Battling for Balance

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When I left the Marine Corps, I had a hard time carving a new identity for myself. I was terribly invested in what others thought of me. My public story was of crisp uniforms, physical fitness metrics, and successes. I always looked good on paper. My private story involved destructive choices, broken doors and holes in the walls, hiding weapons in the house, and getting dragged across the living room floor by my hair.[/caption]

I had no words to explain the disaster that had become my personal life and felt crippling shame about being one of “those people” with disordered drinking behavior going through a violent divorce.

I would have fit right in on the Jerry Springer show.

Right now we are losing more veterans to suicide than to combat. I’m a pretty decisive person with limited ability to ask for help and zero trouble taking risks; there was a time I could have become one of those statistics.

I stumbled quite by accident into three things that helped me regain my footing and become more resilient. I’m grateful for that stumble and always will be. Later, I learned that the research supports mental fitness training in the pre-incident space. Unfortunately, I didn’t learn until I was decidedly in the “post” camp.

First, I started treating myself in a healthy way again. I ate a little cleaner and made time for physical movement.

Not my typical physical movement, the kind where I used throwing up or a stress fracture as evidence that I was working hard enough – REAL, wellness-building movement that strengthened my body rather than punished it. I found myself on a yoga mat and never wanted to leave. In truth, I came to yoga as an athlete looking for something challenging, a fitness fad to master, and something to help me bend my unyielding muscles a bit more easily. What I found on the mat changed my life entirely. I found a practice that was about more than my body.

Be still and know that I am God –Psalm 46:10

For me, a huge part of self-care involved slowing down enough to listen. I spent a little less time talking and a lot more observing. That made space for faith and for a focus on other people. All of a sudden, my energy was redirected. I could be generous with myself and with the people I cared about. I found a new tribe of healthy people who shared those service ethic values.

And that was my beginning.

We can weather storms much better than I did – we don’t have to wind up tearful and alone with only a six-pack of beer to help us mourn. Resilience can be taught. Self-care modalities, social support cultivation, and spiritual practices are the components upon which we must rely to build our foundation in advance of the storm.

So if you’re left asking what it means to practice wellness?

Spoiler alert – it ain’t about your biceps’ size.

Military-Civilian Drift: Leaders Work to Bridge the Gap at S2C Summit

I spent last week at the University of Alabama’s second Service Member to Civilian Summit. S2C was full of amazing speakers from realms academic, government, and grassroots. It was a truly humble space where thought leaders strove to collaborate rather than “talk at” one another. A key theme kept emerging, and it is one that data support as relevant to veterans’ reintegration strongly, as do my own experiences. Social support. Tribe. Community. Military-civilian drift. We used a lot of words for the same problem and shared success exemplars to bridge gaps. We have military personnel falling into risk and illness because of issues related to alienation and we can change that together.

I came away thinking about that rallying cry – both for veterans to be resilient leaders who contribute and connect in their home communities and for civilian members of those communities to care, notice, and commit to change.

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Warrior Culture

My community is a military one, and we in the military social work and health communities know that we’ve lost too many this year. Not all veterans lose their social support systems upon returning home, though many of us do. It can be tough to stay close to people when we aren’t sure that we speak the same language any longer. Some veterans are blessed with the ability to keep communication lines open, even in hard times and with loved ones able to weather the storm alongside. These are the cases that highlight even more powerfully the importance of connection, and I will always be grateful that this was my brother’s experience.

I was already deployed to Iraq when my brother e-mailed me to share that he was probably going to propose to his girlfriend before he headed over. She was a civilian schoolteacher from Philadelphia that I had yet to meet, and I just rolled my eyes when he shared his romantic plans with me. I was surrounded by guys losing their girlfriends to the grind of deployment, and I expected that his schoolteacher would be mailing him the same “Dear John” letter after a few months. I told him I didn’t have a problem with the proposal but admonished him to buy her a ring made out of cubic zirconia. No sense in buying a diamond he might never get back.

As younger brothers often do, he ignored my advice and bought her a beautiful ring.

Well, that is some cash he will never see again! Should have listened to me!

He didn’t listen, but he did come home around the same time I did, sent back by a pressure-detonated IED that tore apart metal and bodies and all of our hearts.

When my brother arrived at Bethesda, we didn’t know what he might be facing. There was so much damage. On his third surgery, the physicians in the operating room took a vote about whether or not to amputate his leg at the hip; he had infection setting in and they were worried it could get worse. Two voted to amputate, and three voted to give him a couple of days.

