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The Star: An "Investigation" into Afghanistan and Violence in Canada

George Wallace

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Quickly skimming that, without my morning coffee yet, I wonder if the intent is to make the CF carry out the functions of Veterans Affairs and create another redundant agency and see specialists employed, but a plethoria of paperwork and frustration for the members in getting the services they need and long waits as they plead their cases several times before their problems are accepted as legitimate.  (A long run-on sentence, I know.  It exemplifies the frustrations many have experienced dealing with Veterans Affairs)

I wonder if the MPs should be pionting their fingers in another direction (Not at the CF, but at Veterans Affairs) and asking why they have let the members down by not sorting out the bureaucracy at Veterans Affairs.  If the blame is being focused on the CF, why do we even have Veterans Affairs?

Time for me to go have a coffee and wake up.
 

Old Sweat

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According to an interview with NDP MP Peter Stoffer (sp?) this morning on CFRA, the Veteran Affairs Committee has been and will continue to study this issue. He seemed to have a good understanding on the responsibilities of DND and VAC for serving and released  members of the CF.
 

observor 69

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I thought this item would fit with this thread but mods feel free to move.

Well written article in today's Globe and Mail on Major Mendes by
Christie Blatchford and Jessica Leeder
Did we push her too much?'
 

vonGarvin

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Baden Guy: Thanks for posting that.  What a sad story indeed.  My only problem is with one of the comments on the news site in which some person suggests that she "...learned the true nature of the invasion" and then killed herself because of it.  Holy friggin' moly.
RIP Maj Mendes.
 

PD

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Please note that a lot of members are offered a lot of help, and they simply dont take it.  I cannot give details on a public forum, but suffice to say, if a person wants to be violent they will be.  If a person wants to not heal ..they wont heal. A person cannot be forced to stop being abusive.  The cycle of family violence and its dangers are not caused by the military, in fact one would aspire to soldiers that have more emotional control due to conditioning, regardless of experiences in or out of theatre.
 

a_majoor

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Frankly,the only paper which has any half decent reporting on Afghanistan (in any regard) is the National Post, which just finished its series on the history of the mission.

The Globe and mail could not even get basic facts like how long we were in Afghanistan correct (end of the "five year" mission?), and the electronic media is really no better. I have put the Star on "ignore" for ages, and suggest the best way to deal with this sort of "reporting" is for everyone to place the Star and all its advertisers on "ignore" as well.
 

john10

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Thucydides said:
Frankly,the only paper which has any half decent reporting on Afghanistan (in any regard) is the National Post, which just finished its series on the history of the mission.

The Globe and mail could not even get basic facts like how long we were in Afghanistan correct (end of the "five year" mission?), and the electronic media is really no better. I have put the Star on "ignore" for ages, and suggest the best way to deal with this sort of "reporting" is for everyone to place the Star and all its advertisers on "ignore" as well.
The articles clearly refer to the mission in Kandahar, which has indeed been going on for 5 years.
 

a_majoor

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Oddly the mission began with combat in Kandahar in 2002 (OP HARPOON and OP WHALE in the Sha-i-kot valley), then shifted to Kabul then back to Kandahar. Separating them out the way the G&M did is ahistorical at best, or dishonest at worst (the focus is clearly on the mission during the years that the Conservatives were in power, but avoiding mention of the mission during the period when Liberal governments were in power).

You may draw your own conclusions as to the motives of the G&M editors, just don't hold your breath expecting a correction.
 

john10

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Thucydides said:
Oddly the mission began with combat in Kandahar in 2002 (OP HARPOON and OP WHALE in the Sha-i-kot valley), then shifted to Kabul then back to Kandahar. Separating them out the way the G&M did is ahistorical at best, or dishonest at worst (the focus is clearly on the mission during the years that the Conservatives were in power, but avoiding mention of the mission during the period when Liberal governments were in power).

You may draw your own conclusions as to the motives of the G&M editors, just don't hold your breath expecting a correction.
A correction for what? The bulk of our mission in Afghanistan for the past five years has been in Kandahar. That's what the articles are about. There's nothing ahistorical or incorrect about it.

And what exact kind of sinister motives/dishonesty do you see here? The G&M has endorsed the Conservatives in the last two elections.

You may dislike the G&M, but I really don't see how a series of articles about our presence in Kandahar the past 5 years would be the source of that.
 

kstart

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Some sad stories and I can also relate to feeling anger and frustration about them.

PuckChaser said:
You'd think with this second guy, maybe his steroid use could be the cause of the violent outbursts and bad temper? Oh wait, that wouldn't make a good Anti-CF story.

Yeah exactly, "roid rage".  Also the cocaine can't be helping, and by the sounds of it,  sounds like longer term, prolonged use and heavy use (his manerisms, mouth movements-- seen that on the streets in chronic users on an extreme binge).  Cocaine withdrawal can also cause irritability, restlessness, violent outbursts. . .  He probably uses the pot and the Zyprexa for 'coming down' after binges.

Also concerning is that he doesn't have any aversion to needles for the steroids, I hope he's not injecting coke.  Needles + coke + pattern of high risk/reckless behaviours + the doctor prescribed Viagra. . . HIV risks. . .?

From a PTSD perspective, the high risk behaviours (totalling his car, fights, heavy drug abuse, etc.) can be tactics of Avoidance (numbing, distracting symptoms re: PTSD) through distraction, 'adrenaline junkie'-pattern.

But I can't see any of the PTSD issues being resolved, having a chance to heal with the active severe drug abuse.  I think this man's life is at risk, from severa fronts.  Probably would need some in-patient rehab, but he would have to make that choice and committment and stick with it.  Relaspes are also dangerous (miscalculation of factors re: lower tolerance and over-doing it/OD. . . and for a person that has addiction to extremes. . . :/).

Sad, depressing and frustrating.

There can be high comorbity of addictions co-existing with PTSD-- there's programs like Bellwood that treat this  (I think would have to do the dry-out via inpatient rehab for the addiction first stage recovery?).  If he followed through with that, would have a better chance of getting a good trauma counsellor to agree to treating him?

Not uncommon for people to resist, or deny the need for trauma help, but it can also be a hard battle for a person who's very attached to their addiction to make a firm committment and follow through on that committment via addiction treatment programs.

Another concern I have is if he got a lump sum of money via medical discharge from CF-- getting a big whack of money all at once while having an active (and very expensive) addiction-- if he was smart, he'd get himself to rehab and appoint a trustworthy person to hold on to his finances (trustee/guardianship), make it less accessible, less of a temptation.  This guy could be heading for the street down the road and that's sad.

