Operational Stress Injuries, Part 2: Shoulder To Shoulder

February 10, 2013 by Sharon Adams
 [ILLUSTRATION: RORY KURTZ]

ILLUSTRATION: RORY KURTZ

Jeff looks every inch like a guy who can take care of himself, especially when he’s astride his motorcycle. He’s got the beefy upper arms of someone who has worked out a lot and a muscular body proving he does a physically demanding job. Tattoos peek from cuff and collar. He’s the kind of guy who takes life head-on. But when he returned from one of his two tours to Afghanistan, he carried a load of guilt that brought him to the brink of personal destruction. 

On one mission, someone who had taken his place was killed. “I came back, and he didn’t.” Eaten by guilt, scared to socialize lest he get into a fight, plagued by nightmares, and with relationships flashing by as though he were in a turnstile, he knew he was in trouble, but wouldn’t ask for help.

When he was in the military he worried it would harm his career if anyone found out he’d received psychological help. That mistrust followed him to civvy street, where he wanted nothing to do with veterans programs either. “I sloughed it off for years…and dealt with my own beast.” Sometimes it felt like the beast was winning.

He blew off steam with other guys in an ex-military motorcycle club on the West Coast. One day one of them started talking about the Veterans Transition Program (VTF), and Jeff and a buddy decided to check it out. What they found was a group of military guys on a mission to help each other start living—not just surviving—in the civilian world. Jeff discovered he didn’t have to fight the beast alone. “You can draw strength from other people.”

Jeff, who asked that his real name not be used, is one of more than 275 British Columbia veterans over the past 15 years who have gone through the Veterans Transition Program for help in making the transition from military to civilian life. Founded at the University of British Columbia and funded over the years by British Columbia/Yukon Command of The Royal Canadian Legion, the program is going national.

Over the next two years The Royal Canadian Legion Dominion Command Poppy Trust Fund is providing up to a half million dollars in start-up funds to the Veterans Transition Network, the newly formed foundation that will run the program across Canada. The funds will be used for such things as training psychologists and providing infrastructure so the program can be offered countrywide. Legion provincial commands and individual branches will provide up to another half a million dollars to pay for the program to be delivered to veterans in individual provinces. That brings the Legion’s total commitment to about $4 million, considering B.C./Yukon Command’s investment of $1.8 million over the years for treatment and $1.2 million to support research. As well, Veterans Affairs Canada will provide $600,000 over the next four years to pay for veterans to participate in the program. True Patriot Love Foundation has donated $250,000 to fund sessions in Atlantic Canada, and Wounded Warriors.ca has donated $100,000 to fund a test program in Ontario.

“We understand veterans need special care and attention, especially as they transition from military to civilian life,” said Legion Dominion President Gordon Moore. This funding will ensure anyone who has served in the military will be able to attend the program free of charge. “The number one reason I believe why we need to be involved is once veterans go through the program, they are able to go home and live a normal, adult life. It brings them back to civilian life. They’re not isolated any more. We can help veterans, their families, their kids.”

No one is quite sure how many veterans need help making the transition to civilian life. A Canadian Forces study of the 30,518 personnel deployed to Afghanistan between 2001 and 2008 showed roughly 30 per cent received mental health services within 4½ years of return and 13.2 per cent were diagnosed with an operational stress injury such as post-traumatic stress disorder, depression or anxiety. But those are people who asked for help.  Nobody knows how many did not ask for help then, or later, as veterans. There are Second World War veterans, NATO veterans and peacekeepers with issues from service decades ago who still have not asked for help.

“Everybody comes back from tour with some sort of issue. If you’re six months out of tour or 50 years out, VTP will help,” says Jordan Irvine of the Royal Westminster Regiment in New Westminster, B.C., who had two tours to Afghanistan. He found his own session so helpful he has referred many others to the program.

Veterans interviewed for this story say VTP differs from other programs because it focuses on skills needed to deal with their personal issues, whatever those issues might be, but the work is done in a group, shoulder-to-shoulder, with other soldiers and veterans and guided by professionals who understand military culture.

This ‘band of brothers’ mentality is what sets the VTP apart, says Halifax psychologist John Whelan, a naval electronics technician in the 1970s and ’80s before he trained for a career in psychology. He left his position as clinical director of addiction services for the Canadian Forces in 2004 to start a group-based service for serving and retired military.

Standard treatment for ex-military personnel is one-on-one ‘talk’ therapy, but VTP is “quite different,” Whelan adds. “Instead of just telling their stories, they have to go back to the event symbolically and work it through. (They) bring out, in the presence of other soldiers, events they have not discussed with any therapist, including myself. Because of that trust, they have a willingness to help each other get through tough places.”

Jeff’s tough place was Afghanistan, where he believed someone died in his place. With other members of the group filling the roles of comrades, Jeff re-enacted what happened on that fateful mission a decade ago. “It was very intense. (The enactment) brought me back to that experience.” With a buddy playing the part of the dead soldier, “I was able to talk to him about not being where I was supposed to be and how because of that I’m still here and he isn’t.” He was able to tell his comrade how sorry he was. “I talked about the guilt” as fresh that day as the day his comrade died. And he cried. He cried, and cried.

In the military, he says, “You don’t show emotion, and when trauma happens, you kind of freeze up. Because you didn’t have time to feel at that time, everything just gets locked up…bottled up, frozen. You start going through the enactment and blaaaah, it just spills out. It’s a roller coaster; you can be laughing one second, crying the next.

“By the time you’re done you’re soaking with sweat. You feel like you’ve just run a marathon.  You just flop back in the chair; you’re spent. It kicks the shit out of you. To learn how to release those emotions in a good way is amazing.”

