By Dr Mike Colson

Everyone ought to have high points and things to look forward to during the week. Doing interesting things, seeing and spending time with people we like, and maybe even hoisting an adult beverage can all be part of life lived well. I attend each week a single hour session that explores spirituality. I look forward to it because it changes me.

All of the members of the group are volunteers, predominantly Vietnam-era combat veterans, and knowledgeable thinkers. One by-product of the group trying to find joy and peace is that we often experiment with “spiritual recipes.” During our last few conversations we concocted the theory that trauma might be a window – however imperfect – that opens our minds to larger truths shining out of impenetrable darkness. A prime ingredient in this “Light in Darkness” soufflé is trauma…ours.

What is becoming more and more obvious for the group is that the trauma that has marked us appears to have a soft underbelly. Apparently, trauma takes a break from time to time. Imagine a large and foreboding oaf rolling off of you and while doing so exposing rolls of stomach fat. Right then and there you realize the oak isn’t so tough and not nearly as invincible as you thought. You get a gulp of air, you adjust your own body position, and for the first time in a long time you see light. It is not bright or uncompromising light, nor is it startling to the senses. But it is warm…a good indicator that the Spirit has arrived.

Isn’t warmth something we crave?

Oaf or not, I just love to be warm: in my bed, in the sun, snuggled up with a loved one. For dog lovers out there, I also have Jock. He is my large chocolate lab who is typical of his breed – lovable, huggable, and he snores! Just thinking about being warm gives me goose bumps. In the best of all worlds, warmth equals affection.

In contrast, trauma can leave us cold…especially when it’s laying on top of us.

But there is hope; as long as we have the ability to shift, move, jostle, or scrape. In the midst of the struggle – and when the glow appears – take the advantage and look for the spirit. Our group thinks that you’ll see it, feel it, experience and connect with something that “while mysterious and non-physical”, is good.

“The fruits of the spirit are love, joy, peace, patience, kindness, goodness, and self control” – sounds like a prayer request to me.

Posted by Dr. Mike Colson at 10:20 PM | Permalink | Comments (0) | TrackBacks (0)

Dr. Mike Colson

Over the last few years I have become quite used to being a lighting rod for people’s anger. People I haven’t seen in years appear to be triggered by the knowledge of my wartime experiences and forego social pleasantries to launch right into some anti-war, anti-government, or other tirade. For argument sake - and arguments they can become – let’s call this habit “bad talk”.

A few examples of bad talk hurled in my direction – and maybe yours – are:

“Hey, what you think of your government now?”
“Enough soldiers are dead now…when are we going to get out of there?”
“How can we send people to war and neglect them when they return?”
“You were a military guy…what’s up?”

These comments have one thing in common; all inexorably lead me to a dark place where I fight to remain calm and stay composed. But that isn’t the worst of it. As I spiral through one bad conversation after another, I see a pattern began to emerge…bad talk is in reality sad talk.

Sad talk, as I see it, is depressing conversation that people employ when they do not know what to believe. Confusion, media bombardment, death tolls, pictures of suffering, stories of faulty facilities or uncaring bureaucracies can have debilitating and long term effects on individuals and communities at large. The talk is simply a way of speaking out. Bad talk is the result of sad thinking…and I get sad listening to it.

So, what do combat and service veterans do when the sad bug infects conversations? Here is a thought; listen. If we take the time to hear them we might find that the “bad talk sad talk” isn’t personal to us, rather it is a cry for help from them.

We are servants – scarred, skittish, someone afraid ourselves, often angry. But we also have answers because, unlike so many who utter baseless opinions and rhetoric, we’ve been there and done that. We are the experts…so lets help them. And, in so doing we might find our own voice that underscores – with credibility – the value of living a life of importance in uniform and out!

Good Luck.

Posted by Dr. Mike Colson at 10:40 PM | Permalink | Comments (0) | TrackBacks (0)

By Dr Mike Colson

No. 1 Barrier - New age babble and pop psychology: I have spent 22 plus years attempting to provide useful human services to military, combat, and other veterans who find themselves traumatized by the circumstances of their work. Without a doubt the biggest barrier to making the post-trauma transition to good health is poor information. It seems that every person we meet knows more about the problem than the sufferer. In a society where it is tempting to reduce complicated subjects to slogans that fit on bumper stickers (e.g. “Save the Whale”, “Make Love not War”, or “Visualize Whirled Peas”), important information gets left out. For instance, in psycho babble, PTSD sufferers are often referred to as weak, crippled, or somehow unable to cope. You can see how this would be a barrier to getting some assistance?

We do not need to be pitied by the well-meaning or treated like damaged goods. Rather, we need to do everything we can to get the facts about the chemical changes that trauma wreaks on the body, how those changes affect biological processes, and how best to address these physical concerns early with good results.
Solution to well-meaning psycho babble: Get advice from competent medical resources that have experience in treatment and care of the kind of trauma experienced.

No. 2 Barrier – Fear: Men are sensitive about sharing anything from their personal lives, but women are quickly closing the “secrets gap” especially when it comes to harassment, assault, or other sex-based trauma. In my experience stigma and breaches in confidentiality create fear and prevents or delays a trauma sufferer seeking resources for support. Some career types – like police and firemen, security, senior managers, government or other public/community employees DO NOT want anything to interfere with the persona they project on and off the job.