Another issue, maybe not relevant, but re: being close to a blast where he saw his friend get hit. . . even if he himself was not hit by a projectile, not a visible head injury, can still get blast injuries which can cause TBI (traumatic brain injury, e.g. mild) and there can be overlap of PTSD and TBI, there's some similar recovery challenges, re: concentration, and other traumatic effects.

Sometimes it helps reduce the 'shame factor' for survivors re: PTSD, when it's also understood as a brain injury-- which it is, it affects the amygdala and hippocampus regions of the brain (which causes trippy experiences, flashbacks, fragmented memory, anxiety, nightmares, etc.-- the PTSD range of symptoms).

Yeah, there's likely more to this story. . . could even be prior traumas to the combat trauma and sometimes those are even harder to talk about or mention, whereas combat trauma makes some sense, most can understand the connection.  Not uncommon to stick to one trauma that feels safer to disclose, and even ruminating on it as a way of avoidance, distraction from other traumas.  Pick the most violent one to help block recall of the other ones which may be equally distrubing and frightening, hard to bare/tolerate. . . feed self-anger, self-punishment re: survivor guilt (Aphrodite Matsakis has a good chapter on PTSD guilt, in book Trust After Trauma).

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It's an interesting form of reporting, like a mini "ethnography", a glimpse at a person's experiencing at that moment in time.  I wonder about the reporter ethics re: how valid is a person's consent to an interview when they're clearly intoxicated (rapid speech, coke effects, etc.)

(I'm not a 'professional', I just live with PTSD (prolonged, multiple exposures) and in lieu of treatment accessibility at times, I've self-educated (cause it sucks to have no power, so it's taking some power back for myself and for my own recovery, to not be passive just cause things don't work out, 'out there').  I've witnessed others in really bad states, re: PTSD with active addictions, etc. and found that really painful.  They have to make those first steps towards treatment, and continue to actively strengthen their committment to recovery, one day at a time-- can't do it for others. . . (and it hurts to be powerless over that).

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About PTSD Education:  there's a lot out there now on the net.  A lot of it comes from the States, because there seems to be a lot of funding, research institutes, etc.

Here's some examples (consider it a 'mini-bibliography'  :salute: ;) :yellow:)

http://www.centerforthestudyoftraumaticstress.org/csts_items/CSTS_understanding_postdeployment_stress_symptoms.pdf

http://www.camh.net/about_addiction_mental_health/drug_and_addiction_information/cocaine_dyk.html

http://www.ptsd.va.gov/public/pages/coping-traumatic-stress.asp


http://www.ptsd.va.gov/public/pages/overview-mental-health-effects.asp

Really good one on TBI, and it's relation to PTSD (some TBIs might go unnoticed, but nonetheless present problems down the road, good FYI):

http://afterdeployment.org/media/elibrary/mtbi/index.html#/5/zoomed
 

mariomike

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kstart said:
About PTSD Education:  there's a lot out there now on the net.  A lot of it comes from the States, because there seems to be a lot of funding, research institutes, etc.

I am not an expert. This is just my observation - opinion:
When the psychiatric hospitals began deinstitutionalization 30 years ago, it put a lot of mental health experts out of work. Many found employment with the emergency services. CISD was introduced in 1983. Attendance at debriefings was sometimes mandatory back then after a critical incident. It was believed by some, at the time, that the cumulative effects of trauma would inevitably lead to PTSD in the workers.
This school of thought was reconsidered in the wake of 9/11. Nine thousand counselors descended on New York City after the attack on the World Trade Center. It was later found there is a substantial number of people that rely on their own internal resources to handle a crisis. That people are more resilient than some may believe. I read that intervention may actually undermine some people's natural means of dealing with critical incidents. 

 

kstart

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mariomike said:
I am not an expert. This is just my observation - opinion:
When the psychiatric hospitals began deinstitutionalization 30 years ago, it put a lot of mental health experts out of work. Many found employment with the emergency services. CISD was introduced in 1983. Attendance at debriefings was sometimes mandatory back then after a critical incident. It was believed by some, at the time, that the cumulative effects of trauma would inevitably lead to PTSD in the workers.

This school of thought was reconsidered in the wake of 9/11. Nine thousand counselors descended on New York City after the attack on the World Trade Center. It was later found there is a substantial number of people that rely on their own internal resources to handle a crisis. That people are more resilient than some may believe. I read that intervention may actually undermine some people's natural means of dealing with critical incidents. However, CISD seems to help some people.

I'm not an expert either, so I had to look up CISD (Critical Incident Stress Debriefing), just to familiarize more.
 
General CISD concepts:
http://www.aaets.org/article54.htm
And they're saying the first 12-24-72 hours are critical. . .

Efficacy studies not conclusive, re: samples, populations? http://ps.psychiatryonline.org/cgi/content/full/51/9/1095

I think it is an important thing to emphasize people's resilience and to respect that.

In support of your POV, this was a good article and a story to people's reactions and shifting reactions re: CISD:

http://www.emsworld.com/article/article.jsp?id=2026

And on where and what the role of Psychological First Aid can be, which also respects people's own inner resilience:
Thus, what role should mental health play in modern emergency services? Several organizations and researchers have addressed this issue. Leading psychological researchers who specialize in traumatic stress,29 NIMH22 and the WHO23 have recommended that competent mental health personnel provide psychological first aid to trauma survivors. This includes such things as listening to rescuer concerns, conveying compassion, assessing needs, ensuring that basic physical needs are met, and protecting the rescuer from further harm. Most important, those who do not wish to talk should not be compelled to talk. For those who want to talk, somebody should be there simply to listen not to provide any sort of care or intervention. In addition, education and information can be provided to better help personnel understand psychological trauma, specifically what to expect and where to get help if needed. If additional help is needed, affected personnel should be referred to competent, licensed mental health professionals with experience treating trauma-related stress. Psychological first aid is not an intervention technique, but only provides practical supportive care while at the same time respecting the wishes of those who may not want to discuss what happened or are not ready to deal with a possible onslaught of emotional responses in the early days following exposure. They do, however, recommend that competent mental health personnel be available within two months of a critical incident to screen and assist any personnel who may be developing stress-related symptoms or PTSD

I don't want to create panic about PTSD, I think having some knowledge re: prevalance and intensity of symptoms and signs to look out for which may indicate a need to get things checked out, can help, because earlier intervention I think can prevent total loss of capacity and 'global functioning' which become bigger recovery challenges, a higher climb back up.  It can make recovery more manageable, re: earlier intervention vs. if it's left for later intervention.

