I've another book to add to my lengthy list of books to read: Recalling our Own Stories: Spiritual Renewal for Religious Caregivers, by Edward Wimberly. Wimberly discusses the myths that we bring from our families and experiences into our vocation. In our cohort's discussion of Wimberly's material, I realized there is a commonality in the myths revealed in veterans' stories and the literature on PTSD. Two myths, especially, seem to be dialectically related in stories I hear:
1) as one would expect in a volunteer-based military, particularly one that markets itself to young men and women, there is a myth of invulnerability. Many of these young people, and the military establishment itself, act on a belief that being vulnerable is a liability. Vulnerability is associated with weakness and imperfection. The very admission of psychic wounds is an admission of vulnerability that runs counter to the promotional ladder, and not uncommonly will knock one off that ladder altogether. Bravado is applauded and rewarded, and it manifests differently in men and women. The cultivation and utilization of anger to fuel bravado and action is frequently present in military activity.
2) on the other hand, there is a myth of powerlessness that is manifested in the top-down hierarchy of many organizations, and which is exemplified by military structure. The men and women express little control over their coming and going, their destination, their missions, and the outcomes of those missions. For the vet whose PTSD manifests in anger or intermittent rage that makes it difficult to hold down a job in the civilian marketplace, there may be the option of ongoing employment with some branch of the military -- at the "price" of staying in the reserves, and the "risk" of being re-deployed. For the national guardswo/man whose trauma and fear manifest in magical thinking, the coping mechanism may be a "religious" avoidance of certain places on base that are identified with higher risk of being mortared. (unguided weapons) Another person on that same base may ignore all the sirens and take-cover warnings, revealing by inaction an operating belief that the ignoring wards off the danger. There's an innate passivity in each of these soldiers to their experiences of powerlessness over themselves and their situations, coupled with a methodology of coping that is implausible, illogical, &/or incapable of personal agency.
In the context of pastoral care, the first myth is certainly an obstacle, although some vets may reveal to a chaplain what they may not confide in a mental health worker (or vice versa). Exposing either myth carelessly might unbalance someone who is already fragile, even though that myth ultimately isn't serving the person well.
I noted a startling disconnection in a presentation that compared Compassion Fatigue and PTSD. A primary indicator of risk for CF is the lack of control over one's environment; gaining a sense of control over the caregiving environment is also a primary factor for preventing CF.
The high incidence of PTSD in the Vietnam War vets has been directly attributed by psychiatrists and care-givers to the powerlessness that many soldiers felt over their missions, their placement in combat units without integration or training with fellow soldiers, and their distance from officers, among other factors. The breakdown of military command structures in Vietnam, the fragging of officers, and the increasing incidence of military "refusal" (i.e., mutiny) contributed as much or more to the US withdrawal than the anti-war movement in the US.
Should the military not anticipate PTSD as "normal" rather than "abnormal"? Military order always risks increasing powerlessness down the lines of command. I'd surmise that it's the rare commanding officer who gives authority and agency to his/her subordinates. Would that even be taught? It's rare enough that the medical caregivers attending the seminar wondered what increasing "control over the caregiving environment" might look like in practice.
This is no different than the typical corporate command structure, many ecclesiastical orders, churches, and families too, by the way!
Humans seem to be born with another myth; I'd name this myth the myth of control. That myth would reveal itself in the constant domination/manipulation, ruling/submitting, that characterizes most human interactions. In the military setting, it manifests in blinkered following of orders, regardless of what those orders may comprise. It manifests in the coping mechanisms mentioned above on the base under fire; avoiding certain areas gives one person a sense of control, just as ignoring the sirens gives the other person that same sense. In churches, it manifests in biblical ignorance and idol-creation. (Note: I'm using idol so as not to offend any polity more than another!) Idols are the infallible church leaders who may be present in every type of church polity, whether that be an episcopal, presbyterian, congregational, or independent church polity. The followers believe this myth, and the leader nurtures it by fear, intimidation, charisma, or power-abuse. It looks like this in action: Our leader always speaks with the voice of "god." Do not question him/her. Their position, alone, makes biblical authority irrelevant. Their actions and knowledge are above us, unaccountable to us, unquestionable by us, and they always know better. They hear god "better" than we can (so many of us don't even talk/listen to god). If you dare to question them, or if you dare to point out something inconsistent between profession and action (hypocrisy!), you will be penalized, perhaps even crucified. If you note the hypocrisy of the leader, the only appropriate action, according to this dysfunctional system, is to shut up and go along, or disappear out of the system.
An African friend, today, told me of a myth that manifests in his culture in a similar way: older men are never wrong, never questioned, and never confronted. To tell an older man that he lied, erred or deceived in some manner may bring civil penalties of a fine, or possibly a jail sentence to the younger person. Some families in this country manifest that same myth, and the enforcing of this myth is accomplished through verbal abuse and domestic violence.
Does your family or church or workplace offer value and worth in their affirmation of you? Do they grant you an atypical sense of participatory "control" by their welcome of you and your unique talents, experiences, and contributions in that structure? If you feel powerless, what might you do or say constructively to promote change?