Well, I had another session with my individual therapist today.  We did a lot of talking about my recent realizations about being black and white about everything.  We still haven't come anywhere close to a work around or work-through.  One realization that I did make was that survivor's guilt plays a huge role in setting the standards I hold myself to (and my inability to forgive myself for not being good enough) and why I can't forgive others for disappointing me (well, violating my trust is more accurate).  There's a lot more to this that I still have to work through, that's for sure.  One of the things she told me is that she's concerned that because I need to have people fall into one category or another (Trusted or Not), I may try to force people to fit into those narrow categories, even when they don't belong there.

We talked about this for the vast majority of the session and she asked me if there was anything else bothering when I unintentionally dropped a bomb on her.  I could tell it concerned her greatly because her demeanor went from relaxed and attentive to focused and intense.  Here's the situation:

Last week, Thursday night into Friday, I lost a day.  What do I mean by that?  I went to sleep a little after midnight and the next thing I remember coherently is waking up and realizing I have to be at work in 45 minutes - work started at 2PM.  I slept for over 12 hours.  I remember nothing in the interim.  The next thing I remember clearly from that night is helping to clean the slicers at the end of the night.  I know interacted appropriately with my coworkers, but I have absolutely no sense of the passage of time for that night.  None.  I have no idea whether I was asleep all that time either.

I drove home that night wondering whether I was going to be walking into a shitstorm at home.  I had no idea.  After talking about this with my therapist today and seeing how concerned she got, it raised some alarms in my head and I ended up not working on the newsletters I wanted to send out today - I could barely concentrate on writing this blog post.  So I decided to take a break and watch a movie or two.  I couldn't concentrate on anything and it was starting to ratchet up my anxiety something fierce.

What I thought was strangest was the timing.  Everything was going well.  My PTSD symptoms were wll-managed.  The only thing I can think of is that it happened the night after I talked to the consultant about incorporation and foundation documents for the non-profit and I had a funding proposal that I put before a local veterans group for consideration.  I was extremely excited.  I was thinking that maybe my body doesn't know how to tell the difference between excitement and fear.  I know my adrenalin was pumping like crazy.

Unfortunately, the end result was the same - I lost a day.

So now, I have to track when this happens to see if there is a pattern.  I did some looking online and the specific information about the symptoms of TBI seem to fall in line with some of the issues I have with short-term memory, loss of sense of time, anger, etc.  Anyone out there know more specifics or resources online that articulate this better?  I don't want to pee up a tree and send doctors looking for ghosts if there's nothing to this.

A good friend of mine asked me to address this question.  He recently made the realization that he may have crossed over from acceptance to giving up on himself and having a good life.  As a result of this, I wanted to very carefully address this (unfortunately) all too common occurrence.

One of the most important steps we, as veterans with PTSD, have to make is accepting that what happened was not something we could have prevented or changed the outcome of.  As Rod Deaton says, we veterans are 'intensely intense'.  Most, if not all of us, feel that accepting what happened means that we stop fighting the guilt that it is our fault.  Here's the hard part:

The instinct to fight is what also keeps us motivated to continue fighting for a better life.

Many of us (myself included) have tried to accept what happened.  What we were really doing was feeling guilty that what happened was out of our control.  We end up surrendering to the guilt.  It can feel a lot like acceptance, but it is not.  It's insidious.  What has really happened is that by surrendering to the guilt, we have given up fighting and we convince ourselves that giving up on having a good life - it's just something else we have to 'accept'.

When I made this realization about myself, I felt even worse about myself, knowing that the last thing that I wanted was to give up on myself.  It was back to square one with the idea of acceptance.  In short, I hadn't actually accepted anything.  I just gave in.  That's what made me feel worse about myself.

So there you have it.  I hope this makes sense.

This question was a serious gut check this past weekend.  After my last blog post where I explained my struggle to stay motivated to get healthy, I talked with my mom about it.  She said that one of the things she has always loved about me is my gentleness.  I only become a fighter when absolutely necessary.  While I don't entirely agree with her assessment, it did turn a different light on:

I can fight for a cause.  I can fight for my loved ones.  I will fight for ideals worth fighting for.  But me?  Am I worth fighting for?


