Announcement

Collapse
No announcement yet.

Senior Australian Commander's Painful struggle with PTSD

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • Senior Australian Commander's Painful struggle with PTSD

    From the Sydney Morning Herald

    An incredibly moving story from the Australion Army Senior commander in A'stan and his difficulty returning home.

    This is a view into how crushing the burden of leadership can be.



    Casualty of war
    Published: September 22, 2012 - 3:00AM

    It is early February 2011. I am home again, back in Australia. I have returned from war for the last time.

    With a long break ahead, I should be relaxed, but I feel untethered and lack direction. I can't seem to fix on anything that seems worth doing. It is all so unimportant. I try to take an interest in current events, sport and TV programs, but I can't escape a feeling of pointlessness. Everyday life seems frivolous. My mind keeps darting back to Afghanistan. I picture heavily burdened men walking carefully down a dirt footpath or wading through an icy aqueduct or climbing aboard a helicopter for another high-risk night mission. These things seem real, substantial. The confected nonsense of reality television shows and political posturing in Canberra seem utterly without meaning.

    I had promised myself that when I returned, I would try to visit the families of all those who were killed in 2010. But I can't muster the courage: I know that I will break down in front of them, and what would be the good of that? I badly want to see them, to offer my personal regrets, but I need to be stronger. This realisation that I cannot do what I feel is my duty makes me feel pathetic. What have I lost compared to them?

    I experience a feeling of severance, that I am no longer responsible for all those men and women I have constantly worried about, fought to protect and felt so deeply accountable for. I realise I can't do anything more to help them - a situation that feels like a betrayal. I am redundant, without purpose.

    Released from responsibility, it is as though a dam in my mind has cracked, flooding me with despair. The barriers I built and shored up over the years, especially over the past 12 months, start to shift and buckle, releasing a pent-up misery.

    The sadness and regret that I had pushed deep down inside resurface, amplified. Memories flood my mind: cold bodies in a morgue, torsos violated by bullets or explosives or a shattered helicopter; the pain and uncertainty of the wounded whose lives have been forever changed; the horror in the eyes of men who have picked up pieces of their mates. My nights are tormented by ghastly nightmares, punctuated by sudden shouts as I come awake, shaking and confused. The melancholy that has lurked in my heart begins to tear at my sanity.

    I try to fight it. Surely I can beat this by force of will. I deliver myself a stern lecture: Snap out of it! You're whole, unharmed, alive! What have you got to moan about? I force myself to think of the hurt being suffered, right now, by men who have survived awful wounds. I think of the wives and partners making daily treks to hospitals, sitting in sterile rooms, listening to doctors' reports, supporting their damaged men. I force myself to think of the grieving families of the dead. My wife, Jane, has endured a long separation and months of worry, and now here I am moping about like a sulking child. I am dismayed by my weakness and selfishness. You pathetic jerk! Get a grip on yourself!

    Determined to be "normal", I smile at small jokes or amusing stories, but it feels false, skin-deep. I try to take an interest in the lives of friends and family, to share in their achievements and concerns, but inside I'm a dark pool of sorrow. I feel constantly distracted, as though events around me are ethereal - the weight of memory and the millstone of guilt seem to be the only things of substance.

    I talk to Jane, my one true confidante, and she encourages me to stop being so hard on myself, to remember the happy moments, the enjoyment of being with servicemen and women, the pride in them I had spoken of so often. This sound advice bounces off me.

    An undirected anger works within me. I am angry about the random violence that claims lives on the battlefield. I burn with anger at the months and years of pain confronting the badly wounded. I resent the fact that they must now struggle to live without eyes or legs. I am angry with myself - I should have done more, thought of some new technique, insisted on some new strategy, to save them. But I didn't. I couldn't. I was powerless, a spectator in a deadly circus, cast in the role of official mourner and speech maker.

    The rawness of the new memories sharpens images from the past. The old familiar demons invade my sleep and sometimes my waking hours. I see the hand of a man buried alive in Iraq. The thump and buzz of incoming artillery fire fill my ears. I am seized by the terror of leading soldiers across a dark, empty desert. My fingers feel the weight of a man's head and I smell the stench of burnt flesh. The dread of death, so close, so immediate, hollows my chest, as it did when I forced shaking legs to walk past half-hidden mines. I am transported back to a Baghdad suburb where a car bomb in a marketplace left a little girl's pink sandals floating in a pool of blood. I taste bile in my throat at the realisation that I have ordered men down a road that killed them. I feel like I'm losing it.

