Tuesday, August 28, 2012

Changing the way we view PTSD (Post Traumatic Stress Disorder)

Dr. Edward Tick spoke last week to a large group of Army Chaplains at the Chaplain’s Annual Sustainment Training in Norfolk, VA concerning the ongoing problem of PTSD.  Dr. Tick is a clinical psychotherapist, has been working with American Veterans for over 30 years, has authored the book War and the Soul, and has done extensive research into the history of war and the way societies throughout history have dealt with returning warriors and the wounds they carry.  His findings challenge the way that our modern mental health care system is attempting to treat PTSD.  From what I can tell he is a Theist, not a evangelical Christian.   Below you will find some of his most insightful comments and my attempt to interact with his ideas.
PTSD is a “Soul Wound” that manifests itself with physical symptoms.  Those symptoms (here) are the outworking of an internal wound of the soul/spirit. 
Dr. Tick is directly challenging the assumptions of our mental health system.  He argues that returning veterans who have been exposed to the horrors and brutality of war, do not have a head problem, they have a Soul problem, a Soul Wound.  Modern psychology has chosen only to focus on the symptoms of PTSD that manifest in physical problems.  In all my experience of seeing suffering soldiers attempt to get help in the Army Mental Health system the answer is almost always the same—prescribe drugs to deal with the symptoms (anti-depressants, sleeping aids, anti-anxiety aids etc…) and occasionally some one on one counseling.  Mental health providers only attempt to control or inhibit the PTSD symptoms that plague returning veterans.  Doing this ignores the underlying cause of the symptoms.  Dr. Tick explains that from the beginning of time PTSD (or the observed equivalent) has been known as a spiritual wound.  What the warrior has experienced has hurt him at a level much deeper than the physical, and his soul must be tended and made whole again.  Treating the symptoms does nothing to answer the deep hurt, confusion, and anger often felt by the warrior. 
What if PTSD is the cost one must pay for wisdom? 
This is a question no one in the helping community is asking!  Everyone assumes that PTSD is only a negative condition that must be treated and fixed.  But what if we ask the question, “what can be gained from PTSD?”  In the old testament it seems clear that King David had PTSD.  In Psalm 22 he says that he has no rest at night (vs 2), he feel impending doom (vs 12), he sees himself as a worm, not a man (vs 6), he has no strength left and his body is withering away (vs 14).  Yet he goes on to be the best kings in Israel’s history.
Looking to American history, by all accounts, General George Washington had severe PTSD.  He barely slept and when he did, he heard the screams of his men who were killed in previous battles he had brutally lost.  He was quiet, withdrawn and usually depressed.  Yet his “disorder” led him to become the man who untied 13 armies to fight the British, and later on become the President who willingly stepped down after two terms in office.  He used his previously painful experiences to ensure he did the right thing at the present moment.  He accepted what happened (with great sorrow) and moved forward with a determination and fortitude of the rarest kind.  No one believed he needed to be “fixed” because he had nightmares of his soldiers dying. 
You see there is a certain wisdom that can only come through extreme pain.  Once you’ve experienced it, you are different.  Your outlook on life is different.  Those who recognize their wound, engage with it, accept it as the price of wisdom, and lead with that knowledge and wisdom become leaders of incredible strength. 
PTSD- Post Traumatic Soul Disorder and/or Social Disorder
The symptoms of this “disorder” are the souls way of crying out.  So rightfully, Dr. Tick refers to PTSD as a Soul Disorder as we’ve already seen.  However, he also calls it “Social Disorder.”  Through his research he has discovered that it takes an entire village to reintegrate a warrior into a society.  The contract that society has historically entered into with its warriors is a simple one—the warrior fights for the village and risks everything he has and the village, upon his return, will tend to the warrior in every way possible.  Many soldiers returning from Iraq and Afghanistan are by-in-large experiencing difficulty reintegrating themselves back into our society. 
Dr. Tick discovered that PTSD was defined by the Native Americans as having too many rocks in your pack to carry on your own.  The village would welcome the warrior back home after battle and help him remove the rocks out of his pack and the village would collectively carry the rocks.  They had ceremonies and rituals to show this process within their village.  We in America, unfortunately, do not know how to celebrate correctly returning warriors.  More on that later.
Mr. Tiger: “The wounds of war are in the heart, not the head.  Feel sorrow, not survivor’s guilt.  The bullet is the messenger of karma.  To prevent PTSD, Stay Home!”
These words were spoken by a veteran of the Vietnam war.  He fought for the North Vietnamese against the American Army.  Dr. Tick led a group of US Vietnam veterans on a return trip to Vietnam to visit various battle sites in an attempt to find healing for their wounds.  They met with “Mr. Tiger” who fought against them in numerous battles.  Mr. Tiger now runs an organization that helps their Veterans.  He offered these four gems of wisdom to our veterans.  He, like countless cultures before him, understands that War causes an inner wound.  First he say, these wounds are not often visible and are not usually strictly mental in nature.  Second, as warriors, we must feel deep sorrow for those who did not make it home—not guilt!  Third, while I do not believe in Karma, I do believe in God’s Providence.  I don’t have the room in this post to fully develop this idea, but if I lived through combat, it was by God’s Providence that I made it through.  All three of those ideas are powerful for veterans, but it’s the last phrase I want to fully address.
“To prevent PTSD, Stay home!”  This was not said out of anger or frustration on the part of Mr. Tiger.  He was getting at a much deeper truth.  He went on to explain that PTSD is almost non-existent in Vietnam Veterans who fought to defend their homeland.  They experienced atrocities and probably carried some out as well and we would expect their PTSD rates to be similar to our veteran soldiers.  Mr. Tiger explains that he has worked with their veterans since the end of the war in all parts of his country and the rates of PTSD from soldiers who fought in that conflict are miniscule.  However, he goes on to tell another story. 
When innocent civilians were being slaughtered in neighboring Cambodia, the Vietnam army came to the aid of these civilians.  They entered into Cambodia and fought against the soldiers who were killing innocent civilians.  It was, by all accounts, a noble and just reason to go to war.  However, when their Army returned, the rates of soldiers with PTSD skyrocketed.  As it turns out, when we fight a war on our own soil, in our own country, against an invading army, the PTSD rates are minute.  Inversely, when warriors go to foreign soil to fight a war, no matter how just the cause, the warriors will experience PTSD at exponentially higher rates.  It would seem that the human Soul has no problem fighting a truly defensive war in its own land against an aggressor.  The implications of this reality could have an astonishing impact on our foreign policy, the use of force and the mission of the US Department of Defense. 
When there is a justified and necessary use of force on foreign soil, we will have soldiers return with PTSD.  The question we need to ask is how do we (both an internal question for the Army and an external question for the general society at large) help soldiers come home?  So how do we welcome them back home?  Coming next in part II.  Check back tomorrow.

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