While America was at the Mall, our military was at war. Our brave Soldiers, Marines, Sailors and Airmen were still engaged in numerous operations with real people against real enemies and unfortunately, real deaths. We are at the beginning of something significant because many in our military who went through combat will now need to put their experience into perspective. This is important because how one deals with this will determine one's quality of life and life with one's family, friends and work.
The official DOD position is to approach this as a mental health issue. However, those of us in the "Chaplain" trenches have observed it is more of a spiritual condition. Chaplain Timothy Libertay has written an article addressing many of these issues. This is the first of a three part series addressing how combat stress affects a person and how it should be confronted. With that in mind, read and enjoy the first of three part article dealing with "Combat Stress."
THOUGHTS ON COMBAT STRESS AND ITS TREATMENT
by Chaplain Timothy Libertay
It has been ten years since I
finished my dissertation on “Ministry with the Navy SEALs.” Little did I know and understand that one of
the minor correlated parts of my research would come back time after time to
help me minister to Veterans returning from Iraq and Afghanistan. At the time of my research over ten years
ago, little had been done in this field of PTSD to help those coming back from
war. Back then, as stated from one of
the guys I interviewed, problems were viewed as a character flaw or weakness of
the individual and one was expected to “get over it.”
This view thankfully has changed due
to many societal and culturally changes acknowledging our collective
responsibly to help those who serve our country. I still remember in the early part of the
Iraqi war listening in on a Marine General’s meeting. His emphasis was to get the word out to His
Marines that if anyone was having difficulties adjusting or suffering from
Post-Traumatic Stress Disorder (PTSD), they could come in for help and not have
it affect their career. This was indeed
a cultural shift from a warrior’s perspective.
In the early parts of the war with
Marines and Sailors, military Chaplains were the traditional people to go to
for counseling and help. Chaplains had
been at the forefront of every major conflict in America since 1775. As care providers, Chaplains unlike any other
staff officers lived, ate and slept with the Soldiers and Sailors on the front
lines. This unique relationship gave Chaplains the credibility to do the briefs
on “Combat Stress,” Pre and Post Deployment Stress” and family counseling
related to the unique problems of the war fighter’s war experience. As one who had numerous oversea tours on
ships, shore and finally operational Marine units in war zones, this was my
experience and world. However, in the 7
years I was gone, I noticed a not-too-subtle change once I came back to the
States. It was a brave new world where
the Chaplain was relegated towards only doing “religious stuff” and had little
say in the world of PTSD and care for our war fighters. I noticed a very distinct change over how
the warfighter was taken care of as they returned. It was one that I had a lot of concern over.
Not only because it was a huge paradigm shift on how PTSD was handled, but it
was going down a wrong path.
The concern was that something that
was originally a spiritual and moral question had been redefined and packaged
as a “psychological” issue. To their credit,
the Mental Health Professionals of the Navy and armed services stepped up to
the plate and filled the vacuum that was left from the inactivity of Senior
Chaplain Leadership. Mental Health
Professionals are to be commended for their tireless and compassionate efforts
to help those with acute hurts. However,
like Patroklous masquerading as Achilles in the Iliad, it was a venture that
had serious problems with its epistemology and hence, will never completely consummate
the intended desire.
History
and Problems
The intention of this paper is to
help our Sailors, Marines, Soldiers and Airmen who serve this great country get
over an affliction that paralyses their life: PTSD. Post Traumatic Stress Disorder is a real
phenomenon which sucks hope out of the soul of a sufferer. Having experience in treating both civilian
and war time tragedies, I submit the results of PTSD can be the same to an
individual. However in the military,
there is a distinct difference which confuses the symptoms of PTSD with that of
re-adjustment problems in coming back from a war-time environment. It is a subtle difference that the
uninitiated without military service or combat deployment do not understand. For the purpose of this paper however, this
difference will be discussed briefly because the main focus is on military
PTSD. Likewise, I will not address
Traumatic Brain Injury (TBI), as that field has different variables for
diagnosis and treatment.
