Issues and Answers on the Home Front

Why do combat veterans struggle so much with resolving conflicts or coming to terms with many situations in civilian life? One reason may be the issue of "rank." In the military, the troops don't make decisions as equals. You get an order and you follow it. You don't discuss your feelings. You don't hear the reasoning behind the order. You simply obey the one who outranks you.

The same is true if you are a leader. When you give an order, you don't expect to explain yourself, or to have to listen to everyone's feelings about your order. You expect obedience. Military members often carry this hierarchy of rank over into their personal lives. We've all heard of military commanders who try to parent their children as though they were in boot camp.

That kind of parenting doesn't work well with our own children, and it is especially detrimental to interpersonal relationships. If you care about your spouse, you must value his or her needs and wants, remembering that their viewpoints and insights are just as important as yours.

A relationship has nothing to do with rank. Relationships are formed by equals, and putting effort into really getting to know one another. One must put time and energy into exploring the differences between you in order to understand your similarities and visa versa.

Another way combat training may interfere with reaching "middle ground" in coming to terms in a civilian situation has to do with human biology. As we strive for peaceful resolution of conflicts it's important to know something about adrenaline-it is the "juice" that drives most of us from day to day. It also gets us into trouble in our relationships. It sometimes overrides our judgment and leads to behaviors and decisions, which may not settle well within a relationship.

Here's how it works.

We came into this world with adrenal glands. Located on the top of each kidney, the adrenals are small glands, which are stimulated by the autonomic nervous system. When we get upset or frightened these glands secrete survival hormones-chemicals which pour into the bloodstream giving us new energy and strength to overcome perceived dangers. This sudden flow makes us stronger and more alert. It also protects us from blood loss, increases our lung capacity, focuses our vision, and directs blood flow away from unnecessary organs to the large muscles of the body. In other words the adrenaline serves to hone in our natural instincts for survival.

These physical changes are commonly referred to as the "fight or flight" response. For example, it enables a frightened wife to lift the car off her injured husband, or a terrified person to run long distances for help. With this system fully functioning, our physical capacity to do extraordinary things borders on the supernatural.

While this system helps keep us alive in the face of extraordinary danger, it does have one major flaw. The human brain cannot differentiate between a real threat and an imagined one! The brain doesn't notice (or care) if it has encountered something real or a memory that has been triggered from something in our immediate surroundings. Determined to keep us safe, it simply sends out the signal to react, which is also reinforced by military training. The adrenaline flows, and sometimes we may even function with an "out of body" response.

Adrenaline flowing from a "false need" can result in a precarious reaction. It can be notably dangerous to our own health as well as those nearest to us. Not only does it add stress to normal body organs-like the heart and circulatory system-but the constant presence of adrenaline can become quite addictive as well. Many trauma survivors seek the next adrenaline "rush" and do not feel complete without the routine experience. This is one of the reasons that thrill seeking behavior after surviving something that has turned on our system is so often the case. Life can be pretty boring without this feeling of vitality, but at the same time this can certainly result in negative consequences if it interferes with ones ability or desire to devote time to a relationship.

In relationships, the adrenaline response almost always works against us. Once the process begins, adrenaline is nearly impossible to control-especially after months of combat, where survival depended on adrenaline for prolonged periods of time. This is an automatic response pattern, so it important to be aware of the messages your body receives in order to head the reaction off at the pass.

In human relationships the adrenaline cycle can send us down two equally destructive pathways. First, you have heard about the combat veteran who suddenly dives for cover when he (or she) hears a car backfire or fireworks explode. The noise signals danger; the brain, unable to differentiate between a real or imagined threat, initiates the adrenaline cycle. An old imprinted message says move into action to survive. Without thinking the familiar response takes over just like it did in combat; most of the time this response is inappropriate for the situation on the home front.

The trigger can be a smell, sound, or any combination of many other sensory perceptions that may be associated with a past injury or threat. When these sudden triggers occur a veteran may suffer tremendous emotional upset. The pain, fear, helplessness, and confusion of horrific wartime experiences might surface immediately. Not to mention the disappointment or embarrassment that may be part of the package.

When this cycle happens in the presence of those close to the veteran, they too become affected by these behaviors. I have had many spouses vent their frustration to me about how little they understand about what is happening with their loved one. They feel so helpless to change situations as they arise. In order to obtain a better understanding of the effects of combat trauma it is vital to educate oneself. If family members do not take the time to learn as much as they can resentments may be formed and they themselves begin to move away from the relationship.

