While I was waiting at Starbucks for my car to be serviced, I was working on my notes and sketches for this blog when someone said, “My wife takes notes just like that.” I looked up, a guy in a black T-shirt and black pants, a bit husky, looking a bit tired (he was just coming off a night shift as a medic) was standing there stirring the coffee in his Starbucks coffee cup.
“With all the doodles?” I said.
“Yup, with doodles like that,” he replied.
He asked what I was studying and I said, “Psychology; I’m researching PTSD and rage, PTSD and anger.”
He began talking about the short temper he and some others he knows have. He mentioned he had been both a medic and in combat, in Afghanistan and Iraq, on several tours starting back around 2002, in both the Air Force and Marines. And we talked a bit about our experiences dealing with PTSD.
“Liberals Don’t Understand”
When I was listening I was filled with an awesome and huge respect for everything he has done and has been through. He talked about a number of interesting experiences, but after shaking his hand and watching him walk to his car to make the drive home to his family, the thing that struck me most was his statement that liberals don’t understand. He said it with a kind of sadness, looking down, shaking his head. After he left I wanted to say, “Please don’t listen to anyone who doesn’t understand how you were a hero everyday out there, and how you continue to be a hero everyday here dealing with raising a family while having PTSD!” But he had gone.
There is a kind of grief called ambiguous grief which is loss that is ongoing in some manner in that there is something or someone partially lost and partially present. This applies to situations when someone (or yourself) has changed mentally or physically, for example after an accident, so the person is still there but you need to grieve the parts of them that have been lost. (Article: Grief in the Midst of Ambiguity and Uncertainty in book Grief and Bereavement in Contemporary Society) There is a grief disorder, a type of complicated grief called socially negated grief which is defined as “losses that society treats as non-losses.” (Grief Counseling and Grief Therapy by J. William Worden, page 2). Another term is disenfranchised grief defined as “grief that is not recognized or sanctioned by society.” (also Worden).
There is some clinical evidence that the act of naming and validating ambiguous loss has the effect of immediate relief and increased ability to cope (Grief and Bereavement in Contemporary Society, page 169). This probably extends to the other two kinds, socially negated and disenfranchised grief. In all three kinds of grief there is a risk of the individual never receiving the proper kind of validation of their experience from others because of the grief being invisible, hidden and secret, and this complicates the grieving process.
Could there be a parallel disorder with regards to PTSD? An ambiguous PTSD, socially negated PTSD, or disenfranchised PTSD? Yes, of course. If you were raped and people do not believe you, if what happened to you is being kept behind closed doors, if people think you are making it up, if people lack the capacity to understand or think you brought it on yourself. And could it be equally true that naming and validating PTSD has the effect of providing a feeling of relief and increased ability to cope? I think it is possible.
The central issue here is that when the people around someone suffering grief or PTSD convey messages to invalidate their reality, it may greatly hinder the healing process. With PTSD, the validation needed covers several areas: There is validation of the trauma itself, validation of the reality of all the symptoms of PTSD: hyperarousal, hypervigilance, triggers, hot temper, nightmares etc. and validation of any progress an individual makes in recovery. But there is also the validation of the heroic acts of the person. This one unfortunately can be passed over and lost, but it is so important because the actions that one takes that are heroic could possibly be directly connected in the nervous system to the mechanism for healing PTSD.
Peter Levine, trauma expert and author of the book Waking the Tiger: Healing Trauma: The Innate Capacity to Transform Overwhelming Experiences, tells a story of an Eskimo man who as a boy had been given a gift of fur pants symbolizing his transition into manhood. Shortly after receiving the gift, he went out on a hunt when he was attacked and bitten on the leg by a dog. The experience was so traumatic he developed a number of symptoms. Years later, the tool or mechanism Peter Levine used to untangle his symptoms was to help him access the strength in his body that he experienced when receiving the gift of these special symbolic pants prior to the trauma. Levine helped the Eskimo go back into the internal experience of a heroic moment of becoming a man, a moment of strength, of capability, of feeling brave and courageous. By harnessing this energy, within a visualized re-enactment of the trauma scene, the Eskimo man was able to release all the pent up fight energy in his system and triumph over the dog, coming to a point of resolution in his nervous system. What if Peter Levine had overlooked the moment of the experience of heroism in the Eskimo’s story? The Eskimo could still have post trauma symptoms plaguing him today.
Peter Levine also tells a story of a young boy who was trapped underground with a group of children and used his ingenuity to find a way to escape. He was less symptomatic than the other children because he had been proactive; he had thought on his feet. His heroic mentality and actions reduced his PTSD.