Solution to fear: Find a professional health care provider who has a professional and legal mandate to keep any intervention or information private in accordance with recent HIPAA regulations. And, make sure your records are left in written format and NOT entered into an electronic data base.

No. 3 Barrier – No end in sight: When trauma sufferers begin the process of “stinking thinking” – caused by chemical changes, poor sleep, and even some self-medication (think BEER!) – it can be overwhelming and appear permanent. Of course, it is not and will get better when sufferers take that first step to find helping resources and begin getting up everyday thereafter knowing that life has to and will get better.

Solution to the “No End in Sight” feeling: Call and make an appointment and commit yourself to making your own personal health and well-being a priority.

No. 4 Barrier – Lack of Self-care Priority: Trauma sufferers often puts their own needs behind other people and circumstances they feel responsible for. The New England Journal of Medicine’s recent report on PTSD sufferer’s from Iraq and Afghanistan mark those with the HIGHEST incidence of trauma to be the LEAST likely to seek help. Since January 2005 I have debriefed over 10,000 National Guard and Reserve “War on Terrorism” veterans and this rule holds true across the board. As each goes through the demobilization process, they have a mental list of priorities to complete as they transition home. And, few put themselves and their own personal needs on that list. Why? Many people who get traumatized are in jobs that create trauma – almost like being a sufferer is a self-fulfilling prophecy. As true as that might be, everyone has to care for personal needs. I’ll prove it. Do we share mouthwash, toothpaste, a favorite hat or jacket, or more than a small taste from the 3-taco special meal deal? NO!

Solution to poor self-care: I often use the example of flying on commercial aircraft: “In the unlikely event of cabin depressurization the oxygen masks will drop from the console above and you should quickly place one on all the faces of all the people around you…so they can watch you suffocate.” You’ll say, “Dr. Mike, that is preposterous.” I agree and offer that making self-care a priority, while not often a matter of life and death, is a major factor in living a balanced and fulfilling life.

No. 5 Barrier - Thinking we are crazy or something? Are we crazy? Well, it sure does seem like we are at times. Our blood pressure seems to rise and lower at will, we react to things that in retrospect are very small, we shake, often sleep poorly, develop some poor habits with hygiene, communication, and relationships, and we sometimes drink more than we ought to. So, you wouldn’t blame anyone for thinking that “crazy is as crazy does”. But the point we have to hard wire into our thinking is that the body will react normally to abnormal circumstances. Let me clarify this as best I can. Women and men who serve this country are America’s highest quality youth. To be inducted into military service we undergo health, psych, academic and educational, social, and community examinations. This not only establishes our ability to serve, but also verifies that we are normal – above normal in most cases. But a veteran of war, combat, deployment, and extreme conditions can often be put in some abnormal circumstances. Can anyone really say Iraq, Afghanistan, GWOT operations worldwide and deployments at sea and elsewhere are normal? So, when confronted with these abnormalities – whether they happen to you, others, while you are there, etc – the body will adjust itself (a normal process) in the face of those abnormal experiences. So, on the crazy question…are we? The answer is no. Out bodies are doing what normal bodies do everyday day…but those normal body reactions like those mentioned earlier can and will change you if left examined and untreated. I think we’re crazy when we think the symptoms will all go away by themselves. Vietnam-era veterans taught us that this IS NOT the case.

Solution to crazy: Recognize that feeling like we are turning inside out is normal…and even expected! Accept that these changes are part of the readjustment process and seek out support to understand what your options to make it all go away.

No. 6 Barrier - Failure to sleep well: Everyone needs sound and restful sleep. A major by product of war and deployment for many is a type of sleep that is best described as disorded. In point of fact it more like slumber than sleep. Slumber is not a deep sleep, is not particularly restful, and it does not have all the normal bits and pieces associated with rest. Many veterans drink or medicate themselves to get to sleep, finding that this approach can help in the short term. The problem with sleep – or the lack thereof – is that it is accumulative and can create sever physical – and behavioral – reactions when you constantly get up tired…and angry!

Solution to the Post-War Sleep problem: Find out if you have disordered sleep, pursue getting a referral for a sleep test that might help diagnose a common medical ailment called (sleep apnea) (www.sleepapnea.org). This ailment and other factors associated with symptomatic PTSD and readjustment need to be addressed as a top priority for returning veterans – before it creates long-lasting physical concerns. See your doctor immediately.

Barrier No. 7 – Family: When we return to families and loved ones attempting to fit back into the groove of our former lives, not worrying or scaring anyone about how and what we feel, and even the families needs we find upon return can redirect our energies away from taking care of ourselves. The problem with moving on to other peoples needs – vce our own – limits our access to help and resources – and – can signifucantly reduce our post-wat and deployment life expectancy. A recent New England Journal of Medicine survey found that PTSD sufferes, left untreated, can have their post-military life expectancy reduced by some 50 percent. While family is a priority, it makes sense that you being there for your family is very very important.

Solution to Family – Explain to them what is going one, what steps you are taking to make the readjustment home, find ways they can help you, and bring them on board as your “readjustment assistants.” Family and loved ones are a great source of support, and while they cannot be your medical or readjustment professional, they can help you craft solutions to readjustment on a day-to-day basis.