If it's left for later intervention and the situation deteriorates to the extent where it has escalated to an 'urgent crisis' (risks to self/others), I just think it can add more time to recovery time, because usually at that point, it can take time to medically stablize enough, before being able to learn and be receptive to learning PTSD coping techniques (because PTSD-worn out system, can have huge impacts cognitively, due to overwhelment by symptoms).  It just has added challenges when there are further associated 'secondary losses' as a result of deterioration, like this fellow with the addictions problem, isolated from his family, loss of capacities-- that's hard, but it is still recoverable, but it will take diligent work at it.

In those cases it's necessary to learn a new set of coping skills to deal with the impairing effects of chronic, untreated PTSD.  Before I got hit with PTSD, I was high functioning, I could multi-task, get things done on the fly and could thrive under deadlines, etc.  I wasn't emotional (I had a good functioning 'container' around that, till it just got too full and started to spill, which I hated because I had good control-- it's a hard loss, and I had prided myself on being tough enough, resilient enough, having come through some stuff and refusing to accept limitations-- I enjoyed challenging it, resolved to rise above), very professional and could handle a lot.  But the PTSD had a scrambling effect on my brain and now I do need to make lists and stuff to compensate for this loss of functioning which I just took for granted before (the PTSD interrupts routines and plans, it comes down, not by choice, and not when more convenient, but there is new coping skills, which have reduced my recovery time post- [some]PTSD symptom-event).  Sometimes is less to do with adjustment of attidude towards external things as it is adjusting one's attitude towards oneself, and learning some patience and compassion (hard to do). 

I had resilience which worked prior to the development of PTSD and some denial and suppression made it more possible to function (and it's needed through times of handling crisis re: safety of self/others), it's just that it seemed to catch up with me (triggered via a another big-T, Trauma, "staw that broke my back", injured my brain) and became a situation of having to deal with it, but with some changed capacity levels due to PTSD-brain injury.

:-[ ran out of space :-[  Just trying to express newer challenges when PTSD has become full-out and the levels of debiitation it can cause and escalate to greater difficulty when not treated.
 

kstart

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When the psychiatric hospitals began deinstitutionalization 30 years ago, it put a lot of mental health experts out of work. Many found employment with the emergency services. CISD was introduced in 1983.

It was probably believed to be a good field to explore and some are genuinely committed heart-wise and if they believed the CISD was an effective and useful method.  I also wonder, there's not enough studies re: different populations re: traumatic impact (e.g. families, with kids experiencing traumatic event(s)/loss simultaneously-- for children [and they're stuck there], family is primary support, but if they're damaged too and need help. . . problems re: resilience-- but kids are very resilient, can compartmentalize (but that can become a habit, and a problem for later on down the road. . .)

One thing I will say, is there can be some less scrupulous 'counsellors' out there who can foster over-dependence, by neglecting to teach coping skills so that the client can be self-empowered by them, to gain confidence in handling tough situations on their own.  Is it a money grab?  Or a counsellor who has poor boundaries, or is it important for a time being (early stage recovery), but forget to shift gears, and it's habit (or transference, creating over-rescuing behaviours).

As for de-hospitalization, well in Ontario (I'm familiar with some resources that would/can serve e.g. Petawawa Base), there was a lot of cutbacks to medical care, some "austerity measures", same members as in Federal government right now.  Not saying it wasn't necessary, but there's likely some casualties (and some you can see at the street level, hiding in addictions, etc).  It wiped out a trauma program at the Royal Ottawa Hospital (headed by Dr. Cameron, which had a lot of efficacy-- I believe he moved to Uplands Base, OSI clinic).  PTSD is not treated by their "Anxiety Program" though technically PTSD, by DSM-IV, is categorized as an anxiety disorder.  PTSD in the general population can be about 8%-- in the States, that's 1 in 13 people will experience it at one point in their lives.  Other programs are privatized, e.g. Homewood, Bellwood and need private insurance, and priorities given to certain groups.  A few other psychiatrists (OHIP_covered) in the area, did get special training re: trauma treatment (Dr. Sequeira, Dr. Frazer, Dr. Wellburn-- associated with Ottawa Trauma and Anxiety Clinic [which does offer some professional training to professionals, and supervision re: trauma treatment].  Reliance on 'civilian resources'/OHIP_funded, can be hit or miss re: if they have trauma/PTSD/DID training.  And this does effect service delivery, because untrained professionals can unwittingly do more damage than good, teach bad coping habits, etc.  There's a professional Code of Ethics, to not deliver treatment for which one is not qualified by training or experience/supervision.  There is a professional duty to keep current on research and treatment methods. 

Ottawa Anxiety and Trauma Clinic was a 2 year waitlist for OHIP (Provincially funded help); then 4 year, then 6 year, then no waitlist, cancelled, but I do know of some CF getting fast-tracked in and also because their medical coverage includes non-OHIP funded psychologists, trauma experts here, and elsewhere.

PTSD can be devastating, involve a lot of losses, but it can become manageable with the right treatment access.  It takes new skills to adapt to it a newer condition vs. pre-PTSD/absense of full-PTSD.  New "Mental Health Program" was introduced past few years, accessed via Family Services Ottawa (Parkdale) and Catholic Family Services (Olmstead/Vanier/Ottawa)-- psychologists and social workers with some trauma-training.  I got on the list right away and it was only a year wait till a phone back from one of them (but I had finally tracked down a social worker with PTSD-treatment knowledge)  Just saying, it was a lot of work, years of work, trying to track down appropriate help and not having 'case management', while suffering in the crisis of PTSD for quite a long time.  Got into a clinic associated with U of O, and so got access to social worker and a GP--both with proper training. 

Psychiatrists can be years waiting as well, hospitalization, no guaranteed of post-hospital treatment/access/monitoring of medications.  Some GPs will only treat one thing at a time (re: billing and trying to make their own political statment), well chronic PTSD, and new studies confirming the chronic stress and lowered immune system (actually causing alteration in the genes), so it's frustrating when relying on GP for medical and meds refill help.  PTSD can be really hard on the body, throw a lot of things out of whack.

It's good to do research from the ground level, because one hospital here it may still be possible to get some after-care.  Otherwise re: meds, it's a wait till it's a crisis, and can go into Urgent Care Consultation Clinic via ER to get get meds re-adjustment, and up to 6 follow-up appointments, to check on meds change efficacy. 

I had a bout of nightmares by night and flashbacks by day, un-fkng-relenting, lasting daily and nightly for 4 months straight and it was exhausting and overwhelming-- 'blender brain"-- too much PTSD hyperarousal symptoms-- it was hell, body just wasn't able to re-stablize so it kept feeding hyperarousal symptoms, bad cycle.  Seroquel was the 'magic drug' for me that finally put an end to that-- I took it for about a year and I haven't been bitten back like that since.  I also don't use illegal drugs and I abstain from alcohol (though I'm able to have a drink or two and stop, if I chose to-- I didn't inherit the family 'gene' vs. other siblings).

