​                                                                  EXCERPT
"The mental building blocks for an operational mental injury may be set in motion long before critical events ever happen. These ingredients can be rooted in early development and amplified through military conditioning but they are also present among those soldiers who come from stable, nurturing families. Essentially, most soldiers develop adaptations (i.e., emotional suppression, compartmentalization, and a detached persona) to help them succeed in training and to do their jobs. Unfortunately, these same adaptations that served them wonderfully in carrying out their military duties can interfere with the normal processing of routine and unusual events. Furthermore, the same embodied adaptations and the over-investment in military specialness seems to underpin the problem of maladjustment to civilian life. We need to move beyond our clichés if we are to understand post-service maladjustment."

Many military and RCMP veterans seem to shift seamlessly into new careers with well established interests and supports. Many others, including the injured and medically released, face significant challenges as they re-enter the civilian world. Retirement can become a series of shockwaves as the
reality of civilian life and the loss of prior identity begin to set in. This can last for years as ongoing sources of stress and disorientation. Major disruptions in relationships because of loss of purpose and identity are all too common.

One’s prior rank, operational roles, black-white codes and military discipline can become obstacles and the usual ways of connecting with other people disappears. Risks of social withdrawal, anxiety and depression, drinking or drug use, and preoccupation with the meaning of one’s life and service can increase dramatically. Many of the activities and personal qualities that veterans put aside to serve can contribute to a profound disorientation, loss of confidence, and mistrust of the broader society.
​

1. “… one-quarter [of all Canadian veterans] rate their adjustment as difficult. VAC clients ​more often reported a difficult adjustment to civilian life”  (Thompson et al., 2011).
2. ​The 2-year period following release is a major transitional strain for military personnel (Castro, 2017). 

Out the Gate – What Now ?

• Finding a Compass
• Reverse Culture Shock
• The Crush: Special to Invisible
• Uniforms as Shields
• Unpacking your Ruck
• Renegotiating Family Roles
• Beyond Medical Symptoms
• Searching for Specialness
• Managing Bureaucratic Shuffles
• Hard Assess and Teddy-Bears

 
Mental Shifts: Sample How-Tos

• Un-training the Warrior Mindset (Finding the OFF switch).
• Removing Emotional Straight-jackets
• Respecting Vulnerability
• Lone Wolves needing a New Pack
• Who was I - Who am I?
• New Risks, Spontaneity, and Self-trust
• Creating your own Values Shield
• Repairing Relationships that Matter
• Beyond Invisibility

Turning in one's kit and ID card happens in the blink of an eye but making the mental shift to a new identity often takes much longer.

 

I write this post on the heels of a recent tragedy in my home province and once again PTSD and military veterans have captured media attention. There is a renewed focus on bureaucratic gaps and available treatment programs; questions about the true nature of military trauma gets lost in the PTSD cliché.  Traumatic stress has faced us as a species since our beginnings - death from predators of all types, starvation, or natural calamities - forcing us to band together. We learned to interact and huddle together in small groups to survive and to thrive as a species. We became social beings out of necessity. Sebastian Junger (Tribe) does a very good job of outlining this basic need for social bonding and connection among military veterans. Veterans miss the intensity of intimate connections that are provided through the experiences of shared adversity. My own experiences and work have taught me that this is the closest that many veterans will ever feel to other humans; more than their parents, siblings, and even their wives and children. Being around other rough and ready men and women means that they don’t have to be mushy about love and brotherhood because these are demonstrated through actions. In essence, there is no risk of vulnerability, especially emotional vulnerability.
 
When veterans leave their sections, platoons, and units – their community of comrades in arms - they can face disconnection and invisibility and I believe that this is the real challenge facing veterans. As James Wright - a US military veteran and historian – noted, military veterans are increasingly separated from and unrepresentative of the larger civilian population increasing the likelihood of invisibility. This reality often gets lost in cliché conversations about PTSD. In contrast to the mandates of military training, learning to lower one’s emotional guard may be exactly what is required to move beyond trauma and to reconnect. Average people who have not benefited from military training do this everyday and they recover and move on in their lives. Many of them have not had the same pressures or exposures to horrific things but many of them have their own ghosts to manage.
   
If we are intent on discharging traumatized veterans back into the civilian world, we need to be honest about the benefits and the downsides of our socially segregated military and the warrior mentality. The truth is that we are all vulnerable, specialness is temporary, we all need other people, adrenaline mode is for the young, nobody is ‘ten feet tall and bulletproof’, and emotional connection to others is the basis of purpose and personal meaning. There are some things about military identity that need to be left behind before people turn in their ID cards.      