Yeah...as is said, gut check.  I realized immediately that survivor's guilt had a big role to play in this story.  The guilt eroded my self-confidence and self-esteem.  I have a very low opinion of my self-worth.  On top of that, I have stumbled and fallen down a lot as I learn to effectively cope with my PTSD.  I think that I am afraid to even try most of the time because I am afraid of failing again.  My lack of confidence turn this fear into a self-fulfilling prophecy.

So how do I get past this?  How does a person learn how to value himself again?  I should have a better opinion of myself.  The PTSD has tried very hard to destroy my life and my family.  Yet, I have persevered and held it all together.  What I realized is that I thought THEY were worth fighting for despite my inability to fight for me.

What a mess.  I literally hate the image I see when I look in the mirror and I wonder how much of that hatred stems from my guilt for having come home from Iraq when other I knew didn't.  Am I punishing myself?  Is that what's going on here?  I don't know.  I do intend to figure it out.  This may take more hand-holding than I thought, though.  The only way a person can truly improve their self-image is by having their worth validated regularly by those who love and care for him.

I don't want empty compliments and platitudes.  I need the people that love me to demonstrate to me why I am a good person.  Maybe I should talk to my parents, my sister, my wife, and others about having them write letters to me.  The idea would be explaining to me why they love me.  What they love about me.  That way, on a down day, I could pull out the letters and remind myself of how my family views me each and every day.  Hmm...

What a long week.  I keep on trying to find the time to write this post and others, but life intervenes.  What is frustrating is that I always feel better after I get out my thoughts in this blog, yet right now there doesn't seem to be enough time in the day.  *sigh*

Anyways, this past CPT session was pretty stressful.  One of the guys brought the kid of a friend to group.  The kid was in his early to mid 20's (wow - I just called someone in their 20's a kid.  Must be getting older...).  He was shot in the shoulder over in Iraq by a sniper.  He was ghost white from the pain and the pain meds.  His PTSD was deep and very severe.

And it felt like I was looking at a shadow of myself before I got help, when I first got home from overseas.  His life was in shambles and he was pushing everyone in his life that cared about him away but you could tell he was desperate for the loving touch of the ones who loved him.  He was a ball of jitters, anger, depression, catastrophic thinking, paranoia and guilt.  It was hard to look at, hard to watch.  I wanted to reach out to him and let him know that he was going to be OK.  The state he was in, he wouldn't have believed a word I said, even if I said the sky was blue.  He had insomnia, partially from the pain of his injury and partially from his wounded soul.

I didn't have the physical injury, but the rest...well, I don't like to think about the shriveled husk of a man that I was before I got help for my PTSD.

Here's the good part, the part that gives me hope:  Every guy in group, no matter how bad their situation was, reached out to that young man with compassion and knowing love and support.  We all told him he had a place with us if he needed it.  The common bond of traumatic experience brought us all closer in that one moment.  I think is was a benchmark moment for all of us in group.  I don't know why, but something about that moment changed the dynamic in group and changed it for the better.

A lot more happened in group in addition to this.  It was an eventful session.  But that is a tale for another post.  Off to hug my daughter now.

I was at work this weekend and I ran into my therapist from CPT group.  I talked to him about having gotten the increase in disability rating.  It was strange.  In that moment as I was talking to him a lot of things came clear to me.

I felt guilty.  I felt like I didn't deserve the rating I received.  When things got really bad over in Iraq, I had a ritual every morning.  When I first woke up, I asked myself whether 'today was the day that I would die'.  I had to confront that fear (and likely reality) every day and accept it .  I had to accept it or I wouldn't have been able to make it through the day.  That's what makes all of this so hard.  Guys who never accepted that they could die, never accepted their fear are the ones who didn't make it back.  They were the ones who had the fire and desire to live.  I was the one who 'gave up', that deserved their fate.

Because of this, I have experienced many a sleepless night since I got the decision in the mail.  What is strange is that my doc told me that most veterans with PTSD that he has worked with have shared these same sentiments.  How about that.  I guess we'll have a lot to talk about in group this Wednesday.

July 30th, 2003.  The day the course of my life irrevocably changed.  The day that I remember every year with trepidation, sorrow, guilt, anger, and gratitude.  It made me question everything I believed.  It shattered my psyche, shredded my soul.

Quite honestly, I am surprised I survived long enough to make it home.  Every day after became harder and harder to bear.  The horrific scene that haunted my mind, the smell and taste of blood...

