When we discuss military trauma and PTSD in North America, we usually focus on external events that produced overwhelming fear, guilt, or even disgust which leads to talking about these events in intimate detail. This includes addressing reactions of guilt which often focusses on what should or should not have been done externally to correct the awful thing that happened. It can be very helpful for soldiers and veterans to revisit events to develop a clearer picture of their roles and realistic options under the circumstances. But, among many veterans, this focus on the external is not enough to help them put bad memories to rest.
There is another component of trauma – shame - that is rarely discussed in the official diagnosis of PTSD or in our treatments, even though it has been written about for many years. For soldiers, reactions of shame can exist from mild embarrassment to severe humiliation, like making a mistake during training or in the field. In other circumstances, it can also lead to social/self-rejection: “I hate myself’, “I am a failure", or "I don’t deserve to enjoy my wife and children.” Where do these kinds of extreme statements come from? It is a reaction or a judement of oneself – a failure to live up to military values and self-values for which one can never be forgiven – worthy of being shunned and rejected. An example, I worked with a soldier whose patrol came under fire during a non-combat, observer role. He had been setting up a tent at dusk when incoming rounds ripped through the fabric, nearly catching him in the head. Instinctively, he dove for the ground and froze for probably 5 seconds when he heard the screams of one of the guys in his section who had been hit. Once he got his bearings, he belly crawled to his buddy and helped to get him under cover. Afterwards, when he thought about the attack, everything zoomed back to his time in the tent. He would freeze up and zone out, sometimes for hours at a time. In his mind, he was a coward, he was a phoney. What other people saw afterwards was a soldier who went from bouts of anger/rage to periods of not caring about anything. Despite lots of PTSD therapy, he continued drinking, he tried to end his life, and he was eventually released. He could never tell anybody how profoundly ashamed he was for freezing in that tent and that he did not deserve to even live – those 5 seconds defined him as a soldier and as a person - this is the power of unspoken shame. It can be deeply painful for proud soldiers/veterans to mentally go to this place, to admit to the gap between what was expected of them, what they expected of themselves and what happened. For many soldiers, to be put in a position of helplessness is a place of dishonour, a crack in military identity that can never be talked about and never repaired. The result is often hopelessness which, as we all know, can lead to a preoccupation with ending it all to stop the pain in living.
Many soldiers and veterans know this place, they have also been there. When they can trust enough to talk openly about the ‘unspeakable secret’ without fear of ridicule they start to come back to life. Soldiers and veterans have in common the wonderful ability to back each other when the going is tough and help each other to revisit awful things and face and resolve those things. Getting well again, can start by telling the secret to one buddy or someone else that you trust.
Ending one’s military career is a period of adjustment lasting up to several years as members learn to deal with the loss of rank, status, and established military social networks. Even among those who retire voluntarily, they can feel lost when it comes to knowing what to do with themselves. Making the mental shift takes work. While many look forward to retirement and launch new careers or decide to travel to enjoy retirement, others are consumed by boredom and lack of purpose. Some may find part-time work to occupy their time, they may have a few military buddies that they stay in touch with, and others will isolate themselves or turn to alcohol to manage the loss of who they were in the past.
When it comes to men and women who are released for medical conditions, these challenges are compounded for a number of reasons. The two that I hear most are: (1). They often have young families so worries about finances and future work possibilities cause them a lot of stress, and (2). They are younger and had no control over how they hung up the uniform. This second issue is often more important than concerns about money. Most of them did not want to leave the military but decisions were often made for them by the system. This is particularly true for those released because of operational stress injuries, including PTSD which has increased dramatically in recent years. Many in this younger generation, I generally mean post-Cold War but bad things also happened during those years, have been actively involved in warzones and have been profoundly changed by those experiences - they have no connection with the larger civilian society in Canada - sometimes called reverse culture shock.
Military training and operational experiences transforms people and galvanizes an identity that is often fundamentally different from who they were as bright-eyed, anxious recruits. When it comes right down to it, there is no choice from basic training onward to take on a set of values that emphasizes strength, self-reliance, and dependability and to prove repeatedly to peers and superiors that you can be counted on to do your job, your duty. If soldiers, I also mean sailors and air force, begin to realize that they are not up to the job, they often try harder and become tougher to prove to themselves that they are still good soldiers. But secretly, their confidence and self-worth often takes a tremendous hit as they feel themselves unravel and begin a downward spiral. They may decide to step forward for help on their own but often it is a supervisor or a spouse who alerts them to get their issues under control. But, how do soldiers reconcile a value system that directs them to be strong and to overcome adversity with the world of mental health that requires them to admit to potential flaws and weakness and to turn control over to other people, often civilian caregivers? I see this struggle as the biggest challenge facing ‘trained warriors.’ Many of the veterans I meet see themselves as broken; they are ashamed because they could not get over something that happened and because they let their buddies and their units down. They often see ‘mental health injuries’ as personal failures – “I let my unit down’; “I don’t like myself”; “I don’t know who I am”; “I don’t fit anywhere.”