Having a bunch of buddies you trust watching your back while you’re doing it makes it a whole lot easier. “You feel like you’re back in your section again,” adds Jeff. “It recreates that camaraderie. When you go on tour you know you’re going to do some shitty work, but with the best group of guys you’ve ever met. When you come to VTP, you’re going to be doing some really tough work, but you’re doing it with the best guys you ever met. Once that atmosphere is created, they’d do anything. You can send them out over the wire—or you can send them in a circle to cry.”

Servicemen and servicewomen call that emotional release “dropping the baggage.” It is a whole lot harder than it sounds, but there’s strong motivation. “They have uncontrollable pain, or their lives are out of control,” says University of British Columbia psychologist Dr. Marvin Westwood, adding that addictions can take over. Professionals and veterans interviewed for this story speak of a variety of problems experienced by veterans in pain. They leak anger, which poisons workplaces and social relationships; they might not be able to express emotions other than anger; they don’t feel like the person they used to be; they’re stuck in limbo, with attitudes and behaviour more suited to military life, unequipped for their roles as civilians.

 [ILLUSTRATION: RORY KURTZ]

ILLUSTRATION: RORY KURTZ

“I’m very clear about it being a transition program,” adds Westwood, who co-founded the program, along with physician Dr. David Kuhl and Dr. Tim Black from the University of Victoria. “I tell them ‘you got wonderful skills that served you in your military career, but they won’t be productive here. You require new skills. You are going to skills boot camp.’”

Participants meet at a retreat for 10 days on weekends spread out over a three-month period. They identify the barriers keeping them from moving on in civilian life, which might include something from a military tour, current family issues or something that happened before they joined the military. Then they find ways to move beyond those barriers through participation in dramatic re-enactments and other exercises designed to free up frozen emotions, and learn new communication and relationship skills.

Although Paul Farrugia’s worst symptoms of post-traumatic stress disorder had been calmed by traditional therapy, the new skills he learned at VTP helped him move back into society. “They said straightaway ‘we’re not going to cure you, we’re going to help you.’ And that’s what they did. They took care of a lot of burning issues inside me.” He joined the Australian army expecting to be a peacekeeper—and then came 9/11. “It changed; it was all about going to war, which was a shock.”A handler whose sniffer dogs sussed out explosives and weapons, Farrugia served in the Solomon Islands, on tsunami recovery in Sumatra and two tours in Afghanistan.

“There wasn’t one exact incident,” he adds. “Everything just built up to a moment where it just blew up inside my head, and I had PTSD. It’s like once I turned it on, the training took over; when I came home I couldn’t turn it off. ”

Farrugia developed severe paranoia. “I was always searching my house. I would search in every corner, all the doors, every crack in the house, looking for shadows, always looking if people were around. This is my daymare.” After his friends learned he booby-trapped his house and barricaded himself in at night, they insisted he move in with them and get some help. Eventually therapy and medications helped calm the paranoia, but his temper was easily triggered by ordinary things—frustration in traffic, seeing an animal mistreated. “I would have reactions, and I’d hold it in so nobody could see it and once I was home it would boil over.” After his medical discharge he moved to Vancouver to be with his girlfriend.

“I was happy to sit home with my pension and just do nothing for the rest of my life.” His partner and her family had other ideas. They contacted veterans support agencies and Farrugia was referred to VTP. Now angry outbursts “are few and far between; I have tools to recognize when it’s about to happen. The feelings aren’t so strong and they don’t come on instantly; it’s just a normal emotion, and not out of proportion.” He gained the confidence to train his service dog Perry, and is now in training himself for a job in border security.

VTP has also helped those with less dire issues. Like many returning from Afghanistan, Jonathon Mishrigi returned from his 2008 mission feeling numb. “I just felt like I didn’t care about anybody or anything. I felt very distant.” He had gone through individual counselling, and that helped but “it didn’t deal with the underlying issue, to understand it and how to address it. VTP helped me identify what was going on”—loss of trust—“and to sort out how to be able to trust again.”

At home, this inability to talk about his emotions and needs played out as anger. Arguments became commonplace, says his partner Natalie Hodge. “He’s really particular about how to stack dishes in the dishwasher and he’d lose his temper about how I’d do it. I didn’t understand why he was so upset, and that would make him even more angry.”

After learning communication and relationship skills, “he is able to be more open with me to talk about issues. He’s able to communicate what he needs from me or what he needs me to do for him. He wasn’t able to do this before…”

Mishrigi went on not only to train as a paraprofessional who helps out during VTP sessions, but to take courses in psychology as part of his university education for his new military career—he’s training as a pilot in the Royal Canadian Air Force. As an officer and leader, he will be responsible for the well-being of men and women under his command, and his VTP experience and training will help him more easily spot others who need help and make sure they get it, he says.

Such stories are heartening, says President Bob Brady of B.C./Yukon Command, which has poured nearly $2 million into the program over the years. “We’re pleased VTP is part of the spectrum of services we have for veterans.”

After researching the program’s success in B.C., “We…felt we couldn’t go wrong in bringing that type of program here,” said Steve Wessel, co-chair of Nova Scotia/Nunavut Command’s Veterans Outreach Program. The command spent upwards of $60,000 to fund a program in 2012. “This is not the be-all and end-all,” he adds, but it adds to the variety of services available to veterans and increases opportunities for veterans to find things that work for them.

Part 1 of this story, The War Within, can be found in the November/December 2012 issue. More information about the veterans transition network is available online at www.vtncanada.org.

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