Posted by Dr. Mike Colson at 10:27 AM | Permalink | Comments (0) | TrackBacks (0)

By Dr Mike Colson

When the blush is off the rose and we find ourselves home at last – whether from deployment, combat, duty in some seeming forgotten corner of the globe, or even stationed on a foreign with an Anthony’s Pizza – it is normal to feel like we are somehow turned inside out. I ask the question when I brief soldiers returning to CONUS; “Are you feeling different these days?” Invariably they answer yes but are somewhat unsure of why they feel this way or that. PTSDresources.org wants to help military members, their families and loved ones understand what has taken place, why we often do feel different, and what can be done once we’ve finally had a few nights sleep in our own bed. So let’s begin by examining issues GWOT veteran’s can expect to engage with as a direct result of their service to this country during this global war on terror.

When we raise our right hand and swear allegiance to the Constitution of the United States, we do so for the very best reasons. As America’s newest war veteran, we stand as a sentinel to faith in our country’s ideals and are prepared to stand in the breach and execute the will of a good government. We may not have run fast enough past the recruiter’s door prior to joining up but we certainly can be classified as America’s high quality youth now that we are in service. And it is important to remember that we, as military servants and military family members, are special people who for whatever reason have a higher than normal does of interest in service above self. That is a good thing! It is also a prime reason why we can become traumatized by that very same service. Think about the 100% you give to serve. If you give 100% to anything, what do you have left over for yourself? The answer is obvious…nothing. GWOT veterans, according to a recent New England Journal of Medicine (http://content.nejm.org/cgi/content/full/351/1/13) who are the most likely to traumatized by their service are the least likely to get some (or any!) kind of support for what can be called symptomatic readjustment /PTSD concerns. In another New England Journal of Medicine article (http://content.nejm.org/cgi/content/full/351/1/75) the psychiatric cost of war is explored, but what is particularly useful about this research is that it points out that the number once reason for not getting support is stigma…being seen to be weak in the face of this new, often misunderstood, and certainly overly dramatized malady…i.e. post-combat and deployment readjustment.

When we get the call-up for war it’s “Hi ho hi ho and off to war we go” and that pretty much holds steady until our hooch mates funk starts burning the hair out of our nostrils! Sure, there is a honeymoon phase when the food doesn’t taste so bad, the water is OK, the mission isn’t too critical, and R & R is easily come by. But when all that good stuff ends and we are forced to life the deployment day and night, then we get to the disillusionment phase. Many get her fairly quickly and dark thoughts peppered with stinking thinking rules. Of course, when we come home we are supposed to start the rebuilding phase and that is when readjustment and symptoms associated with PTSD rear their ugly head. Lack of sleep, excessive vigilance, trembling hands, being startled by noise and crowds, the need for isolation, unexpected anger, fears, inability to sleep or relax, and other factors start degrading our quality of life. Most of us experience this when we get home and the longer we leave it the greater risk we run of it taking root in lives for a good long time. We have been changed and knowing how and why is important.

If you are feeling different these days…you ought to. If you or someone you love and care about has been deployed and served in the Global War on Terrorism, the expectation is that their lives have been radically and dramatically altered as a direct result of their good service. PTSDresources.org is one source – along with many others – that can help you both understand and then get support to “Get Home, All the Way Home” with your hopes, goals, dreams, and family intact.

Posted by Dr. Mike Colson at 10:21 AM | Permalink | Comments (0) | TrackBacks (0)

By Dr Mike Colson

The expectation that we have been radically and dramatically altered as a direct result of our military service. We first begin to see small changes in ourselves – or those we love – which can over time create larger and more complicated circumstances. For 45-50% of returning veterans there can be fairly significant behavioral changes that creep into the way we think, react, and live out the business of our lives. There are classic symptoms that include disordered sleep, failure to dream, weight gain or loss, dark or disturbing thoughts, inability to manage small tasks and issues, anger, and more often than not some over-drinking. Left unchecked these can fester and grow into serious concerns. One of the important things to understand about readjustment home is that our chemistry has been changed forcing us to be – as a result of training and experiences in theater – much more reaction than we ever remember being. Others can see these changes and describe it has having a short fuse, being depressed, or being anti-social. These observations can lead to even further misunderstanding when there appears to be – at least on the face of things – no good reason for the behaviors. In point of fact there are very important reasons for the changes. I often ask Iraq veterans if they would like to bring the war home? They always shout back, “no”. But war and deployment can and does follow us home. We need to EXPECT to be impacted negatively by war and deployment. If it doesn’t happen to you or the one you love…be thankful. If you are one of the 45-50% who are impacted with some readjustment concerns – even symptomatic post-traumatic stress – ask two questions.

Question 1: What has it cost you personally to serve your country? In my 1999 book, “The Paradox of Underachievement”, I was trying to figure out while doing a PhD at Walden University why it is that military personnel do not fulfill their pre-enlistment goals. The research led to a review of some 53 studies on military culture, life goals of enlistees, and how military benefits like the Montgomery GI Bill are used and with what result. What I found is that “Dissonance” – the disconnect between what military service members want out of the military and what they think they can get – creates a whole community of military volunteers who put their personal goals on the shelf in order to succeed – or survive – their military commitment. So, assessing the personal cost of service requires soldiers to figure out why they joined and what they hoped to achieve. Once that question is answered, the next step is seeing how much you have achieved and to decide if there is a shortfall. That shortfall, along with other trauma or tough experiences you had while serving in the global war on terrorism, is the personal cost of military service.

