There is a necessary debate going on about whether or not to drop the D from PTSD. ADM Mullen, past Chairman of the Joint Chiefs and GEN Chiarelli, current Assistant Chief of Staff of the Army, think it should be dispensed with. So do most mental health professionals I know who work with veterans. Lives certainly become disorder-ed as a result of severe post traumatic stress but it is not an alien condition. Rather, it is the mind-body's way of coping with and attempting to transform overwhelming repeated traumatic circumstances such as war often presents. And these do not occur only in the line of fire. Operational stress injury is what the Canadian Forces calls it.
Most people associate war zone trauma solely with PTSD, but the psychiatric syndrome, whatever the acronym we use for it, doesn't capture the depth and power of what keeps some veterans awake, eating at them from the inside -- sometimes for years. These are the moral and spiritual injuries of war. Evidence-based treatments and medication can sometimes help with symptoms, but rarely if ever do they alleviate such injuries. At a Coming Home Project retreat one vet described his problems with anger, how he'd go from 0-60 in a flash. But later he revealed what awoke him from sleep: the vision of an Iraqi boy he almost shot. He'd see the boy's face through the sights of his weapon in his not-quite-dream (more like a night visitation). Sometimes the face of his own boy would flicker back and forth in the sights, changing places with the Iraqi boy's face. Damned if you do, damned if you don't; shoot that is. A medic at our retreat had been blown up pretty bad more than once and also had his share of emotional concussions. But what tormented him most was shooting a child who was about to throw a grenade into a Humvee full of his buddies. He considered himself a healer and struggled to make his peace with what he'd done, even though he "knew" it saved the lives of his buddies. Impossible choices. Things done or things witnessed that compromise your core values. The helpless inability to make a difference. All these can cause profound anguish.
And then sometimes your whole world comes crumbling down. Kenny, a Marine Sergeant overseeing vehicle maintenance in Iraq, had his head shattered when a bullet entered his vehicle, ricocheted around and went through his head and neck. When I visited him at his home in Oceanside a couple years ago, his wife was getting ready to go to church, a new one. After all they'd been through, it'd taken some time for her to open up to church again. I asked Kenny why he was staying back. He described how betrayed he felt, how bereft, as if still not over feeling forsaken by God. "I didn't kill anyone, I was just a mechanic. I tried to help people." His whole "assumptive world" was blown apart: all the unarticulated beliefs, all the ways things were just supposed to be. No psychiatric acronym can capture the force of this blow.
Finding the (inner) peace after war is what many veterans (and their family members) want. What heals? What repairs and regrows a sense of connection and trust, aliveness, bonding, emotional balance and meaning? Stay tuned for Part 2 of on Spirituality and the Road Home.