Waking Up From War, Part 2

War trauma brings in its wake a collapse of time. The present is engulfed; the past colonizes moment-to-moment experience; and the future is collapsed. Severe PTsxD and all variants of PTspD are characterized by an experience of haunting.
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Excerpted from "Waking Up From War: A Better Way Home For Veterans And Nations", a new book by Joseph Bobrow. Foreword by H.H. The Dalai Lama

Part Two

Turning Ghosts into Ancestors

"What's the matter? The war's over," someone said to a veteran. "Yeah," she replied, "over and over and over."

War trauma brings in its wake a collapse of time. The present is engulfed; the past colonizes moment-to-moment experience; and the future is collapsed. Severe PTsxD and all variants of PTspD are characterized by an experience of haunting. I am not referring to religious "demons" but rather to unprocessed experiences that have been sequestered away and frozen in time in the interest of survival. Their impacts are potent and fearfully unpredictable but they cannot be easily identified and contained, not to mention explored and transformed.

Ghosts In mythology, ghosts have no roots, and their restless wandering does not cease--and does not cease to disturb the living--until they are properly honored. Veterans and other trauma survivors can feel as if they were possessed, as if something were clamoring or silently exploding or imploding.

There is a way a ghost becomes an ancestor, and traumatic experiences become memories. The community provides the connective emotional tissue that holds. The fear of falling through the cracks abates; we stop holding our breaths in traumatic reaction and anticipation, and finally exhale. We hold ourselves less tightly wrapped and come to trust that we are supported. As this trust deepens, we allow ourselves to engage again in the moment. The community provides a bigger container in which unrepresented anguish can be represented, reexperienced in a new key, and transformed from a haunting ghost into a memory. The integrative and dynamic process I call turning ghosts into ancestors depends both on consciously cultivated attentiveness and unconscious emotional activity in the relational field. This transformative activity was originally named by the psychoanalyst Hans Loewald. Although he was not referring to dissociated traumatic residues such as war generates but to the unconscious byproducts that ensue when we repress sexual and aggressive drives, his words speak directly to the struggles we have been discussing.

"Those who know ghosts tell us that they long to be released from their ghost life and led to rest as ancestors. As ancestors they live forth in the present generation, while as ghosts they are compelled to haunt the present generation with their shadow life."1

I want to introduce you to two recent veterans. Robert was remote and suspicious, and one could palpably feel just how depressed he was. A heavyset Iraq veteran, he came with his wife, who stayed close at all times. But he was not responsive to her, or to anyone for that matter. Arnold had a gruesome tour in Afghanistan, witnessing things he could barely acknowledge. After returning he alternately withdrew and exploded. After blowing up at his son for being "soft," something Arnold of course could never let himself feel, Arnold flew into a rage and shoved his son against the wall. But he said he really felt like killing him. Ashamed, alarmed, and afraid, he fled his own house and did not return. The retreat was the first time he had been in the same room with his son for two months. In the group of fifteen fellow male veterans, he spoke little and often sat with his head near his lap, his face covered. Once, after beginning to speak, he bolted from the room.

In the introduction we met drone pilot Anthony, who said his brain hurt each night after returning home. Working out and video games, activities of choice for many veterans, didn't work for him. "I need something real," he said. This experience of hearts and brains hurting, of "going out of my head," is also represented in a poem by Zen master Thich Nhat Hanh.

For Warmth

I hold my face in my two hands
My hands, hollowed to catch what might fall from within me
Deeper than crying
I am not crying
I hold my face in my two hands
To keep my loneliness warm
To cradle my hunger
Shelter my heart, from the rain and the thunder
Preventing my soul from flying in anger

Writing from his own struggles, Nhat Hanh wrote also for the thousands of his fellow Vietnamese being shattered by destruction and loss during what the Vietnamese call the American war. In the poem he cradles his head in his two hands to prevent his soul, or his humanity, from fleeing in anger. The Scream, a renowned work of Norwegian painter Edvard Munch, captures the agony, the
shock, and the helpless despair of severe trauma. The figure in the painting, who seems to both have seen and to be a ghost, has his hands over his ears, blocking out sounds, but could just as well be holding his head, preventing it from exploding with terror, leaving a vacant shell of a man.

Despite the surges of adrenaline and the profound bonding of going through hell together in the war zone, the sense of being real is often a major casualty of war trauma. Paradoxically, dissociation can also protect hidden corners of humanity from further damage. Chunks of lived experience retreat into a kind of witness protection program. "Can I get a witness?" becomes more than an old R & B song; it is one of the deepest desires of veterans and their families.

