ACCENT: Living with the scars of war
News
Posted By MARY KATHERINE KEOWN
Updated 1 month ago
Richard Cane (not his real name) grew up in Nova Scotia and says fishing jobs were scarce. With few other options, he decided to join the military after graduating high school. By the time he was medically discharged in September 2003, Cane spent nearly 15 years in the Canadian Armed Forces, achieving the rank of corporal. His pride is evident when he speaks of his military career. But easy, it was not.
"I did a six-month rotation over in Bosnia, which was considered a peacekeeping duty. But some of the things I witnessed were not things I felt we were prepared to deal with," he says.
"When I got back to Canada, memories lingered; however, me being in soldier mode, I just tucked them away and buried them.
"I was deployed during the Canadian ice storm (of 1998). Again, images came about of things I felt we were ill-prepared to deal with during peaceful times."
Those images -- of desperation, human indignity and dead bodies frozen in time and place -- left Cane with post-traumatic stress disorder, or PTSD.
William Pickett, also a veteran of Bosnia, credits an earlier tour as a medic in Rwanda -- where he was stationed at a field hospital during the 1994 genocide -- with the onset of PTSD. At its operational peak, hospital staff treated 500-700 patients per day, many of them victims of the genocide.
"You make this snowball and you start pushing it up a hill," Pickett says.
"Eventually, it gets so big that it falls back on you and you get caught up in it as you start rolling back down the hill. That's what PTSD is for me."
Different soldiers, same story. Across Canada, veterans too often return home with invisible wounds. Once known as soldier's heart or shell shock, PTSD dates back to ancient Greece and is characterized by flashbacks and nightmares in which sufferers re-live the traumatic event(s); hyper-vigilance; seclusion; isolation; emotional emptiness; sleep disturbances and aggression; and often substance abuse.
According to a November 2008 CTV News online report, Veterans Affairs Canada (VAC) puts the number of veterans (with the exception of those returning from Afghanistan) who experience PTSD as high as 10%. Of those serving in Afghanistan, the incidence rate is expected to be higher.
Since 2002, when Canada joined the mission in Afghanistan, the number of VAC members diagnosed with PTSD has more than tripled -- from 1,800 to 6,500, according to a VAC briefing note obtained by the Canadian Press in March 2008. At that time, the numbers were expected to climb until Canada's scheduled departure from Afghanistan in 2011.
"The onset of PTSD was very confusing to me, as I was not sure what I was going through," Cane explains. "I know that after returning from the ice storm, I was not myself. I was withdrawing from family, friends and co-workers. ...
"I would sit alone in the dark, drinking more alcohol than usual in an attempt to deal with the memories and feelings. PTSD developed over time, with exposure to traumatic events, sights, sounds, etc.; however, they were pushed aside and not dealt with at all, as I did not want to come across as weak."
Pickett says he was also confused, but he knew -- and his wife confirmed -- that he had changed since returning from Rwanda. He was anxious and depressed, and he had difficulty putting on his uniform. Before reaching the base, he says he often needed to pull over to the side of the road to vomit.
He denied and dismissed the symptoms.
"I told myself I was stronger than that," he says. "I could handle anything. You're taught that you're bullet-proof; you can do anything you want, as long as the mind is strong enough. When I was first diagnosed, it was perceived by a lot of people as being a sign of weakness, as in 'you just don't have the constitution to do the job right.' "
HITTING ROCK-BOTTOM
Flooded with memories and images, Cane says he reached a low point on Sept. 9, 2001, as he watched the twin towers fall in New York City. On Christmas Day 2001, he bottomed-out.
"After being on sick leave for a few months, the drinking d I acted out more and more -- misusing the Internet, chat rooms, etc. I finally hit rock-bottom after my wife discovered everything I was trying to hide. I had become so full of anger, disgust, guilt and shame that I attempted to take my life in front of my family on Christmas Day. I was constantly filled with anger, fear and anxiety, and I was afraid to be around people, especially in crowded places."
Pickett bottomed-out in 2000, when he, too, tried to commit suicide using a potent combination of drugs and alcohol. He had drunk so much, however, that he vomited his stomach contents. It saved his life.
Pickett says his marriage nearly ended -- he was so empty he was not certain he still loved his wife. Perpetually depressed, upset and angry, his children 'tip-toed around' him to avoid triggering his temper.
"When I went down hard, I was actually looking forward to dying," he says. "I had no feelings, no emotions. I was actually numb."
Pickett had lost one friend to suicide, while another had attempted to kill himself. That is not uncommon, says Dr. Trevor Deck, a Sudbury-based psychologist. When sufferers cannot see a future for themselves, when they are plagued by flashbacks and nightmares, they withdraw from life and often become very lonely.