I know people can get caught up in 'war stories' or 'story-lines' of whatever sort related to trauma.  Me, that's not good for me to do (it just triggers more, and I can flood-- flashbacks, one upon another and it can create further debilitating dissociation and risk getting into that crazy cycle of extreme, unrelenting hyperarousal symptoms).  Meditation practice was a good thing to learn-- breathe and ground-- remembering to remind myself that "it's just a memory, it's just recall, it's not happening right now. . .I'm safe and others are safe at this moment. . .and I can look around me and see [objects in the room, name-game, name them, notice colours, shapes, use my 5 senses awareness to help re-ground in the present moment" and not to push myself to over-process right away till, body's physiology is calmed.  This method can work, and with practice, reduce recovery time post-flashback (and body awareness meditation can also help notice things pre-flashback, and a way to avoid getting hit by them).

I'm not sure where this comes from, I think it might be Babette Rothschild's work.  Good book is 8 Keys of Recovery. . . i think that might be where 'flashback management technique" comes from.  The challenge is trying to re-learn patience and self-care from reacting to percieved threat (when the phsyiology is also geared up in anticipation of it), which re: PTSD re-living it, thematically or directly (triggered) (cause trauma, crisis situations required some immediate action-- I think combat people, EMS understand that-- can't sit and twiddle the thumbs, re: crisis situations).  PTSD re-living of a traumatic event, the threat can be percieved threat, as if it's happening in the moment, a product of trauma and not the actual reality at the moment, ti's just memory recall, though it can be really disorientating (but sometimes the alarm system is there for a reason, and situation needs to be re-appraised, if it's not an immediate external crisis/threat to deal with, but need to stablize PTSD physiology first, to help get clear).

If I over-relied on help actually being there, I'd be totally screwed.  I also know that I do have some good inner resilience, which is confidence-building and I keep a generally positive attitude (but not always possible in the midst of PTSD-re-experiencing hell).  Personally, I wouldn't want 'rescue' all the time, I think that would drive me more nuts, someone over-doting on me-- I stay away from 'overly-clinging' people (can be toxic, especially a looney co-dependent [tends to be some darker, hidden agenda's, psych-vampire stuff going on ;) ), can be a bit much and also disempowering, robbing me of realizing my inner resilience.  I need some privacy, time alone, just need to not over-isolate (e.g. weeks on end-- that can get too easy to do and harder to get out-- can develop some 'agoraphobia' in the extreme).

At the same time, I don't think it should have had to have been so difficult to try to track down ptsd-help-- taking years, just to get some help and guidance on how to cope with symptoms, and get some training I can use on myself.  Hospital without private insurance, they have no resources to refer a PTSD person to, to get the right help, to help get a handle on the symptoms which can be super disorientating, and cause a lot of loss of time and functioning, and wear down hard on one's self-confidence.

If CF neglects keeping up with demand for community resources and the spill over into civilian resources which are also seriously underfunded and not up at all with demand for them. . . it's just something I hope they can keep on top of and take it seriously, IMO.  Regardless, there are things a person can do in the meanwhile of longer waitlists, and can self-educate, maybe find some support groups.  Alanon can be helpful for families coping, find the right group that feels right.  Also Alateen, for teens-- it can help with getting some perspective-- there's the benefit of 'experienced-others', who have encountered and overcome some similar challenges, it can reduce some alienation.  There's some basic self-care, resilience strategies, checklist, pointers and guidance that can be found (earlier post, I provided some links), but it can also become overwhelming if in a situation of on-going crisis, to read too much.  It can help to prepare a bit ahead of time, some ideas, and things to look out for (easier then trying to learn while in the midst of on-going crisis, where one's energy can be over-tapped, overwhelmed, harder to learn new things in those times-- that's why there's training-- combat, and medical have a core of training before heading into crisis).  "In times of peace, prepare for war".

:-[  continued. . .
 

kstart

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Some things about Petawawa access, community resources (continued) and related to the corporal story, and present waitlist for families in Petawawa for help (first Star Article)

Addiction treatment is probably easier to access vs. trauma treatment, at least in the past, I've noticed that.  4-6 month wait for inpatient vs. many years re: trauma treatment-- at the civilian level, no private or specialized health care plan.  Some good programs e.g. Rideauwood and they can do referrals and provide counselling while waiting, etc.  AA/NA something to do, try out while on a waitlist.  If there's addiction co-occuring with PTSD, or anxiety, depression, it's worthwhile to start attending to that, then when there's access to trauma help, could lessen the chaos a little more, to make it easier, and be more receptive to learning and practicing new skills.  What's not good is to get over-used to constant crisis, and melt into a denial numb, while things continue to escalate, and especially if things continue to escalate to becoming more dangerous-- and that can be common (e.g. experience of battered women [or men] :( ).

I don't find that everyday people, lay people have much understanding re: PTSD, but it's good to try to keep up a support network, people to even try to enjoy some non-traumatized time with, distraction, healthy activities, etc.-- can go a long way.  But I don't really find that there are many people who are safe, trustworthy to talk about harder stuff (some listeners are overly-dramatic, and I don't find that to be helpful; or judging, and using their own frame of reference, but not understanding the particulars of the challenges of coping with PTSD, vs. coping with hard situations but not impaired by PTSD-- so, you get 'pop psychology' which some might work for non-PTSD-- just change your attitude about things. . . I think the attitude might have to change from within, one's attitude towards one's own suffering and to learn to be compassionate that way, empathy, vs. self-loathing, shame-based, overly sensitive to external labels, or attitudes of others who don't understand.  I also believe that a lot of others don’t like to admit encountering situations that may be beyond their immediate comprehension (so there can be a tendency to over-compensate, block out, put others on ignore-- because certainly feels better, ego-protecting-- it can become easier to just disregard and I think that can be a fairly common experience of PTSD-survivors among others, and it can feel alienating, lead to more isolation even, to get control over those wounds-- things hurt more when already down, over-stressed, impatient).

Normal is trying to chase away any uncomfortable feeling, and that's a survival technique, has a functional purpose and can be for a while (can't afford to fall apart in the face of immediate danger). . . [. . .but till it all comes crashing in  ;) but not necessarily does that happen to all people, many variables which mitigate who's more at risk for PTSD vs. not: exposures, proximity to events, prior traumas, duration/prolonged stress, etc.).  Normal to PTSD, is numbing by habit, but it can also become more problematic, because the tension can escalate anxiety and exasperate symptoms, and be much worse then feeling it through, letting it pass (but in a bad state, it's hard to grasp that it can pass, but that can be learned through more evidence and experience of things passing, and it being okay-- and building tolerance for what doesn't feel tolerable at the moment).  It's trial, and error, and a learning process.  Self-loathing maybe be more common generally in this culture too ;) and when pushed to the limits and beyond. . . loud awakenings, not wanted usually (and it sucks to lose power over it, like what PTSD barrage of symptoms can do). 