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"Moral injury is the damage done to one’s conscience or moral compass when that person perpetrates, witnesses, or fails to prevent acts that transgress their own moral and ethical values or codes of conduct. Within the context of military service, particularly regarding the experience of war, “moral injury” refers to the emotional and spiritual impact of participating in, witnessing, and/or being victimized by actions and behaviors which violate a service member’s core moral values and behavioral expectations of self or others. Moral injury almost always pivots with the dimension of time: moral codes evolve alongside identities, and transitions inform perspectives that form new conclusions about old events." [http://moralinjuryproject.syr.edu/about-moral-injury/]

The notion of moral injury, including betrayal have been around for many decades but it is only recently that serious efforts have been made to understand their impacts on military veterans. It goes well beyond the traditional idea that military PTSD is only the result of seeing something awful in war to refer to something deeper and more insidious. As many veterans tell me, it feels like something that just crept into their souls over time. When it comes to betrayal, it often leaves a crushing blow making a mockery of military values and one's military identity. Betrayal comes in many forms - starting with the persistent reports of sexual violence, harassment, and indifference, to instances where official reports are inconsistent with event facts to personal instances of being promised postings or promotions for doing special things only to be ignored and forgotten.  Among these men and women, these types of things seem to create the most serious and lingering damage of all.  As difficult as it may be to accept, there is a way to move beyond this blackness .... It begins with the full, unedited story.

Most soldiers remember the Green Zone designation from the Iraq War. Compared to being outside the wire, it was a protected area where it was relatively safe to lower one's guard, rest and recoup, and mentally decompress for a time. Why is this analogy important when it comes to mental health? Despite all the efforts over the past 20 years to develop mental heath programs to deal with operational stressors in military and most first response organizations, many people still do not risk coming forward. From my perspective, the glaring answer to this problem is that it is still not safe. While we can pretend that members will not be judged, that formal mental health will always help, or that they will be able to resume their careers, we know that a tremendous amount of work is yet to be done to humanize many of these workplaces. Reputation is everything to most first responders, including military, police, fire, paramedics, and correctional officers so they remain stoically silent. But, we also know that social isolation is the breeding ground for routine stress and emotional distress to grow into unmanageable reactions. So how do we protect their 'psychological safety' (only jargon, I promise) as they try to mentally decompress without fears of being judged, misunderstood, or sent to the head shop on their way out of employment?
 
People need to have safe places and safe people within their organizations and within their communities where they can begin to air out things spinning around in their heads or emotional reactions that they can't shake. This means considering designating particular places within units, shifts, or watches where lowering one's guard does not come with the risk of being 'outed' or tagged as crazy. Places and specific people where anything can be said or explored without requiring them to give up control. I recently attended a mental health day organized by paramedics - their level of openness and honesty with each other was inspiring to watch - In mind my they get it. First responders of all types have to start being honest with each other about the benefits and the true costs of doing the job.  This is where it has to start because some people will never seek out formal mental health because of the risks of losing one's reputation or employment unless these organizations change fundamentally.  And, the reality is that there are not enough qualified mental helpers to go around.
   
In the meantime, I wonder about the usefulness of a term like 'Operation Green Zone' to think about an initiative aimed at creating practical ways and forums for first responders to connect honestly with each other. To create an environment of psychological safety despite any bureaucratic shortcomings or outdated workplace practices. This is not to say that all workpalces are inadequate or that supervisory practices are oppressive; they just have different priorities - getting the job done with an eye on liabilities and fiscal limitations. Designating areas, particular supervisors/co-workers, or groups as a green zone would be a great place to start; at least in my mind.

I am quite interested in hearing feedback or thoughts about the usefulness of moving this type of initiative forward. It would not be a formal mental health 'program' and it would not rule out a role for formal mental health, if needed. 


  

Public attention is focused sharply on the lives of military personnel and first responders because of ongoing reports of suicide among these men and women. Politicians and bureaucrats of various stripes have been forced to take action while a plethora of theories have been offered to explain the plight of these men and women. Theories about pre-existing conditions (e.g., childhood abuse or neglect), concurrent stressors (family pressures and financial distress), disordered brains, and even self-stigma (self critique and denial of problems) have all been advanced as the ‘cause’ and even though these factors may contribute to distress among first responders, they offer only a partial explanation. But, what about the workplace itself? We do not appear to be courageous enough or mature enough to look honestly at the actual day-to-day context of these workplaces, including the value systems, the consequences of basic training models, unspoken but shared codes of ‘manly’ conduct, and supervisory practices as major sources of distress among these men and women.

Emotional suppression, bravado, pride, self-reliance, and dependability are among the most sacred values steeped within these organizations and handed down to young trainees. While these values and codes of conduct may well be necessary to get difficult jobs done, the cost is that these work places can become inhuman and these very values run counter to the requirements of good mental health. I think we are faced with a fundamental dilemma – we either will continue to try to train first responders to become tougher and even less human or the nature and organization of these workplaces may require substantial and fundamental changes. We may need to humanize these places again.
  
