In this piece titled, Combat PTSD, the artist, Silverider, dramatically captures the loneliness that often accompanies a soldier returning home from war. Of the 2.3 million combat veterans in the United States returning from service in Iraq and Afghanistan, twenty per-cent are said to suffer with PTSD, according to a study conducted by the Rand Corporation.*
This is a staggering statistic, considering Rand published these findings in 2008. Running the numbers, this equates to almost 500,000 human beings in the United States alone living the inner torture we see in the artwork of this piece.
The numbers themselves create heartbreak enough. This image, depicts the suffering and loneliness of this illness in brilliant detail. A veteran, still wearing his combat clothes. His boots, worn and caked still with the grime of the desert, dirt brought home from a world he likely will never want to see again. His dog-tag, still hanging around his young neck, his identity on a chain. The images of further art behind him, makes one wonder: is this artwork part of a process this young, broken vet uses to help heal his invisible wound?
Post-traumatic Stress Disorder is an emotional illness that can develop when we are exposed to horrifying situations of violence. Classified in the Diagnostic and Statistical Manual (DSM V) as an anxiety disorder, the condition disrupts our internal fight-or-flight, survival processes in the body and mind. One stricken with the condition lives a life wrought with barriers to living a quality life. While not all who experience a traumatic event in life will develop PTSD, soldiers are highly susceptible given the nature of the chronic stress imposed upon them during combat. (***Wikipedia contributors. "Post-traumatic stress disorder.”)
Art therapy in mental health practice is a treatment modality in which a veteran, facilitated with the help of the art therapist, uses art media to explore the conflicts PTSD creates in it's manifestation. The creative process, and the resulting artwork created, is used to explore a veteran's feelings. Through this process, the intent of this and other therapeutic treatments is to help reconcile emotional conflicts, fostering self-awareness as to the nature of the torment living inside the troubled soul of a soldier confused by the experience of carnage he's endured.
Such therapy can help to manage behavior and addictions. It can develop social skills and improve a soldier's orientation to reality. The creative process of art therapy, can reduce anxiety and increase a veteran's self-esteem. (**Enari: PTSD & Art Therapy: 2009).
Researching the story behind this image, it's surprising to learn that the artist at the time of this creation was just entering military service as a U.S. Marine. This artist hasn't yet experienced combat. Yet, his depiction is hauntingly accurate as a representation of the illness characterized in the piece.
When PTSD strikes, as shown in this image, the after-effects of traumatic experience reach far beyond the one suffering directly with symptoms. Behind this broken young man we see more of the truth of PTSD. A Welcome Home sign, and likely the soldiers wife standing off in another room, staring into the cave our veteran needs now to feel safe.
It is a separate room of isolation, where he must now retreat to sort out all that he has seen and done. The families of veterans are often vicariously traumatized along with our returning soldiers. Many families are torn completely apart due to the influence of this often obnoxious, inner-demon.
PTSD can ruin lives. A sad additional struggle for most who develop this disease is the struggle of addiction that comes along for the ride. To numb feelings, so out-of-control and frightening, many turn to substance and alcohol to find relief.
Hair-trigger survival instincts, groomed to perfection during training for combat, leaves a returning soldier with PTSD lost as he attempts a return to civilian life. Tragic consequences come home with our soldiers who often find themselves dealing with levels of rage so hard to keep under control, they often unintentionally cause harm to others, both emotionally and sometimes physically.
When it comes to understanding PTSD as public citizens, we aren’t very well informed. Many of us will judge those with the disorder, not fully understanding problem behaviors from one stricken with PTSD. We aren’t aware that a veteran isolating himself like this, is actually demonstrating to us a normal response, given the circumstances.
With the experience of combat, PTSD alters a returning soldier’s perception of danger. Given the repeated nature of the trauma he's faced, the images of battle haunt a veteran with PTSD. Many veterans find their way to a prison cell after they return home. Most tragically, suicide is far too often the final outcome for many of our service personnel when treatments are either avoided or unavailable in home communities.
What do we do, with the truth that is conjured up in our own minds from this image? One thing we can choose, is to attempt to understand the brokenness that often befalls those who stand up to defend us and our freedoms. We can argue all we want over the morality of nations still choosing to rise up against one another. The facts remain, as this image so brilliantly depicts, war continues and war is hell, both during conflict and obviously after the battles are done. It is true that a picture can grant thousands of words we might not otherwise be able to find to depict the tragedy of war. This artwork, does just that.