I think of this guy with the addictions, the former corporal and he seems to be struggling a lot-- there seems to be an attachment to preferring to be and feel invincible (and part of that has been needed, confidence, re: walking into where there's crisis, and threats to safety of self/others), and that can cause more stress, vs. self-respect, acceptance, trust in oneself, keep faith, etc.  . . . it can be hard challenge to make that leap, but if working on PTSD and the challenges of abstinence from addiction, that can be learnt and can get beyond that impasse and a lot more recovery then can start to happen.  It can be a hard fall from feeling the high of  “invincible” and then to “invisible” even.  The corporal could have been a great soldier at his time, ‘first in, last out’ (I used to be fearless, I liked that time ;) ).  Reality is that no-one is truly invincible, sometimes it’s a matter of luck, to not have the experience of ‘wings clipped’ and falling hard to the ground.  It felt good to not have to feel any pain .  .  ., it’s a hard loss, when the system breaks and pain comes flooding in, when not wanted and when no-longer so easily containable.  PTSD itself, feels like a constant fear of ambush, by the symptoms presenting alone.  Try to get things done and bam, get hit with it. . . Frustrating and having to clear the fallout.  It’s different training requirement, not operating on external situations, securing scene, containment, apply training, but coming back to operate on internal situations which is entirely new and hard to be objective without some training for that (and even a bit of outside guidance, to help with the training), internal landscape.

-----------

There's a John Prine song, "Sam Stone", I've discovered it seems to resonate a bit with some of the Viet Nam Vets, in a way, like some blues, validates suffering, a person who's isolated themselves, and addictions to chase away the pain, puts some honour to those who've lost comrades due to PTSD/addictions and brings a sense of presence to that suffering, numbness, soul struggle/faith, etc. 

http://www.youtube.com/watch?v=xSeBEgFjGLA

(Might not like the accompanying picture. . . I have a feeling it might reflect some feelings of some left behind, hidden-injury sufferers.  It's haunting, disturbing.  Can hear in Prine's intro to the song, re: a visit to the Washington Memorial [the VN one also misses a few, e.g. one‘s who flew into Cambodia, not sure if that ever got resolved, but I personally know that it hurts a few]):

http://www.youtube.com/watch?v=cqLLglEfbbU&NR=1

There are some choices, but not all can see that or have the faith (or enough left) to rise to the challenge and the endurance it calls upon re: recovery and to take the leap despite stigma or shame to seek help when it‘s become problematic.  I think it calls upon a newer courage (and not commonly acknowledged, or understood, and still always uphill re: stigma, etc.) for that particular challenge.  Sadly, there have been a few who've lost faith (even temporarily, but enough for it to be fatal and taking an unhealthy path to cope) and it's also an old story, years long.  PTSD stats I think are similar re: percentages, Civilian general population and Military (?) around 8%, mitigating factors, as I’ve mentioned some previously re: duration, exposure, proximity, pre-conditions (prior traumas) etc. (more from the links in previous post).

Another version of the song here-- comments show that it does resonate with Vietnam Veterans, families, survivors:

http://www.youtube.com/watch?v=cqLLglEfbbU&NR=1

(I thought it was Johnny Cash at first, the low voice).  There’s another video tribute, using a Dylan song (Eddie Brickel cover), “Hard Rain’s A Gonna Fall”, some honour to the experiences in general, validating (makes me cry sometimes, and some images are reminders for me) but also affirming.  The metaphor of a “Hard Rain’s Gonna Fall”, reminds me about acceptance of PTSD.  Dedicated to the families and  ISAF survivors of the Afghanistan war, with a nod to all NATO partners.

I can’t handle ‘over-sentimentality’, but I find these songs resonate with me, a level of real, that for me, feels translate-able to PTSD-experience (metaphorically even)  but not over-dramatic (as is the habit of media at times, everyone has learnt to sensationalize, over-dramatize), distortive in that way.  I feel there is a ‘middle ground’, not to abandon, and disregard real challenges and struggles (and the urge to sweep it under the rug) and to be active and pro-active to help support, have those options available.  Temptations in people can go to extremes of avoidance, denial, shame of problem challenges (stigma) to being overly dramatic about things.  The middle ground I think is a mature stance, and responsible.  These fallen soldiers, and one’s with ‘invisible injuries’ are our brothers and sisters, CF family, I also see it in the context of the larger ‘human family’ and I feel compelled to stand with them (at least in spirit).  So I’m compelled to try to myth-bust,  challenge stigma, misunderstanding and would wish to express dignity to the experience, and respect for others who are affected (not achieve-able alone, but if there can be a ripple of some helpful understanding that can help others).  I think a lot of positive things have happened within CF, and that’s really good to see.  But there can be problems, re: resource shortages re: qualified and competent professionals re: PTSD and families. . . There’s been some positive changes, past 10 years re: ‘the system of support resources“, but still some challenges which preparation ahead of time can help mitigate escalation into deeper troubles.
 

kstart

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I don't know if I've just mucked this up.  Writing about it to try to help normalize it, don't know if it helps de-stigmatize or help others currently experiencing, struggling with it.

While some reactions to the Star articles, I could feel the discomfort of anger, frustration.  It's not cool with me at all, if the PTSD dx is misused to escape accountability for really bad behaviours (e.g. assault) and I feel particularly angry about the case of wife assault, in the first story.  I feel PO'd that a person would allow their behaviours to escalate to violent acting out on others and not take that as a cue to seek immediate help and follow-through on that.  I've seen a 'dark side' to PTSD, where the survivor, mistakenly believes they are the only one's affected, not taking into account their families (I lived that in childhood), e.g. get mad at the wife, because "she wasn't there", etc. and think it's okay to take out anger aggressively on another.  Anger treatment, there are effective, non-destructive (or less destructive to self or others) ways of releasing it and a person is responsible for their actions, and if they've lost self-control ability, it's their responsibility to self, family, CF family, society. . . to seek treatment, no BS.

In the second article, re: the corporal and the addictions that have taken hold.  From my experience of people deep in the throws of a serious addiction problem, a reluctance to get help, because the hold of the addiction is so strong (it's looked like a person is split in half, two personalities, one is the addict, which seems to sabotage and create further resistence to seeking help [so, it's not always a case of lack of access to helping resources, but the addict-self taking a strong hold over the person, sabotages, and is a barrier to get through to seek out some help).  A person resistent to taking the steps to get help, might latch on to excuses, like "no help there for me, I've been abandoned by the Military, or the system, etc.", it becomes self-perpetuating distortive thinking, denial, they can even believe the lie (addict-part's lie), because they haven't actually 'reality-tested' for themselves to actually actively seek help.

