The Problem with A Diagnosis

By now, nearly everyone in America has heard of PTSD and that can be good news and bad news.   Posttraumatic Stress Disorder or PTSD is often misunderstood by the average reader and even by those in the medical field.   The term PTSD, first coined following the Vietnam War, but it did not start then.  One of my first therapy clients was in her 80s when I met her during my Internship.   She was the first person I met with PTSD; in her case, it was secondary PTSD.  Her father returned from World War I with "Shell Shock" and he would struggle with re-experiencing his traumatic events, which led to hyperarousal and probably dissociation (not knowing who and where you are).  In his mind, he was back in the trenches.  He would threaten his own family with a large kitchen knife or other weapons!  PTSD was also called nostalgia, wounded heart, or battle fatigue following the wars in the past.  PTSD can result from any traumatic event not just war.   PTSD can be "shared" by an individual with his family.   For warriors, the experience of combat always changes them.  Issues identified as "symptoms" of a PTSD diagnosis are actually normal human responses to combat.  Anger, hyperarousal or hyper-vigilance, and emotional distancing, are the brain's attempt to keep the person alive in combat.  The problem begins when a warrior returns from combat and continues to respond to normal life (whatever that is) as if he or she was still on the battlefield.  This should be called combat stress injury or posttraumatic stress.   It's only an actual disorder when the behaviors prevent the warrior from living effectively back home.  The warrior learned to dial up these emotions and behaviors in combat and may need some help to learn to dial them back down after returning from combat.  Not every situation is a "10".  Not everyone who has been in the military has been in combat, and not every combat veteran is "disordered".

Coming Home Pt. 2

After returning from Afghanistan, I jumped back into my doctoral studies in psychology full-time, so I could transition from fighting wars to caring for younger warriors preparing to go to or returning from combat.  One of my favorite books at the time was Once a Warrior Always a Warrior by  COL Charles Hoge, (Ret) MD.  I read about a third of the book and then set it aside because I got so busy with required reading on my doctorate.  Big mistake!  Had I kept reading I would have learned that concentration problems are common for returning warriors.  I would study my textbook or research articles, and realized that after about 20-30 minutes I couldn't learn any more.  I couldn't stay focused longer than that.  I thought (automatic thoughts which I will described in a later post) would look like this: "I am brain damaged.  I will never be able to finish this course.  I will fail to become a therapist. I will fail as a warrior."  I ranted, I doubled my efforts, I cussed, I prayed, I escaped to do something else.  I felt like drinking myself into a coma.  Fortunately I'm too old and "seasoned" to waste time with getting drunk.  I learned as a leader of a 12-step program that adding another problem like alcoholism is not the way to fix any problem.  It only leads to other problems like damaged health, damaged relationships, divorce, and other problems I don't want.  So I adapted to overcome my limitations. I set my watch for 20 minutes of studying followed by 5 minutes of anything else involving movement- gardening, watering, exercising, etc.  Then I would return to studying and it was like resetting something in my brain.  Later when looking for some information for a paper I was writing, I picked up Dr. Hoge's book again and came across a statement that difficulty concentrating is very common for warriors returning from combat.  Wish that I had found that truth a little sooner!

Coming Home

When I returned from Afghanistan in November 2011, I was pretty worn out.  It was a tough year of combat with the 4^th Brigade of the 10^th Mountain, fighting in two of the most active provinces of the war Logar and Wardak.  Seen as the gateway to the capital of Kabul and therefore active with insurgents.  So, I just wanted to rest for a while.  The experts call this phase the postwar transition or readjustment.  In the old days warriors returned on slow ships.  I left my FOB and got home in 4 days, the day before Thanksgiving.  Right after we finished our big turkey dinner the next day, I heard a commotion in the family room by the backdoor.  My first thought was, where is my gun?  Why am I not carrying?  A second later, these "targets" were identified not as terrorists but as "non-combatant" family members!  My two daughters, their husbands and five children.  They surprised us with their unexpected return from Kenya!  It was party-time, not rest-time for this old warrior.  The holidays that year were fun but very hectic.  Living with 11 people in the home causes every day to feel like a party, which is fun for a while.  Of course, I'm talking about living in America.  In most of the world, it is very common especially in the Qalats of Afghanistan where it's a workforce of laborers or fighters.  Looking back, I hardly remember a thing from late November until April!  One of the early theories about PTSD was that you have problems remembering the traumatic events.  My experience is that I remember the traumatic events too clearly but the period for months afterwards are a blur with very few clear details. 

Why start this Blog?

I was born to be a warrior for some reason.  Born in the Balboa Naval Hospital in San Diego when my Dad was stationed in Yuma AZ with the Air Force and they had no base hospital.  When we traced our family roots it points to Attila the Hun, so I guess it's in my blood.  I begged my parents to let me join Scouts, because they had uniforms, but my Dad who left the AF after one 4-year hitch liked sports so I was in the YMCA programs instead.  Next I begged my parents to send me away to a military school.  I discovered them while looking through my friend's Boys Life (scouting) Magazine.  Of course, they said no because they didn't want to pay for school when their taxes already paid for my Elementary school in Los Angeles. At 17, I begged them to let me drop-out of school and enlist in the Marine Corps.  I could tell that the Vietnam War would be over for the US before I could graduate high school in 1973.  I joined the Air Force in 1975 this time with my wife's permission.  Together, we spent 30 years in the military and reared 5 kids during that time.  After retirement, I tried civilian life for a year and half before I accepted an offer from a private military contractor, to lead a security force of former military men. I did 2 1/2 years in Afghanistan after that as a military advisor.  Next, I spent another year in Afghanistan with the 10th Mountain Division as the commander's Afghan cultural advisor.  I loved working with the infantry, patrolling the villages of Afghanistan.  When I returned from combat, I found the adjustment to life in the US difficult.  Living on the edge between life and death is a rush!  I can't lie to you, as someone has said "You've never lived until you've almost died."  Traffic jams, shopping, watching TV, is no comparison and can drive an amped up warrior crazy.  It was very difficult not to sign-up for another combat tour but I knew it was time to stay with my family in the US.  Many warriors returning from combat turn to alcohol and substance abuse, high-risk sports, motorcycle riding or other adrenalin-producing activities to replace the rush of combat.  I am a combat stress therapist, working on my doctorate in psychology to treat warriors with stress injuries.  This blog will be about the warrior life and fathering two of my biggest passions.