Monthly Archives: December, 2015

Soul Care Conversation (Psychological Effects of Trauma)

December 24th, 2015 Posted by Blog 2 comments

(The purpose of Soul Care Conversations is to create a place to generate dialogue, initiate thoughtful consideration for the challenges our veterans face each day, share ideas of veteran and family well-being and healing, and spark within all of us a call to be engaged with the veteran and caregiver community. Click here to visit the forum and join the conversation!)

Last week we continued our conversation on the impact of trauma to the warrior. We focused on the physical effects of trauma. This week we will discuss the psychological effects of trauma.

Last month, many thankful citizens expressed their words of appreciation to our veterans for their sacrifice. As we consider the word “sacrifice”, it generally means something was given up. If you are a veteran, what did you give up while you went to war? Birthday and graduation celebrations? Holidays with loved ones? Watching your children play school sports or their involvement in other activities? The intimate connections with a spouse? Although these are important and can never be recaptured, I would imagine there were other important sacrifices consequential to your deployment such as your health and well-being.

It is important to note, trauma changes the person.  It is not that we are worse, but we are different.  Each person who returns from war will be different.  War changes all who have stepped onto the battlefield.  Post-traumatic stress or deployment-related stress are normal reactions of normal people to extreme and life threatening events. It is part of the human survival response. Warriors often experience during a combat deployment intense fear, panic, confusion, helplessness and even horror. How can one return from war feeling anything but changed? In fact, some returning veterans ask the question, who am I?

Can we do anything prior to deploying that would preclude a negative response to a traumatic event, to build our resilience? I thought so.

PRE-EVENT FACTORS

Prior to my deployment to Iraq in 2003, I intentionally spent much time in prayer, study, and meditation. I thought that this prep time would be like an inoculation for me in case I experienced difficult times. I believed that I was emotionally and spiritually resilient. However, that was not the case. Even though while deployed I was able to fully function, I returned deeply changed by my experience and I was not prepared for this response.

Why do we respond to traumatic events the way we do? We think that we have all we need to help us on the journey, and then we experience combat and go through what no one ever wants to experience; isolation, fear, loss, and the terror of war. There are numerous pre-trauma factors that could affect how one responds;

  • ineffective coping skills
  • survived another trauma event; plane crash, fire, violent crime, serious car accident, natural disaster such as an earthquake, or tornado
  • lack of spiritual grounding or faith
  • sexual/emotional abuse, especially experienced as a child
  • poor social support mechanisms
  • lack of realistic training to deal with the sights, sounds, and smells of death
  • distrust of leaders and mission intent

There are other factors that we could add to the list. The point is that each person’s response will be different because of one’s experiences in life and also their spiritual and emotional grounding prior to going to war.

EVENT FACTORS 

Additionally, we must remind ourselves that no two persons are effected the same way from a similar traumatic event. Whether we experience a one-time event, or multiple events, or sustained repetitive events, the psychological responses to trauma will be different for each person.

There are numerous factors that impact how a person reacts to trauma;

  • closeness to the incident (were you injured or did you witness another being injured)
  • amount of warning time, such as a bomb or a sustained attack
  • existence of an ongoing threat
  • seriousness of personal injury or the injury of others from the incident
  • intensity of the incident, gunshot versus a bomb
  • responsibility you feel toward causing or not preventing the incident
  • length of time between multiple trauma events
  • an existing condition, such as mild brain injury from a former incident
  • poor command climate and support
  • loss of confidence in the success of the mission
  • where one is in their spiritual journey

There are numerous factors that affect how a warrior copes with adversity. In a times of stress, warriors react in a variety of ways. You may know of other factors that effect how a warrior reacts to trauma. If so, what are they?

PSYCHOLOGICAL SPECTRUM OF RESPONSES

We have shared the various factors that impact how a warrior reacts to trauma. What are some of the common psychological conditions of trauma? Particular responses vary in range from the following;

  • anxiety
  • panic attacks
  • emotional disturbances
  • Post Traumatic Stress
  • Post Traumatic Stress Disorder (PTSD)
  • depression
  • suicide

The above factors are marked by numerous and differing symptoms that occur in three main areas: flashbacks, hyper-vigilance, and avoidance.  Most people recover on their own. However, when a warrior becomes stuck with these symptoms for more than 30 days, a formal diagnosis of PTSD can be made. Often the above symptoms can combine and lead to depression and the tendency for the veteran is to isolate themselves. Suicide is the risk.