Ward 5 was a dark place. We were surrounded by morphine drips, pain, injury, and struggling families who weren’t sure what to make of it all.

Into this world walked my brother’s civilian schoolteacher.

She won’t be able to handle this.

We Can All Be Warriors

When a wounded service member is medically evacuated, he or she often has a long period in a hospital ward and in lots of different outpatient treatment facilities ahead. There are no guarantees and it is painful for both the patient and those standing alongside. I watched the prospect of a long, uncertain recovery level some people. In others, I watched uncertainty and trauma bring out their diamond-hard character.

Throughout this period I watched his young fiancé with a cynical eye. I stereotyped her on sight—she was a pretty girl who often wore makeup and always had on matching accessories. I assumed she lacked gravitas and would fall apart any minute.

She never did.

When her leave ran out at work she went back to teaching all day long in nearby Virginia, but made the drive every night to sleep in a chair at my brother’s bedside. I would find her sitting by his side laughing about some silly thing or another, always keeping him smiling. She never complained and never gave up, never confessed fears about marrying a man with so many new health issues.

While I fumbled gracelessly in his hospital room, once even dropping a portable DVD player on his gaping wounds, she was all kindness and poise. She kept him looking toward their future on a daily basis. Even when he left the hospital and had to spend long days in a reclining chair. Even when he needed help with any and all of the most basic tasks.

The makeup had fooled me; she was more than serious. Only in her twenties, she helped him make it to the bathroom, shower, move, and get through hard physical therapy appointments without complaint. There were guys on the ward whose wives filed for divorce when they saw what they were going to have to struggle through together. I don’t think the thought ever crossed her mind. She helped him through medical retirement, a search for a new career and a civilian identity, and they became parents with that joyous excitement reserved for newbies who don’t yet know how much sleep they will soon go without.

She married a Marine with three sisters, all of whom would gladly hide a body for her today—no questions asked. She has a good memory though. Every now and again, I hear about that cubic zirconia comment.

Invisible Wounds

For me personally, this was the start of a very confusing time. I spent some nights in the hospital lounge, some with my parents at the Fisher House, and many others with friends in the local area. I began to struggle with leaving the hospital and interacting in the real world – it was a world I no longer recognized. Everyone was so casual and happy, oblivious to the pain and sorrow facing everyone I’d just left. I lost the ability to speak to civilians and my resentment seethed under the surface. I was simply angry with no way to articulate why.

And then, I got self-destructive.

Not all wounds are visible, and you can join us in working to navigate this space at the next S2C Summit. Look for dates next year! Until then, how can you connect? Where can you help?

Mental Fitness Training: A New Military and Veteran Mental Health Paradigm

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The idea that PTSD is an unalterable, lifetime sentence is neurologically untrue. This is good news!!! So why haven’t our conversations about military mental health moved from narratives of broken veterans and disability diagnoses? Let’s have a new conversation with military personnel about mental health –

Stress Injuries vs. PTSD

Stress injuries are very natural responses to unusual situations and exist along a spectrum. Whether you’ve experienced a single traumatic event or multiple stressors over a long period of time, your body likely responded in a totally appropriate way by adapting to the threat. Your nervous system kicked into high gear – your body and brain woke up and went into overdrive.

savasanaYour response was vital to navigating a stressful or dangerous situation well. However, now that imminent danger is past, your stress response may still activate out of context. When this happens, empathy may disappear, your focus may degrade, and you may struggle to make logical decisions.

It’s true that severe stress injury (also known as PTSD) is a complicated disorder. However, healthcare practitioners often apply the “chronic” label to mild or moderate stress injuries – which are 100% recoverable. This label can be psychologically deadly – sapping resilient people of the agency they need to learn and apply tools to quickly de-escalate the body and brain’s response to perceived threats.

The truth is that PTSD is not everyone’s stress injury. A misdiagnosis suggests irrecoverable brokenness, and can layer on a host of additional anxieties and worries.  It also keeps us talking about problems rather than focusing on solutions and prevention through mental fitness.

Road to Recovery

One of the most empowering first steps you can take toward recovery is to seek out information about stress physiology – work to understand what is happening in your body.

Self education is an incredibly empowering step. You’ll discover that your out-of-context responses are natural, and you’ll simultaneously find ways to calm your body and mind through a variety of self care practices.

When you put these tools into practice on a daily basis, your body and brain will respond in some really interesting ways. Your neurons will fire differently, you’ll shrink the amygdala (the part of your brain that activates the fight or flight response) – your brain will literally start to look different. Stress hormones will drop, too.