In the increasingly demanding workplaces for first responders and the military, there is considerable attention on professionalism which ironically can turn these places into ‘soul-less’, rationalized places where the focus is on one’s ability to do the job. There is not much leniency or time to treat co-workers as human beings. There is not much room for people to have a bad day or to be emotionally upset following a bad call because of organizational pressures and paranoia over public scrutiny and possible legal actions. Workplaces can turn into emotional pressure cookers – a working wasteland.

Maybe a little less focus on ‘what’s his/her problem’ and a little attention to ‘what’s our problem’ could go a long way in reminding everyone that at the end of the day we are all just human beings – nothing more, nothing less. 

​The message in the dream was so strong that it woke me – hard to ignore a realization that feels heavy in my body. I am struck by the sophisticated and yet paradoxically simplistic efforts to link trauma among soldiers to personal or biological vulnerabilities that produce distress from scenes of human suffering and devastation or experiences of betrayal and institutional neglect. A focus on individual susceptibility. I believe that an alternative social-relational understanding of military trauma could lead us in an entirely different direction. It accounts for the importance of military identity and values in understanding trauma. Namely, that once a soldier has a direct experience of failures to meet codes and values or physical deterioration, he is faced with fundamental questions of what it was all about. She is often forced to face the hollowness of pride and specialness and the limits of comradeship. He may realize that nobody else wants to hear from him and the simple and painful truth is that he often has to keep quiet or he has to go.

Concerns about unit morale and operational priorities means that there can no space for ‘negative nellies’; there can be no conversation about the impacts of contradictions, dilemmas, and other realities of military life itself which may be injurious to its members. Training, perfectionistic standards amid silence and emotional suppression can erode one’s mental stamina especially when faced with the realities of deployments or domestic catastrophes. The 110% ones and the ‘go to’ guys seem to suffer the biggest fall from grace; pride is often replaced with disheartenment and bitterness.

These members can witness or experience things which are intimately personal and yet unseen by the person standing next to them. Their worlds can be immediately altered – they take a hit and the mirrors shatter. Values, beliefs, and expectations can come crashing down in an instant and they realize that they stand alone in an empty room. I have heard many times that in these moments of unwelcome clarity - which can happen in the blink of an eye - everything suddenly changes. It is this unchangeable moment, that soldiers try to ignore or deny, that can create the basis of trauma. And, in many cases these situations contain some unsolvable moral dilemma. They try to think their way through what is essentially an emotionally-centred problem – shame or outrage - that has no outlet. These men and women remain stuck with fragmented memories and bodily felt reminders of these internal struggles.
​
What if the negative ones, the ones who move to the fringes were treated as the valued social conscience of the military? I wonder about the need for safe places where these other voices and experiences can be heard and respected by others in uniform? We might come to a better place of taking care of each other and not leave it to the civilian world to try and figure out. Instead of occupying our efforts exclusively on individual vulnerabilities, we might be better off by also uprooting the basic nature of military training and culture and the inherent contradictions, including the downside of stoicism and individual secrecy. After all, we developed as a highly social species out of necessity – we are cannot survive physically or mentally on our own.  

​Serving in uniform on behalf of the country is a special life in many ways. It means taking on a new identity and adopting a set of values that few people in everyday life understand or fully appreciate. We develop confidence, pride, and self-worth linked intimately with our ability to carry out our military roles; the people we are at home is usually of secondary importance. We have very little in common with everyday people who seem undisciplined, lack focus, and occupy themselves with trivial things compared to the adrenaline-soaked military world. It also means that soldiers, sailors, and air force men and women live compartmentalized lives. One’s military life and civilian roles are easily divorced from each other – they have nothing in common. And, it is important to compartmentalize these roles. After all, it is not cool to act like an RSM when teaching one’s son or daughter how the dishwasher works and for those who do, strained marriages and parent-child relationships are often the lingering results.

When men and women leave the military either voluntarily or because of injury, the price to be paid for a lifetime of compartmentalization shocks many of us: “It was like leaving a huge part of myself behind.” It can feel like a profound loss and disorientation. Part of the way forward, or making the transition through no man’s land, if you will, means integrating one’s military and civilian worlds. One of the hardest things to face is having to do an honest values checklist – figuring out our true values which may or may not be the same as the ones we adopted to serve. It may mean giving up some of these values and remembering the other ones that had to be packed away. One of the biggest challenges comes down to the issue of emotional suppression – having to keep our true thoughts and emotions bottled up. The very things that make us human. Being stoic and focused were of primary importance. Having to face loneliness, uncertainty, or lack of confidence in managing day-to-day relationships and waiting for permission to be oneself have to be overcome in order to move forward. Admitting to anxiety but giving new things a shot anyway, taking time to say good-bye to the uniform on your own terms, talking honestly with family and friends about losses, irritations, or confusion, figuring out who you want to be as a good man or woman are all necessary parts of making the mental transition back to ourselves as people. It means learning to truly speak up.