Effects
of PTSD
PTSD has been around ever since
antiquity. In fact, Herodotus mentions
it in his writings in the battle of Marathon between the Athenians and
Persians:
Epizelus, the son of Cuphagoras, an Athenian, was in the
thick of the fray, and behaving himself as a brave man should, when suddenly he
was stricken with blindness, without blow of sword or dart; and this blindness
continued thenceforth during the whole of his afterlife.[1]
In more recent times, Karl Meninger of the
Meninger Clinic researched PTSD (even though it wasn’t called that at the time)
right after WW2 and concluded : “Out of every five men who died, one never came
back to live a normal life due to psychological problems. They were institutionalized and needed care
for the rest of their lives.”[2] Karl’s biggest contribution at the time was
his research demonstrating the most effective way to prevent and overcome PTSD
was work with the individual on the front. David Grossman conversely mentions
in his work “On Killing,” that most people suffered PTSD after Vietnam due to
not having societal support once they had left the battlefield.[3]
More recently PTSD has gained a lot of media attention and used by politicians
to give the impression they actually cared about our service members (my
opinion of course). As a result,
Congress passed a massive bill to fund PTSD research and development for those
psychologically affected by the war in Iraq and Afghanistan.
First
of all one might ask: What is PTSD and what are its effects? While there are many different definitions
found in research, it is something that is described better by its symptoms
than anything else. Those suffering
from this affliction have: lack of sleep, nightmares, daymares, and difficulty
in concentrating on anything, loss of appetite and/or motivation,
argumentativeness, depression and sometimes lack of self-control which can lead
to violent outbursts. Some sufferers may
have multiple symptoms or perhaps just one.
The bottom line is that the individual undergoes some type of change
from the inside out due to their wartime experiences.
In response to many coming back from
combat and having suffered one or many of these symptoms, funding was given
from the Department of Defense (DOD) to help those suffering to relieve the
effects of this malady. In response and
to their credit, the Mental Health professionals of the military came up with
some good models to help our brave men and women. COSC (Combat Operational Stress Control), OSC
(Operational Stress Control) and Battle Mind/Resiliency have arisen as a
response to this need. Along with this,
numerous studies and research methodologies from many foundations and schools
of Psychiatry and Psychology are also a part of this movement. In a few short years, a lot of research,
debates, conferences and seminars have filled the coffers and enhanced the
reputations of many. Academia has
exploded on the scene as various models, therapies and studies jockey for
position as being THE answer to cure for PTSD.
Trouble is, one can describe the symptoms, but the cure is still an
enigma.
As the dust settles
down on this adventure, one thing is certain.
In spite of all the invested money, time and research there is
absolutely no proof that any of this stuff actually works! While perusing and studying most of the data
and research in the last few years, my experience has shown that there is no
definitive mode of “curing” this malady.
Every research paper on the study has been inconclusive and is only
preliminary and has limited success.
Thinking my discovery on this specific topic inconclusive, I sought out
at the major Military experts and in conversations with them, they admitted
what I discovered too. There are many
reasons for this, but the fact remains that in spite of our best efforts,
something is still missing. It is in
this milieu, I propose a new solution. It is in fact a new way to look at an old
perspective. It has already offered
solutions in times past, but no one has been asking the right questions. At least up until now.
I call it the “Emperor has no
clothes Syndrome.” It is a based on a
different world view where someone removed from the heat of the battle can
honestly sit back and give a reasonable analysis of what is happening. Like the little girl who noticed the
important man did not have any clothes on while everyone complimented the King,
no one has stepped in and questioned the effectiveness of what is being done
for our troops. Unfortunately, this is
where ego’s, money, funding issues and turf wars intersect.