I am actually a very liberal person. I do not think war is a good strategy for solving problems, and I don’t agree with the wars in Afghanistan and Iraq. I disagree with our leaders’ strategies, but in knowing the psychology of PTSD I would never say anything to in any way invalidate the real heroism of any member of our troops. For the most part they are interested in safety and are our warriors, a respected, time honored position in society. Of course there is pathology in the military, especially from the leadership, and this needs an entirely different kind of solution. But the soldier or medic who is there to genuinely serve and protect, or pay for school, or advance their career skills, when they come home they need so many things validated it’s not even funny. These are the things they need validated:
- All the symptoms of PTSD have to do with your nervous system, they do not reflect on you as a person. It does not matter what you think about it, it will happen on its own as your nervous system does its best to handle what you experienced. Triggers, hypervigilance, nightmares are all natural responses of the nervous system if you were injured, endangered, and if you witnessed horror.
- You may have grief for loss of friends, time with family, normal life experiences. These are legitimate things to grieve and it is natural to go through the stages of grief if you lost something or someone important to you.
- You may have ambiguous grief, and may need to go through the grieving process for it – this is grief for parts of yourself or someone close to you that have changed, loss of who you used to be, loss of innocence – it’s when something is part there and part gone. These are legitimate things to grieve.
- You may be guilty and angry at yourself, and angry at others which means you need to seriously take the time to understand all the motivations of everyone, to eventually come to a place of understanding.
- You should be congratulated for any steps in healing PTSD you have achieved; it can take courage to talk to others, seek help, educate yourself and work on healing a challenging condition and that should be fully acknowledged.
- And very important – You were and are a hero in many many different ways.
Acknowledging every past and current heroic act of someone you know who has PTSD sets the stage for them to reconnect to the inner resources that not only will give them more strength to tackle their healing process, but could become the key, as with the Eskimo, to turning around their symptoms for good. Of course for truly healing PTSD, one would need to go beyond just the acknowledgment of someone’s heroic acts. There is work to be done on self-understanding because seeing the heroic nature of oneself can be compromised by unnecessary guilt and self anger, especially if there were some non-heroic acts (acts of cowardice, self-sabotage, or malice for example) one committed that need to be fully, deeply understood. There is work to be done in the trauma energies stuck in the nervous system as well. For example, even after acknowledgement, the inner hero and the inner overwhelmed, helpless, terrified and angry monster have no connection to one another without more effort put into trauma therapy. But it does help. It’s a start.
So, if you have PTSD and anyone ever tells you anything to invalidate any aspect of the traumas you suffered, your symptoms, your bravery, or anything else about the truth of your experiences, please just tune them out. Don’t pay them any mind. And write a list called “All the Ways I Was and Am a Hero.” Then create a Certificate for yourself, including each item on the list. This should read something like this:
This Award is in acknowledgment of every time (YOUR NAME):
- acted to defend
- came up with a solution
- tried hard, was determined
- did the best of his/her ability
- was innovative, clever
- acted on his/her feet
- took control, took responsibility
- faced and overcame great odds
- made a difference for someone else
- acted with courage
- asked for help
- did something outside his/her comfort zone
Then write down a few specific times you were a hero.
In conclusion, I will never agree with war. But as the medic/soldier said, he made a choice to serve and protect this country. It may be that the whole war is misguided, but from a psychological perspective that personal choice, for those reasons, is pretty damn heroic, I don’t care what politics has to say about it. This is because of the nature of his individual perspective on what he is doing. For another person at another moment in time leaving the military would constitute an act of heroism, but every single individual is a hero in their own way; every case is its own case. This is why ideology has no place in the science of psychology – each individual is living out their own very specific lessons at any given moment in time and the important thing is to fully see what those lessons are and how they are impacting the person. For one person, to pick up a gun is to be a hero, for another, to lay down a gun is to be a hero. The psychologist’s job is to recognize each one for who they truly are, and enter their world in the spirit of service.
As a future licensed psychologist, when dealing with PTSD, I will make sure to validate not only the real, daily difficulties of PTSD but also all the strength, all the courage, all the bravery, all the determination, all the amazing skills – combat skills, logistical skills – and the service, the help performed for others – everything that makes up a hero in that individual case.
Today, it may have seemed like I was looking at someone still pretty beat down by PTSD, and believe me I’ve been there too and know that darkness, but in those times it’s just that we forget – we forget that we really are heroes.
Heidi Hanson is an artist and writer in Asheville, North Carolina currently working on an illustrated book chronicling her journey healing from Post Traumatic Stress Disorder.