Sunday, November 10, 2019

The History of Military Trauma--Veterans Day

On April 6th, 1917 the US Congress declared war and we entered WWI. It was our first full-scale entry into armed conflict on European soil. War has changed since then, and we have changed but there is one constant, which is the sad fact of psychological injuries sustained by soldiers in war.  

Various authorities—military and psychiatric—put the estimate of “stress casualties” between 25 and 60 percent, though the words we use to describe them has changed over time. Terms have included: Battle fatigue, war neurosis, shell shock, military hysteria, trench suicide and  “LMF” or “lacking moral fiber”. These labels reflect the cultural attitudes of each time period, but they are also influenced by military strategy and even demographics.

In 1917 the US population was at an all-time high. In supply terms this meant there were plenty of soldiers. In that war, where supply met demand, it was not uncommon to find that those who broke down, who froze on the field, who hesitated to shoot, retreated or exhibited any other detrimental behavior were considered to have problems of character rather than injuries. 

 By contrast in World War II, with fighting in both Europe and Asia putting more than 16 million Americans in uniform, the condition of a struggling soldier was framed very differently. War trauma became an illness which could be treated or cured. 

But beyond the words we use, it’s important to note that there has always been a civilian hand-me-down from the military and the psychiatric casualties of war. The need to keep soldiers on the battlefield or to return them to combat in World War II saw one of the United State’s largest investments in psychology and psychiatry. Through the 1940’s the Pentagon spent millions of dollars for psychological research. 

That has had a lasting impact on all of our lives.

The research for that war’s soldiers spilled over and into the fields of advertising, education and even design. 1946 saw the first National Mental Health Act; in 1948 The Snake Pit –a movie about shock treatment and psychoanalysis won 7 Academy Awards, and also that year Psychology Today magazine was launched for the general public. 

In 1949, the Nobel Prize for medicine went to Dr. Egas Moniz, who “invented” the pre-frontal lobotomy. Today our casual talk of “issues” and “processing feelings” has its roots in the Pentagon’s need. 

 Of course, each succeeding war has added research and changes to how we view our psychological selves. In the Korean War, the Army created mobile psych units that focused on cognitive treatments which attend to how one processes thoughts. 

Out of this came civilian interest in mind control, positive thinking and yes, that old stuff about subliminal persuasion. Then we went to Viet Nam and saw the military test new methods of replacing troops --not as units but as individuals. We know that the style of jungle warfare along with the media coverage of that war—and the tricky politics of the time—all contributed to the total impact on soldier’s health.  

 More than any other war Viet Nam redefined our beliefs about mental health.  Five years after the fall of Saigon, “Viet Nam Syndrome” was identified, which morphed into Post-Traumatic Stress Disorder, which rapidly generalized to civilians who suffered trauma. 

Now, we are in danger of more war—and wars with yet newer factors. In Afghanistan and Iraq our troops faced guerilla combat with the added stress of suicide bombers and armed civilians. More chemical warfare seems to be approaching. These increase the psychological difficulties, and as this changes we see another reframing of the resulting psychiatric casualties. 

Especially today on Veterans Day--we must remember to factor in these injuries when we talk about the costs of war. We must  ask how we will label our broken soldiers, how we will care for them and their families. What will be changed, now and later.

For more on the history of military trauma you may want to see my book:

Wednesday, October 30, 2019

Preparing for Day of the Dead

 This week I’ll be celebrating Dia de los Muertos, the Day of the Dead.  It’s not a holiday I grew up with but one I’ve borrowed from the Southwest and Mexico.

And it’s become one of my favorite holidays –in part because it’s a good spiritual counterpart to Halloween. Except for the candy, October 31st doesn’t leave much for grownups.

Being scared of goblins and ghoulies lost its sway when I got old enough to lose people that I loved. The dead just aren’t scary in the same way anymore. In fact, I’d welcome a visit from many of them.

That’s what Day of the Dead is about.

There is a belief that on this day the veil separating this world and the next is thinner and so it’s a time we can be closer to those that we love who are dead.

Day of the Dead celebration centers on rituals for remembering loved ones. We can visit them in our imagination or feel their presence. It can mean prayer or conversation, writing a letter or looking at old photos.

The tradition that I use includes making an ofrenda, or altar, something as simple as putting photos and candles on the coffee table and taking time to talk about these loved ones and remember them. We also have spicy hot chocolate as a symbol of the sweet and bitter separation from those we love.

A ritual is a way of ordering life. Whether Purim or Advent, hearing Mass or saying Kaddish, small ceremonies help us sort and reframe our memories.

When someone dies the relationship doesn’t stop, it’s renegotiated, literally re-conceived.

No, this isn’t a very American idea. Culturally our preferences are for efficiency and effectiveness; even with grief we use words like closure and process.

I remember my frustration when I was grieving the loss of my brothers and sisters and my truly well-intentioned friends would suggest I move along in my process and they quoted (actually, misquoted) Elizabeth Kubler-Ross.

The simplified version of her theory lists stages: Denial--Bargaining--Anger--Depression, and Acceptance.

But it’s false to create that expectation of five discrete steps. That listing implies order, and that a person can move from point A to point B and be done. That makes grief into an emotional Monopoly game where you go around the board, collect points and get to a distinct and certain end.