Hidden wounds. This is the truth of war. Some in battle lose limb. Some return disfigured in other more gruesome ways, with visible burns and scars upon faces once innocent of such things. Some veterans of war are wheelchair-bound for the remainder of their life. Physical wounds, as heart-breaking as they are, are not the same animal as damaged minds can be. Without a functional mind, nothing in life can really work out all that well again in terms of quality.
We need a functional intellect to process the hidden wounds that come with PTSD. Another sad result of a human survival mechanism being broken like this, is that the brain while working in survival mode shuts down blood-flow to the cerebral cortex, the reasoning area of our brain, making decision-making next to impossible.
As a defense as well, symptoms of avoidance of any reminder of the trauma suffered keeps many veterans from seeking appropriate treatments, such as art therapy could provide. Art therapy is a way to open things up and helps to create new neural pathways in the brain. The creative process of working with paints, chalk, drawing pencils or scribing as an author can offer a means of expression of the pain, often so difficult to express.
We need to know in our society that this is the truth coming home from our most recent human conflict. The more the general population can grow in understanding this illness, the greater the likelihood full recovery will be for our soldiers. We need to understand this for our veteran's sake, this is true. However we need also to understand the nature of this illness for the sake of ourselves.
Trauma, knows no boundaries. War and soldiers are just one combination in our human life experience that leads one to suffer PTSD. Three out of four of us on the planet will experience at least one traumatic event in our lives. Victims of physical, emotional, or sexual abuse in childhood, often manifest PTSD later on, sometimes years following the experience. Emergency Services personnel, develop PTSD at rates of thirty-percent above those cases diagnosed in the general population.
PTSD is not only a soldiers disease. We all are at risk, should trauma invade our lives, of living the inner-torture depicted in this piece of art - the tragic nature of Post-traumatic Stress Disorder coming home to us from war.
*Tanielian, Terri L.: Invisible wounds of war : psychological and cognitive injuries, their consequences,and services to assist recovery: 2008: Rand Corporation Health Research Division (http://www.rand.org/content/dam/rand/pubs/monographs/2008/RAND_MG720.pdf)
**Enari: PTSD & Art Therapy: The Importance of the Self-Body Image in Survivors of Sexual Assault with PTSD Using Art Therapy Techniques: 2009: Pandora's Project Online (http://www.pandys.org/articles/PTSDarttherapy.html)
***Wikipedia contributors. "Post-traumatic stress disorder." Wikipedia, The Free Encyclopedia, 18 May. 2014. (http://en.wikipedia.org/wiki/Posttraumatic_stress_disorder)
****Veterans statistics: PTSD, Depression, TBI, Suicide: VeteransPTSD.Com (http://www.veteransandptsd.com/PTSD-statistics.html)
Image: Combat PTSD: Silverider: 2012: Deviant Art.Com
One of the most helpful stepping-stones in recovery is breath- work. Learning to breathe effectively forms a foundation for all future work we may choose to engage in. Breathing through our anxiety, for instance, can help reduce our symptoms, quickly and dramatically.
Breath-work also forms a foundation for developing meditation practices should we choose to pursue adding meditation to our recovery toolbox. Mindfulness (learning to live in the present moment) is a practice that is revolutionizing recovery in mental health.
Breath-work is a first step in learning mindfulness concepts.
A second key concept is Grounding.
In my own recovery practice, Grounding translates to simply using techniques that help me to restore my direct connection with reality. I still find myself in states of self-protective dissociation, from time to time. Dissociation protects us emotionally. The state allows for detachment from our surroundings when the senses start taking in too much of the action.
Numbing out for a time acts to silence things inside, for those days when our mind is dealing already with far too much in terms of trauma memories.
Dissociation only really becomes a problem for us when the activation of the process creates enough of a loop in memory that activation of dissociation quickens and makes more reactive the dissociative response.
The response is quite normal for us otherwise.
When a feedback loop occurs in the filing system in our brain: This creates a problematic issue as the process causing the action of checking out of reality for a time, and with this looping in play, dissociation comes at us more often than is helpful.
For some of us with PTSD, this dissociation then shows up for us when we'd rather it didn't.
What does dissociation feel like?
Do you recall, for instance, losing touch with reality for a time while driving? Feeling as though you've missed, mile upon mile of highway? Then, seemingly suddenly, you sort-or 'wake-up' to realize where you actually are on the road your travelling?
This is what the dissociative response feels like in action to me.
The symptom can become quite problematic for us in the long-term, should we end up with this state looping in the brain leading us deeply into a more debilitating situation of absolute withdrawal from life.