Using the "PTSD-card" as an excuse or as a way to manipulate others is not acceptable to me. 

Also, if that guy did smarten up and seek addiction help and while through the harder parts, appoint a Power of Attorney, Gardian to restrict access to $ temptation to spend on drugs (particulary sticky re: cocaine addiction and can go broke and lose everything fast = plus the gambling mistake) till he can regain a sense of self-control again, and tested and practiced-- that person would also have to be strong enough to resist manipulation.  It sucks to see a person lose everything and keep sinking (and in the worst case scenario, lose their life by accicent, or suicide, etc), the bottom can be raised up.  Having the military training, should be able to be teachable, recover some to help get through tough spots, and towards greater recovery (but if it escalates, then sometimes will need to stablize on meds for a bit, so more ready to learn). 

Anyway, I wrote a lot and apologies, I don't mean to dominate the thread.  There could be up to a 1000 CF members (+ add in families) who could be facing struggles-- not a guarantee either, not deterministic, but just that risks are there.  It's a risk factor, re: exposures, not all develop full-out PTSD, some is acute PTS-effect, etc.  Being prepared can take some anxiety out, it can also create anxiety too, so it's about attitude and how to keep balanced, grounded with it.
 

mariomike

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kstart said:
And on where and what the role of Psychological First Aid can be, which also respects people's own inner resilience:

Kstart, it's funny to remember what  Psychological First Aid was before CISD. It was a hard-hat and shovel spreading asphalt for six weeks, or until you got your mind right. Just the threat of that helped develop "inner resilience". Perhaps that is why many of us schooled in that era resented mandatory CISD. You know they actually made us sit on the floor, hold your partner's hands and stare into his eyes - without laughing!? The union stepped in and put a merciful end to it.  Management agreed because it was putting a strain on operations, and costing overtime. Especially when crews started telling the psychologist how much fun it was making time and a half to eat cookies and drink fruit juice. :)

We had very little Psychological First Aid training for patients and families in emotional distress back then. But, we did the best we could to help people without being judgmental. "Help others, help yourself", they told us. I believe that to be true.  Incidentally, attempted suicide was still a crime in Canada when I went through the academy. Most of us treated suicide attempts, no matter how weak, seriously. It wasn't our job to judge people. Although there were a few tough-guys who thought it was funny to make certain suggestions to them. That made no sense to me because we would be the ones sent back there.

Maybe we relied on the straight-jacket a little more than we should have back then because we didn't know any better.
I mentioned deinstitutionalization. Turning the mentally ill into the streets. It was overwelming. A total failure, in my opinion.
I have no doubt the warm transfer lines did in fact save lives. I remember occasions when they traced open lines for us to respond to.

You have a lot of good information and advice on the subject.





 

kstart

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mariomike said:
Kstart, it's funny to remember what  Psychological First Aid was before CISD. It was a hard-hat and shovel spreading asphalt for six weeks, or until you got your mind right. Just the threat of that helped develop "inner resilience". Perhaps that is why many of us schooled in that era resented mandatory CISD. You know they actually made us sit on the floor, hold your partner's hands and stare into his eyes - without laughing!? The union stepped in and put a merciful end to it.  Management agreed because it was putting a strain on operations, and costing overtime. Especially when crews started telling the psychologist how much fun it was making time and a half to eat cookies and drink fruit juice. :)

We had very little Psychological First Aid training for patients and families in emotional distress back then. But, we sincerely did the best we could to help people without being judgmental. "Help others, help yourself", they told us. I believe that to be true.  Incidentally, attempted suicide was still a crime in Canada when I went through the academy. Most of us treated suicide attempts, no matter how weak, seriously. It wasn't our job to judge people. Although there were a few tough-guys who thought it was funny to make certain suggestions to them. That made no sense to me because we would be the ones sent back there.

Maybe we relied on the straight-jacket a little more than we should have back then because we didn't know any better.
I mentioned deinstitutionalization. Turning the mentally ill into the streets. It was overwelming. A total failure, in my opinion.
I have no doubt the warm transfer lines did in fact save lives. I remember occasions when they traced open lines for us to respond to.

You have a lot of good information and advice on the subject.

"You know they actually made us sit on the floor, hold your partner's hands and stare into his eyes - without laughing!?"
 
Whoa. . . couldn't find a 'barfing smiley' to accompany my reaction to that ;)

The union stepped in and put a merciful end to it.
  --Thank goodness! ;D

Psychological First Aid was before CISD. It was a hard-hat and shovel spreading asphalt for six weeks, or until you got your mind right. Just the threat of that helped develop "inner resilience".

There's an old Zen saying, "chop wood, carry water", kind of a way to calm the mind, and re-ground.  Can also apply 'mindfulness skills", be intuned to the body/physiology, work safely to prevent injury-- can work out some anger via physical work (or exercise), can pray or meditate while doing it (provided not in immediate combat zone. . . ?)-- there are opportunities for choices for inner resiliency through that experience.  (My brother works hard labour, he treats some of it as active meditation, allows him to enjoy it better and it's grounding--he's fast, but not reckless-- wraps 20 skids to another's 2, very efficient--he's an older worker [maybe more attention to efficient energy expediture ;)).

This makes a little more sense, CISD post-combat field event, a little more direct and to the reality, check it out:

http://www.usmc-mccs.org/LeadersGuide/Deployments/CombatOpsStress/generalinfo.cfm

[quoteHold regular “hot wash” After-Action Reviews (AARs)
Marine leaders are already familiar with the hot wash or After-Action Review (AAR) as a tool for gathering and sharing information with their Marines after significant actions or events, in order to promulgate lessons learned and to improve future performance. These same AARs can also be effective tools for Marine leaders to help their Marines achieve a common understanding of what happened and why it happened, and what purpose was served by their actions and sacrifices. Open and honest two-way discussions during a small-unit AAR can help reduce excessive feelings of guilt or shame, and help restore lost confidence in peers or leaders. AARs can also help identify which Marines in the unit are experiencing persistent stress injury symptoms. Helping Marines make sense of their combat experiences, restoring their confidence in themselves and each other, and ensuring that seriously stress-injured Marines get immediate help all promote readiness and healing and prevent long-term disability.
][/quote]

I also like the clarity of their terms:

Definitions
Combat Stress:
changes in mental functioning or behavior due to the challenges of combat and its aftermath. These changes can be positive and adaptive (e.g., increased confidence in self and peers), or they can be indications of distress or loss of normal functioning that may be symptoms of a combat/operational stress injury (see below).