    In the midst of this misery, I am summoned to Canberra to see Lieutenant General Mark Evans. He wants me to debrief him and his senior staff on my observations and assessment of the Afghanistan campaign. It requires an effort of will to make the trip and present myself. I play the role of a calm, rational returned general, offering wise comments and penetrating insights to him and the other officers. I even make a few jokes. Inside, I'm churning.

    Afterwards, Evans, always a gentleman, walks with me to my vehicle. In the car park he asks me how I am, really. He has detected my unease. My instinct is to trot out another glib answer, to say that I'm fine. But I'm not fine and I'm tired of the facade. I take a deep breath and tell the truth. I say that I'm not well, and that I'm troubled by the losses of the previous year and older memories. I tell him I am having trouble sleeping, that I feel unhappy and guilty. He tells me, rightly, that war is always a source of sadness and loss, that lives spent on the battlefield are the brutal currency of combat.

    I know this but my mind rejects his counsel. I ask him to speak to Angus Houston, the Chief of the Defence Force, and tell him about our talk.

    When I get back to Puckapunyal, I know that I must do something to seek help or go under in a wave of misery. I go to the base's medical centre and the office of a military psychologist. It is the start of an awful, belittling, painful but necessary journey. I am now officially mentally unwell.

    The psychiatrist at Melbourne's Repatriation Hospital is attentive, understanding and very familiar with the emotional trauma that can arise from military service. He tells me he believes I am suffering acute post-traumatic stress disorder (PTSD) and depression. He says medication will help and that he will arrange a program of meetings with a psychologist, along with periodic sessions with himself. I walk out with a prescription for drugs to calm my anxiety and rebalance my moods and an appointment for some counselling. I still feel wretched, but at least I'm doing something about it.

    When Houston calls in May 2011, I have begun the course of medication. I have also made up my mind that I cannot continue to serve in the army. The prospect of being selected to be the Chief of Army is an extraordinary one, especially for someone who started life in the army as a private. It would be a career-topping pinnacle. It is also impossible. Even if I were to be chosen, which I doubted, I would not be well enough to do the job.

    I tell Houston straight up that I'm not fit to command, and that I should be considered unavailable for the army's top job. In his quiet, unhurried way, Houston says, "John, you will not be Chief of Army." It's a mercy: the game is over. Now I know where I stand. With this behind me, my hope is I can get better.

    I could not be more wrong.

    Sorrow now takes centre stage in my mind. Irrational anger simmers, bursting out at the slightest provocation. I seethe at the indifference of most Australians to the efforts of our troops overseas. Anxiety stalks me. At shopping centres, I feel threatened, surrounded by unseen dangers. I find myself moving towards the walls of crowded spaces to protect my back. I look for exits and places to take cover. The hyper-awareness that had me flinching at unexpected noises now becomes a disabling compulsion - I jump at any sudden noise. One day we are on a train to Melbourne and the conductor behind me calls out, "Tickets, please!" I jerk in terror, throwing up my arms defensively and emitting a cry of fear. Several people laugh. To my total humiliation, I start to weep.

    A battle is being waged between my rational intellect and my damaged mind. When the guilt reduces me to tears, or when the anger blinds me to the hurtful things I say, or when I convulse in fear at the slamming of a door, the real me - the thinking person who has led soldiers in battle and managed the most complex problems - watches aghast at the blubbering, twitching, confused fool I have become. I'm a mess. And my darling Jane bears the brunt of my despair. I add shame to the list of emotions swirling in my mind. I've become a person I despise.

    Compounding this is physical pain. The damaged vertebrae in my neck, the injury I sustained in a training accident on a tank back in 1982 and aggravated in Afghanistan, has deteriorated further. The pain is intense.

    The combination of pills for depression, anxiety and pain relief leaves me dull-witted. I find myself groping for the right word or mangling my speech when I have always prided myself on my vocabulary and speaking skills. I drop glasses and plates. I sleepwalk and wake, confused, in an odd part of the house. When I do sleep, it is a visit to Hell. The nightmares have become more horrid, vivid and frightening, and they come every night.