For years after my return from Iraq, I exhibited five of these factors. I realized if I was to begin a journey toward healing, I needed to learn more about trauma and trauma care and find ways to mitigate the impact, and develop self-care practices in my life.

SOME HELPFUL RESPONSES

What are some helpful responses that a veteran can make?

  • create a safe place
  • develop relaxation and breathing techniques to reduce stress
  • step away from business to meditate, pray, read
  • consider growth possibilities from the trauma experience (Post Traumatic Growth)
  • deliberately plan and take time to heal

Lastly, if after following these helpful responses and a personal assessment, you believe you are stuck in a depression or are suicidal, reach out to a friend or a professional for care. Take care of you! We will discuss PTSD in more detail in another conversation.

What are some of the helpful responses that the faith community and faith partners can have? We too can be an integral part of our veteran care. What can we do? How can we care? Let’s be in conversation as we explore answers to these questions.

In the meantime, thanks for sharing in this important conversation. We will share next after the New Year. May you and yours experience a blessed Christmas and a Happy New Year…

 

 

Soul Care Conversation (Physical Effects of Trauma)

December 16th, 2015 Posted by Blog 1 comment

(The purpose of Soul Care Conversations is to create a place to generate dialogue, initiate thoughtful consideration for the challenges our veterans face each day, share ideas of veteran and family well-being and healing, and spark within all of us a call to be engaged with the veteran and caregiver community. Click here to visit the forum and join the conversation!)

We began our conversation last week on the impact of trauma to the warrior. We considered this from the whole person perspective. This week we will focus on the physical effects of trauma.

TWO DISTINCTIVE SYMPTOM FACTORS

Trauma impacts individuals in ways that can be observed physically, emotionally and spiritually. It has been through my personal therapy and experience, and from observations with other combat veterans that I have learned several common trauma responses that reflect the physical side.

First, if a person experiences a bodily injury or wound, that individual will experience some physical after effects, such as;

  • physical scars
  • chronic pain
  • loss of mobility

For our veterans who have experienced limb amputations, burns, eye injuries, or facial and head disfigurement, their symptoms are readily detectable.

Second, trauma overstimulates the autonomic nervous system. This over-stimulation results in chronically high arousal levels that can wreak havoc on our bodies. It is natural to have a physical reaction to this kind of stress. Prolonged stress can lead to sleep deprivation that can have other serious physical effects. The physical effects to an emotional or mental trauma are more difficult to detect and it is difficult to develop a helpful response.

PHYSIOLOGICAL RESPONSE

Individuals can have many different reactions to a tragedy. It is good to be able to recognize the physical symptoms of trauma stress;

  • shallow breathing
  • cold hands and feet
  • muscle tension
  • increased blood pressure
  • paleness
  • lethargic
  • fatigue
  • racing heartbeat
  • aches and pains
  • headaches
  • nausea
  • trembling and tingling
  • sexual disorders

From the above list we can surmise that symptoms can be very diverse. Also, symptoms can be stable, or they can come and go. Or, an individual can experience symptoms in clusters, or one at a time. Each individual will respond to their trauma stress in different ways. Also, each individual will have to discover for her/himself how to respond.

SPECTRUM OF RESPONSES

Symptoms typically last days to months, and gradually fade as a person processes the trauma. Even if feeling better, a person maybe troubled by painful memories or emotions, especially triggered by an anniversary of the event or an image or sound, or a situation that reminds the person of the trauma.  Sometimes, symptoms emerge later in life even after the passage of time. An event, or seeing a movie, or a smell can trigger a symptom. For some veterans, their symptoms linger for months. In fact, symptoms can linger for years.

One evening, while living in Vicenza, Italy, I decided to watch a movie. This was a movie I had seen years prior, one that I remembered was extremely funny, Good Morning Vietnam. As I was laughing and enjoying the antics of Adrian Cronauer, a scene brought me to weeping, for it was a flashback of a similar experience I had in Iraq when two Soldiers were killed by a roadside bomb. My reaction to the movie occurred 3 years after my return from Iraq.

