Friday, August 24, 2012

Not just a river

Before I take up how realizing one's vulnerability in combat affects life back in the world, I want to say a bit more about my contention that men are pre-disposed to ignore/deny their vulnerability.  Maybe, if someone asks, I'll describe why I think it's so, but in this post I want to tell a story that will describe an extreme, hopefully convincing case that it is so.

In my division there was one sailor, an E-4, who had already done one tour as an ARMY sniper.  I capitalize that to indicate how extraordinary that was.  Even though in the Navy, he was apparently such a good shot that the Army "borrowed" him, sent him to sniper school, and then to Viet Nam for a one year tour.  In that tour, he would go out into the jungle, by himself, climb a tree and shoot the highest ranking person he could see coming down the Ho Chi Minh Trail.  Now, however, he was one of 10 forward gunners in the division.  On patrol, he would sit in a turret in the bow of the PBR and man the twin 50 caliber machine guns that were the main armament of the boat.

You might imagine he would have been admired, but he was widely disliked:  no doubt a result of his near open contempt for the fearfulness of the other sailors on the boat.  While in ambush they were all anxious, managing their fear, he was not.  He saw no reason for fear and was quite relaxed "in the bush."  Not cavalier:  he did his job, maintaining a watchful alertness, but he was not afraid.  They might start firing at a snapped twig in the night.  He expected more evidence before he would break the ambush.

Although unpopular in the division, he was very useful to me because he would volunteer for the occasional insane missions we would be directed to do by headquarters.  As an example, in order to "lower our profile," we were provided a Boston Whaler and told to send patrols out on it.  It's hard to convey how insane we thought this was.  Standard tactics had two PBR's going out on patrol together.  Each had twin 50 cal. machine guns forward, one 50 cal. in the rear, and an M-60 amidships.  The Boston Whaler was armed with one M-60 and the M-16's of the four man crew.  I had to go on the first missions since I was in charge of the division at that time.  Fortunately for me, this ex-sniper volunteered.  Fortunately for all of us, we were soon able to stop these patrols.

One night, back on the river in ambush tied to the bank, he was in the forward gun turret when a grenade struck him in the forehead and fell into his lap.

Had it not landed in his lap, it would have fallen into the boat and he wouldn't have been able to get out of his seat before it exploded.  But, though dazed by the blow, he managed to pick it up and  throw the grenade off the boat where it exploded.  A brief fire-fight ensued and the boats returned to the base with no one injured.

The next day he came to see me in private.  "It could've killed me!  I might've died!"  "No fucking shit." I said to myself.  It was shockingly clear that he had never realized that before.  It took a grenade off the head, into his lap for him to see, to feel.   But with that realization, he was now afraid and he did not want to go back out on the river.   "What's real courage?" I asked, "Going out when you're not afraid, or when you are?"  In spite of my efforts he all but refused.  This was a problem for me because no one wanted to go on the river and either he had to or I had to court martial him.  Since he was scheduled to go to Hawaii in two weeks for 5 days of R&R, I made a deal with him.  I'd keep him off until he went but when he returned it was back on the river or else.

Though I didn't know if he would, he returned from R&R, resumed his duties and he was much better warrior: more alert, more cautious and, yes, less arrogant.

Although his was an extreme case, I believe most who go to war share his capacity.   We have ways to diminish, manage the fear.  But when the uber-violence of modern warfare meets the powerful capacities of the human mind something's gonna happen.  In my next post I'll talk about the impact.

plato told
him:he couldn’t
believe it(jesus
told him;he
wouldn’t believe
certainly told
him,and general
and even
(believe it
told him:i told
him;we told him
(he didn’t believe it,no
sir)it took
a nipponized bit of
the old sixth
el;in the top of his head:to tell
e.e. cummings

Roy Clymer

For the background and context for these remarks, please read my article on PTSD published in the Psychotherapy Networker which can be found here or see a copy of it found on this blog titled "The Puzzle of PTSD." 