Not only is education important but the forming of social support amongst others who have similar experiences does much for emotional stability. One very bright young wife also knew that it was important that her husband who was returning from Iraq and she had a therapist in place once he returned. She consulted with me and by the time her wounded husband returned to their hometown he was scheduled for an appointment. It was very rewarding to help them both work on gaining insights into his behaviors, which could have clearly caused a great deal of distress in their relationship had this not happened.

Children are certainly affected by the process of deployment. Sometimes both parents are deployed at the same time, and this creates unique and very challenging times for the children, extended family members, friends, and for the troopers who are deployed. Children have many behaviors that can indicate stress symptoms, however this varies according to age. We might see quite a few regressive behaviors such as bed wetting; thumb sucking, feelings of insecurity and being more needy in terms of attention, poor sleep patterns, fearful of being left alone. With older children they may show signs of anxiety or depression in other ways. They may sleep longer, use substances or alcohol, be less cooperative at home, and isolate. These are just some examples but it is clearly not an exhaustive list of possibilities.

It is very important for the parents or other adults to help the children understand their emotions, provide support, and not to burden them with the issues best carried by adults. In order to help them discern the difference between reality and fantasy, use language that does not alarm them and monitor the programs they watch on television-including the computer games they play.

Teachers are a very good first line of defense also. They are in a position to observe and address the subtle changes in their student's behaviors, school performance and peer interactions. It is vital for parents to alert the teacher of the concerns about their children and the circumstances that could affect them.

Family members, as well as those returning from deployment, need to get emotional support from those experts who truly understand the adjustment issues associated with deployments and trauma reactions.

Many of the VA hospitals have Deployment Clinics, that are doing their best to streamline the red tape in order to get the service member registered and in the system. They are entitled to two years of care for medical issues through the VA federal system, and it is critical that they get established as soon as possible to assure care.

There are also options available for those who are fearful of going into the VA system: Military One Source is good because they can refer the service person to a mental health provider in the community and off base. There are also programs that are available in some states, such as Washington State where I am a provider, who can provide free mental health care to active duty, veterans and their families. So there are options in the community that might provide more security for those who are concerned with the stigmas and negative implications of seeking help.

One phenomenon that occurs frequently when an embarrassing episode catches an unsuspecting veteran, or any heavily traumatized person, is "flight." Out of a sense of protection for loved ones, the survivor may withdraw, isolate or dissociate. The resulting distance is a breeding ground for theerosion of healthy relationships.

The second pathway is equally as destructive. The flowing adrenaline produces a type of high that was perfectly acceptable in the war zone. That high commonly known as an adrenaline rush can be described as rage. However becoming accustomed to acting out with rage during combat can become an all too familiar pattern in the civilian world. Sadly, these behaviors or violent responses (in times of danger or perceived danger) in civilian environs have incarcerated many veterans and destroyed lives.

Over the years of working with combat veterans and their families I have found that the more trauma survivors learn about the dynamics of their experience the easier it is for them to make positive changes. So, in relationships we need to go back to square one and work forward from there.

Finally, learning the techniques of reaching middle ground and applying them to situations in life is critical to fending off many negative behaviors and reactions. Searching for, finding, and isolating personal triggers (and perimeter wires that do not allow others to get close) is paramount in achieving peace in our lives.

About Bridget C. Cantrell, Ph.D.

Bridget C. Cantrell is a member of the American Psychological Association and Association of Traumatic Stress Specialists. She specializes in trauma with her primary work encompassing therapeutic counseling for war veterans and their families. With a Ph.D. in Clinical Psychology, Bridget is a licensed Mental Health Counselor in the State of Washington, and a Nationally Board Certified Mental Health Counselor. She currently works as one of a small number of specially selected and trained Washington State Department of Veterans Affairs PTSD Contractors.

Dr. Cantrell is the founder and President/CEO of Hearts Toward Home International, a charitable non-profit organization dedicated to the recovery and reintegration of trauma survivors. She is the co-author of Turning Your Heart Toward Home, a vital re-integration workbook course for returning troops and families. Her books, Down Range: To Iraq and Back and Once a Warrior: Wired for Life both co-authored with Vietnam veteran Chuck Dean, presents information and resources on PTSD and the various transitional issues for returning troops and their loved ones. In 2004 the Governor's Veterans Affairs Advisory Committee and the Washington State Department of Veterans Affairs appointed her the Outstanding Female Non-Veteran for her service to veterans.

Bridget travels extensively around the globe teaching and lecturing military personnel and their families regarding the different aspects of re-integration after experiencing war. Her workshops have been given in both the European and Pacific duty assignments.

Please contact her directly to schedule a time when she can work with your unit or organization. 

