Overcoming Post-Deployment Syndrome by David X. Cifu and Cory Blake - Read Online
Overcoming Post-Deployment Syndrome
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Summary

David Cifu and Cory Blake work at the Hunter Holmes McGuire Polytrauma Rehabilitation Center, one of only four comprehensive inpatient, residential and outpatient centers of excellence for polytrauma in the country providing intensive rehabilitation care to veterans and service members who experienced injuries to multiple organ systems. This type of injury that results in physical, cognitive, psychological, and functioning deficits has been termed as Post-Deployment Syndrome. The high numbers of soldiers with these types of multiple injuries has been a hallmark of the Iraq and Afghanistan wars.

Overcoming Post Deployment Syndrome is a comprehensive guide for servicemembers, Veterans and their families dealing with the all-too-common repercussions of combat duty, including traumatic brain injury, post-traumatic stress disorder, anxiety, depression, chronic pain and musculoskeletal injury, and substance abuse. It offers a practical blend of state-of-the-art traditional and holistic medicine, and teaches the value of mindfulness, movement, psychotherapeutic, and creative arts practices, as well as active engagement and partnership with clinicians in one's own health care. The men and women of the Armed Services have trained in the art of war. This book offers training in the art of healing. Those that learn, understand, and apply the principles within will discover that warriors can excel at both the art of war and the art of healing.

Overcoming Post-Deployment Syndrome provides:

Personal vignettes of servicemembers who are going through the process of successfully reintegrating into their families, workplaces, and communities. A twelve-week basic training in self-directed healing arts. A wealth of community and government resources, tips, and suggestions. The means to integrate traditional and complementary medicine techniques to treat common symptoms.

David Cifu and Cory Blake have been at the forefront of treating Veterans and servicemembers and know what the issues are and have real-world answers. Overcoming Post-Deployment Syndrome empowers Veterans, servicemembers and their families to prevent combat stresses from having a lasting negative impact.;1.Putting it all together - A holistic system for health; 2.Post-deployment syndrome - The illness of war; 3.Military and Veteran Healthcare systems - A traditional approach; 4.A new model of wellness - Rebuilding the Warrior; 5.First Step: Understanding your body's symptoms; 6.Second Step: Discovering your strengths; 7.Third Step: Applying healing principles; 8.Fourth Step: Re-establishing normalcy; 9.Fifth Step: Integrating health into your life; 10.Final Step: Resuming the productive mission; 11.Return of the Warrior: A lifetime of success;"This guide is a must-have for all of those affected by Post-Deployment Syndrome."-Felise Zollman, MD, Co-project Director, Midwest Regional Traumatic Brain Injury Model System Center

"Drawing from and integrating Eastern, Western, and pop culture philosophies, this is a wellness handbook that will take you from the problems of post deployment through the journey of healing to preparation for your next mission: the successful life you've earned."-Amy Bowles, MD, Chief, Traumatic Brain Injury Service, Brooke Army Medical Center, Fort Sam Houston, TX

"The road to recovery takes time, effort, patience and understanding from our wounded warriors, their families, and health care providers alike. ...A very unique feature of this book is the authors' ability to present evidence-based information without jargon or dry data. Instead, the book was written from the perspectives of our service members and veterans who were wounded in combat, by experts who specialize in their clinical care In essence, the book is a crystallization of evidence-based care, with helpful tips in the diagnosis and treatment of post-deployment syndrome."-Henry Lew, MD, PhD,

Published: Demos Health on
ISBN: 9781617050398
List price: $16.95
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Health

Putting It All Together: A Holistic System for Health

A military force has no constant formation, water has no shape. The ability to gain victory by changing and adapting according to the opponent is called genius.

—Sun Tzu, from The Art of War

A WARRIOR’S MISSION

True warriors are called to honorable missions. All warriors take pride in their personal achievements of athleticism, toughness, inner discipline, and becoming all that they can be. But, there is a deeper calling to that mission and that’s their calling to genuine service. It infuses the warrior’s life with meaning. It is the ultimate goal of any warrior. No mission is more honorable, or urgent, than taking care of your own.