Not only will your body and mind change, but so will your behavior. You’ll find that you’re better able to handle a fight with your partner. You’ll be able to focus better and exist with more empathy. Of course, you’re still human. Your stress response will still fire. But by practicing effective self care, you can begin to respond to others in a more deliberate way.

But what if a vet’s stress injury is severe?

Some people experience permanent changes to their brains. If your injury co-occurs with a Traumatic Brain Injury, depression, or an anxiety disorder, that is totally normal, but incredibly challenging. When you have a major stress injury and you’re dealing with a chronic condition, the symptoms can be extremely debilitating.

The symptoms of severe stress injuries can be improved upon, but – much like a bad back injury – you may need to accept that your condition will need to be managed for many years to come.

* For severe stress injury, you will need highly individualized clinical help. Seek medical guidance and talk to your clinician about your specific stress injury and wellness techniques.

Training for Mental Fitness

What is really exciting for today’s law enforcement, military, and emergency management communities is that mental fitness and resilience can be taught, trained for, and tested.

The three pillars of a resilient life are social support, self-care, and spirituality. The individual value of these pillars is backed irrefutably by science, and – when practiced together – their benefits increase exponentially.

Ready to get started? Here are some simple tactics you can start using today to build a better life.

  1. Social Support: Surround Yourself with Good People

The first and most important step in building resilience is making the hard choice to surround yourself with great people. If you don’t have them around you, you can’t get started. You won’t start or keep growing.

Take a moment to honestly evaluate the influence of the people in your life. Is their influence negative and destructive or positive? If you don’t have great people around you right now, that’s ok. It means you have plenty of room to grow.

  1. Self-Care: Calm Your Body and Mind

Start here by choosing just one or two healthy practices you can incorporate as daily habits, then track how they benefit your life. Don’t worry about trying to change everything at once.

By practicing effective self-care to calm your body and mind, you can become less reactive to external stressors. When you’re less reactive, you’re more capable of engaging in positive social interactions. There’s a ripple effect here that’s really exciting.

Self-care can be as simple as cooking at home or going back to the gym. What you’re looking for is something that makes you feel relaxed. You might be working hard, but you’re going to feel your sympathetic nervous system (body and mind) calm down. Some people call it a click. An exhale.  A down-shifting. When you feel it, you’ll know you found your thing.

  1. Spirituality: Find Your Meaning

Finally, there’s a clear correlation between physical, mental, and emotional resilience and a sense of meaning in our lives. We all need a connection to someone higher – with God, or a sense of personal purpose. Whether you approach this aspect of resilience from a secular perspective (think Maslow’s hierarchy with transcendence at the top) or with a theological view, give yourself some time to ask questions about the source of purpose and meaning in your life.

To plug into a community that supports you as you explore this aspect of resilience, consider getting involved with a faith group, volunteering, or taking time to study some concepts of purposeful living you’re curious about.

Remember – the practices that make us a better warrior also make us better parents, partners, friends, and professionals. Make the time for mental fitness, whether you are recovering, preparing, or both!

How Do We Alter the Dialogue About Resilence

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Despite the vast news coverage of the wars in Iraq and Afghanistan since 2001, one figure has remained mysterious: the number of suicides among US servicemen and women, compared to combat casualties. Here’s one statistic to contemplate: In 2012, the US military lost 295 soldiers, sailors, airmen, and Marines in combat in Afghanistan. But over this same time period, 349 took their own lives.

Right now, we are losing more veterans to suicide than to combat. I’m a pretty decisive person with limited ability to ask for help and zero trouble-taking risks; there was a time I could have become one of those statistics.

Those figures are mysterious because even as we throw money and resources at clinical mental health treatment and blame rising rates on multiple deployments, the answers are elusive. The narrative of the “broken veteran” struggling with combat stress just doesn’t ring quite true to those of us who served over the last decade, and the issue is more complicated than simple statistics can show.

I became a Marine to serve, and I loved being part of the Corps. As with anything I have ever loved intensely, the military changed and shaped me. To the casual observer looking in, the world seems brutal and intense. That casual observer isn’t entirely wrong—the military is some of those things. Shared hardship and challenge are vital parts of the refining and rebuilding process that changes a civilian into a warrior. If you ask anyone who served, they wouldn’t have it any other way. No one wants what comes easily or is handed to just anyone.

That process of obstacles, mastery experience, and shared suffering offers growth and transformation, but coming back to civilian life afterward can be incredibly hard. Standards are different. Camaraderie is different. Culture is absolutely different. I witnessed firsthand the toll that leaving the service took on many of us.