Operational Stress:
changes in mental functioning or behavior due to the challenges of military operations other than combat.

Stressor:
any particular mental or physical challenge or set of challenges.

Stress Adaptation:
the normal, reversible process of coping with a stressor, usually by either changing oneself physically and mentally to be better suited for that particular stressor, or by becoming numb to the mental and physical effects of that stressor. Stress adaptation is always temporary, and it always fades after the stressor is no longer experienced.

Combat/Operational Stress Injury (COSI):
potentially irreversible changes in the brain and mind due to combat or operational stress that exceed in intensity or duration the ability of the individual to adapt. Symptoms of stress injury normally resolve over time as the injury heals, but intervention may be needed to promote healing in some cases. COSIs can be of three types, differing mostly in the cause of the injury: (1) traumatic stress injury, (2) fatigue stress injury, and (3) grief. Many COSIs include components of more than one type of stress injury, since trauma, fatigue, and grief are not mutually exclusive.

Traumatic Stress Injury:
a stress injury caused by the impact of specific events involving serious or sustained threat to one’s own life, or a loss of life or serious injury witnessed in another.

Fatigue Stress Injury:
a stress injury caused by the wear-and-tear of unrelenting exposure to operational stress during long or repeated deployments, often compounded by concurrent stress from other sources such as family problems.

Grief:
Stress caused by the loss of someone who is cared about, such as a buddy, leader, or family member. Although everyone who lives long enough suffers the loss of others who are cared about, and grief is a normal healing process, it is important to recognize that losses of close friends, valued leaders, or family members inflict mental and emotional wounds that take time to heal, and may interfere with normal functioning until they do heal.

Posttraumatic Stress Disorder (PTSD): a traumatic stress injury that fails to heal such that the symptoms and behaviors it causes remain significantly troubling or disabling beyond 30 days after their onset. PTSD is not the only stress disorder that can result from unhealed stress injuries; others include clinical depression and anxiety, and substance abuse or dependence.

Combat/Operational Stress Control (COSC):policies, programs and actions designed to prevent, identify, and manage COSIs

I remember reading "A Soldier's Account" up on CBC, one guy was a field ambulance/medic, pretty intense journey, and they got pinned down for 3 days because of heavy fighting.  I could see the grounding of getting meals happening, but then getting shot at. . . and there's a lot exposures, re: injuries, bodies, etc.  Looks like a situation which guarantees fatigue, plus other risk factors.

Your point about resilience is important and I want to come back to that.  There are normal stress reactions, normal PTS-effects, which in most cases can clear up on their own; it's a matter of knowing the threshhold of when it's a good time to seek help.  Also re: mild TBI, often that can clear up in a year on it's own (several factors of resilience, including the body's natural healing ability), but for about 10%, it doesn't clear up naturally and so they may need to seek out help. 

I still think the Star articles are opportunities for learning and reflection-- it's not generalizable, in research terms it's some 'qualitative data', anecdotal, but it can have some value re: presentation of issues which can be work exploring.  Some of his experience is validated by some statistics as well, meaning he's not alone, not a single case.  I've noticed that some of the US VA-related sites are no-holds-barred, very direct, informative and responsive.

--------
Corrections from previous posts:  Math error :-[-- re: PTSD rates, in the States "1 out of 13" does not equal 8%, lol-- there were different stats, 1 out of 13 males, and higher rate for females (hypothesised re: various kinds of traumatic exposures, non-military-combat +). . . and Dr. Wellburn-- not sure if that was a psychiatist, might be a psychologist (not OHIP-funded).  I do know some of the best of help are servicing CF members, what concerns me is shortage of that kind of quality relative to demand, present and future.  Also, re: psychiatrists, check out 'past findings' via College of Physicians and Surgeons. . . better to research before the fact. . . some do have a sick pathology that was not corrected by disciplinary actions (pay attention to targetted gender). . . curiously short waitlist. . . bs a person in recovery doesn't need, can create setbacks-- consumer warning, take reasonable precautions, trust in your self.
 

kstart

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Re: Resilience

http://www.apa.org/helpcenter/homecoming.aspx

The number and intensity of stressful experiences notwithstanding, most returning personnel and their families should be able to bounce back successfully.

Even those who have learned resilience skills, however, should not expect homecoming to be effortless or free of emotion. It is quite normal to experience days or several weeks of mild to moderate symptoms of depression, anxiety, and anger, even if the initial homecoming was full of joy.

Children, for example, reassured with the safe return of a parent or sibling, may now feel they can express some of their negative feelings of fear or anger over what they may have experienced as abandonment.

Normal Is What Works for You
There are no standard or normal stages for homecoming. The process varies from person to person. Understanding that homecoming has its own brand of stress is a first step in the process of a long-term successful reentry for military personnel, their families, and the community.

and Resilience Tips Re: Homecoming:

10 Tips for resilience during homecoming
Early in the process, identify people who can help--a friend, clergy, mental health professional, financial advisor--and seek help if needed. Some of these sources can supply emotional support, while others can provide direct help with day-to-day problem solving. Resolve to be open about problems and work on resolving them together, either with family members or those professionals who can help.

Dismantle big problems into manageable small parts. Then, attack and solve these parts as a means of rebuilding confidence. A step-by-step approach can eventually resolve the larger problem.

Be an active player, not a passive victim. Social involvement through religious organizations, hobby groups, exercise clubs, social groups, etc., helps individuals rejoin the community.

Don't put off solving problems. Begin to work on problems immediately; inaction can reinforce the feeling that a problem is out of your control.

Don't seek solace in drugs or alcohol. This not only fails to resolve the problems at hand, but creates new ones.

Recognize that family readjustment problems are normal. Don't blame others for your distress, and don't blame yourself excessively.

Keep things in perspective. Cynicism or excessive pessimism about life and the future can become self-fulfilling and have a negative impact on you and others. Keep things in perspective-- not every problem is a catastrophe. Although it sounds simplistic, a positive outlook helps raise morale and increase resilience.

Recall how you met past challenges and use the same strategies to meet the stresses of homecoming. By facing current problems with an eye to solutions, you are more likely to achieve a sense of progress, of "getting ahead" with life.

Realize that the stress of homecoming can magnify other daily stresses, so make allowances for yourself and your family.

Accept as inevitable some setbacks in the return to "life as normal"--whether they are emotional, financial, physical, or job-related. At the same time, be aware that the skills of resilience can help you bounce back.


