Trauma, Diagnosis, and Therapy
Compiled, Researched, & Narrated
by Anthony Servante
My apologies for the long wait between updates, but I didn't feel like writing. That's it. No excuses. Just didn't want to follow the psychiatrist's instructions. It's these damn pills, you see. One for depression, one for anxiety, one for pain. I don't even have any pain. Maybe the pills are taking away the pain, you say. What pain? The pain of living, I suppose. Maybe it's because I often tell the Shrink about my headaches. So all she hears is "pain" and prescribes the Tramadol. Damm pills make the nightmares worse, so I avoid taking meds before bed--when the headaches can be numbing. But I digress.
As I continue to follow my [Shrink's] trauma therapist's instructions, I write another update in my blog regarding the treatment and reason for my sessions with her. As I have mentioned, my health insurance will not pay for therapy but does pay for a psychiatrist. She has agreed to provide counseling if I take my meds and write these blog updates as a valve to alleviate my pressure from stress. According to her, she will be reading these updates and discussing them with me. If I don't write anything, then it's meds and "see you next week". And I want the talks, so I will be keeping up with these updates. It's in these talks that I get to peel back the defense mechanisms that cover my bad memories.
These updates will consist of sharing accounts of trauma but hope to include accounts of treatment as well. I will speak of myself and allow other trauma sufferers to speak for themselves.
Thus I begin with the latest of the accounts I have received and find reflective of the subject matter at hand.
Testimonial: Bill's Account:
I am a Vietnam War veteran. Where we were stationed isn't important. What happened to snap my spirit is. Lieutenants came and went. They were mostly young ROTC punks or college kids with a degree. No West Point pukes made it to our corner of the Happy Hunting Grounds. Just the punks and kids. Not that we weren't kids anymore ourselves--that is, the survivors who managed to secure our little corner and keep our enemies far away from us. We were close to water, the jungle half a klick away: Quick extraction by chopper if necessary. And we posed no threat to anyone in the strategic scheme of things. We were a nobody platoon. The Brass forgot about us. We had time to barbecue and play music and get high. Pot was easy to get. Beer was harder, but we managed to keep ourselves well-stocked by trading rations and candy bars with the locals. We just had to keep our heads down and stay out of the war. Sure there were battles. They shot at us from the jungle skirmish line. We shot back. Except for a few flesh scrapes, there were no casualties. And those lucky enough to actually get shot got to picnic in morphine park for a few days. For me, the pot was enough. That and the beer.
It's just that the fucken Lieutenants kept coming. I'm your new C.O. You'll salute me, soldier. You boys are lazy. You need a mission. Fuck that. The punks and kids were never satisfied with the skirmishes. I want you boys to follow the enemy into the jungle and find their headquarters. They're underground, Sir, we always tried to explain. They got ten times more men than we do down in those tunnels. Why piss on the bee hive?! Because I'm giving you an order, that's why. I want a location by tomorrow. I'll radio the position to Command and await further orders. What do you mean, 'further orders'? You're the only one giving orders. You're going to get us all killed. He said 'getting killed' was the job description. They always talked like that. Like it was business.
That night the first new LT arrived, he had us build a crow's nest and stationed a watch with optics, you know, binoculars. We rotated watch all night long every five hours, during which time the damn gooks took shots at the nest. The Lieutenant would yell at the watch to keep an eye on the origin of fire, that's probably where the tunnel entrance is. But the watch kept his head down. Fuck the Lieutenant. And every one of those punks and kids with their clean new uniforms and clean-shaven faces always had ideas about how to find the Viet Cong, the Chop Stick Calvary. The punks always wanted to meet the enemy and notify Command that we need support, we need to flank the Cong, we need to push them back, cut down the skirmish line of trees if we had to, we were there to win the War. Fucken Baby Politicians with a hair up their ass.
The first Lieutenant was the easiest. We walked him into the jungle just past the skirmish line and led him into a field of 'bouncing Betties' or 'pungi stick' traps. By the second Lieutenant, we started building the traps ourselves. Click. Snap. Wham, bam, thank you, Bettie. A half dozen pungi sticks in the face and chest. We'd wait a few days to report it. No hurry getting a new C.O. Pop open a beer, bogart a joint, fire a few rounds into the jungle. It was the gooks who usually took the Lieutenants down and left his body by the skirmish line. Once the birds and insects began to feed on him, we'd have to call it in. It got stinky.
And so they left us alone--the Cong. And we bided our time. The boys with deep wounds during skirmishes got a ticket home--after losing a limp. They always wanted to stay a while longer before heading back. Medic would warn them about infection. They didn't listen. All they heard was the clang-clang of a Purple Heart. When a new Lieutenant arrived, then they'd go home. The rest of us didn't go home. And the routine got nastier. Some boys would shoot themselves, but Command always knew a self-inflicted wound. Shit, they'd seen enough to know the drill. And Lieutenants stopped showing up one day. And the skirmishes began to last longer. The medic said that the Cong probably wanted to put down the rabid dogs. But it was war, man. We didn't know we had become feral. Not until later.