Wednesday, August 15, 2012

Degrees of death

In October of 1969 I reported to a miniscule "base" on a river north of Saigon to assume the position of the Executive Officer of River Division 594.  Although my primary duty was not to lead combat patrols, as part of learning the job, I had to become qualified as a Patrol Officer.  A Patrol Officer is a junior officer or senior enlisted personnel who leads a "patrol" of two river patrol boats (PBRs), usually to set an ambush trying to catch Viet Cong personnel crossing the river in order to transport troops or supplies.

The training consisted of four break-in patrols where I would ride along with a senior Patrol Officer, followed by patrols thereafter on my own.  On my last night break-in patrol I suddenly heard a boom and then everyone started shooting.  (We had been attacked, I later learned with a B-40 RPG.)  I instantly felt the most overwhelming feeling of helpless vulnerability imaginable.  I felt totally exposed, "naked" to injury and death.  I was standing on the engine covers, the highest point you could stand with nothing between me and incoming death.  It was crystal clear to me that I could be killed at any instant.  Indeed, the bullet that would render my hopes and dreams for my life a mere puff of air may have already left the barrel of a rifle. My whole body shaking, I somehow managed to pick up an M-16, flip off the safety and start shooting back. Even though it felt much better to be doing something I still felt the undeniable reality that at any instant I could be rendered a pile of flesh.

When I spoke of vulnerability in my last post, this is the experience I am talking about.  Different than fear, though fear is obviously a part of it.  It is the knowledge that you are not in control of your fate/your life.  I believe this knowledge is particularly difficult for young men to accept.  Indeed, I believe it is so threatening that most men commit a form of suicide in order to protect themselves.

As you might imagine, I was quite scared to assume my position as XO in a combat division.  Any qualms I had were only reinforced as I flew up the river in a helicopter from Saigon to my base.  I will never forget the sight of the river, totally pockmarked with craters, dead trees everywhere, nothing moving.  Yet as scared as I was, the men of my division scared me even more.

It's not that they were a bunch of bloodthirsty gangsters.  They were simply dead.  They had no life to them.  No emotion, no affect at all. No pleasure, no connection.  When they spoke, it was robotic, saying what needed to be said and no more. They seemed to be actual zombies.  Indeed, I was so frightened of them, the fate for me they represented, that I did what I had never done before, wrote a letter to my father (a fomer naval officer) asking for help.  I did not want to become like them.

I have come to believe that their emotional suicide was a defense against the ever presence of death.  By being already dead, they tried to rob death of its power.  Death was not so terrifying if life isn't much anyway.  This self death made it just barely possible to go back out on patrol after having had the experience of helpless vulnerability to the loss of everything.

Yet a strange thing happened after my first firefight.  When we got back to the base the men went through an amazing transformation.  They became alive, friendly, celabatory.  The beer came out and there was a party.  The ribbon on my black beret was cut to symbolize I had "lost my cherry."  Story after story of previous firefights were told, the whole history of the division.  And then the next morning everything was the same, back to zombie.  It was as if the beer had been a dessert rain, producing a brief flowering.  The rain came after each firefight when no one was hurt.  When the VC starting hitting us harder there were no more parties.  Yet, strangely, these men came to seem to me to be the best bunch of men in the world.

When Churchill said "There is nothing so exhilarating as to be fired upon without effect" he is correct but incomplete.  He fails to mention that the cost of the exhilaration is the fearsome vulnerability that precedes it.  In my next post I'll say more about how the experience of vulnerability affects veterans when they return to the world.

Roy Clymer

For the background and context for these remarks, please read my article on PTSD published in the Psychotherapy Networker which can be found here or see a copy of it found on this blog titled "The Puzzle of PTSD."

Tuesday, August 7, 2012

Some important issues combat veterans struggle with

In thirteen years of working with veterans at Walter Reed, you'd think I would have learned something.  Well I did, but unfortunately, at the same time I was developing that disability associated with "maturity" known as CRS: can't remember stuff.  So I'd find myself in sessions knowing I knew what was going on but unable to remember how to best name or understand the issue.  As a result, I invented a mnemonic for myself that enabled me to call up what I thought were the central issues faced by those struggling with the effects of war and combat.  Since it might be useful for others, I'll share it here.