 

kstart

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Resilience Tips, General and Through Recovery:

From:  http://www.apa.org/helpcenter/road-resilience.aspx#

10 Ways to build resilience
Make connections. Good relationships with close family members, friends, or others are important. Accepting help and support from those who care about you and will listen to you strengthens resilience. Some people find that being active in civic groups, faith-based organizations, or other local groups provides social support and can help with reclaiming hope. Assisting others in their time of need also can benefit the helper.

Avoid seeing crises as insurmountable problems. You can't change the fact that highly stressful events happen, but you can change how you interpret and respond to these events. Try looking beyond the present to how future circumstances may be a little better. Note any subtle ways in which you might already feel somewhat better as you deal with difficult situations.

Accept that change is a part of living. Certain goals may no longer be attainable as a result of adverse situations. Accepting circumstances that cannot be changed can help you focus on circumstances that you can alter.

Move toward your goals. Develop some realistic goals. Do something regularly -- even if it seems like a small accomplishment -- that enables you to move toward your goals. Instead of focusing on tasks that seem unachievable, ask yourself, "What's one thing I know I can accomplish today that helps me move in the direction I want to go?"

Take decisive actions. Act on adverse situations as much as you can. Take decisive actions, rather than detaching completely from problems and stresses and wishing they would just go away.

Look for opportunities for self-discovery. People often learn something about themselves and may find that they have grown in some respect as a result of their struggle with loss. Many people who have experienced tragedies and hardship have reported better relationships, greater sense of strength even while feeling vulnerable, increased sense of self-worth, a more developed spirituality, and heightened appreciation for life.

Nurture a positive view of yourself. Developing confidence in your ability to solve problems and trusting your instincts helps build resilience.

Keep things in perspective. Even when facing very painful events, try to consider the stressful situation in a broader context and keep a long-term perspective. Avoid blowing the event out of proportion.

Maintain a hopeful outlook. An optimistic outlook enables you to expect that good things will happen in your life. Try visualizing what you want, rather than worrying about what you fear.

Take care of yourself. Pay attention to your own needs and feelings. Engage in activities that you enjoy and find relaxing. Exercise regularly. Taking care of yourself helps to keep your mind and body primed to deal with situations that require resilience.

Additional ways of strengthening resilience may be helpful. For example, some people write about their deepest thoughts and feelings related to trauma or other stressful events in their life. Meditation and spiritual practices help some people build connections and restore hope.
The key is to identify ways that are likely to work well for you as part of your own personal strategy for fostering resilience.

Some of the CBT techniques can go a long way as well in facilitating healthy, balanced perspective.  Through difficult times, added stress, it can be a challenge to maintain-- know how to find 'home' (back into positive thinking).

I think returning home, post-deployment, some extra care, is a good idea, knowing that stress will be a normal part of that transition.

I think this is one of the best sites I've uncovered re: Post-Deployment/Return-- useful for both returning CF and for their families.  It's straight-forward, clear, seems to address a multitude of issues with practical coping tips, options.  Knowing what is normal to expect re: returning service members and for families, can help reduce some stress-- just understanding that some of the stress is very normal:

http://www.ptsd.va.gov/public/reintegration/guide-pdf/FamilyGuide.pdf


This can be some comfort (vs. my sounding the alarm re: PTSD as if it's deterministic/guaranteed-- I'm just an example of very late intervention [not by choice-- access issues]):

Most service members coming from war zones will have stress reactions. But only a small number will develop PTSD. The Army produced the “Resilience Training” program (https://www.resilience.army.mil/) and the Navy and Marine Corps produced the Combat Operational Stress Leaders Guide (www.usmc-mccs.org/LeadersGuide) to help service members and families understand how a wartime mindset is useful at war but not at home.

I can't access the links above, and I don't know if CF would have similar programs (?), but it's interesting.  I think the Resilience Training program was once called "Battlemind.org"?  If I imagine being in dry, dusty Afghanistan, maybe I'd want to go on a canoe trip, be around lakes or ocean, lots of Canadian greenspace, different smells, pines, spruces, Maples (Sweet Home Canada :) )  I think I read somewhere about some programs in the States of outdoor adventures, for service members, families, including members with physical injuries which can limit some mobility, facilitating easier access to Nature. . .?  "If I had a million dollars", or owned a great resort, that would be a pleasure to be able to offer that, a great way to  :yellow: :salute: :cdn:  My exposures to Nature, helped me build imagery to use for "Guided Visualization Technique" -- I can take a 'vacation' anytime, and it helps re: symptom management (especially, e.g. hypervigilance symptoms. . . just have to remind myself, recognize it when it's happening and take a mini-vacation  ;D).  It's to have safe imagery, of a safe place, a pleasant place, that doesn't have traumatic reminders. . .

Anyway, I think back to the corporal who's struggling with addictions and PTSD, whether some preparation and training earlier on could have helped prevent a deeper slide (not always the case, I'm just wondering. . .).  The issues are likely much more complex, several factors.  He was young on his first tour-- only 22 years old?  That's one of several risk factors re: combat OSI, but it can affect anyone.  Likewise with the one from the other story who assaulted his girlfriend, if some earlier preparation could have helped prevent things from going that far?

I know that CF pursues excellence and I have a lot of respect for that as what it is, an on-going endeavour and there is so much to be proud of :salute: :cdn:


These resilience factors, "hopeful outcomes" and "positive view of oneself"-- these are strong assets and when strengthened, it's power against external shame (e.g. from stigma) and protection from internalizing it.  It's strength to rise above.  Under stress, or not understanding that it's even normal stress it's a challenge to maintain it, but it can be recalled.  Also, volunteering, service, helping others, that's also useful for perspective, IMO.  Compassion directed at others can also bring a gift, or an opportunity to learn a compassionate attitude with oneself, and this can build resilience through PTSD hassels.  Getting down to a level of active listening, practicing for some years (without hinderance from excessive judgement, pre-conceptions, garbage from shaming cultural attitudes, etc.), but acceptance, re: where a person is at and what they are presenting is a useful experience. 

The 'inner critic", internalized by various sets of experiences, can influence attitudes in judging others and also in judging ourselves.  I don't want to bible-thump (I'm not a thumper), but there's a passage in Matthew, re: "do not judge, lest you be judged yourself, for the manner in which you judge, you will be judged. . .you hypocrite, first take the log out of your own eye, before you seek to remove a speck from your neighbour's eye".  I think there's a psychological truth to that, not separate from 'spiritual truth'.  So if one gets stuck in the judging, shaming. . . there may come a day of humbling and a harder fall.  It's a deeper level of protection from stigma, because like or not, it's always going to be there to a certain degree (and it comes from lack of understanding, bias, distortion, self-deception), although Militaries such as CF and US ones, are actively seeking to change that. . .
 
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