbacks, the guilt, the grief?  All the above?

If only the latter, if only.

There is a part of the brain called the hippocampus.  Among its various functions, it serves as the “cataloguer,” if you will, of our life’s experiences.  It is the part of the brain that allows us to remember an event and actually remember it, i.e., put it in the past, in a particular context, one that began and then ended, one which no longer abides with us today.  The hippocampus is our own personal scapbooker, of the good times, of the crummy times, one of the main producers of our episodic memory, the this/then-that/then-that of our existence.

For the most part, the hippocampus turns off when we experience trauma, when Reality overwhelms us with the fire and brimstone that ignite our emotions into a wildfire worthy of any California hillside.  No time to catalogue in such a situation: it’s time to move!

Unfortunately, as a result, such memories then hang around as vivid videos inside our heads, as if we’d been transformed into a smartphone that could transport us back to Hell with the mere tap of a finger.  They’re not downloaded off the phone, if you will, into our brain-laptops, into file folders marked “War” or “Attack” or “Earthquake,” with each segment named and stored as a WMV file, ready to be watched at any time, true, yet just as ready to be shut off by a click on the Play button.

Ready—and able—to be “closed.”

The “closure” of grief and the “closure” of trauma are not, in quite important ways, synonymous, even though both processes are ultimately about loss: the former of someone real, the latter of a fantasy, a hope-against-hope that “it will never happen to me.” It is precisely because the experiences are indeed both about loss, though, we can see how they often find their ways to plow together into our souls like the proverbial Mack truck.

Max, like so many combat veterans, is once again having to catalogue the world:  Dr. Casagrande is gone; his buddies and the Iraqi civilians are gone, whether they “left” a month ago or, as Max noted recently, ten years ago this month. There is a comfort in cataloguing, in filing a memory, an emotion into a neuronal cabinet so that it isn’t just sitting around ready to be stimulated at a moment’s notice.

Sadly, though, neither the cabinet drawers of “grief” or “trauma” have the common courtesy to stay closed.  They have this tendency to fly open at the most inopportune of times:  a song heard on Pandora, a film clip on the History Channel, a photo on page five of the local morning paper.

Once they have been downloaded and filed at some point, though (all metaphors wonderfully mixed), they can be filed back, even after they’ve popped out here and there.  There is comfort in that.  One doesn’t have to live in the mind-cinema from Hell, in other words, stuck on the front row, all that horror careening toward your senses, larger than life.

That theater at least can be closed, hallelujah.

I’m glad that you had that time in the cemetery, Max.  I’m glad that Dr. Casagrande can be “filed,” while never filed away.  May his “folder” pop open at all the right times, causing you to remember once again his warmth, his wisdom.  May he rest in peace in Pennsylvania, and may he continue to bring you peace wherever you might find yourself.

In Memoriam, Joseph J. Casagrande, PhD, 1943-2013

In several past posts I have talked of Max Harris, a former Army Arabic linguist who has bravely written of his struggles with combat trauma /PTSD in his blog, Every Day Is a New Day. Below is Max’s most recent post.

I have had the honor of working with Max as a friend and fellow blogger  over the past year, and I have especially been glad that he had been able to find a solid, meaningful therapeutic relationship with his psychologist at his local Community-Based Outpatient Clinic (CBOC) in Allentown, Pennsylvania. I was quite saddened, therefore, to learn of his therapist’s recent passing–and especially saddened at how deeply the doctor’s death has impacted Max.

Below is Max’s tribute to his therapist, Dr. Joseph Casagrande. It speaks for itself, both in his pain, his frustration, and his hope. I gladly reblog it to share with others the work that this dedicated clinician did with Max and with other men and women who have served in the military. May Dr. Casagrande’s work and compassion continue to be an example to us all.

 

I try to keep the tears from hitting the keyboard as I write this. I found out today that I lost a man who held a special significance in my life. In his honor, I want to share what I knew of the man.

Read His Obituary Here: Dr. Joseph Casagrande

I never even knew his first name. We just always called him ‘doc’. I didn’t even know him for very long, but Doc Casagrande had a huge impact on my life. About a year ago, when I was out on short-term disability and learning how to cope with my PTSD, I found out about his Cognitive Processing Therapy (CPT) Group and asked to join it. That’s when I first met him. We met one on on and he asked me pointedly whether I was committed to learning the tools I needed to learn to better my life.

That should have been the first clue that this doc was different. I went to my first group session two weeks later…and my life was changed forever.

Over the course of the past year, I have taken control of my life. I still have horrible nightmares, I still get triggered. I still have to fight the depression, the anxiety. The difference is that I have acquired, through emotional growth and a considerable amount of emotional pain, how to better cope with these symptoms of PTSD. I learned these skills in my CPT group and at the direction of Doc Casagrande.

He was an amazing man. He never wore his heart on his sleeve but his passion for helping veterans came through in his straightforward attitude and brutal honesty. He told us what we needed to hear, no matter how difficult. This was his gift to us, he taught us to look at our behaviors and beliefs unflinchingly, to never back away from a problem. Doc always knew what we needed to hear and talk about the most and directed group discussion. He didn’t drone on and monopolize group time. He asked pointed questions and, throught his direction and the support of the other veterans in the group, each of us learned more about ourselves and what we could do to make changes for the better.

Four weeks ago, Doc wasn’t at group. Neither was anyone else. When I asked where everyone was, I was told that Doc was out sick. Concerned, I let it ride. Two Wednesdays ago, someone else was leading the group, a clinical social worker (for more about this group session, click here.) By this time, Doc Casagrande had already passed away. No one said anything. When I asked about Doc, the social worker evaded the questions with ‘I don’t knows’. Growing more and more concerned, I went to group today and noticed that the room was empty again. I didn’t wait around. I left and drove around for a little, thinking. In the end, I came back just after the group was ending and I ran into another doc that I have worked with and asked him for a no-bull explanation as to what was going on. The doc stared at me, stunned. The look in his eyes told me everything I needed to know but the doc said. He passed away. I found out that Doc Casagrande had passed before the last group session that I had been to and I felt the lights grow dim. My world took on a much more threatening glow.

As I said in my previous post, ‘The VA Screwed Up, Big Time.’ I was angry and very distraught. My grief was eating me alive. As I have had many times in the past when I have worked with Doc Casagrande, I felt a moment of clarity. The grief is still there and still profound. The fact that I never got the chance to say goodbye, to have closure, will haunt me for quite some time. What that moment of clarity gave me was resolve – to continue to do the work he would have wanted me to in order to make the most of my live. And to make a difference for others. That moment of clarity showed me that, while I was robbed of my right to honor the man after he died, I could live my life – the live he had made possible – in his honor. To live my life as he lived his: with compassion, honesty, integrity, and unflinching resolve to do the right thing.

It is with this in mind that I share with you my vision. I want to take what he has taught me and make a difference for veterans with PTSD. As I move forward with creating my non-profit, I will be needing a physical location. In his honor: It will be named the ‘Joseph Casagrande Center’

I ask for your support in making this a reality. Please help me and others that knew him honor his memory and his mission.

In Love and Grief,

Max Harris

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