Question 2: Who can help me understand readjustment and help deal with these changes? Whether you are active duty, reserve, a National Guard member, spouse, child, or even parent of a GWOT veteran who has been potentially traumatized by war and deployment…there are many kinds of resources available to help with readjustment. Some of these are on the base, others with the Veteran’s Administration or Vet Center, and there are many dozens of providers in the local community where you live. Cost is always an important part of the equation, as is confidentiality. What is important to realize is that there are many providers and options and many of them are available by calling your state Department of Veteran’s Affairs (www.va.gov/statedva.htm) to find doctors and counselors in your area. Calling the Veteran’s Administration at 1-800-827-1000 will put you in contact with the local VA in your area. Mentioning PTSD or readjustment will get you connected to an agency that can help in most cases immediately.

IMPORTANT: It is important that a compentent and experienced clinician help veterans understand what is going on. This is not the time to guess at personal health and well-bing issues. Getting solid baseline medical information will radically improve quality of life. Start with getting a full physical which is provided at VA centers for returning GWOT vets via Deployment Clinics.

Posted by Dr. Mike Colson at 10:14 AM | Permalink | Comments (0) | TrackBacks (0)

By Dr. Mike Colson

Other than normal behavior patterns tend to be the rule for returnees who have experienced things that are hard to talk about and even more difficult to forget. Death, sexual assault and harassment, prolonged deployment, limited scope of operations, loss of security, alienation from friends and family, and other factors force the normal body to react. Feeling crazy – like we are turned inside out – is the result of the brain and body trying to overcome the stimulation of those experiences. Breathing and thought processes change, sleep is disordered and interrupted, weight fluctuates, chemicals like testosterone are released at the slightest provocation, and the personality becomes almost manic/depressive.

Note: This is not crazy. Crazy is a diagnosable mental illness in most cases and we only expect to loss less than 1% of GWOT to this type of diagnosis. Readjustment – even the many symptoms of PTSD – is the body reacting to abnormal circumstances rather than being a systemic mental problem.

So…understanding what is happening is a major first step in finding how to make it better…faster.
Angry comes from, in most cases, the inability to rest and relax. Lack of sleep, disordered and episodic rest patterns, and the inability to dream or enter REM (www.sleeping-disorders.org/rem-sleep.html) all contribute to people waking in the morning angry and irritable. It only takes about two weeks for the body to make the shift to perpetually angry if the behavior pattern is left unchecked. What that means is that early into your tour overseas or in theater, you have already laid the “angry person” framework. Getting control of that anger is important if you are going to retain within your inner circle your hero status. As I tell soldiers every week, everyone returning from the global war on terrorism is a hero until your tell your oldest child to &%^$ off at the dinner table. Anger can set a different table where loved ones are afraid or frustrated with “the new you.”

Of course, anger can get a pretty good boost from depression. And one of the most common ways for veterans to compensate for the changes caused by deployment and war without a prescription is to drink. Alcohol has always been a cheap bus ticket to get someplace…anyplace. If I ask you to complete the sentence; “Alcohol is a ___________”, you probably would answer; “a depressant.” Alcohol is, of course, not a depressant until you stop drinking. For those who self-medicate with booze, the rush of alcohol acts as a social accelerant. When one stops drinking, or awakes from a binge of alcohol, the chemical-based body starts looking for the accelerant. When it cannot find it depression – or low functioning – sets in. This can become a chronic cycle with a very short period of time – especially for younger drinkers. I am not saying that all drinking is bad, but if veterans drink to medicate against readjustment symptoms, they become their own doctors – with limited choice on treatment plans. By that I mean the problem can only get worse when one adds in the associated issues like DUI/DWI, alcohol-attributed domestic violence, poor health and performance on and off the job.

We loose good men and women every year who are released from military service because of alcohol-related incidents – some with other than honorable discharges and the corresponding loss of benefits. What’s up? Better health knowing the challenges of getting all the way home.

Posted by Dr. Mike Colson at 10:07 AM | Permalink | Comments (0) | TrackBacks (0)

Author's Name Withheld

As a combat veteran wounded in one of America’s wars, I offer to speak for those who cannot. Were the mouths of my fallen battle brothers not stopped with dust, they would testify that life revolves around honor. In war, it is understood that you give your word of honor to do your duty -- that is -- stand and fight instead of running away and deserting your friends. When you keep your word despite desperately desiring to flee the screaming hell all around, you earn honor.

Earning honor under fire changes who you are. The blast furnace of battle burns away impurities encrusting your soul. The white-hot forge of combat hammers you into a hardened, purified warrior willing to die rather than break your word to friends -- your honor. Unbeknownst to civilians, some things are worth dying for.

Combat is scary but exciting.
You never feel so alive as when being shot at without result
You never feel so triumphant as when shooting back -- with result.
You never feel love so pure as that burned into your heart by friends willing to die to keep their word to you. And they do.

The biggest sadness of your life is to see friends falling. The biggest surprise of your life is to survive the war. But although you are still alive on the outside, you are dead inside -- shot thru the heart with nonsensical guilt for living while friends died. The biggest lie of your life torments you that you could have done something more, different, to save them. Their faces are the tombstones in your weeping eyes, their souls shine the true camaraderie you search for the rest of your life but never find.