Grounding techniques can help significantly in regaining our connection with reality. Or, grounding can assist us through a process we can us as a means for coming back into the real world following a dissociative episode:
One that perhaps kicked in to calm the input of the environment for us to physiologically protect us from adding insult to the injury of an already far too busy, hyper-vigilant mind.
Trauma, with anxiety active, gets us thinking incessantly sometimes. Focusing too much about the past or transporting our imagination too far into the unknown future. This can leave us in a state of inner-flux and can leave us highly symptomatic.
Remaining grounded and functional in these situations can be quite difficult for us to do. Keeping our focus about living only into the reality of the present moment takes practice following traumatic experiences.
When living with PTSD, it's best for us in terms of recovery to schedule a consistent practice regime for breath-work, mindfulness, and grounding techniques. For us all, every ounce of prevention we can muster can be definitely worth it's weight in gold.
Managing our symptoms: This for many of us will be a need long-term. It's therefore better for us, in all situations that can be troublesome for us along the way, to be ahead of game and educationally prepared.
Practice, does make perfect. It keeps us on our toes and in touch with the sweet-spot of near perfection over time. Daily practice prepares us for those unexpected triggering events that are inevitable in our lives.
During our breath-work, for example, when we allow just TEN MINUTES periodically throughout the day of selfish 'me' time to work with our breathing, I personally found myself by doing so making incredible strides in my own recovery.
With breath-work alone added at intervals (like a pill we might swallow) every day, we can use those ten minutes of silence by focusing on only our breath, which will prepare us, should we so choose to explore the concepts, towards learning the deeper practices, like mindfulness, which will over time bubble up inside of us to accept the validity of this singular truth:
The Present Moments in Life are truly the only real moments we have to experience in our unique, personal surroundings, and it is within our uniquely personal inner-space that we can appreciate some near-silent, quiet moments, simply observing our thoughts, rather than allowing these thoughts to steal away our sense of peace.
Looking back at the past or fretting about what lies ahead in an unknowable future?
This activity is really, in the present moment, only about us recalling memories and imaginings we're reflecting upon. There is no reality left in either one of these states of mind.
Daily breath-work and daily grounding practice will improve our connection to reality in a preventative way, reducing the brain and body's need for dissociative self-protection, over time.
Traumatic memories can be so intrusive, this is true. They seem to constantly override our experience of the present. It is important to learn to reflect upon the trauma experiences by choice. As we might do in the safety of a counseling relationship.
To learn breath-work practices and grounding techniques we sometimes do best with a human teacher. This is the gift of therapy, actually. Finally accepting the courage we need to allow ourselves a little vulnerability can lead us into the world with a human being who just might know a thing or two about exactly where we've been.
Let's face it. We aren't supermen. To learn these techniques takes training. Help is waiting. We only need the courage to risk being vulnerable enough to ask for it sometimes.
Thus my own consistent insistence that any who might visit here consider entering into a relationship with trauma-and-violence informed, clinical care:
I hope you can use the two videos included in this blog as an introduction to developing your recovery practices. The video is courtesy of Dr. Anna Baranowsky with the Traumatology Institute.
One of the best products they offer, the Breath Trainer App, is a very inexpensive smart-phone application and is an ideal tool to get started practicing and training our bodies to respond to anxiety.
I've included here a video as well that grants 10 minutes of doing nothing else at all, which helps to train the mind in focusing solely for awhile on the breath when anxiety might take hold, or we find ourselves dissociating from reality for whatever reasons.
Learning to reduce our symptoms consciously, using our own breath and the act of our own breathing to get us there: This is what starting out in recovery was first actually all about for me.
It's a very wise decision to make, agreeing to learn these tools. In terms of adding to our lives a little prevention, follow the links below as well to find a 12-Step grounding tutorial.
Many thanks to Dr. Anna Baranowsky and The Traumatology Institute for explaining in the video for us both of these very powerful techniques.
Be Well. . . . .
Darren Michael Gregory: The Trauma Recovery Blog
Further Reading and Links
Breath Work: TI Breath Trainer App
Relax & Breathe: Do Nothing for 10 Minutes: YouTube
Disclaimer: These materials and resources are presented for educational purposes only. They are not a substitute for informed medical advice or training. Do not use this information to diagnose or treat a health problem without consulting a qualified health or mental health care provider. If you have concerns, contact your health care provider, mental health professional, or your community health centre.
Darren Gregory © 2014: All Rights Reserved
Certified: Community & Workplace Trauma Educator Traumatology Institute.
Associate Member American Academy Of Experts In Traumatic Stress.