Army wife Angela Ricketts was going through a particularly bad time during one of her husband's many deployments. Her friends advised her to channel her "black soul," a phrase they used to mean going numb. Angela's words for this experience, to "hover above," clearly reflect dissociation, in service of making it through in one piece. Being in multiple pieces paradoxically helped her feel intact. Only when it was likely that her husband would not be deployed again could she "step back and really feel," a precursor to a more durable inner peace than "pieces" can provide. By dissociating potentially overwhelming emotion, Angela stayed psychologically alive until a time when she felt her husband would be reliably there to listen, when they could face things together. I think her appraisal of when that time was had both conscious and unconscious elements, much like participants' appraisals of safety during retreats.

Turning Bearing witness is not a passive impersonal affair. The something real that drone pilot Anthony, other service members, and veterans need is kindled by reconnecting in a safe community of veterans and families. This helps make real what has become numb and lifeless by rendering unprocessed traumatic residues digestible--by making use of healing relational conditions to develop the capacities necessary to transform splintered parts into thinkable, feel-able, dream-able and narrate-able experiences and memories.

The five elements that comprise Coming Home retreats are not a new quick fix, but rather are rooted in how humans have, since time immemorial, worked to transform overwhelming trauma. They include sharing stories in a safe environment (healing dialogue), wellness exercises (spiritual practice), expressive arts, being active in the wild (the healing power of nature and beauty), and secular ritual (adapted from reverent religious experience). The veterans, family members, and providers we have worked with uniformly do not want their own suffering and the suffering of those they hold dear to have been in vain. They want it to mean something. "What have we got to show for it?" one service member asked about a certain campaign. He'd make any sacrifice, including the ultimate one, for a mission that to him made sense. Driven by the reparative instinct and the need for meaning, veterans commonly endeavor to "make something" of war-related trauma, to "redeem" it.

What we cannot acknowledge we cannot process. What we cannot process, we cannot transform. What we cannot transform haunts us. It takes other minds and hearts to help us heal our own, to help us grow the capacities we need to transform suffering. This is done in concert, reweaving the web of connective emotional, relational, and spiritual tissue that cumulative trauma tears asunder.
With an informed, responsive culture, it is possible to transform ghosts into ancestors, to make what haunts us into elements we can hold and properly remember. This opens up the present once again, and the future as well.

Coming Home Project retreats provide optimal conditions for processing war trauma in a relational field bigger than ourselves, in the presence of others, breathing, listening, witnessing, and sharing our humanity with us. Transforming trauma asks that we recreate and reauthor it, rather than solely experience it as lodged within, a kind of foreign invasive element, inflicted on us, inscribed and burned into our neural and relational circuitry by the profound helplessness to change it. Without working it over and making it our own, overwhelming trauma remains a ghost, what some experience as an "inner demon."

A ghost gradually becomes an ancestor, and traumatic experiences become memories, by a most human alchemy. The community holds us as trust grows, and we learn to return our attentiveness to body, breath, peers, family, and surroundings. It provides the buoyancy that genuinely lifts all boats. The military chaplain whom we met earlier said that on the final day at a retreat he was able "to exhale" for the first time in three years of working continuously in a large military receiving hospital. In an unconditionally accepting environment veterans come to feel they belong, feel understood, and become less on the defensive and more open. Wellness practices that reconnect them to ignored and undeveloped inner resources can become internalized. Optimal environments for connecting and healing are also optimal for learning and relearning.

When the environmental conditions are right, participants feel safe enough to represent their experience. In Coming Home retreats this happens spontaneously among peers and family members, in small support groups, and through expressive arts. The fear of shame, humiliation, and other crushing reactions is disconfirmed and replaced by a loving response. Buoyed, they are freer to venture in and share, according to their own rhythm. The content and pacing of what they reveal is at the direction of the participant, modulated according to his or her degree of felt safety so that rarely, if ever, does it retraumatize. They are supported, as they are ready, in reexperiencing their anguish in a new key.

On the third evening of the retreat, Robert, the profoundly depressed Iraq vet whom we met earlier, watched a film on grief, one of several programs offered. Two-thirds of the way in, I looked over and saw him begin to emerge from his deep freeze. First his eyes began to water, then a few tears ran down his cheeks. When the film ended, he stood up. The color had returned to his face. His arm was around his wife. A few more tears trickled down. He made no effort to conceal or wipe them away. As we approached through the crowd, he began to talk in a low voice about his losses during the war, how unbearable they had been, how he hadn't told anyone. There were more hugs with his wife, conversation, and, during the large group the next morning, he leaned over and gave her a kiss. Everyone took this in.

He began talking with his fellow vets. He was alive again. In a men's veterans group he described how desperate he'd felt and revealed for the first time how he had tried unsuccessfully to kill himself. During the large closing circle he surprised everyone by actually speaking and expressing genuine gratitude to all gathered. It was visible that the numbing freeze had lifted, at least for the moment. He seemed to have come back from the dead. Then he said something that stopped me: he looked forward to seeing everyone again next year, if he was still here.