Then it just stopped. The war was over. We were being sent home. We weren't ready. We had our routine down pat. How could we take our routine back home with us. We needed our routine. Motherfuckers. So we took the routine home with us. The skirmishes. The traps for the new Lieutenants. The morphine drip. The haggling for beer. Smoking dope became a solo act instead of a sharing circle. The routine to keep our corner of the war safe for our company. They took it away and didn't give us anything to replace it.
I lost my family. My wife and little girl. Eventually the good-hearted landlord who welcomed me home kicked me to the street. I lived in the corners of Alhambra for many years. People gave me food. But no one knew about things like PTSD back then. And the VA counselors are still learning what it is. I have a place now. I have a part-time job. I am a counselor. It's like I remolded a routine that I can live with in my new corner of civilian life. For every new trauma victim I talk to, I tell them not to worry about remembering. That goes away. It's living with the re-remembering. That's the new goal to learning to survive again. It's still all about survival. Only now the enemy is yourself.
WAR IS HELL!
A Short History of Trauma
A Frontal Lobotomy (antiquated cures)
The definition of trauma has changed over the years as science, psychology, and culture have given name to the state of the soldier returning home from war psychologically and physically changed by killing, surviving an attack or seeing the butchery of battle. In ancient literature, we've read accounts of the "war-weary" warrior or "nostalgia" during the American Civil War. By World War I, we had "shell-shock" troops, and in World War II, the term "battle fatigue" seemed relevant. Post Traumatic Stress Disorder (PTSD), named by the American Psychiatric Association (APA), DSM-II (Diagnostic and Statistical Manual of Mental Disorders), after studying the depression suffered by Viet Nam War veterans. In DSM-III, the trauma symptoms became linked to survivors of rape, child abuse, assault, and domestic abuse. Even today DSM-5 continues to expand the definition of trauma to include more and more cases over and beyond war scars and psychological distress victims.
In Varieties of Religious Experience by William James, the author lectures on the state of the human mind prior to undergoing a radical religion conversion. He terms this transition, "the sick soul". Symptoms include nightmares, depression, anxiety, manic mood swings, and darker thoughts involving suicide. These same symptoms echo those of PTSD, as defined by the DSM. But it's interesting to also consider that during this period of "the sick soul", James points out that a choice is made by the sufferer to accept a religious solution that places order on the chaos of the unsettled mind, thus giving organization and meaning where there was none before, where self-destruction seemed like an attractive alternative. Rather than choose death by one's own hand, one turns to some form of God (although James uses Christianity as an example, most any religion or religious text would suffice). Still others turn to other forms of "supernatural" relief, believing that the soldiers they have killed are haunting them, or that the rapist was a demon, for instance. Based on the culture of the traumatized victim, the choices to avoid oblivion can be found in The Gita, The Torah, The Koran, The Talmud, The Bible, or even the books of H.P. Lovecraft. In the Alcoholics Anonymous 10 steps, to overcome one's dependency on drugs or booze, one must accept a "higher authority" to lean upon in times of temptation back to "the sick soul". Often trauma is seen as a spiritual disease rather than a physical one.
But what of those who prefer traditional medicine or physical answers to their mental unrest. For there are those who do not have the temperament for supernatural support? Where does such a victim turn to for treatment. That's where science comes in. In my case, it's medication and dealing with my dark dreams or my stray thoughts about nature turning to chaos. For the sexual victim, it's dealing with the fear of authority figures by asserting one's self. For the soldier and law enforcement officer, there is formal therapy which deals with each case individually. In other words, there are professional therapists who guide us to deal with our daily lives.
Not all solutions are perfect. As I've stated earlier, this is an evolving field. New traumas are emerging, so new treatment must be designed to help this new form of troubled mind. For example, how does the therapist distinguish between a patient who finds God as a solution and a patient who finds the Devil for a solution? What approach can therapists use to treat "the sick soul" when science doesn't recognize a "soul" at all? Is the answer found in "the sick mind"? Where and what is the "mind"?
These are the current questions that PTSD treatment and therapy must consider. It reminds me of that old movie with Jimmy Stewart who had an invisible pal called Harvey, a six-foot tall talking rabbit. In the movie, Stewart's character is the most sane character while doctors are portrayed as "quacks" with their medieval medicine. I mean, in the 1950s, "shock therapy", "hot and cold running bathes", and "frontal lobotomies" were common tools for "curing" depression and other stress-related ailments. And that's why the patient must be careful not to find a radical cure too far away from science, but also not to rely too heavily on science alone when it may be an outdated therapy or, as in my case, very reliant on drugs to mask rather than "peel away" the defenses trauma builds and memory triggers.
This is some of the subject matter that we will address as we continue to post our accounts of trauma, our discussions of the latest therapy, and the alternative solutions that can be found in faith and religious instruction. And, of course, we cannot leave out the cozy sanctuary of the supernatural [the close cousin to religion], whether it be an omnipresent God, a six-arm divinity, or an escape from death in reincarnation. All possibilities within our limited updates will be considered.
Thank you, readers, for joining us.