    Then one day I fall off a cliff; at least that's how it feels. I am in the office of my psychiatrist and Jane is with me. On the way in, she whispers, "Be strong, darling." At one point the psychiatrist asks, without emphasis but watching me closely, if I have had thoughts of suicide. I recoil at the words, but the idea of oblivion, of ending all this, seems like an escape. I stammer, then it comes out: "Sometimes I wish I was dead." Then the tears come, from such a deep place that I can hardly breathe. The look on Jane's face pierces my heart.

    The doctor is concerned. He quietly suggests a period in hospital for more focused treatment. He wants to change my medication and increase the dosage, and hospital is the best place to do this. He suggests a week, perhaps a little longer.

    The next day I wave goodbye to Jane, who is in tears, through the wire-impregnated glass of a door in a psychiatric ward. I am locked in. When I find my way to my room, I sit and weep like a child. How did it come to this? What the hell am I doing here? Outside my window, just metres away, construction workers in hard hats and fluorescent vests are building a new wing for the hospital. They drop bundles of steel pipes onto concrete flooring and hammer on metal beams. Each crash evokes a convulsion of fear. I lie on my bed, waiting for the artillery shells, or the car bomb, or the improvised explosive device (IED). Restful it isn't.

    Over the days that follow, the change in my medication regimen goes well, although there is one bad day when the demons come crowding into my room with such ferocity that I press the button to summon the nurse, who finds me incoherent and sobbing. More pills are administered and I sleep for 12 hours. I spend most of my time alone, avoiding the other patients locked in the ward with me. My room has unusual fittings: the taps are buttons, the door handles are nubs, there are no towel racks, and the shower curtain rail is embedded in the ceiling - it's suicide proof. I feel out of place, but perhaps I'm kidding myself.

    Late in my week-long imprisonment, I have a cathartic session with a senior psychiatrist, a professor, and for the first time ever I tell my story in full. I describe every event that has shocked or revolted or terrified me, one after another. It's a long session, and by the end I am a mess. I feel like I've been bashed. But I also feel like I've crossed a bridge, or at least taken the first steps onto it.

    That night I have only one nightmare instead of the usual series. The next day, I dress in my street clothes and put my pyjamas away in my small suitcase. I want to feel normal. I ask if I can go for a walk outside. After some deliberation, I'm allowed to join a small, supervised group of well-behaved patients on a short stroll around the block.

    On the last day of my stay, I am allowed to walk alone, unsupervised. I head for a cluster of shops down the road, in search of real coffee. I am almost there when I see rubbish on the footpath ahead of me, the wind whipping at a black plastic garbage bag. My mind screams, IED! I freeze, then force myself to calm down. You're in Melbourne, it's just a bag of rubbish. Keep walking. I stare at the flapping black bag. Take a step, you idiot! I take a step, then another. I keep my eyes on the bag until I am several paces beyond it. My pulse only slows when I drop into a seat at a coffee shop.

    It has been a year since my stay in the ward. I have retired from the Australian Army after 38 years of service. Jane and I vacated the last army married quarters we will ever occupy, moving to the Sunshine Coast. Our new home, the 23rd house we have occupied during our life together, is set among gardens and has a creek running through it: a quiet, restful sanctuary.

    I finally had surgery to relieve the chronic pain in my neck and left arm. Now I have only a little residual pain and a metal plate in my neck as a souvenir. I still suffer nightmares on most nights. At times I wake violently, thrashing about, fighting off ghosts. The pills help, although I still feel a bit groggy the next day.

    I still can't drive a car except for the shortest of trips into the town near our house. I don't trust myself. I can be fine, but then a car will come from a side street or veer in front of me and I suffer a convulsion of fear. The words "car bomb" are on the edge of my mind. This happens when I'm a passenger, too, but at least then Jane is in control. Bizarrely, I can ride a motorcycle without having these foolish panic attacks. I have no idea why.

    Busy places are still difficult. I'm told it's because I feel I'm not in control of my surrounds. The noise is unsettling. The scream of a child will rasp my nerves like a rusty blade, while the crash of a shopping trolley causes me to spin, half-ducking in expectation of an attack. It's ridiculous, I know, but that's the way it is.