Note that Robert was already in psychological treatment, and on quite a few medications. After the retreat, a fellow spouse whom his wife had befriended contacted us to say his house was being foreclosed on. This had brought him spiraling back down, and he'd become suicidal. The support and resources he and his wife received from fellow vets and spouses they had connected with at the retreat helped him make it through the crisis and regain a measure of his aliveness.

Not only is this a huge relief, but repeated instances of this benevolent cycle regrow our capacity to encounter and integrate the "ghosts." The power of the community support and the inner capacities developed and practiced in this optimal relational setting work in concert to animate and bolster us through this process. Gradually the fear of being retraumatized abates and the traumatic shards reintegrate and take their place as memories. Our sense of meaning becomes renewed. Traumatic experiences thus represented and reexperienced, gradually become reencoded into a transformed, more cohesive worldview. Although painful, they are now memories rather than haunting ghosts. As they recede to the background, we can paradoxically remember them, think about and dream them. They trigger us less because they've become more integrated, and when they do rear their heads, the community and our wellness practices are available to help us meet the surging tides of powerful emotion. We accept ourselves and our broken elements more, we breathe into, rather than react to the pain, and tame and regulate it better. Not perfectly--the wounds of war do not disappear--but we go forward with reduced anguish, increased hope, aliveness, emotional stability, and connectedness.

Safety, trust, and belonging are the alpha and omega and grow throughout this process. Let's expand the series of R words at play to unpack a sequence that, although operationally more interconnected than strictly sequential, we have seen repeated scores of times. It begins with the community invisibly helping regulate affect, as well as arousal and energy levels, in a relationally attuned field. Veterans recognize themselves in one anothers' stories, with a resulting destigmatizing and normalizing effect, and in turn feel recognized. They become more able to manage the anxieties of becoming visible and to risk sharing their story. As they represent their experience through expressive arts or verbally in a large or small group or one-to-one setting, they reexperience traumatic events that had been haunting them, but in a new setting, where fears of falling to pieces, leaving themselves open to physical harm, being painfully shamed, rejected, and ostracized are disconfirmed by the unconditionally loving response of the community. Through repeated mini-cycles of this process, traumatic experience is reencoded in a new key. Regulate, recognize, risk, represent, reexperience, reencode is not a conscious process. It occurs in varying sequences, each element supporting the others, as it is "practiced" in retreat and off-campus settings.

At Coming Home Project we knew we were onto something after our second retreat, in 2007, which confirmed and amplified the good results of the first and showed they weren't a fluke. But it took time for us to develop an instrument to effectively measure the changes. Initial program evaluations and anecdotal impressions were strong and consistent but did not "data" make. We overcame our reluctance to "studying" veterans and began to use traditional PTSD and some newer quality-of-life scales. We got some positive results, particularly in participants' ability to modulate anger, but the number of subjects was not high enough to make our results significant. I felt that the measures did not capture the effects because they were not tailored to do so.

The Rand Corporation was interested in studying the effects of the retreat, as was the Samueli Institute, but they couldn't find the necessary funding. So we brought together for several meetings a representative group of retreat participants, small-group facilitators, retreat leaders, and logistics team members that included veterans, family members, and staff and providers, all of whom had experienced the powerful but seemingly ineffable transformative results. We took turns describing the kernel of our and others' experience, recalling comments made during the retreats' closing circles. These feelings and impressions repeated common themes, time and again, from event to event. Yet they were expressed differently by new people. We developed a working list of participants' impressions, and feelings, and developed scales based on these, fine-tuning as we went. We plugged along and after a series of five more retreats between 2010 and 2011 we had enough data. In 2012, Coming Home Project, an independent CBO unaffiliated with and not funded by a government or academic institution, published its results in a peer-reviewed journal of the American Psychological Association.

We had learned that turning ghosts into ancestors is a remarkably robust and consistent process, given the right ingredients, and its impacts are reliable and predictable. It enhances PTgr (post-traumatic growth) whether or not specific symptoms of PTsxD are altered. Stigma was reduced and participants reported highly significant reductions in stress, exhaustion, burnout, anxiety, isolation, hopelessness, and emotional "numbness." Furthermore, they reported significant increases in happiness, relaxation, energy, sense of support, and ability to care for and calm themselves. In follow-up studies four to eight weeks out, these positive results remained strongly significant, consistent, and reliable. While our article was being peer-reviewed for publication, I discussed our research trajectory with two of the leading researchers in DoD and VA; each said, of course, develop your own scales to tap what you're actually doing.

