Monthly Archives: April 2012

Superheroes have issues too: The #Avengers and #PTSD symptoms

Ok, these are DC Characters, but this shirt is hilarious

One of the greatest compliments I ever received sounded like this: “Dude, if I didn’t know about your wife and kids I would think you live in your parent’s basement.”  I’ve been a closet geek for decades, (okay actually been out for a while but that’s not the point).   I grew up reading about the superheroes that are now finally exploding onto the big screen.  Without a doubt my two favorites are the Green Lantern and Captain America.

This post is in response to a number of readers telling me the blog was a wee bit too intense.  So, in the spirit of “The Simpsons and Philosophy” and others, I will take a trip down a more lighthearted vein of reflection.

I know Marvel won’t need any more publicity this week. But, having spent lots of time in a basement, huddled around stack of comic books and twenty-sided die, I was not about to let my knowledge of super heroes, the release of this movie, and of course a spin about PTSD slip away.

So without further ado, here is my professional diagnosis (note: my psychology degree is about as real as they are… ) of the Avengers and their survival with symptoms of PTSD.

Hulk:

I’ll start this off with a layup.  One of my continuing struggles is with anger issues. The big green monster known as the Hulk epitomizes many veterans struggle with rage.  Although I cannot leap miles in a single bound it is similar to my struggles in that anger swirls into more anger eventually forgetting where I started.  My wife and I even have secret code for when I have “Hulk Days” where I fight to keep from unleashing anger.

How does the Hulk survive?

Amazingly enough many of the treatments the Hulk relies upon are very effective for combating PTSD. Bruce Banner, the Hulk alter ego, maintains a regimen of exercise, meditation, and when necessary medicine, both holistic and prescribed.  Unfortunately, even with all of his efforts sometimes the Hulk gets out.  But, as my therapist says, its ok to be angry when warranted.  The key is not leaving a path of destruction.

Thor:

A bit more complicated to diagnose, Thor is the Norse god of thunder.  So while he doesn’t have a God complex, after all he is a God, he does struggle with control issues. Despite wielding the power of his hammer and thunder and lightning he still cannot save everyone. It is a hard lesson to learn but even with all of that ability sometimes things are out of our control. When I was in the Army I strived for perfection in execution and preparedness. I hoped that all of that would create the luck needed to keep everyone alive.  Sadly, this world does not work that way. The “would have’s” and “could have’s “ in the end did not even matter because control is an illusion.

How does Thor survive?

Thor relies heavily on the understanding of his limits. He still puts forward a tremendous effort, but he does so with the understanding that some days even that will not be enough. Unfortunately, the reminders come with bitter letdowns and tragedy, yet his solace resides from his inner reflection and commitment to his friends.

Iron Man:

Despite oozing with talent and intelligence, Tony Stark often gets sidetracked and derailed because of his addiction to alcohol.  It enhances his underlying depression and his own insecurities about how he is viewed.  His best work is done when he is focused on the task at hand and sober.  Maybe someday I will be able to say otherwise, but I have completely given up alcohol and drugs in order to combat my symptoms and stay healthy.  The side effect of all of the other medications combined with alcohol was too much to enable me to be productive.  I have instead switched my energy to physical fitness and therapy.  I would challenge those who are dealing with their own PTS to skip the booze for a while and really focus on getting healthy.

How does Iron Man survive?

Iron man has built a tremendous support network around him. When he slips or falters he knows that the people he has invested in, who are aware of his demons, will help him come back stronger.  I have leaned heavily on the scaffolding I was lucky enough to have in place when I left and when I came home.  For me, it was a main contributor to my survival.

Captain America:

What Soldier doesn’t want to embody at least some of the character of Captain America? In terms of fictional heroes, the Star Spangled Crusader is on the top of the list.  His strong moral courage, both before and during the war are exemplary stories of heroism.  But, after Cap fights his last battle and is trapped in ice for 60 years, the world he returns to has passed him by.  It is alien.  He struggles to see through all of the changes and how he can make a difference now that his war is over.  Ultimately, it is his strong character that strengthens his resolve to continue to make a difference.

How does Cap survive?