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The Healing Aspects of Helping

Over the course of a year my relationship with the 173d Airborne Brigade was formed through an ongoing e-mail exchange with the chaplains on the ground in Iraq. These paratroopers of the 173d made the night combat jump in early 2003 to open up and secure the northern front in Iraq.

In mid 2003, we began communicating with key people of the 173d Airborne, and soon thereafter I contacted Chuck Dean and collaborated with him on writing and designing a new course workbook. The focus of this book, (“Turning Your Heart Toward Home”), is to help those returning from the war reintegrate and rebuild relationships with loved ones at home. As a result of working together on this project an invitation was extended to us to provide information about the ramifications of the impact of war on the returning combat troops from Iraq. My years of experience in counseling and working with veterans and families through the Washington State Department of Veterans Affairs PTSD Program was invaluable in bringing simple understanding about combat stress to these troops who had just returned from combat in northern Iraq.

We arrived in Vicenza, Italy on May 24, 2004 and were escorted to Camp Ederle, the home of the 173d Airborne Brigade, by Army chaplains Major Tom Wheatley and Captain Steve Cantrell (no relation to me). These wonderful men did an excellent job in arranging all our meetings and services. As well as our logistical needs, they helped setup battalion-sized meetings plus individual and small group counseling sessions with the troops.

On the 25th of May, 2004 we had the opportunity to address the issues of Post- Traumatic Stress Disorder (PTSD) with over 2500 men and women from three battalions and one artillery battery of paratroopers. When the program was then turned over to me I presented a power point introduction to describe the basic aspects of PTSD and readjustment issues. The presentation was given in a way to offer psychological tools to enhance coping skills and illuminate some of the challenges they may encounter along the way.

To help these soldiers gain an understanding of what to expect from witnessing, and participating in combat, it was critical to “normalize” their symptoms and reactions. This was accomplished by stressing the idea that what they are feeling, and perhaps acting out, is not out of the ordinary. However, I explained, that this is common in those who experience such stressful and traumatic events as found in combat. Our purpose on this mission was NOT to alarm the troops, who were so fresh out of combat, but to help them understand some of the reactions to stress and the “signs along the trail” that they may be experiencing (and many were). It was important to give them a simple understanding of PTSD and to “normalize” their responses to life after war. If done properly there is a greater possibility that they may be able to recognize and avoid some future problems that could otherwise cause prolonged, unpredictable and adverse effects.

Our days were spent by presenting information to large groups, small focus groups and individuals. We believe that many of these troops came away with more effective tools to help them with present and future readjustment issues. As time goes by we currently continue to pray for and communicate (via e-mail and USPS mail) with some of the troops whom we were so privileged to meet while there. It is our hope that this is just the first of many open doors for us to continue to work in unison with the U.S. military in caring for the troops and their families.

 ***

My take-away value and impression of this particular opportunity has afforded me valuable insight on some of the needs of those coming home from war. It also gave me an opportunity to understand how we as a society can provide better support for them.

One observation I made is in the area of how helping can be important in the healing process. It seems as though the moment a person transcends from receiving help to wanting to give it, an interesting phenomenon of healing begins. As I watched and dialogued with some of the chaplain’s assistants of the 173d Abn, who had been in Iraq, a unique aspect of the adjustment process surfaced—and it had to do with the subject of help, healing, and an open willingness to discuss their wartime experiences. (This willingness to talk of stressful and traumatic experiences is oftentimes indicative of a more advanced stage of restoration). Since they appeared more open to discussion than most of the other troops, it occurred to me that this might be a direct result of their military job of helping others. It had to do with the decision to step beyond their own war issues and spend time comforting those in need (i.e. fellow soldiers and Iraqi people).

Observing first-hand the anger, sadness, and frustration that many of my patients on the home front harbor over war (many of whom are veterans or family members of previous wars), I felt a need to transform the negative to the positive. I was led to find an avenue from which they could use these emotions to change the lives of those serving in our military in a meaningful way. I provided an opportunity by which my patients could begin to reach outward with compassion, rather than harboring these negative feelings inward. 

I began inviting my patients to join a concerted effort to help bring some joy and good will to the soldiers serving our country in the war zone. Together we formed the “bake club”. It was by the good graces of some of the contacts I had in the Chaplaincy Corps that my patients and I were able to send 300 pounds of homemade chocolate chip cookies, brownies, literature on PTSD and other necessities to the combat zone of Northern Iraq. Needless to say, these gifts from home represented the feelings of support throughout America for our troops. Here on the home front the hearts of those who contributed were lifted in spirit by knowing their efforts were not in vain, and that they had made a difference in the lives of soldiers who are so far from home.

