Post Traumatic Growth

"Some soldiers respond to the trauma of combat with a new sense of hope. How crazy is that?" 

With a subtitle like that one, Jim Rendon's New York Times Magazine article, "The Postwar Attitude Adjustment" Sunday (March 26) was an automatic must-read for me. I couldn't put it down.

Conventional wisdom has accepted the near inevitability of combat related PTSD (Post Traumatic Stress Disorder) for some time now. Rendon's article points to research that challenges this.

One of the researchers is Richard Tedeschi, a psychologist from the University of North Carolina. Tedeschi has written a book, Posttraumatic Growth: Positive Change in the Aftermath of Crisis. He speaks of the kind of seismic event that "causes you to question your fundamental assumptions about the world."

Most of us have the luxury of avoiding such questions. Most soldiers don't.

The Amazon write-up of Tedeschi's book lists the following questions, among others, that the book answers: "What role do changing belief systems, schemas, or "assumptive worlds" play in positive adaptation? Is "stress innoculation" possible? How do spiritual beliefs become central for many people struck by trauma?"

Why is it important to get this right? Rendon's article tells us that The Department of Veteran Affairs spent more than $5 billion on mental-health services last year and the number of soldiers with diagnosed PTSD more than doubled from 2005 to 2010. Something has to change.

Rendon goes on to describe a new preventive measure, the "Comprehensive Soldier Fitness" program, aimed at creating a more psychologically fit and resilient U.S. Army soldier. The cost? At $125 million over five years, it's a fraction of the $5 billion annually spent on drug related treatments that assume PTSD to be normal and unavoidable.

Brigadier Gen. Rhonda Cornum is behind the program. She is an amazing lady - a physician, pilot, competitive horseback rider - and former prisoner of war. She wrote a book, She Went to War, about her experience as a flight surgeon on a Black Hawk helicopter, which was shot down in the first Gulf War. She was pinned, with two broken arms, by the wreckage, and then held prisoner for eight days. The New York Times article quotes her as saying, "The crash had been so devastating that I should have died then, and I regarded every minute I was alive as a gift. I vowed to survive. It's the only way I would think. I've been practicing that my whole life. If you don't do that, why would you ever proceed with anything?"

When she returned home, instead of tales of anguish and suffering, she had only positive things to say. A core principle of her Comprehensive Soldier Fitness Training is "seeing an event as neutral, neither bad nor good, and focusing instead on your reaction to the event." Soldiers are taught to "hunt the good stuff" and write down three good things that happened before they turn in for the night.

My own father was a survivor of a  machine-gun wound in World War II, considered mortal by army doctors. He did not suffer from PTSD. He instead experienced "Post Traumatic Growth," not only surviving his deadly wound, but going on to become a successful lawyer/banker/father, and a deeply religious man.

So I was glad to hear that the U.S. Army is questioning the inevitability of PTSD and starting to focus on positive prevention, especially since the drug dependent reactive medicine currently being practiced is not effective.

One of the participants in the program, Sgt. Jeffrey Beltran, whose amazing story begins the New York Times article, and whose grandfather survived the Bataan death march in World War II, survived a horrendous I.E.D. attack himself in Iraq. After a PTSD diagnosis and multiple drug treatments for pain, anxiety and depression, he was sent home and offered a medical discharge. He declined.

He is now a trainer in the Comprehensive Soldier Fitness Program at Fort Stewart in Georgia. He has "discovered a sense of spirituality," and reports that, "instead of labeling myself as a PTSD veteran, I say that I am a post-traumatic-growth veteran. I am a person looking forward."