    From time to time I become deeply anxious, but can't say why. Sometimes I have an overwhelming desire to get away from where I am or to avoid an upcoming activity. Travelling to one of the rare social events I can tolerate, I occasionally become so tense that Jane can sense it in the car. I have a feeling of dread, even though I know the gathering will be pleasant and undemanding. I force myself to go through with it.

    I try hard not to dwell on the troubled past, but it invades my consciousness without prompting. At other times an insignificant reminder of a place or a person, or even a smell, will trigger a vivid memory. Sometimes it's the other way around: I have memories so strong I can smell the places where the original incident occurred. I smell strong perfume and burnt flesh whenever my mind takes me back to the bombed wreckage of cars north of Kuwait City. Mental images of the bombed market square in Baghdad are accompanied by the smell of raw sewage and blood. When I recall bodies in a mortuary, I catch a whiff of antiseptic and bodily fluids.

    My ability to concentrate has improved, although I sometimes forget simple things. Jane has to remind me to take my medication, even placing it in my hand. My sentences sometimes drift to a halt because I can't remember the word for something. At times I feel like a simpleton.

    Sometimes I'm prone to overblown emotions and now cry easily. I have become a bit of a serial hugger; I hug my dad and my brothers and some of my male friends without the slightest hesitation, an activity I once reserved exclusively for women and girls. It feels good and right.

    Rationally, I know my feelings of guilt and remorse do nothing to ease the suffering of mourning families or the pain and disability of the wounded. Emotionally, though, I feel compelled to bear part of their burden. I constantly wear a braided wristband, one I made in Afghanistan from parachute cord. It is fastened by a button; the small click it makes whenever I place my hand on a desk or tabletop prompts me to spare a thought for the men killed under my command. Some might think this maudlin; I think of it as paying respect.

    I am determined not to wallow in my condition. I am fortunate beyond words: I have found and kept the love of my life, Jane, and we have raised two boys into men we are proud of; I have had an extraordinary career, filled with excitement and change; I have seen the world and met countless amazing people; I have had the thrill of command and the satisfaction of success; I have been humbled and uplifted by guileless young warriors; I have been trusted and have trusted others with my life; I have walked with heroes, and count them as friends; I have had adventures you can't pay for and rewards you can't buy.

    I would not change my career, but I know it's come at a cost. One day I might accept I am wounded, but the memory of the physically ruined men I once commanded is too raw to allow that yet. What I do know is this: I have been a soldier; I have served my country; I am proud of what I have accomplished; I have endured hardship, trauma, pain and loss; I have done so voluntarily; I am not a victim, I am a survivor.

    I understand that I am on a long journey of recovery, but I know also that I will complete that journey, someday. I am determined to get better. I will beat this thing.



    Edited extract from Exit Wounds: One Australian's War on Terror by Major General John Cantwell (with Greg Bearup), published by MUP on October 1.

    Lead-in photograph by Tim Bauer.

    Like Good Weekend on Facebook and get regular updates on upcoming stories and events: facebook.com/GoodWeekendMagazine

    This story was found at: Casualty of war
    “Loyalty to country ALWAYS. Loyalty to government, when it deserves it.”
    Mark Twain

  • #2
    A.R. Reply

    Absolutely devastating to read. I think of him and, however close he was to battle, I know that so many more were closer. I also know that age, intelligence and maturity separates this man from many, many younger and less-equipped to deal responsibly with their wounds. And it is a wound, as much so as any physical ailment acquired by combat.

    I've hated this war now for five full years this fall and feel we've utterly failed to meet our grandiose expectations. I think of all the empty words spoken by politicians and key military leaders far removed from the sharp end and know that so many of our troops have been thoroughly misled and callously misused for inconsequential gain. I fear for all those men and women out there who've endured their trauma silently and pray they'll have the courage to seek help wherever available.

    God love them all. This was a tough read.
    "This aggression will not stand, man!" Jeff Lebowski
    "The only true currency in this bankrupt world is what you share with someone else when you're uncool." Lester Bangs

    Comment


    • #3
      This is the feeling that most commanders in battle have.