Stressful work environments, high rates of divorce and domestic violence, family separation, and repeated combat deployments all contributed, but the biggest reason for the reintegration problems many of us faced is cultural. We subscribe to unbalanced notions of what it means to be a warrior and uphold silent suffering as a virtue. Mistakes are shameful; pain is weakness. Saying that something is hard or stressful just isn’t done.

I don’t want to contribute to the silence that surrounds these issues anymore. Too many aspects of warrior culture are destructive lies we tell ourselves.

Who are we maintaining this veneer for?  What do we have to prove anymore?

Constant invulnerability is an illusion, and cultural mandates to be “together” in every way become dangerously prescriptive. We lose our authenticity in this way; we don’t know how to reach out to each other when stresses start to overwhelm us. Too many of us who are used to appearing strong would, indeed, rather consider suicide than admit to being human, fallible, or broken.

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Dr. Kate Hendricks Thomas

My own public story was of crisp uniforms, physical fitness metrics, and successes. I always looked good on paper. My private story involved destructive choices, broken doors and holes in the walls, hiding weapons in the house, and getting dragged across the living room floor by my hair. I was as far from God as a person could be but had no idea at the time.

As a Marine Officer, I was not supposed to make mistakes, feel depressed, or need help. But I did. Tough places and situations became tougher because I didn’t know that people might be okay with an imperfect version of me. For too long I chose silence over reaching out to loved ones. I opted for deeply felt, visceral shame over openness and vulnerability.

When serving in the military we are trained to lead with confidence. Presenting a certain and effective façade requires some incredibly useful skills. We make decisions quickly and responsively, but these very same skills become incredibly destructive when we never learn how to turn them off. This description fits most service members. We tend to be a driven, almost comically dysfunctional, lot.

What if I told you that I am not perfect?

What is so useful about sharing our experiences with one another is that we offer each other the opportunity to say that kindest of phrases: “Me too.”

We are not alone.

The determined avoidance of care-seeking I lived through is disturbingly normal in the military community that I call home. For me, learning to do better involved stumbling by accident into the three key components required to build human resilience. My later academic study brought a wry smile to my face as I realized that the answer had always been there; I just hadn’t known it when I needed to.

What if I had training in resilience before hitting rocky shoals?

To get to a healthier space, I had to make some hard choices, choices that involved leaving destructive patterns and people in the rearview mirror. It felt like dying to do so, but it allowed me space to breathe and to focus on becoming a new version of myself. Once I deliberately and consciously began stepping outside old patterns and belief systems to connect with and serve my community, embrace a healthy lifestyle, and seek and find an authentic relationship with God, the world stopped spinning in quite such an unforgiving fashion.

It wasn’t a chaplain or a counselor who pointed me in the direction of wholeness, though I certainly tried those routes. I keenly remember sitting in my first counseling session with a well-intentioned professional, answering her with short sentences and half-truths. While I have great respect for clinical mental health practice, many of us are not interested in embracing the identity of a patient. I never was. I sneered at things that would have been really useful!

You can keep your couch.

I’m a true nerd at my core, and when the dust cleared in my personal life I became motivated to learn all I could about how we as veterans are talking about mental health. I went back to school for an interminably long period of time and threw myself into community-based programming and health promotion. When I really drilled down in my issue analyses, I didn’t much like what I found. We are killing ourselves alone in apartments and no one is seeing any symptoms—we are that good at hiding out. It really isn’t that services aren’t available to veterans and military personnel when things become difficult, we just won’t use them.

No matter what magic we do in the clinical realm, focusing on treatment requires a disempowerment narrative that is perceived as being incompatible with the cultural values of military veterans. We cannot overcome such norms by asking warriors to become patients and pop pills, no matter how dedicated, innovative, and gifted the clinician is. While treatment is certainly part of the solution, it is not culturally acceptable for it to be the entire answer.

I know this to be true on both an academic and a personal level and believe we need to alter the dialogue about resilience. We must flip the current paradigm and turn words that currently connote weakness (like authenticity, self-care practices, and social cohesion) into training mandates and metrics of performance.

There is tremendous work to be done.

Trying to do that work is a translational team coming together at the 2016 Service member to Civilian Summit. S2C brings together researchers, practitioners, government employees, veterans, and military-connected family members to talk about best practices and processes to improve veteran health and reintegration. Speakers include field leaders like:

There is still time to join us. Register today.

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