Showing posts with label PTSD. Show all posts
Showing posts with label PTSD. Show all posts

Thursday, October 8, 2009

Serious Business

At times, I've been told that I'm too serious, too intense, and at times, too observant and out-spoken for others' comfort levels, and for their political and financial ambitions. May I propose this: the central idea of Religion concerns the serious nature of life in all its difficulties, relationships and outcomes.

Regarding justice and injustice:  Most of us think of law and consequences when we think of justice. If people we know, or if we ourselves have experienced injustice or criminal behavior, our thoughts may quickly jump to returning fire for fire. Christians may cringe at the images in Psalm 137:9 "Happy shall they be who take your little ones and dash them against the rock."  Many of us cannot imagine wishing such harm to other people's infants and children, much less carrying it out! Taken in the context of the previous verse, the source of pain in this imprecatory prayer becomes clear: "O daughter Babylon, you devastator! Happy shall they be who pay you back what you have done to us!"

The cry of the psalmist is for retributive justice against the perpetrators of the horrible suffering and pain caused to their children, and to them by watching their children die. We cannot ignore these cries from those who are the most abused, the most downtrodden, the poorest, and the sickest among us. Every one of us has experienced some time in life where we have been victimized by others, but few in the U.S. have experienced this particular pain. The message of this psalm should be considered when we consider the pain war and terrorism bring to the people of Iraq and Afghanistan. We know that other groups have also victimized the people, but we shouldn't be surprised at the backlash which occurs when US soldiers and military actions kill or injure children and family members. They cry out for justice, and the natural human response is to seek revenge.

If we look at this Psalm's lament, however, we see a foreshadowing of Jesus Christ. The psalmist does not claim that the people of Israel will be happy when they take revenge on the Babylonians who have taken them captive and killed their children in front of the parents. The avenging people are an ambiguous, "THEY." Why is that?

We should know ourselves well enough to understand that the enacting of vengeance and the exacting of justice according to human measures harm us. There is no detached "justice"; we can only try to increase the distance between ourselves and those whom we have judged. Distance can be measured in miles: an impersonal missile launched from a ship or a plane may feel "impersonal" to the owner of the hand on the trigger, or the commander giving the order to fire, but the missile's explosive destruction is very personally experienced by the people in the impact zone. Distance can be measured in relationships: a distance of race, gender, political party affiliation, religious system, education, economic status, nationality or ethnicity can permit the perpetrator to depersonalize the offense in her imagination, but the offended party knows exactly how personally wounded s/he is. Distance can be created by lies: liars frequently fabricate a false reality that is a combination of blatant lies, innuendo and semi-truths in order to push the truth or the truth-teller away from the liar's self, or worse, to kill the truth-teller by slander, gossip, libel (all of these are a form of judgment and death).

God-with-us, God-in-Christ, the God who reconciles humans to God and to one another - this God loves the victim and the perpetrator. This God loves Nineveh and Jonah, the Persians and the Israelites, the Babylonians and their captives, the Afghans, the Iraqis and the Americans. Our God knows that distancing ourselves in order to cause pain with words or actions, or distancing ourselves from sensing the pain we cause others inflicts harm on us, not just on those whom we've hurt.

During an internship at the Denver Veterans Administration Medical Center, I saw firsthand the damage done to soldiers by their participation in wars. Perhaps, to the people of Vietnam, Iraq or Afghanistan, these soldiers may have seemed akin to the Babylonians of Psalm 137. Yet, these soldiers also experience pain from participating in war, even those who joined the Army because a relative or friend was killed on September 11, 2001. Their own physical injuries may be healed or treated medically, but the psychological damage may last and last. One Vietnam vet was broken in ways he'd been able to ignore for most of the 40 years since leaving that country. Then, too, our government's system of treating soldiers and vets refuses, at times, to diagnose psychological harm from combat in the interest of saving money, denying benefits' claims, and maintaining troop levels. A soldier may "justify" their actions because "I was only following orders." Nevertheless, he will know - in his body and person - that his actions killed or injured other people. The more people the soldier kills, the higher the risk of PTSD. Imagine then, the soldier returned home is told by the VA that his experiences of anger outbursts, sleeplessness, nightmares, flashbacks, discomfort or fear in crowded places, anxiety if someone stands behind him, are nothing. Our society believes a myth that we have the resources to heal all ills and to treat everything, and to perpetuate that myth people in authority do lie to the suffering, and will "kill" anyone who endangers their myths.

We need to reconsider our myths! That reconsideration is part of the "serious business" of religion.

The Psalmist knew that any revenge against the captors by the captives would harm the captives, too. The implications of our belief in One God and One Creator of all things, and in humans being created in God's image resonate strongly. If God is truly with us in our experiences of suffering and injustice, and not distant from us in dispensing justice, then the Christian call to be conformed to Christ means that Christians love the victims and speak truth to the perpetrators; we reflect grace and truth to every person just as God-in-Christ has done to us. We know that for all that we have been victims of injustice and suffering, we have also been perpetrators of injustice and suffering. We are responsible, we are accountable, and we face and confess the truth about ourselves knowing that the judgment of God against sin has been lifted from us by Jesus Christ's sacrifice.