Within the mental health world, treatment of operational injuries, including PTSD usually means focusing on specific events so they are less bothersome in day-to-day life. Some people are able to come to terms with the past and to rejoin their units but many are unable to put upsetting memories to rest. They are unable to find the focus and direction from the help that is offered to them because it is provided outside of their units. And, the things that are happening to them in their units matters a lot. Sometimes, the help makes no sense to them especially if the solution requires them to talk about very personal things or about their feelings. As I will often hear, what have feelings got to do with anything? This skill of looking inward is something many do not have even though clinicians assume that everyone should be able to do this. It is a real problem for those who may have had a tough time growing up; they want to forget about those years so allowing themselves to be vulnerable can feel like going crazy. I will talk amore about this in a future post. For now, I will just say that people who were hurt or betrayed as children often find it very difficult to trust other people, especially when they don’t have control. The real problem is how can they talk about the fear that if they lose their military identity, the sum of all their training and personal investments, that they will be left with nothing and that all their work to overcome their past lives has failed.
Generally, military people are trained to be pragmatic, concrete, and externally focussed; they are trained to take action to change things and not simply to sit and talk about problems and solutions. So, dealing with the loss of one’s core values and military identity and learning a new way to function can be a monumental challenge. Medically released veterans are often angry, bitter because they believe they were just thrown away. They feel betrayed, that their sacrifices meant nothing in the end, and that nobody understands them. They often have little interest in moving forward in the civilian world – “want nothing to do with it”. So, they are stuck wanting to return to a military past that is no more and forced to re-enter a world that is alien to them.
What can people do? Veterans who can come to terms with their anger at the system and learn to trust and reconnect with other veterans do make this mental shift. They do this by being around other people who understand what they have seen and done, who speak the same language, and who understand what it means to have to say good-bye to the uniform. Sometimes, it happens in social media groups, peer support groups, doing things with military buddies, or in formal group therapy programs. As far as I am concerned, it is not an accident that numerous groups are springing up across the country – as a social creature we are driven to connect with other people like ourselves. Moving out of isolation and shame and being around other people who understand our struggles is probably the most important thing to resolve before other things like school or work can be successful.
"Ten feet tall and bulletproof": A necessary belief among soldiers and RCMP willing to walk into harm's way. It takes a lot of guts and a lot of training to see yourself as larger than life. It gets people through tough days in getting the job done. But, is there a downside? I think there can be when 'stuff' seeps through cracks in the armour. Watching children or innocent people hurt or starving, watching friends lose their lives, or questioning the mission can all take their toll. When the invincible man or woman is reminded of human fragility, the instinct is to file it away, ignore it, keep moving forward because there is no place for these things. If they are traumatized, this is also tucked away. The idea of reaching out or talking about how they are doing is not even on their radar. Those members who show signs of weakness like becoming emotional are quietly viewed as weak or not up to the job. They are a threat to the myth of invincibility. What do invincible people do to manage? Many jump on the adrenaline train even harder; looking for the next rush, the next call, the next deployment. All the while ignoring and on the run from the past because that is what training tells them to do - keep moving. Some will get into drinking to switch off, others will look for fights or have extramarital affairs to keep their images intact, and still others will start having unexplained physical problems like irritable bowels, headaches, or grinding their teeth down. When sleep starts to go off the rails, this is usually the first wake-up that something is off. Even then, the idea that the invincible person may be having mental issues and may need help from someone else often does not register for them. This would mean that they are weak. As I see it, invincibility is a shield but it can also be a prison because there are no outlets to just be human and to put down some of the loads they may be carrying.
In this video, Dr. Whelan describes a group therapy program for veterans who are living with chronic PTSD and other operational stress injuries.
"I found this book - Going Crazy in the Green Machine - to be extremely well-written, not only from a professional standpoint but also from a humanistic one. Dr. Whelan clearly explains for the Canadian public the experiences of our heroes and our veterans. I highly recommend this book for anyone who wants to understand what our men and women go through." - Peter Stoffer, Member of Parliament, Sackville-Eastern Shore, Veterans Affairs Critic.
"John, after reading the book, I do truly believe you captured the story right. The story accurately reflects, with sensitivity and compassion, Billy's story as a man, soldier, and survivor. I believe any member of the CAF can read the book and relate to his fall into addiction, his experience with trauma, and the barriers to receiving care he required. Again, great job and feel free to quote me, no anonymity required." [5 January 2015, Michael Hobson, CD].
"Dr. Whelan’s book “Going Crazy in the Green Machine” is a human and humane illustration of the evolution of post-traumatic-stress in Canada’s military. The book is in two parts: the first illustrates the painful and moving story of Billy, a young enlisted who struggles with his experiences, his symptoms, and with the system. Part Two is a discourse on the factors that undermine the mental health of veterans, including systemic factors arising from military culture, government practices, and mental health silos. Both parts underscore how much needs to change! I am a practicing clinical psychologist (and former naval reservist) who has worked with vets in some capacity for over 20 years. Billy’s story, and Dr. Whelan’s insights, and resonated with me - making me want to rage and cheer and shout Amen. Anyone seeking to serve those who serve Canada should read this book." [Dr. Robin McGee, Amazon.ca]
"This was a great read...first time it felt that someone else 'gets' how it is to go through the military medical system! I wasn't overseas but still had to deal with the process of medical issues..." [Posted 10:18pm, 2 January 2015 by
John J. Whelan
John J. Whelan, Ph.D., is the author of Going Crazy in the Green Machine, available now on FriesenPress.