Another project I introduced my patients to was that of the needs of the Iraqi children. My women’s groups (consisting of women veterans, spouses or partners of veterans, and the adult children of veterans) gathered donations of toys, school supplies, and clothing to replenish personal items lost in war. We sent hundreds of pounds of goods, which were well received and appreciated.

The dedication and determination of my patients to give to those affected by this war has left a new sense of purpose and gratitude in their hearts and mine. While many admit that their troubles pale in comparison to those whose lives are devastated by this war, there has been a renewal of purpose in finding healing for themselves through the gift of helping others.

I am honored to be in the midst of such wonderful human beings who are so touched by the suffering of others, that they too see the importance of reaching out to those who are in need.

It is my hope that more people will participate in similar acts of compassion, not only to help themselves, but to change the lives of those who are so willing to pay the ultimate price by serving in uniform. As I continue to provide mental health services in Bellingham it is my hope that similar projects will be undertaken on behalf of supporting our troops.

We look forward to presenting our workbook course “Turning Your Heart Toward Home” in many local areas. For information on seminars and group material please feel free to contact my office in the Fairhaven District of Bellingham.

Sincerely,

Bridget C. Cantrell, Ph.D. 

Rolling Up Our Sleeves to Help the Troops

Bridget Cantrell, Ph.D, and veteran author Chuck Dean have combined skills and experiences to structure vital course materials for re-integration. This information addresses and helps resolve many of the destructive issues surrounding re-adjustment when soldiers return from war.

Perhaps we now have the opportunity to make up the ground we lost when our troops came home from previous wars. “Turning Your Heart Toward Home” is a course that utilizes many lessons learned from the past. It provides tools for warriors to reintegrate with theirloved ones upon returning from their military assignments. As a supplement, we have created a free preliminary course called, “Hearts on the Home Front”. This short course helps dependents and loved ones understand Post-Traumatic Stress (PTSD), and gives them general insight on what to expect when their deployed loved one returns from the combat zone.  

During the course, war veterans and family members alike are directed to the core concerns that work against healthy reconnections. Using step-by-step inventories, participants are guided toward rebuilding healthy relationships.  The course encompasses re-adjustment education and focuses on interaction between the participants and their loved ones upon their re-deployment home. It is designed to heighten one’s awareness of how each individual (both the service person and the loved one at home) has changed during the prolonged deployment separation.  Each inventory is specifically designed, and proven, to arouse valuable dialogue for both parties, in order to begin understanding the anatomy of trauma, stress, and other challenges facing healthy re-integration.

Dr. Cantrell specializes in trauma with her primary work encompasses counseling for war veterans and their families to find therapeutic resolutions to the aftereffects of wartime trauma. She currently works as one of a small number of specially selected and trained Washington State Department of Veterans Affairs PTSD Contractors. In 2004, the Governor’s Veterans Affairs Advisory Committee and the Washington State Department of Veterans Affairs appointed her the Outstanding Female Non-Veteran for her service to veterans.

Chuck Dean is a Vietnam combat veteran and author of several books about his own homecoming from war, addressing the unsettling spiritual and emotional issues caused by serving in a combat zone. His popular-selling book, Nam Vet: Making Peace with Your Past continues to help thousands of veterans. He has served as the National Chaplain for the Society of 173d Airborne Brigade—the same Army unit he served with in Vietnam.

Dr. Cantrell and Chuck Dean have joined forces,and this powerful combination adds a special feature to their work.

It is through these experiences, that we have been able to go to “ground level” and analyze many of the homecoming hurdles Vietnam veterans had to cross when they came home. We have integrated these findings into our inventories to assist in a more rapid re-adjustment for the current troops.

Our new book "Down Range: To Iraq and Back" is a timely work, which is dedicated to bringing the troops home and addressing the challenges of re-integration from combatant to civilian. Vital information is presented to the troops and their loved ones exploring why so many veterans suffer from flashbacks, depression, fits of rage, nightmares, anxiety, emotional numbing, and other aspects of Combat-Related Stress orPost-Traumatic Stress Disorder (PTSD).

There is a great deal of work to do with these men and women returning home, and we invite you to join us in helping them and their families with this process. The more we can collaborate and providethese helpful tools, information, and support, the more positive the outcome will be for us all.

We present this course, “Turning Hearts Toward Home” and book, “Down Range: To Iraq and Back” and invite you, your organization, or group to join with us in disseminating these materials across the nation. We, the authors, are available for speaking and/or facilitating this workbook course.

Please contact Hearts Toward Home International by calling (360) 714-1525 for scheduling and ordering information.

Our best to you,

Bridget C. Cantrell, Ph.D. and Chuck Dean