You come home but a grim ghost of he who so lightheartedly went off to war. But home no longer exists. That world shattered like a mirror the first time you were shot at. You live a different world now. You always will.
Your world is about waking up night after night silently screaming, back in battle.
Your world is about your best friend bleeding to death in your arms, howling in pain for you to kill him.
Your world is about shooting so many enemies the gun turns red and jams, letting the enemy grab you.
Your world is about struggling hand-to-hand for one more breath of life.
You never speak of your world. Those who have seen combat do not talk about it. Those who talk about it have not seen combat.

People you knew before the war try to make contact. It is useless. Words fall like bricks between you.
The hurricane winds of war have hurled you as far away as Mars, and you can never go back home again, not really.

Your terrifying – but thrilling – dance with death has made your old world of babies, backyards and ballgames seem deadly dull. Serving with warriors who died proving their word has made prewar friends seem too untested to be trusted – thus they are now mere acquaintances.

Doing your duty under fire has made you alone, a stranger in a strange land. The only time you are not alone is when with another combat veteran. Only he understands that keeping your word, your honor, whilst standing face to face with death gives meaning and purpose to life. Only he understands that spending a mere 24 hours in the broad, sunlit uplands of battle-proven honor is more satisfying to a man than spending a whole lifetime groveling in the vast wasteland of civilian life.

Although you walk thru life alone, you are not lonely. You have a constant companion from combat -- Death. It stands close behind, a little to the left. Death whispers in your ear: “Nothing matters outside my touch, and I have not touched you...YET!”

Death never leaves you -- it is your best friend, your most trusted advisor, your wisest teacher.
Death teaches you that every day above ground is a fine day.
Death teaches you to feel fortunate on good days…bad days...well, they do not exist.
Death teaches you that merely seeing one more sunrise is enough to fill your cup of life to the brim -- pressed down and running over!

Down thru the dusty centuries it has always been thus. It always will be, for what is seared into a man’s soul who stands face to face with death never changes.
--------------------------------------------------------------------------------
Author’s Note: (Name Withheld)
This work attempts to describe the world as seen thru the eyes of a combat veteran. It is a world virtually unknown to the public because few veterans talk about it. This is unfortunate since people who are trying to understand, and make contact with combat veterans, are kept in the dark.
I offer these poor, inadequate words – bought not taught – in the hope that they may shed some small light on why combat veterans are like they are.
It is my life desire that this tortured work, despite it’s many defects, may yet still provide some tiny sliver of understanding which may blossom into tolerance – nay, acceptance – of a Warrior’s way of being from doing his duty under fire.

Posted by Dr. Mike Colson at 09:44 AM | Permalink | Comments (0) | TrackBacks (0)

Dr Mike Colson

Trauma does strange things to people. A few years back I was spending some time with a good friend who I hadn’t seen in years. I was going through a cynical phase after many years in southern Africa and found this man immersed in life and whacking away at the reality of a hard life. Like many of us in a post-combat life, my friend was finding it hard to keep control of things in his life that had flowed well together in the past. In the years since our last meeting he loaded more trauma in his heart than people ought to be asked to handle. Yet, he remained buoyant, positive, approachable, attentive to others and their needs, and even patient with others even when they clearly had little regard for the struggles he was engaged in. In short, it was obvious to me that he was managing.

Our destination on that day was Disneyland in California. Like buddies often do, we jabbered back in forth in the car heading out to Anaheim. Sports teams, family, one or two pipe dreams, and the odd lie made up the bulk of the conversation. Every once in a while a really important message wedged itself into the conversation, only to dismissed by a louder than required half laugh. One of these kernels of truth struck resonated in me because it was clear that my friend was being extremely patient with a court appointed attorney trying to arrange custodial visits with my friend’s children. After hearing him describe the circumstances he was facing and interrupting a big but false guffaw, I said to him: “You are a better than me for putting up with all that.”

The silence that greeted my “better man” statement was deafening - and - prolonged. I knew I had stepped in it but the smell hadn’t wafted up from my shoes…but that changed fairly quickly. A grunt similar to what you might hear from a boxer getting pummeled escaped from my friend and I this is what he said:

“Mike, I am not better than anyone and it’s not getting any better”. He went on to tell me that I could offer that type of bullshit to guys who get C’s in math, a speeding ticket, or maybe passed over for a promotion at work. But, for guys like him who have lost track of hopes, personal dreams, kids and family, and all the stuff we think we have control of, you ought to just shut up. This was no kernel of truth. This was the whole corncob and trauma had reared it head.

“So, Dr Mike, what happened?”

We never made it into Disneyland and my friend spiraled downward – awash in the darkness caused by heaving seas. Two years later he was dead.

My friend’s trauma was his and his alone. But he never saw himself as a person of value, substance, importance, or significance. He has ceased becoming a man, a father, a husband, a member of his community, and an individual in his own right who has the power to find support. He did not take his own life. But he did isolate himself during the trauma years and crystallized dark behaviors that would keep him away from good resources and support.

So, let me revisit my original comment: “You are a better man than me.” Any one of us who face head on out trauma, who take a risk and talk to people about things, and even take risks in finding the support we rate…are better men because of it. And here’s the kicker: “You do that and you can be better than me…anytime.”