There, I hope that helps. ;>)

If I had to say the one issue I believe is universally common to those diagnosed with PTSD, I think I'd go with betrayal.  It is almost always a central thread of the story of a veteran's experience.  Most frequently the veteran describes his/her experience of being betrayed by a superior who's job it was to "look out for" the veteran (or his/her comrades.)  Sometimes "God" is seen as having betrayed an implicit compact. Examining the betrayal in detail is an important part of the work.  Having said this, I recognize I've said a tenth part of what could be said about this issue.  In this and the others below, I'm just giving the briefest of overviews of the issues.  I could (and will) say much more about them.  For now, I mainly want to bring them to you attention.

You don't come back from war without some questions of responsibility/guilt.  Each person has their own, private knowledge of what they did that they shouldn't have or didn't do when they should have.  There is always more one could/should do.  Even the smallest actions can have horrendous consequences.  When someone dies anyone involved feels responsible to some degree.  And our tendency to want to have an explanation for events leads the finger to point somewhere, often at ourselves.  Yet at the same time, truly accepting responsibility for our actions in the chaos and moral fog of war is a daunting challenge, especially since we so often overlook the compassion to which we are all entitled.

Of the "symptoms" of PTSD, this is the class easiest for most to recognize as really adaptive behaviors.  I remember a veteran who would drive miles out of his way back home to avoid going over a bridge.  If what happened to him on bridges in Iraq also happened to you and me, we'd all be forming a convoy taking the long route.  Yet this is also the issue that is, in many ways, the most dangerous.  The trouble with avoidance is that it's usually successful and therefore keeps you stuck. You'd think the person who could find the courage to do the things they did in combat could easily deal with his/her fears back in the world.  But it's one thing to do what you "have" to, another to do it for yourself.

Whenever I make this list for myself, I always debate which is the most crucial, the one that plays the biggest part in keeping people stuck.  For men, at least, I most frequently land on the avoidance of vulnerability.  Men are, I believe, genetically predisposed to deny their vulnerability (their worldwide double risk of death by auto accident is a bit of evidence in support.)  The first fire fight frequently shatters their believe in their invulnerability and though they've got nothing to replace it, they must still go out on patrol and face their fear again and again.  When their daughter runs into the street, swamped once again with vulnerability and helplessness, they go immediately to the only defense at hand: rage.  This reluctance to tolerate feeling vulnerable makes intimate relationships near impossible.  And makes life in our crowed social world a huge challenge.  The avoidance of feeling vulnerable is, I believe, the main reason so many veterans are attracted to the idea of retreating to "the woods."

Here's another tough cookie.  In the "Official Version" of reality, soldiers are all about duty, loyalty, selfless service.  Yet, as I sometimes reminded them "You were a person before you became a soldier and someday you will be a person again."  And people want things for themselves. In the military culture, however, powerful mores prohibit acknowledging self-interest with a result that much of it goes "underground:" there, but it won't be acknowledged.  
War, however, even though truly hell, still provides many opportunities for pride where one can perform prodigious feats under the worst possible circumstances.  Though officially "just" doing their duty, is it really possible not to feel some pride and some wish to be acknowledged?  Read the account of Achilles finally routing the Trojans and I don't believe you will believe he expects nothing for what he has done.  But he certainly says nothing of it.
I believe it is impossible to come back from combat without some sense of entitlement, which, when unacknowledged, frequently leads to difficulties in relationships, work, and sometimes leads to an endless effort to wrest "benefits" from the military/VA. (The quotes are to indicate not that they aren't entitled to benefits, but that there may also be more to it than that.)

Obviously this is not an "all inclusive" list and I will address some in more detail later.  I would also love to hear any comments, questions, doubts, criticisms, etc.  Give me something to respond to.

Roy Clymer

For the background and context for these remarks, please read my article on PTSD published in the Psychotherapy Networker which can be found here or see a copy of it found on this blog titled "The Puzzle of PTSD."