This false notion of linearity is apparent when we hear people judge someone who is grieving, “Oh, she missed the anger stage”, or “He hasn’t reached acceptance yet.”

I always thought that “losing a loved one” was a euphemism used by people who were afraid to say the words dead or died, but after losing my brother Larry I know that lost is the perfect word to describe that feeling of something just out of reach, still here, but also gone.

Though he died years ago my feeling about my brother is that I have misplaced him; I have that sensation of knowing that my book or that letter I was just reading, are around here somewhere…if I could just remember where I left him. 

I think this is why we can be so hard on the grieving, and why we want them to go through those stages and be done with it. We love closure and things that are sealed and settled.

But death and grief, for all their seeming finality, are not as final as we would like.

So tonight, I’ll make cocoa and light candles; we’ll take family pictures into the living room and tell stories. And we’ll laugh.

The root of the word grieve is heavy. We carry our dead as a cherished burden.

Death may end a life but not a relationship. Who would want to close the door on that?

Sunday, September 29, 2019

Stay in Your Lane

“Stay in Your Lane.” I’ve been saying that to myself a lot recently. It’s a great mantra and a reminder, and it comes with an easy visual.

We know, as drivers, that it’s dangerous to weave back and forth lane to lane, and even more dangerous to drift into an oncoming lane. It’s also true—though maybe not quite as life-threatening, that it’s dangerous to drift into someone else’s lane—at work, at home, in friendships and in romantic relationships.

Staying in your own lane is a combination of boundaries and discernment: What is my business? What is not my business? It’s not always clear. But—continuing the metaphor—that’s what the broken line on the highway is for.

A couple things can help us stay in our lane. One is watching for the red flags.
One tool is listening carefully to what you are saying, especially how you preface any comments.

If you hear yourself saying, “It may not be my business, but…” You are correct. Stop right there and get back in your lane. Ditto, for “I’ve never been (a parent, married, seriously ill, faced with infidelity, a boss, laid off…etc.) but I know that I would….(Insert unsubstantiated advice here.)”  No, you wouldn’t. And, you have no idea so cruise back to your own lane. 

Anytime we say things like, “If my husband ever..” or  “If my kid ever…” we’re blowing hot air. We might fantasize about what we’d do, but in reality there are so many ways to live thru hard things that none of us actually knows what we’d do. Turn that wheel.

Another red flag to tell you that you are drifting is to pay attention to your body. Is your heart racing, breathing accelerating, temperature rising, voice raising? You have left your lane and what you say next is 99% most likely to be a mistake or an over-reaction. Gently bring your lips together and take a seat, get a glass of water. Wait a minute or 30. 

We almost never regret what we did not say. If it turns out that you have had a related experience (You directly, not your sister-in-law) then maybe share that privately, one-on-one. 

A good friend of mine likes to remind me: “Diane, if the other person did not specifically say, “Diane, I want your advice”, then you have not been asked for your advice so don’t offer any. At all.”

Most days, I count myself good if I feel myself drifting out of my lane and pull back just in time. 

Monday, August 26, 2019

Letting Go--Just Throw the Ball

Letting Go is a topic I can never hear about enough. I love it when it’s the topic at meetings, and I really love it when people talk about how they let go—what exactly they do that helps them. 

Letting go is probably the answer to 99% of my questions. (What should I do in my relationship? Let go. What should I do about that cranky relative? Let go. What about the future I am worried about? Yes, let go of that too.
But still, and often, just as in my newcomer days, I can sigh and say, “But how?” and I try to keep the whiney tone out of my voice.

So, I love the advice on letting go from the amazing Melody Beatty. Beatty is a recovering woman, recovery writer, and a recovery role model. I highly recommend her books especially the day meditation book called, “The Language of Letting Go.” My first sponsor gave me that book in 1983 and I still read from that dog-eared, underlined, tear-stained copy every day. 

So here is her advice on how to let go:

*If you are holding onto a worry or a problem or a person—think of that as holding onto a baseball.

* If you have tried to solve a problem three times (and worry doesn’t count) then stop yourself. Let go. Throw the ball.

*If someone asks you for advice, you give them the advice one time. Then throw the ball to them. Let go. Say nothing more.

*If a person has not asked for your advice, or if you offered some advice and the answer was “No thanks,” there is nothing to throw. Let go. The ball is not in your hands.

It might be helpful—if you are really struggling with an issue or a person—to get a small ball to hold, use a ballpoint pen to write the issue you’re struggling with on that ball, and then let it fly. Throw that ball off a cliff, into a river, roll it down a hill away from you, and say out loud, “I am letting go of….and name it.”

That’s what letting go looks like. Let it go.

More on life in long-term recovery--see "Out of the Woods" published by Central Recovery Press.

Thursday, July 04, 2019

On the Shore--The Glorious Debris


“Every one of us
 is called upon, probably many
 times, to start a new life.
A frightening diagnosis, a
marriage, a move, loss of a job…
And onward full tilt we go,
pitched and wrecked and absurdly
resolute, driven in spite of
everything to make good on a
new shore. To be hopeful, to
embrace one possibility after
another—that surely is the basic
instinct…..Crying out: High tide!
Time to move out into the
glorious debris. Time to take
this life for what it is.”

--Barbara Kingsolver, from High Tide in Tucson