I know when I returned home the battlefield felt more normal than the streets of the US.  I had a dismal outlook of the US having lived in an inherently dangerous place for a prolonged period of time.  Everyone walking around without a care in the world, or at least my perception of it, made me frustrated.  I imagine Captain America felt similarly as he re-integrated.  Where I constantly looked for a weapon that I long since handed to an armorer, Captain America famously had to adjust to Germans living among us who were not the enemy.  Captain America relies upon his solid set of beliefs and his moral compass to continue to fight for what is right.  He exercises, meets with his friends, and leads from the front to effectively stay balanced and moving forward.

ASSEMBLE!

In the end, the team that is the Avengers feed off of each other to create balanced and networked support.  My team is my family and friends, my therapist, and this blog.  I hope you enjoyed this interlude from the “heavy” stuff.  I am lucky enough to have a friend that invited me to a pre-screening of the Avengers Wednesday night, but I am still going to see the movie on Thursday AM for IMAX 3D too…  Have a great week everyone!

Its all in the approach: you, your therapist and #PTSD

This latest blog post is about a different kind of continuing struggle: finding the right therapist.  I am keyed in with a new guy now and I am confident and comfortable in his office. But, it was not always that way…

Just happy (or not) to be here…

I think a lot of times when a new Veteran enters the VA system, or a therapists office, they are initially just so happy to be getting help.  A weight is lifted when you can finally feel like the person you are going to dump your problems on is a willing participant.  But with one major obstacle overcome, more are waiting to smack you right in the face:  Trusting your therapist, establishing boundaries, learning that your therapist is not a wizard but more a sounding board for you to work it out yourself.

It is not until a little ways down the road that a Veteran has enough experience to question “is this therapist right for me?” or “am I putting in the time and effort required?”  Here is my disclaimer up front: I am not endorsing kicking your Doc to the curb at the first bump in the road, nor am I saying that I was correct in the way I dealt with my former therapists.  But, I am saying that the right fit and learning the approach will save a lot of time and heartache.

Trust Issues Everywhere

Part of therapy for PTSD is relearning how to trust.  I would argue one of the most immediate and significant trust hurdles begins the moment you walk through your therapists door.  Some of my most serious setbacks, avoidance of therapy, and general deflection of the real issues came at the expense of my therapist at the time.

When I relocated to New York I was ushered into the VA system where there is an abundance of new interns cutting their teeth on us juicy veterans.  My first encounter with an intern went poorly to say the least. The lack of therapy I received was my fault.  I was eventually overwhelmed by the stress of trying to go through cognitive processing therapy, trying to work, and being away from my family. But I can point to that first failed attempt and isolate the cause directly to my approach with my therapist.

The “You must be joking” moment…

I remember walking through the door and thinking “is this bring your daughter to work day?” Then, when she introduced herself as my new therapist I immediately thought “there is no way this woman can help me. There is no way she will ever understand what I went through.  I am a combat veteran. I led men her age into hell. SHE IS NOT A VETERAN. What can she help me with?”

I cannot emphasize this enough THAT IS THE WRONG APPROACH.

THE.

WRONG.

APPROACH.

First, going in with an open mind is an imperative. Second, and just as important, the life experience of your therapist is not proportional to the amount of help that you will get. The therapist is there as an instrument. All of the hard work, and the positive gains, come from within.

I wasted the next two sessions grilling her and questioning how she could help me.  I eventually stopped going halfway through the writing exercises in cognitive processing.  I wasted time and energy.

Here we go again…

One of the reasons I gave the VA for stopping therapy was the time commitment in the middle of the day. I said that with everything I am juggling, I could only go in the evenings. Shortly thereafter I was contacted by another therapist within the VA who had evening hours.  I wanted to be committed, or at least give the impression I was committed, so I showed up on that first day.  I still had not learned from my first encounter.

I walked into a slightly older clone of the previous intern.

“Oh good, her aunt works here too…”

I started this new first session with the same barrage of questions I had for the previous therapist. It’s funny looking back, and I say this with a smile, but she took me apart like a shotgun that day.  She cut through all my bullsh!t insecurities, established professional boundaries, and dug out all the issues I had with the last therapist.

My tiny therapist who could double as the president of sorority in a B movie saved my life.

Over the next 2 1/2 years under her guidance I finished cognitive processing therapy and prolonged exposure therapy. She adjusted my approach to getting help for myself.  It took time, and on occasion some steps back, but the results without question are positive.  But, once again, as the title states: it’s all in the approach.