Combat trauma survivors experience a spectrum of responses from mild to severe. On the continuum, a warrior who suffers mild combat trauma will usually exhibit fewer symptoms that will typically improve without significant treatment. These warriors may encounter some reintegration issues and possibly experience combat stress reactions. Common symptoms of combat stress are fatigue, slower reaction times, indecision, and an inability to prioritize. However, the warrior who experienced a severe trauma event most likely will exhibit profound symptoms that could persist longer, and if untreated, a lifetime. These warriors most likely will be diagnosed with PTSD.

Throughout the continuum, each returning warrior will experience some sign or signs of stress. It is normal.

What is required? The body of a trauma survivor needs care. For the returning warrior, to be able to recognize the signs of stress will be helpful in reconnecting with a measure of control over how their body reacts.

Remember, when the trauma event strikes, the survivor is no longer in control of what has happened around them. A first step in healing from the trauma is to recognize its impact. The ability to recognize the signs of trauma stress will impact how the individual takes control of their care!

My sons and I were engaged in some father and son time shortly after my return from Afghanistan in 2012. My youngest son did something that immediately brought forth a visceral reaction from me. Later in the day, as I considered my over-the-top reaction to my son’s insignificant mistake, I realized several important considerations;

  • I had not dealt with the trauma from my Iraq deployment in 2003-2004
  • I needed to take control of my care by being attentive to my body
  • I must take the step to seek professional advice

For me, with the passage of time, I had put my personal caring and healing process on hold. First, immediately after I returned from all of my combat deployments I jumped right back into the responsibilities of my jobs. (Most likely it was an avoidance technique.) Second, I thought I could deal with my trauma in my time. What I did not realize is how my trauma experiences affected my family or my work. I also did not recognize the long term negative effects that trauma had on my physical health.

SOME HELPFUL RESPONSES

This is the reason why trauma healing must address the whole person because trauma invades and disrupts the mind, body and spirit. The process of healing can be a journey. What can one do in the mean time? How can a combat veteran care for his/her body? When an individual recognizes the signs of stress, some helpful tips to work through may be;

  • feel safe, be aware of your physical environment and move if you feel threatened
  • be aware of your physical body, its needs and how it works
  • stay grounded, planting your feet as firmly as you can to the ground
  • daily exercise
  • journal, write, paint, draw
  • practice relaxation and breathing exercises, prayer
  • ask others to help you stay connected to them

These are only a few protective tips. Maybe you have some that you would like to share that has worked for you? We will discuss in a later conversation some strategies for the journey toward long-term healing. Next week, we will focus on the psychological symptoms of trauma. Until then, thanks for the conversation….

 

Boulder Crest Retreat

December 9th, 2015 Posted by Organizations, Resources No Comment yet

Boulder Crest Retreat is the nation’s first privately-funded rural wellness center dedicated exclusively to our nation’s combat veterans and their families. We are committed to improving the physical, emotional, spiritual and economic wellbeing of this remarkable community of heroes, and ensuring they have the opportunity to succeed in their new mission – a life of passion, purpose and service – here at home.

FOX News Health: US veterans find combat-related stress relief in holistic-medicine retreat

December 9th, 2015 Posted by Articles, Resources No Comment yet

Ever since 47-year-old Andy Kaufmann retired from the U.S. Army in 2009, scenes from active duty in Iraq, Bosnia, and the Saudi Arabia and Kuwait border have rattled his body and mind— giving him hyper-vigilance, disrupting his sleep and memory function, and threatening his marriage of 21 years.

Soul Care Conversation – Introduction to the Understanding of the Whole Person Perspective of Trauma

December 9th, 2015 Posted by Blog No Comment yet

(The purpose of Soul Care Conversations is to create a place to generate dialogue, initiate thoughtful consideration for the challenges our veterans face each day, share ideas of veteran and family well-being and healing, and spark within all of us a call to be engaged with the veteran and caregiver community. Click here to visit the forum and join the conversation!)

Last week we concluded our conversation on the challenges experienced during transition and reintegration by focusing on the effects to the children. For the next several weeks we will review the impact of trauma on the warrior as we consider this from a whole person perspective.  Additionally, as we review the effects of trauma on the warrior, we will also discuss how the residual effects of trauma concern the family and community.