      And it comes back to haunt all the time!


      "Some have learnt many Tricks of sly Evasion, Instead of Truth they use Equivocation, And eke it out with mental Reservation, Which is to good Men an Abomination."

      I don't have to attend every argument I'm invited to.

      HAKUNA MATATA

      Comment


      • #4
        Saw this guy interviewd on TV the other night. Articulate, moving & timely. That such a senior officer is prepared to speak openly about such issues can only help those men & women who struggle wiht such issues.
        sigpic

        Win nervously lose tragically - Reds C C

        Comment


        • #5
          Originally posted by Ray View Post
          This is the feeling that most commanders in battle have.

          And it comes back to haunt all the time!
          Sir,if I may ask,how do you personally deal with it?

          Never seen the stuff for real,yet,but IMO,the mind is something that needs training too.And the only thing I found is to contemplate wanton death and destruction.To know everything that is to be known and be aware that,no matter the cost,others had it worse in the past and survived.To love the men,but being ready to see them torn apart.And the belief in God and that the soul is greater than the mortal flesh.Hopefully,it will be enough.
          Those who know don't speak
          He said to them, "But now if you have a purse, take it, and also a bag; and if you don't have a sword, sell your cloak and buy one. Luke 22:36

          Comment


          • #6
            My sympathies from one who knows .

            Comment


            • #7
              Originally posted by Bigfella View Post
              Saw this guy interviewd on TV the other night. Articulate, moving & timely. That such a senior officer is prepared to speak openly about such issues can only help those men & women who struggle wiht such issues.
              How would this openness effect his future in the military if he had remained in Service and do you think other Commanders may well stay silent about their own condition?

              Comment


              • #8
                Originally posted by dave lukins View Post
                How would this openness effect his future in the military if he had remained in Service and do you think other Commanders may well stay silent about their own condition?
                We stay silent. Such a small service do not have the luxury to have walking wounded healing on the job. You have problems, you step aside and let someone else more capable to take over.

                The General was lucky that his pension was secured. I've known people who did not get help in time because of their need to keep their pension going. You asked for help, at best, you're regulated to a desk job with chances of promotion reduced to nil and more than likely, your contract will not be renewed and you will be push aside for someone else who does not show problems.

                End result of one was swallowing a shotgun shell.

                Comment


                • #9
                  Incredibly powerful... Decades past, the "manly" thing to do was bottle it up, where it festers forever, an unhealed wound. I shudder to think of the millions of vets from WW2 from all nations, our own Korean and Vietnam vets, who suffered in silence. Thank God now it is more recognized and hopefully we will get better at healing our heroes' minds and hearts.

                  Comment


                  • #10
                    Lukins Reply

                    "How would this openness effect his future in the military if he had remained in Service and do you think other Commanders may well stay silent about their own condition?"

                    Seems by his own admission that he recognized an unfitness to lead. That he, physically, appeared "whole" belied his acknowledgement that he was not. To what degree I don't know? As a tactician and operational analyst, was he incapable of rendering sound reflection of his experiences before the key staff at Australian Defence Force H.Q? I do not know but suspect not. I also wondered if becoming deeply involved in after-action remedial training and instruction might have produced some palliative therapy. Then again, it appears he was incapable of focusing sufficiently deeply on a given task of that magnitude to render valued service.

                    As a senior field commander he was uniquely tortured. His contingent of troops appears sufficiently small that he was never far-removed from the trauma they experienced. Yet he didn't likely have the "escape" of immediately being forced to focus on continuing troop-care and the next mission. If such exists at all. Instead, he'd be consigned to step back, absorb and reflect while watching his men prepare yet again to continue mission. Helpless to take a personal role perhaps.

                    I believe he likely took the correct action with respect to his availability for service. Unfortunately, we'll not know whether he could have been rehabilitated to, again, achieving his past effectiveness or whether he'd even be offered the opportunity to prove such. Two separate but related issues. Sadly it's on the minds of many like him who struggle with exposing their pain. Understandably so. The Colonel has pointed to the career consequences for many not quite to retirement.
                    "This aggression will not stand, man!" Jeff Lebowski
                    "The only true currency in this bankrupt world is what you share with someone else when you're uncool." Lester Bangs

                    Comment


                    • #11
                      Originally posted by Mihais View Post
                      Sir,if I may ask,how do you personally deal with it?