LOST BROTHERHOOD
Discharged from the military because of their diagnoses, Pickett and Cane have each sought treatment -- a combination of counselling, medication and peer-based support groups. Cane even underwent eye-movement desensitization therapy, which is used to alleviate the symptoms tied to traumatic and disturbing life events.
Although the military is tight-lipped about PTSD (neither the armed forces nor VAC responded to interview
requests), VAC offers a number of services for veterans and their families, with a focus on early intervention, crisis care, rehabilitation and on-going care.
Ste. Anne's hospital, in Sainte-Anne-de-Bellevue, Que., operates the National Centre for Operational Stress Injuries, which administers out-patient services; develops clinical research modules; participates in policy development; and oversees clinical mental health services nation-wide.
Operational Stress Injury Social Support peer networks, which are affiliated with VAC, are located in major urban centres across Canada and link individuals suffering from PTSD (including active soldiers, veterans and family members) to others who have similar experience.
Despite the apparent abundance of services, Cane and Pickett say they were left to their own devices. The military helped diagnose and treat Pickett, but his healing began after he was discharged.
"Once you're out, you have to find your own help," he says.
He saw a psychologist and a psychiatrist in Petawawa, but Pickett says finding help in Northern Ontario has been challenging. He worked with three different counsellors in North Bay, where he now lives, before finding one who was a good match. They have been together for nine years.
Cane and Pickett both attend meetings with other veterans. Their support groups have been instrumental in their 're-socialization,' and provide a sense of camaraderie and brotherhood -- something Pickett says is deeply woven into military culture. The common threads of PTSD -- night-sweats, nightmares and 'bad days' -- are understood in this brotherhood. The groups are places to talk, to share coping strategies, to be open and honest and to reveal dark thoughts. They are places where confidences are kept, privacy is respected and judgments are withheld.
"We've all done basic training, we've all done trades training, we've all done tours, we've all done the military life. And we've all done PTSD," Pickett explains. "It's like meeting up with a group of brothers. It's just easy."
Deck explains individuals living with PTSD often find reliving the experience too traumatic, so they avoid acknowledging their memories and feelings. Support groups offer 'safe places' for dealing with the traumatic event.
PTSD develops after witnessing or experiencing something that threatens the health, wellbeing or life of an individual or his/her loved one; when it is simply more than an individual can cope with in the moment. Flashbacks and nightmares, Deck says, are the mind's attempt to make sense of what has happened, to order and to put into sequence the events, and to resolve feelings of guilt.
"PTSD is a normal reaction to an extreme, traumatic and abnormal situation," he explains.
Avoidance is a major symptom of PTSD, since often individuals know of no other way to address such an overwhelming experience. It is not uncommon for sufferers to withdraw from family and friends, to isolate themselves and to avoid anything -- smells, sights, sounds -- that remind them of the traumatic event. Discussing their experience is like "letting the cork out," Deck says.
OFFERING HOPE
Cane is still susceptible to episodes of PTSD -- in fact, he says the interview for this article was a mild trigger -- and it has taken years, but he is rebuilding his life.
"I still deal with problems being around large crowds for long periods," he says. "Winter is a hard season to get through. It's the worst period. I deal with (my triggers) by keeping in touch with support groups and talking with friends who understand what it's like. ... I avoid other places -- like bars -- as much as possible.
"PTSD ended my military career before I was ready to retire," Cane says. "It was a contributing factor in the breakdown of my emotional and mental well-being. It was a contributing factor in the breakdown of my family (he is now divorced), and it contributed to my abuse of alcohol and the Internet. ... Living with PTSD means constantly being aware of your triggers, and ensuring you do what you need to do to manage them, instead of letting them manage you."
Cane would like to see veterans formally trained to spot symptoms and counsel their fellow soldiers.
"I believe the military could benefit from having programs, such as support programs, which are staffed by retired military personnel who have been trained to deal with things like PTSD, alcoholism, and gambling and narcotics addictions, more readily available for its veterans," he says.
"For the civilians out there trained in this field, I personally commend you; however, unless you have lived the military experience, you really don't know what it's like."
FAMILIES AFFECTED
Lucie Brière recently celebrated 32 years of marriage. Her relationship is fairly solid now, though she admits some days are better than others. At times, her husband can be unpredictable and quick to anger, and she says they occasionally spar back and forth. Brière's husband, Yvon, is a veteran of the armed forces, with deployments to Cyprus in 1975, the Golan Heights in 1985 and Yugoslavia in 1993-94.