Yet here I am, writing about how that experience and others that followed after changed me.  I don't want to remember what I experienced, yet I am afraid to forget.

Change the date and any veteran could have shared this.  The scary truth: Every veteran with PTSD I know has an anniversary.  A day that makes them pause, unwillingly, and remember horrific experiences.  A day they can't reconcile with physically, mentally or spiritually.

I have had many people ask me why I mark this date on the calendar.  They don't understand why, when it is so horrific, that I am forced to remember.  The answer I give them is always the same - Because I still am unable to accept what happened.  That, to me, accepting it would feel like a betrayal of those that died.  After almost a decade, I still feel this way.  I feel this so strongly that you might call it conviction.

My answer leaves many people shaking their heads in incredulity.  They ask me why I punish myself this way.  The answer:  I don't know.  Is it self-imposed punishment for surviving to talk about it when others never had the chance?

I'll make you all a deal.  When I figure it out, I will let you know.

Yesterday I attended my second Cognitive Processing Therapy group session.  I think I am really going to like this group a lot.  Two positive experiences in a row.  The doc started by letting those of us who didn't know each other introduce ourselves.  We then talked about what had transpired since the last meeting.  One of the items that came up was how relating my experiences last meeting had reminded one of the other members so much of himself that he had a lot of issues with his PTSD for the two weeks between sessions.  Needless to say, this made me feel really guilty that I had unintentionally caused another veteran distress.  I didn't say anything about it at this point, though.

There was a new guy there I hadn't met before and he described how he and his unit had received intel that sent him into a situation that put him and his unit in the blast radius of an IED.  This was a new facet I hadn't considered much until yesterday, mostly because it is incredibly painful to think about - intel I provided probably sent guys just like him into similar situations.  I know in my heart that some of our boys died as a direct result of intel sent in by me and others like me.  Again, I felt really guilty.  

It was in this context that we talked about what we all had in common - confrontation with death.  An intimate knowledge of death.  We discussed the concept of moral injury as a result of this.  I know a lot of people don't like this term, but it is really appropriate.  We have all been confronted by things that fundamentally violate our moral code.  My response to this was to adhere strictly to my morality, getting angry with anyone who did not adhere to my morality.  Obviously this caused a lot of problems with other service members over in Iraq.  This moral injury is a constant companion and my morality is still just as black and white.

The doc asked to stop the session there and I asked to say one more thing.  I wanted to express my guilt to the other two for having caused the one veteran difficulties and for having sent guys just like the other veteran into harm's way.  They both jumped on me immediately to let me know I was being an idiot.  The one veteran said he was concerned that I may take his regression over the past two weeks as being my fault.  He assured me that it was his PTSD that caused the problems.  Not me.  The other veteran told me that he wished that he would have been sent into a situation backed up by quality intelligence.  Then, at least, he wouldn't be going in blind.  By the time he was serving in Iraq, intelligence collection efforts were hamstrung so severely that we constantly sent our guys into situations without really knowing what awaited them.  He said I was the kind of guy who saved lives with my intelligence.  He said I can't hold myself responsible for combat arms guys going into a situation and doing their job.  Death in combat is one of the risks that they assume is par for the course.  Good intelligence meant less guys got injured or killed.

That was how we ended the session.  Whew. What a day.  More to follow in the coming weeks.

Every so often, you just need some down time.  I have been busy with the family and with medical issues and everything else for a while now.  Today is just for me.  Dani is taking a day for herself as well.  She is taking Caley down to her parents' and is spending  time down there quilting with her mother.  As for me, well...

I haven't decided what I am doing today.  I just know it won't involve actually doing much of anything.  I am looking forward to sitting out on the porch for a little bit here and there, reading.  Spending some quality time with my Xbox 360 may also be in order.  I am not sure yet.  I just know that today is a day to unwind and reflect on all that has happened over the last few weeks and months.  I went back and read a lot of the posts from when I first started blogging again.  They were pretty desperate and dark.  I feel like I am in a better place now and not only for myself and my family.

There is going to be a lot happening in the ensuing months.  I am getting more heavily involved in local veteran affairs and advocacy.  I am excited about where that could lead, but I don't want to get my hopes up unrealistically.  There are a lot of opportunities to improve the lives of veterans in my area (as I am sure there are everywhere) and I have some plans in the works to take advantage of those opportunities.  I will probably spend a portion of the day mulling over my ideas and setting them down on paper, writing up a business model to envelope the ideas bouncing around in my head.