Posted by Dr. Mike Colson at 09:35 AM | Permalink | Comments (0) | TrackBacks (0)

By Dr Mike Colson

NLCS Game 7 quote by Fox Sports Anchor Joe Buck; “[This batter]…. Is the best home run hitter in the NL history when there are runners on base after the 7th inning.” What? Is that a real statistic? Does anyone rally track this stuff? And…is hyperbole and hype killing us?

Of course, the answer is a definite…maybe! For PTSD sufferers, this kind of rhetoric has a way of driving us nuts. Take for example the “experts” we listen to in the media attempting to develop long-winded answers to Iraq/Afghanistan and the War on Terror. We all know that most are not veterans. We also know they quote others without conducting their own research. But they are sure they’re right. They’ll bet their life on it. And, laugh off their comment in some disingenuous on-air interchange.

Hearing this can cause the under medicated PTSD sufferer to slowly start twisting in the wind, feel the bile rise in our stomachs, and then explode into a hive of expletives. It is my belief that we react like this because we are honest truth brokers. We have a well-develop Bv)) S&!t meter that causes us to react strongly to people, events, and agendas that skirt facts and miss the critical aspects of complicated arguments.

The fact that some people call us heroes for our service always seemed to be a burr under the saddle of guys returning from combat. Why? Probably because the guy who saved the cat from the neighbors tree, the kid who gave some of his paper route money to charity, or the million dollar athlete who takes time for a photo op at Habitat for Humanity are all hero’s too. Somehow, the blood and gore of war and the night vision of combat seem oddly incongruous to normal people living out their brightest moments.

Hyperbole and hype cause the greatest damage by simply being false. It is my belief that they reinforce this falsehood by setting the hero bar low, rape the English language to justify magnified minimalism, and create a world of the blind huddled near an elephant’s ass. In the bargain they cheapen national service, a veteran’s commitment to serve beyond self, and the willingness to lose a life for a national ideal. Here’s a fact from the U.S. National Census that will startle some of you:

“Military members make up 2/100’s of one percent of the American population.”

That statistic makes my next statement perfectly clear. Raising our hand and swearing allegiance to the U.S. Constitution and then standing in harms way is not equivalent to a guy who just shows up for work on time to simply do their job. That is not hype…but fact. Be proud…and get the help you rate for being one of the few.

Posted by Dr. Mike Colson at 09:22 AM | Permalink | Comments (0) | TrackBacks (0)

By Dr Mike Colson

The primary source of support for the returning soldier is likely to be his or her family. Families can help the veteran not withdraw from others. Families can provide companionship and a sense of belonging, which can help counter the veteran's feeling of separateness because of his or her experiences. Families can provide practical and emotional support for coping with life stressors.

If the veteran agrees, it is important for family members to participate in treatment. It is also important to talk about how the posttrauma stress is affecting the family and what the family can do about it. Adult family members should also let their loved ones know that they are willing to listen if the service member would like to talk about war experiences. Family members should talk with treatment providers about how they can help in the recovery effort.
What Happens in Treatment for PTSD

Treatment for PTSD focuses on helping the trauma survivor reduce fear and anxiety, gain control over traumatic stress reactions, make sense of war experiences, and function better at work and in the family. A standard course of treatment usually includes:
· Assessment and development of an individual treatment plan
· Education of veterans and their families about posttraumatic stress and its effects
· Training in relaxation methods, to help reduce physical arousal/tension
· Practical instruction in skills for coping with anger, stress, and ongoing problems
· Discussion of feelings of anger or guilt, which are very common among survivors of war trauma
· Detailed discussions to help change distressing beliefs about self and others (e.g., self-blame)
· If appropriate, careful, discussions of the trauma to reduce the fear of trauma memories
· Medication to reduce anxiety, depression, or insomnia
· Group support from other veterans often felt to be the most valuable treatment experience

Mental health professionals in VA medical centers, community clinics, and Readjustment Counseling Service Vet Centers have a long tradition of working with family members of veterans with PTSD. Couples counseling and educational classes for families may be available. Family members can encourage the survivor to seek education and counseling but should not try to force their loved one to get help. Family members should consider getting help for themselves, whether or not their loved one is getting treatment.

Self-Care Suggestions for Families:
· Become educated about PTSD.
· Take time to listen to all family members and show them that you care.
· Spend time with other people - including extended family, friends, church & community groups.
· Join or develop a support group.
· Take care of yourself as a family member.
Pay attention to yourself - diet and exercise, plenty of rest, time to do things that feel good to you.
· Try to maintain family routines, such as dinner together, church, or sports outings.
· If needed, get professional help as early as possible.

Posted by Dr. Mike Colson at 09:16 AM | Permalink | Comments (0) | TrackBacks (0)

By Dr. Mike Colson

In the 27th minute of the second overtime at World Cup 2006 in Berlin, one of the greats of the game. Zinadine Zidane, heads butts a Italian defender and is ejected. The packed stadium at first is stunned, then erupts when the red card is flashed and Zidane is forced to finish his long and distinguished professional and international career in the locker room…and his team loses. “What a blunder”, exclaims the headlines. All the joy of living in the womb of a nation’s pride with all the privileges of bravery added in are gone. What happened?