To date there has been no mechanisms set up
to measure the effectiveness of these projects and programs. All evidence is suppositional, anecdotal and
fuzzy. It is a lot like the story of the
blind men and the elephant where each blind man takes a piece of the total
story and comes to a different conclusion based on their incomplete facts. That is all right because some things just
cannot be measured empirically (see the next chapter for this discipline). However, some Mental Health professionals are
now acknowledging something that was missing from their discipline and this
something is the key to unlocking this whole strategy of treatment. This is the realization that not everything
has an empirical or objective solution.
One of the main discoveries as
psychotherapists delve into the depths of men and women’s hearts is they are
uncovering an axiomatic truth: “Moral
Injury.” This is the phenomena where a
person has done something they believe is wrong and has affected their whole
belief system and world view resulting in some type of PTSD. It is a part of Psychology which is a new
field of study and has gathered much debate and research. Simply put, this is the “Holy Grail” of what
causes PTSD and since one now has the cause, one can also work on the
cure. At least this is the thought
process of those steeped in Kantian philosophy typical of clinicians, one
learns morality, so therefore one can undo it and then after cognitive
“manipulations” can “cure” the sufferer.
In reality however, this is not the
case. Let me illustrate a short analogy,
which is something cogent and real, yet is never, ever discussed in “academic
and science” circles because many believe in a dualistic world where the
objective and subjective never meet namely something called “Spiritual
Truth.” The analogy of the clinician’s
world to spiritual truth is equivalent to where the common belief for centuries
was the sun revolved around the earth.
Scientific absolutism via the writings of Ptolomy had defined planetary
motion in three books and was the standard for almost 2 millennia. NO one ever questioned it. However when a Roman Catholic priest named
Nicoli Copernicus wrote that the earth revolved around the sun this new, but
simple concept turned the world upside down. Taking this premise, a young
Lutheran seminary student named Johannes Keplar (via the research of Tycho
Brahe) took this idea and came up with 3 simple laws of planetary motion.
A simple idea coming from a different a priori assumption explained the same phenomena. The solution had been there all along, but
the phenomena were just misread and misinterpreted. Of course, there was a social, academic and
even a religious antipathy to the new interpretation. So ferocious was the outcry against both
Copernicus and Keplar because they went against conventional thinking that they
both had to endure professional and personal ridicule and even death threats. So much for the analogy.
I propose something which is quite simply put, simple. We are spiritual creatures living in a
physical world. We are not only subject
to the laws of physics, but also to spiritual and moral laws. It not only is a marriage of science and the
spiritual, but the complete solution to an age old problem. While others have pontificated and searched
for connections between “science” and theology, I propose a true melding of the
two disciplines which actually works and can be proven both empirically and
subjectively. The application is for the
two disciplines, However, I propose something that can and will help both
Mental Health professionals and Navy Chaplains.
It’s a marriage of what seems like two complete opposite classes of
studies, but historically have been one.
To sum up,
while the Mental Health has a done a wonderful job taking care of our military
people suffering from PTSD, they suffer from a fundamental or foundational
false premise: a false anthropology of what makes up a person. The answers however have been around for
centuries and that is we are spiritual
creatures. Even though Ptolomy was
brilliant and a master of observation, he never fully explained planetary
motion. It was only when Copernicus
posited a different reality that the world benefitted from true science. Much is the same with us today and the
disciplines of Psychology and Theology and what exactly makes us human.
For some this is a
huge stretch and it makes them uncomfortable because it posits a god and that
is supposedly out of bounds for science.
It also means there are some things one just doesn’t understand and that
runs counter to the arrogant belief that we as humans possess the capacity to
know all knowledge. As a result, I submit the following as
another means of answering the same questions that Psychology is trying to
resolve. Even if one disagrees with the
following ideas, at the very least therapists can use these concepts in their
tool box as they deal with Soldiers, Sailors, Marines and the like in their
sessions because many of those suffering from PTSD have some sort of faith
background, be it tacit or active. For those with an active faith, it is merely
a re-iteration of their belief in a personal God who rules and reigns this
world and the next.
TO BE CONTINUED... PART TWO NEXT MONTH