Christians and our churches must not participate in the polarizing rhetoric that characterizes our national political debates right now. We should and will testify to justice, against unjust and inequitable systems, to the care our society should give to all people, and to the harm we cause ourselves by our distancing ourselves from one another. Our system of providing medical care only to the rich, the employed, and the dying is akin to passing by on the other side of the road from the poor, wounded and sick. Our strategies that harm others in the name of the harm done to us will always damage us, too.


On the one hand, we are called to play the Good Samaritan on life's roadside, but that will be only an initial act. One day we must come to see that the whole Jericho Road must be transformed so that men and women will not be constantly beaten and robbed as they make their journey on life's highway." ~Rev. Martin Luther King, Jr.

Friday, April 24, 2009

Touchstones in Reality

This photo was taken by a friend, Andy Larsen, at the Disney Concert Hall in LA.** It seemed to me to give a metaphorical image of how our perceptions of ourselves, others, and our experiences need balanced and faithful interpreters and interpretation.

There was a person who fought, "won" and lost in a war, lost buddies, ministered to fellows having similar journeys, then suffered greater losses still: almost life (in thoughts of an ending, and then twice accidentally - not counting the long-ago war), memories, connections, part of a limb, and most frightening of all, a sense of self and identity in this world and before God. “Who am I?”

Picture yourself in the middle of this photo's disorienting scene. However, imagine that you have no exterior streets or plumb lines to balance your person, your perspective, or even the knowledge of which direction gravity is taking to keep your feet on any one surface.

There are times when our lives resemble this photographic metaphor. You don't know who tells the truth and who lies, who believes the truth and who believes the lies. The surface of a relationship, or relationships, which had seemed solid and sane suddenly curves out from underneath you and falls away. What is truth, anyway? The lying ones and the credulous ones assert their certainty over you, and you find one image of yourself impaled by a jagged edge you hadn't seen before from your vantage point. You cry out with no voice: Who am I? Why am I here? Why don't I leave this pain behind? Can I stand up, can I escape, or is it safer to crouch as if paralyzed, my back to any surface?

Losing one's sense of self is like going back to the garden, after the fall, before the mercy. Cold, naked and ashamed, a grey day, on that metallic reflective - but not truly reflecting - surface. You cannot trust the blurred "image" you see of yourself in the metal. You understand you're here - wherever "here" really is – perhaps in part due to your own choices, in part due to external forces, and you can't get your bearings. Imagining yourself covered with your own waste, you slip and fall again and again. Is this a nightmare, a hallucination, the process of dying, a real experience, part of a real experience, or all of the above? You don't know.

You have no control. You're immobilized within scene that moves with you but without your direction, volition or control.

You become aware that some persons' presences have entered your disorienting and disoriented world. One laughs incessantly, the sound bouncing back and forth across the metal surfaces that encompass you, and you don't know whether the laughter is directed at you because the surfaces change the directionality of the sound.

Yet another presence, like an angel, stoops to pick you up off the cold, metal surface, cleans you, and gently places you on cushions that both soothe and warm you. You're relieved, but you feel still out of control, as one stuck in an endless loop of the same scene. You fall back to the cold surface. The laughter continues to reverberate around you. Another presence assists the angelic one, and they pull you back up to the safety of the soft clean, warm surface. You survive, scarred, but as one continuing to question what is real, "Who am I?"

Who are the faithful ones? Who is the Body of Christ entering into your brokenness, cold, waste and shame? Who are the faithful interpreters of this distorted reality? Where are the touchstones which orient you rather than disorient you still more, leaving you more confused and ashamed?


We believe that our answer is God-with-us, God entering our world of nakedness, shame, filth and cold, through the Body of Christ then and now. The bodies of Christ are the ones not judging the contours of and events in your world as indicative of your worth or necessarily attributable to your own action. God listens and remains as you discern the how of the shapes around you, the actors and the acted upon, and then gives you back the choice of "what now?" "Go and sin no more." You step out of the endless, controlling and uncontrollable loop. You find a true orientation in the midst of the disorientation through maintaining contact with those around you who remain true and stable. Your vision becomes fixed on a horizon outside your warped world which keeps you centered and straight. You become a touchstone, too, to others who seek the True, though you know the world around each of you remains broken, warped and distorted. You point out the horizon to one another, reminding one another, steadying one another, and sharing strength.

Bodies of the Body, touchstones connected to the Rock, the caring hands when the world falls away around us, the arms that lift the injured from the ditches along the way, the parts mirroring the Perfect, the ones being known by the One Knowing, the “we are” of the “I AM.” This is who we are to one another, reconciled and reconciling, faithfully remaining in Christ Jesus.

**
(http://www.flickr.com/photos/papalars/3465101920/ with some rights reserved per http://creativecommons.org/licenses/by-nd/2.0/deed.en)

Tuesday, March 3, 2009

paradoxical myths in vets

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?