A tiger escaped. Living inside many of who are trying to recover from episodic trauma or readjustment home from war and deployment is something akin to a wild animal that rears its head at what is often the worst possible time. Let’s call the tiger anger, or anxiety, or fear remembering that regardless of how we try and control it, feed it, assuage it, or respect it…it pounces. And in so doing take us from hero to zero in a few seconds.

I am not Zidane, but there are parallels among individuals like you and I who serve in harms way and by way of reward live heightened (and therefore, unbalanced) lives. While Zidane lives his life in front of cameras, we live ours in front of family, loved ones, and our community. When our “tiger” gets us red carded it is astonishing how quickly we can find ourselves in crisis at home, at our jobs, with law enforcement or the courts, and elsewhere.

I am not telling you that the tiger can be kept at bay all the time. But I believe in my heart that we deserve the chance to find a balanced life where the tiger can graze in private pastures while we go about the business of living lives of joy and significance.

Good health beats a head butt!

Dr. Mike!

Posted by Dr. Mike Colson at 09:04 AM | Permalink | Comments (0) | TrackBacks (0)

By Dr. Mike Colson

Combat vets …from the Vietnam War…are coming out of the woodwork.

Just about second day of the week, I stand in front of men and women who are either separating or retiring from military service. Most have served honorably and have in they’re possession a Global War on Terrorism (GWOT) Service Medal for non-theater operations while some have a GWOT Expeditionary Medal, having deployed into theater in support of air and ground combat operations. A third type of veteran has one or both campaign medals from Iraq or Afghanistan. These are combat guys like you and me who have a bloody T-shirt and a few holes in their uniform to prove they were there. But another type of vet - the Vietnam-era combat veteran – has been showing up to these events; sitting in the back, listening with intent, and grabbing my arm when the event concludes. And, they really want to talk.

So, who are these Vietnam veterans? Here is my guess:

They are combat veterans who found a way to make the readjustment from jungle warfare to mainstream USA who are now – as a result of TV and GWOT-laden political infighting – being traumatized all over again. The ones I talk to express fears, feelings, and emotions as if they were right back in Vietnam – this after being out of uniform for 30-plus years! Some cry – for dead friends, lost innocence, errors of omission and commission in their post-military lives, and not a few wondering why this again…why now?

When I returned from my second go-round in Iraq, I remember how comfortable it was to sleep on the floor of my detached garage away from family and distractions. I felt safe there. I could prowl at night, check and re-check the doors and windows, and sleep as if awake, alert and ready to meet death’s avenger head on. After eight and a half months, I started to hear a knock at the door. It went like this:

[Knock, Knock]
“Who is it?”
“It’s me” (my wife)
[Long pause]
“Come on in for some breakfast, the boys are both here.”
[Another long pause]
“Are you OK?”
“Yes.”
“How much longer are you going to live out here?”
“I’m coming in now.”
http://65.214.37.88/ts?t=15082087429299857089

And I did…and stayed ever so gently in the home that had for me all the things I had built my life into: family, loved ones, friends, memories, security, hopes, and dreams NOT punctuated with screaming, carnage, or the smell of the dead. Home was where my heart was but the isolation of the garage was a powerful elixir…and it took time to get over its intoxicating draw.

I think the Vietnam veterans are teaching us a new lesson in post-combat trauma: That you can wait as long as you can stand it…but the knock will come.

[Knock knock]
Whose there?
Trauma.
OK. I’ll be right out.

The alternative is decades of unwarranted and undeserved pain.

Posted by Dr. Mike Colson at 09:49 AM | Permalink | Comments (0) | TrackBacks (0)

By Dr Mike Colson

I stand before you all today covered in feathers. Some of the feathers stick to me while others lie about, shift in the wind, and occasionally stick in the corners of my mouth. And they are not just any kind of feather. These are duck feathers…the worst kind.

You may have heard of this phenomenon. Guys will tell you straight up – normally in a loud and vigorous way – that if something looks like, walks like, and talks like a duck (pause for emphasis), then a duck it is. Fellow combat bubba’s…ducks is what we got.

Let me explain.

These ducks can be heard almost any day of the week. One duck shouted out “Bring it on” and they did – with disasterous results for warriors and innocents. Whole flocks of ducks ask for party line voting and thereby stifle conversation (Democracy be damned!) on the merits of fighting a complicated and protracted war. And before you get me wrong, being a duck man is an equal opportunity game. Ducks are found on all fronts, uttering from an equal butt opposite position wonderfully sound statements like “I wouldn’t have voted if I knew now what I knew then” – or – “We can’t afford to fight other peoples conflicts.”

For my part, I sit uneasily in a slightly torn foldout chair outside this political aviary – I’ll call it the “The Duck Inn” after a little restaurant in Stanwood, Washington - wondering why more people aren’t concerned about increasing levels of duck droppings. The anger I feel comes later when I remember that all the quacks I hear quacking never took incoming, fired a weapon, deployed on dangerous roads, or kept a personal danger beam burning night and day. Of course, that doesn’t stop the quacks or squawks in the birdcage.

Our Vietnam era brothers and sisters are more experienced in this phenomenon. Long ago they figured out that these ducks have no desire to taste privation or fear, experience patriotism and folly in full measure, or link friend with trauma. Ducks have a way of being emboldened by ignorance and thereby trotting out all manner of crap…none of which speaks for me one bit.