BACKGROUND 

One morning, you wake up in a combat zone, already experiencing the high stress of where you are and living under the impact of imminent threat. This morning is just like the past weeks and months of mornings in Iraq, the sun is shining and you are about to embark on another day trying to make a difference. However, on this particular day about two hours later, your life will not be the same. A bomb goes off just as your vehicle passes an intersection and you survived. After assessing the situation you hear across the radio that the vehicle travelling behind you was not so lucky, both the driver and the passenger were killed. As you consider the tragedy of losing two battle buddies you reflect on the reality that this happened exactly one week after your vehicle was hit by a bomb.

What do you do? How do you go on? How can you get back into a vehicle and finish your mission? Do you quit? Do you get up the next morning, and the next, and the next, deciding that you cannot depart from your forward operating base? Do you even want to go on? What do you do?

This was my experience in February 2004, and these were my questions. Prior to that fateful day, you wake up thinking that all is OK, that even in the midst of being in hell God is in control and the world is going to survive, that things make sense, that there is meaning to your life. Then in a fraction of a second, your world is turned upside down. You realize that you are not in control, that maybe God is not in control, that nothing makes sense. You begin to question why you are even in Iraq. You feel vulnerable, insecure, and unsafe.

You have experienced trauma. You have experienced something terrible. Trauma is a deeply distressing or horrifying event where one feels a lack of control, powerless and a threat to life or limb. The word trauma comes from the Greek “traumat” which means wound.

SPECTRUM OF TRAUMA

The reality of war is that many who step onto the battlefield will get wounded. Very few can escape either the physical, psychological, or spiritual wounds of war. Some of these wounds heal quickly. Others may last a lifetime. Some wounds can be seen. Others are invisible, like those to the mind and soul. These are the silent wounds of war.

Our veterans who experienced trauma face the most difficult challenges. Reactions to trauma affect the whole person; psychological, emotional, cognitive, physical, behavioral, and spiritual components of one’s being.

One who has experienced trauma may feel abnormal. How can one not? No doubt you are different because of your war experience. To experience the sights, smells, sounds, and did what you did, how can you not return different? This is normal! It is normal to be affected by combat. It is normal to be affected by the horrors of war, the pain, the loss, and death. Facing death changes a person. Again, the consequences of war and trauma affect the whole person.

No two combat veterans will have the same war experience.  In fact, if several warriors experience the same traumatic event, each person will have a different reaction. We will discuss this with some detail in a later conversation. However, the common link for all combat veterans is that combat related conditions without exception affect the whole person.

Can one survive a bomb explosion that resulted in a brain injury, now having difficulty concentrating, and feeling survivor’s guilt because her/his battle buddy was killed, not think that this has not affected him/her as a whole person? Can a veteran who lived on a forward operating base that received a daily barrage of rockets and mortar fire not get sweaty palms, feel threatened, and develop a sense of insecurity when they hear fireworks or a vehicle backfire? All combat related conditions affect the body, mind and soul causing a full range of psychological, emotional, cognitive, physical, behavioral and spiritual symptoms.

Combat veterans are not the only victims of trauma. Exposure to the following events may significantly impact individuals;

  • rape and sexual assault
  • natural disaster such as hurricane, tornado, earthquake, and flood
  • house fire
  • automobile accident or plane crash
  • crime such as robbery or shooting
  • abuse
  • working with trauma victims (secondary trauma)

Those who are at high risk for secondary trauma are;

  • clergy and chaplains
  • health care professionals; mental health, nurses, doctors
  • first responders
  • human service workers; crisis line, advocates, disaster workers

Trauma and the effects of trauma can be seen throughout our society. How can we respond? Often our response only includes the physical and psychological needs of the person affected. However, maintaining health and wholeness includes a spiritual dimension as well. Over the next several weeks we will explore all components of a healthy person and the resources available for care, healing and restoration.

I hope that this conversation will peak your interest in exploring the strategies and resources for soul care. Next week we will discuss the physical reactions to trauma. Until then, thank you for the conversation…

 

 

Soul Care Conversation (Transition and Re-integration Challenges – Experienced by Children)

December 2nd, 2015 Posted by Blog No Comment yet

(The purpose of Soul Care Conversations is to create a place to generate dialogue, initiate thoughtful consideration for the challenges our veterans face each day, share ideas of veteran and family well-being and healing, and spark within all of us a call to be engaged with the veteran and caregiver community. Click here to visit the forum and join the conversation!)