Regardless, I stay aware of where I have come from and what I need to continue to do to manage my PTSD.  Some days are better than others and today's a good one.  It's what I do on the days where things aren't so hot that will narrate my story in the coming years.  I am tired of feeling angry and depressed and am working hard to fight the survivor's guilt.  As the uncertainty of the future weighs more heavily on my shoulders, I look at my daughter to keep my focus.  In the meantime, I will revel in doing whatever I please for a day.

Just when you think all of the doctor visits are coming to an end...I went for an allergist mandated consultation with an ENT.  The doctor deemed it medically necessary to fix my deviated septum and improve airflow in my nose.  As a result, I will be going in for outpatient surgery in two weeks, with two weeks of recovery after.  I am really hoping that this is the final piece of the equation.

It is hard not to think that my body is betraying me, a day at a time.  I feel like everything is breaking down.  I know that's the catastrophic thinking at work, but it doesn't make everything that I have gone through any less scary.  I find that I am a whole lot more anxious on a daily basis about my health than I have ever been.  I think about how debilitating the PTSD and anxiety have been for me over the past few weeks and I feel guilty.  I made it home.  What right do I have to complain?  I think about the guys I knew who didn't make it back and I feel like the world's biggest failure.

Alright.  Enough of the pity party.  This is not who I am.  I am better than this and tougher than this.  Focus on what it going right.  Focus on the local advocacy efforts that are coming together very rapidly.  Focus on your family and your amazing daughter who is days away from telling you all about her days in English.  Focus on the beautiful weather.  Anything.

One of my readers, Josie F., wrote some questions in the comments to A Loving Call For Help From A Reader.  The questions were pointed and earnest and I felt I needed to address her questions as soon as I could.  Here's what she wrote:

I've reread this a few times Max; you tell a lot here about the psyche of a returning soldier - perhaps you say it all. What about getting through this? Are you through it; have you addressed your guilt and if so, do you feel in a better place.. are you easier on yourself or for others to live with? Or, does the power of the guilt drag you back no matter how good your life, your support system? When you are in your cave, do you lose track of time? What turns this around for you, ie, does something happen to start to bring you out? Do you forgive those who may have unknowingly triggered you into the darker thoughts, or hold them hostage... make them pay some penance too, thereby alleviating some of yours? I hope these questions aren't too harsh to ask but would shed a lot of light onto the behavior of other vets, such as mine. Thank you. 

Getting through it?  No.  Learning to live with?  Yes.  I have confronted the guilt I feel for having survived and know that I will still feel guilty for the rest of my life.  It's whether you let that guilt motivate you that is the question.  I remind myself that I would be dishonoring their memories if I refused to live my life to the fullest.  It doesn't mean I don't have my bad days and weeks.  Anniversaries are particularly hard.  It rends the heart because you are forced to remember.  I tried ignoring anniversaries in the past - that backfired...BIG TIME.

Hiding in the Cave:  When I am in 'cave mode' I definitely lose sense of time.  This past time was particularly bad.  It wasn't only the passing of time that was skewed, but events from the past year's place in the timeline were screwy in my head.  As for what brought me out of it?  My love for my family and fear of losing everything in my life that has redeeming value.

Forgiveness:  I never got mad at others for triggering memories or my sense of survivor's guilt.  I have always been my own worst enemy and never blamed others for putting me in my current situation.  That may be due to my introspective nature.  I am not sure.  I know some vets, when they are feeling this way are feeling emotions so toxic that they lash out and 'blame' others, but it's less blaming than trying to push a person away.  It's as I said in the comments of the earlier post.  Sometimes the toxic nature of the emotions a vet is feeling are so diametrically opposed to the love you are showing them that they feel compelled to drive you away - they can't handle the intensity.  If you feel like you are being held hostage for unwittingly triggering this behavior, that's not healthy.  I would never make someone else 'pay penance' for me.  That penance is mine to serve.I hope this answers the questions you asked Josie.  I can only tell you the answers from my personal experience - every vet is different, yet the same.  Ultimately, you are the only one who can ascertain whether your relationship with your vet is something he wants to salvage/maintain.Thank you for your questions and never be afraid to ask the difficult questions.  Sometimes people ask questions I have to answer for myself too!

Yours in Health,
Max Harris