Ducks and politics seem to go hand in hand. That is a historical reality. But I would like to think that what troubles me most about ducks comes from my having PTSD as a companion and bedmate. Which means on the one hand I am a raging “serve this nation” fanatic – and in an instant – am thrown into a depressive lull of lost innocence. When I hear the ducks speak I want to raise the flag even if the stars and stripes wave over market carnage, road bombsites, and boots arranged in neat rows. I want to kick and cry…and live…and die. And every clarion call played for another soldier lost puts my ass back in my folding chair wondering why I can’t engage in the democratic process…and run my own beliefs up the flagpole.

Combat guys don’t swagger like some of the ducks I’ve seen. But in the cloud that we call trauma remains the warrior. We know of what we speak. Having to prove another deficient, showing off personal intellect, or grandstanding are not our ways. Yet, we can tell it like it is. We not only make good arguments – about ducks and whatever – but we can be the argument. We live, breath, adapt, and – by God - find our way even when the maps we were issued prove limited. And finally, no combat guy I know would even go prancing around in feathers!

Posted by Dr. Mike Colson at 09:45 AM | Permalink | Comments (0) | TrackBacks (0)

By Dr. Mike Colson

The sun is right where it ought to be at 3 o’clock PM on a Saturday…dead center in the windshield and blazing the eyes of a GWOT vet traveling west. The terrorist appears seemingly from nowhere. The RPG is aimed right at the GWOT’s vehicle and impact is going to be immediate and intense. The GWOT’s body is already at the ready. Testosterone, so necessary in keeping him alive during attacks, rushes in, and training and survival instincts takes over. With his left hand gripping the wheel he waits for the propellant flash, scans an egress path, and with the off hand snaps his weapon to condition one...and nothing happens.

The war’s been over for more than a year. RPG’s are now the worry of other soldiers still in the field. The terrorist was a traffic cop aiming a radar gun. And only a last split-second impulse stopped him from cutting across two lanes of traffic…but the testosterone was in the GWOT’s system and more than an hour would pass until his heart rate would return to normal.

The GWOT, of course, is you and me…returnees from the Global War on Terrorism with a default upload of personal OIF/OEF stressors. The trick to survival in the past – in combat - was to memorize organizational procedure and quickly learn the nuance and language of combat arms, movement, and security. One hiccup, though, in this regimen, is what to do with the 70 pound Alice pack that held your life’s possessions. Rule of thumb: Make sure it had ever single thing you’re required to have by regulation – but in reality – only carry everything you need. GWOT’s learn pretty early on that you HAVE TO learn to think about what is important. Then, develop a plan of attack. And finally, figure out a way to get stuff done. Success and survival depend on it.

I am a GWOT; so let me give you my own 7o pound pack example. When I went to the field, it was essential for me to have both sides of a shelter half. Sixteen-hour plus days spent moving from unit to unit mandated I rest well; which means alone. Churchill’s “History of the English-Speaking People” and a small Bible, an Army surplus rain slicker, deck of cards, writing set, Ziplock bags, and assorted bits and pieces were also needed. That meant the extra uniform, boots, and field jacket – all required - didn’t make the cut.

Being careful to isolate the main mission, plan well, and setting off in the right direction are second nature to all of us. We all have been tested and found able to carry a regulation pack. What appears to be less well known or appreciated is that many GWOT’s can be weighed down by their own OIF/OEF trauma; I.e. the guy with the RPG masquerading as a State Patrolman. Of course, this is to be expected. Vietnam-era veterans with similar challenges wove that trauma into the fabric of our American veteran guidon years ago.

Here’s a word to the wise; GWOT have their own set of regulations, which like many adapting positions in any organization, requires flexibility. In the Marine Corps we jokingly called this Semper Gumbi - which is funny as long as everyone is laughing. The GWOT’s pack today probably includes guidance from higher authority (spouse, children, employer, and the community-at-large), from which she/he makes sure that everything required, and everything needed to survive, is carried. What that means in reality – i.e. that extra pair of boots – is that something is going to be left behind. If what the GWOT chooses, out of necessity, to leave behind are those intervention options, tools, trust relationships, and freedom to heal so necessary for trauma sufferers – then are we not setting ourselves up for failure?

My own military history records multiple tours in Iraq and Afghanistan and fourteen years of previous service working with war refugees and orphans in war-torn southern Africa. I am a GWOT and have been proud to serve. But, prior to starting my post-war life - and in-between combat tours - I was diagnosed and eventually began treatment for PTSD. The disability gives me foundation when I speak about readjustment challenges facing America’s newest combat veteran. And…it also makes carrying that Alice pack tough at times.

One of the key factors I find in myself and fellow GWOT vets deployed into combat zones is a belief that a betrayal (of sorts) has taken place. It might not be rational, but it exists. Whether true or not, the sufferer is still prone to be distrustful of others, react before deliberation, work as a replacement for balance, and ultimately suffer through the nights and dreams alone. I know this because I have had my own struggles…and suffer.

It is my belief that compassion and understanding, along with openness, frank commentary, and one on one communication allow for wholesome and long-term personal and professional relationships to develop. GWOTs, like Vietnam veterans before them, are trying to find their footing in a complicated times. Is it not time to consider how you are carrying? And, in that spirit work hard to find and pack what you need to survive first, and succeed in good time.

Posted by Dr. Mike Colson at 09:08 AM | Permalink | Comments (0) | TrackBacks (0)