Last week we focused our conversation on the challenges of reintegration and transition for spouses. This week, we will discuss specifically the challenges experienced by children.

THE EXPERIENCE OF REINTEGRATION

Hours before I boarded a bus and then a plane to take me to Kuwait, my spouse, two sons, and I sat in my office lightheartedly sharing about what to expect during my deployment to Iraq in 2003. We were masking the realities of our fears and anxieties. We had numerous conversations weeks prior to my deployment about expectations and fears. I gleaned from these conversations with my sons that they were proud of me and yet they would worry about my safety.

Children experience a myriad of feelings prior to and during their mother’s or father’s deployment;

  • pride
  • loss
  • loneliness
  • fear about safety of deployed parent
  • concerns around the stay-at-home parent’s adjustment to “doing it alone”
  • anxiety on added responsibilities at home

In light of these feelings, reintegration can be a very difficult time for children. They may eagerly anticipate reconnecting with the re-deployed parent. At the same time, the returning parent, the stay-at-home parent, and the children may have undergone significant changes during deployment.

In fact, the infant who now is a toddler, may not even know their returning parent. It is heartbreaking for a returning warrior who has not held their child for a year or more, see their toddler cling to the leg of the stay-at-home parent, because they do not know this person in uniform who so desperately wants to hold them.

All of these factors heighten the unpredictability of reintegration for everyone.

CHALLENGES OF TRANSITIONING HOME

Our family dynamics changed with each deployment. When I deployed and returned from Grenada, we did not have children. The main focus my spouse and I had was on our own adjustments as a couple. However, when I returned from another deployment, we had a 3 month old infant. As a couple and as individuals, we had to adjust how we would relate to one another as a couple and now as a family. As our children got older and we experienced numerous deployments, all four of us had to discuss roles and challenges of transitioning back into a functioning family. Our sons were an important component of our family and they deserved our attention prior to, during and following a deployment!

Families learn to adjust during a deployment in order to survive and thrive while the warrior is in harm’s way. Children develop protective measures such as;

  • maintaining contact with deployed parent during the deployment via email, telephone, skype, and letter writing
  • communicating with stay-at-home parent
  • adapting to changing roles
  • nurturing established friendships
  • continuing involvement in family and school routines

Following the deployment, children can successfully navigate through the family dynamics during transition and reintegration. From my own family experience I learned that there are a variety of factors that affect the transition for the children and the reintegration of the warrior following a deployment;

  • understanding that the age of the children may affect their adjustment (development stages are quite different between toddler and youth in understanding roles, expectations, and challenges)
  • acknowledging family dynamics changed
  • open family communication prior to deployment and maintain during the deployment
  • emotional and marital stability of the parents
  • parenting practices
  • changes occurring in either or both parents, and the children resulting from the deployment
  • satisfaction of both parents and the children with their lives and experiences during the deployment
  • school or disciplinary issues experienced
  • satisfaction with social activities and valued friendships

Many of the factors affecting children seemed to be linked to the parents. This is important to understand. The parents have a critical role in preparing and assisting their children through the transition and reintegration of the returning warrior back into the family. Especially if a parent has changed as a result of separation and the deployment, the children may experience stress.

Some important questions that children may ask during the transition;

  • who do I turn to for advice
  • what do I do if dad or mom has changed
  • how will I get along with mom or dad once they get back
  • what if mom and dad don’t get along
  • what can I do to help fit dad or mom back into the family
  • will I get more attention now that mom or dad has returned

Most children exhibit remarkable resiliency during the deployment and transition. Families that have good coping skills during the deployment and healthy expectations during the reintegration will make the necessary adjustments back to a functioning family. But, this requires work, love, patience, communication, and flexibility.

This concludes the conversation on the challenges experienced during transition and reintegration. As you consider your personal experiences or you have questions, please add to the conversation. Next week, we will review the impact of trauma on the warrior as we consider this from a whole person perspective.  Additionally, as we review the realities of how trauma affects the veteran, keep in mind that as the veteran exhibits the residual effects of trauma, so does the family and community. Until then, thanks for the conversation…