                      Never seen the stuff for real,yet,but IMO,the mind is something that needs training too.And the only thing I found is to contemplate wanton death and destruction.To know everything that is to be known and be aware that,no matter the cost,others had it worse in the past and survived.To love the men,but being ready to see them torn apart.And the belief in God and that the soul is greater than the mortal flesh.Hopefully,it will be enough.
                      It is devastating. The imagery just does not go away and you are continuously haunted with 'what if'. What if, I had done it this way, would it save the man, what if he had not done it the way he did, would it have saved him and so many such scenarios keep bombarding your mind all the time.

                      The worst feeling is when you cremate the dead (we cremate). As a CO you are the Father of the unit and it is your duty to ignite the fire. It is the worst moment for anyone to do this most heart wrenching task. Tears flood your eyes and you cannot show to your assembled troops that you are weak and human! Even as I write, the horror scene are reappearing and so are my tears. It is like losing your brother, who you could not save and you cannot help but feel having that irrational feeling that you,as his superior,played your part in his death.

                      In our Army, we remain in the same unit throughout our service until one finishes his command and then goes out to Staff and then to the Flag ranks (if lucky). So, this long bonding over the years makes you a real family and hence, it hits you harder.

                      What one has to guard against is that one should still maintain his 'human' form since too much of such unfortunate deaths makes one become a mechanical robot impervious to the surrounding wanting to go and take revenge and even challenge Fate (I can't explain the feeling in words) . Such people end up as psychiatric cases.

                      In house amongst friends one discusses. But in public, one has to display the stiff upper lip! And it should not affect your decision making since only rational decisions can win the day and not emotional.

                      I presume the strength to bear it all, all comes through training.
                      Last edited by Ray; 27 Sep 12,, 15:41.


                      "Some have learnt many Tricks of sly Evasion, Instead of Truth they use Equivocation, And eke it out with mental Reservation, Which is to good Men an Abomination."

                      I don't have to attend every argument I'm invited to.

                      HAKUNA MATATA

                      Comment


                      • #12
                        Thank you,Sir.And my apologies.It was rather stupid to ask.
                        Those who know don't speak
                        He said to them, "But now if you have a purse, take it, and also a bag; and if you don't have a sword, sell your cloak and buy one. Luke 22:36

                        Comment


                        • #13
                          Originally posted by Chogy View Post
                          Incredibly powerful... Decades past, the "manly" thing to do was bottle it up, where it festers forever, an unhealed wound. I shudder to think of the millions of vets from WW2 from all nations, our own Korean and Vietnam vets, who suffered in silence. Thank God now it is more recognized and hopefully we will get better at healing our heroes' minds and hearts.
                          It has been known for 1000s of years with various names. The armies of Alexander the Great lost their will to venture further into India. The armies of Byzantium and Persia were so exhausted that they fell before the Turks. During WWI, it was called shell shocked. WWII, battle fatigue.

                          The treatment then as it is now was and is alcohol. Not effective but known.

                          Comment


                          • #14
                            Originally posted by Officer of Engineers View Post
                            The treatment then as it is now was and is alcohol. Not effective but known.
                            I was going the say the same thing sir...alcohol and in the modern world it's Golf also.
                            Nothing can take away the pain of fallen camrades.

                            I still get emotional and have tears in my eyes when I think of friends that I lost.

                            But I dont play golf, I cook it calms me...

                            Cheers!...on the rocks!!

                            Comment


                            • #15
                              Brigadier & Colonel,

                              Thanks for sharing your thoughts with us.

                              The view and impact is different from different levels and different armies. The farther back you get from the front edge I believe the physical risks become less but the emotional and pyschological risks increas dramatically.

                              As I have said numerous times I never expereinced combat but only trained. The nearest I ever came was being in the Pentagon on 9/11 but that is not the same as what you gentlemen, the good general and countless others have gone through and will continue to go through.

                              My you find solace and understand the immense respect the remainder of us hold you in.
                              “Loyalty to country ALWAYS. Loyalty to government, when it deserves it.”
                              Mark Twain

                              Comment

                              Working...
                              X