Finally, after three days, Arnold, who had blown up at his son and bolted from the family home for three months, felt safe enough to describe how ashamed he felt for what he had done. The warm response of comrades-in-arms melted his heart and he cried for a long time. On the final morning of the retreat, with eighty-five veterans and family members sitting in a large circle, participants shared their experience of being together and said their good-byes. After such profound alienation from his family, Arnold approached his shy son and gave him a hug that brought both tears and cheers from the group. The pain of isolation had receded, replaced by the warmth and acceptance of a healing community. Reconciliation takes many forms.

An optimal environment for connecting, transforming trauma, and learning helps regenerate four qualities that distilled out across many retreats: aliveness, bonding, emotional regulation, and meaning. Participants attended because the retreats were "not therapy," but they stayed and benefited because the retreats were therapeutic and rebuilt eroded trust, alleviated isolation, and engendered feelings of belonging and being understood.

Reconnection takes patience. Veterans and family members test the waters to see how real and deep they are before venturing in; they want to verify whether the environment is genuine, and how devoted and skilled the staff is. Suspicion runs deep and is adaptive when you've spent fifteen months in a setting where, as many veterans recount, "people are trying to kill you." No one wants to be retraumatized, as illustrated by the story noted earlier, when, at the end of a particularly moving closing circle, there was a silence. I waited, remembering that a voice would often pipe up just when I thought the group was talked out. As I was about to draw things to a close, a woman veteran cleared her throat and began, half in jest, "So when are you guys gonna break out the Kool-Aid?" The entire room cracked up, aware of the residual skepticism.

Let's review: War trauma is like the shockwaves of an IED, splintering connections on multiple levels and disabling intrinsic capacities to process the trauma itself. An unconditionally accepting and compassionate culture is the engine for a process of transmuting war trauma that promotes a repair of these capacities and a transformation (not elimination) of the trauma reflected in PTgr. What does the operational implementation of this approach look like?

We've discussed the benefits of humor that flowers naturally as safety becomes a given, trust and belonging develop, and wariness and vigilance recede. To compassion and empathic responsiveness we can add the ingredients of mutual respect, clear boundaries, deep listening, and speaking from the heart. No one, however, is forced to "spill their guts." Participants are required to attend small group cohort meetings (male veterans, women veterans, spouses and partners, parents, children, and teens and so on) but nobody is required to speak. They can just listen, for as long as they like. This kind of freedom and the absence of coercion are critical. Transforming traumatic residues rests upon a (mostly unconscious) assessment by each participant of the relational conditions at play. Participants must be convinced that the emotional environment is safe enough. Although group facilitators regularly ask if there is anyone else who'd like to speak, a few participants wait until the last minutes of the last meeting. A striking example occurred at our first retreat for women veterans in 2009, an event that drew six hundred applications for sixty spaces.

Five minutes before the end of the final small group meeting of the four-day retreat, a woman who until this moment had been supportive of others but mum about herself was no longer able to hold things back. She described with a flood of emotion how she was sexually assaulted by her commanding officer. We all remained past the time allotted even though the closing circle was convening and return flight time margins were tight. During a pause in her account, the group went to finish packing and a facilitator remained with her for the next hour to help her work through and consolidate all that had emerged and discuss strategies for addressing it going forward.

I think three elements contributed to this veteran's decision to risk disclosing this rape for the very first time. One was the lack of coercion; since she knew nobody was going to "make her talk" or "force it out of her," she didn't want to return home without having herself taken advantage of the opportunity. Two was the fact that we spoke about her in our facilitator meetings, felt that she might need additional support, and one of us volunteered to connect with her over some meals. Three was the silently growing inner sense that she had the emotional hardiness to withstand the impacts sharing this experience would surely bring. This had been cultivated not only by practices like qigong and meditation; it had also been buoyed by having quietly internalized the examples of her sister veterans. Not only did she (mostly unconsciously) conclude that her immediate cultural environment, her sister veterans and the staff, would not harm, reject, or punish her, but she also discovered that her "processing power" (aka emotional or
meditative muscle) was strong enough to venture forth.

This experience stirred up tremendous emotional turmoil for this veteran that needed further attention. But she also felt more peaceful. Dissociated pieces afford us a transitional resting place of sorts and can temporarily ensure our physical and psychological survival. But genuine peace only emerges as pieces reconnect.

Most of us know that things are interconnected, but how quickly we forget. The song "Dry Bones" contains the famous lyrics: "The ankle bone connected to the shin bone, The shin bone connected to the knee bone, The knee bone connected to the thigh bone, The thigh bone connected to the hip bone, the hip bone connected to the back bone, The back bone connected to the shoulder bone, The shoulder bone connected to the neck bone, The neck bone connected to the head bone." Then comes a line I had forgotten: "Dem bones, dem bones gonna walk around."

A real person emerges as ghosts become ancestors and take their place in a pantheon of diverse memories. This person comes back to life, as she inhabits and shapes the present, and aspires to a future.

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