Diagnosed in 1997 with PTSD, he only began treatment (a combination of medications and counselling) earlier this month. Brière cannot explain the delay, but says it has led to increased stress and emotional hardship in her marriage. As a result, she has also been diagnosed with PTSD.
"When he came back, he wouldn't talk about (his experiences)," she says. "All the anger and frustrations that he kept inside rubbed off on me, because he wouldn't tell me what had happened. I couldn't help him -- I didn't know what he was going through. I couldn't support him. ...
"Even the kids noticed their dad was not the same person when he came back."
She steps lightly to avoid provoking her husband, but Brière says learning when to walk away has been key to coping. She also credits the establishment of a support group.
In 2009, Yvon founded a local chapter of the country-wide Veterans' UN-NATO support group. They meet weekly at Little Montreal on Elgin Street. Although each veteran attending on this humid July evening has PTSD, the atmosphere is jovial and there is a strong sense of camaraderie, familiarity and fraternity. It is, essentially, a group of men (and two women on this occasion) sitting around on bar stools, drinking beer or soda (at least one member admits to being a recovering alcoholic -- a result of his struggle with PTSD), feasting on hearty pub fare and laughing about the little triumphs and challenges of daily life. It is a welcoming group and more than a little reminiscent of that old sitcom, Cheers.
"They've all gone overseas, they've seen the same stuff, they know it," Brière says over the chatter of her granddaughter, an energetic toddler. "By talking about it, it helps relieve the stress. That's why the group is growing. In the army, you meet so many people, but because you're posted out, you lose track of people. With the group now, you can find people that you knew 20 or 30 years ago. You were like brothers and sisters when you were in the army, and the camaraderie is coming back. ... The army is a different way of life than the civilian life, but everyone here has been through the same things. Even the wives know what each other experienced."
BACK ON 'CIVI' STREET
Cane and Pickett, though soldiers at heart and proud of the work they did, have adjusted to civilian life. Cane works full-time, while Pickett, whose marriage is strong now, has adopted a more domestic role.
"I can rock the hell out of an apron," he laughs of his newly-acquired Mr. Mom persona.
Pickett misses the military, but admits he could not go overseas. He says a diagnosis of PTSD is a career-ender, as the armed forces require operational readiness and soldiers with operational stress injuries are not considered deployable.
"I'm not the same guy I used to be, but I'm better now, because I'm stronger in other ways," he says.
He is closer with his family, especially his children; he knows his limitations; and he understands and recognizes his triggers.
He credits his wife for keeping their family together during his darkest days.
Pickett insists veterans suffering from PTSD would rather hurt themselves than other individuals and he is committed to changing public perceptions.
He speaks out about his own struggle in the hopes of helping other soldiers.
"The guys coming home and the guys with PTSD gave their souls for this country," he says. "They shouldn't be looked at as freaks; they should be regarded as heroes. They gave their souls. Now they just want to come home to become part of society once again, and to enjoy their retirements."
Read Accent every Saturday.
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Resources for PTSDsufferers and families:
* Veterans'Affairs Canada: www.vac-acc.gc.caor 1-866-522-2122
* Operational Stress Injury Social Support: www.osiss.ca
* PTSD Association of Canada: www.ptsdassociation.com
* Recovering Warrior: www.recoveringwarrior.com
* Veterans' UN-NATO support group: contact Yvon Brière at (705) 929-1296 or
captbonhomme@hotmail.com
* Dr. Trevor Deck: (705) 524-1000.
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PTSD primer
Information from the Canadian Mental Health Association:
* PTSD is not limited to veterans of war; it is caused by a traumatic event, often involving actual or threatened death or serious injury to oneself or other individuals.
* Trigger events may include violent personal assault, rape, mugging, car or plane accidents, industrial accidents and natural disasters, such as earthquakes and hurricanes.
* Onset of symptoms usually (but not always) occurs within three months of the traumatic event.
* Common symptoms include nightmares and/or flashbacks; avoidance and emotional numbing; withdrawal and social isolation; feelings of extreme guilt; aggression and extreme anger; and sleep disturbances.
* Drug and alcohol abuse are often associated with PTSD.
* Individuals with PTSD are often depressed or anxious.
* PTSD sufferers are often treated with medication, including anti-depressants and sleeping aids; however, cognitivebehavioural therapy and group therapy are believed to be more promising treatments.
* Exposure therapy, in which the patient re-lives the experience under controlled conditions in order to work through the trauma, can also benefit those living with PTSD.
* For more information, contact the Canadian Mental Health Association or visit www.cmha.ca.