The best feeling I ever had in my life was draggin’ Fernandez back inside the wire . . . after I knew he was gonna be alright. The second best feeling was shooting the bastard who had tried to kill him.

—Cpl Leon T. Church, Afghanistan War Veteran


This focus on taking care of a fellow warrior has been a guiding principle of the U.S. military for more than 200 years. No marine or soldier is ever left behind. It’s something that separates the American fighting force from almost all others. With this in mind, remember, you are one of your own. If you have made it home from a tour in theater but do not feel you are the person you were before leaving, that is completely normal. Whether you were wounded severely and have obvious changes in your appearance or functioning, or if you suffered one of the war’s invisible wounds and nothing really feels right, then you have been given a new mission. Your new mission is to drag yourself back inside the wire. It is your new mission to figure out what’s wrong and to understand how to fix it. This book can help to serve as your guide to help you do this. Your personal healing—physical, mental, emotional, and spiritual—and how you bring that healing into the world around you is your new mission. It is a mission of profound importance. It is a mission that is without end, an ongoing one into which you can invest your whole life. It is a mission that begins anew at this very moment and in every moment. It requires, first and foremost, a certain state of mind, a warrior’s mind, and a certain state of heart, a warrior’s heart. This book is dedicated to helping you with that mission. By the end of this book, you’ll better understand why you feel so different and so bad. You’ll also better understand what it will take to begin the process of feeling better, the process of recovering.


Your new mission is to drag yourself inside the wire. This book will give you the tools and techniques to meet that mission.


Just because this mission has been thrust upon you, it doesn’t mean that you have to accept it. The choice is yours. Maybe you’ve already figured out what’s wrong and how to fix it. Or you may decide to just ease the pain the best way you can, to ride it out and to see if time changes things. You’ll actually find out that time alone itself will help you heal. This healing power is at work whether you are engaged with it or not. You may have already found that deep cuts heal over time, broken and fragmented bones will eventually knit themselves back together, and even intense memories will gradually fade over time. Whether you fully engage in treating these injuries or not, the healing process will begin and will proceed with time. The process even works while we are asleep. Sometimes healing works best when we are asleep, so just finding a way to sleep may be one answer to many of your problems. You can use the techniques in this book to just help you figure out how to get the sleep you need.

On the other hand, the full circle of healing, the type that allows you to truly recover, can’t occur with time or rest alone. Or sometimes, by the time recovery occurs, you’ve been suffering for so long that it has severely damaged your life. So you may be searching for ways to jump start recovery so you can get back on the path and move along the process more quickly. This book can be part of that jump start, part of the push (or pull) you need to get that engine humming along again. Maybe you don’t even feel ready to get back out there and resume your life. You need more than just a little push; you need some new fuel to get the process going again. Let this book be the fuel needed to make it all happen. Even if your recovery has gone astray and you are headed down a path that won’t lead to wellness, a road that is bringing you into greater difficulties and a deeper hole, this book can be part of the system of healing that you need to right yourself. It will take something more that a simple push or refueling to get your recovery back on course and to allow you to return to your full potential. This book offers you a blueprint to get on that recovery curve and help move you along it. But, this book is only the beginning of the answer. The strategies, the solutions, even the system that make up the chapters of this manual are there to help get you moving along the road to recovery, but it is you who must decide if you’ll initiate these activities, how much you’ll commit to the system outlined and if you’ll fully engage in that recovery. You can have many supporters and have all of the assistance you need along the way, but it must begin with you.

So, the decision to actively lead the way in your personal mission is up to you. The good news is that it’s likely that you’ll make improvements in your recovery regardless of which path you choose or don’t choose. But, we hope you’ll choose to fully participate in the process. To give your all to this mission. If you do commit to the program, something extraordinary will happen; you’ll notice almost immediately that there’s more juice to your recovery. Purposely committing yourself to involvement in something (almost anything) fires up your body’s healing ability. The cells of our body draw strength from the linkage between our consciousness and our commitment. So what this means to you is that diving headlong into the recovery process will allow you to jumpstart it. It’s a pretty cool thought, that you can play an active role in getting yourself well. But don’t be fooled into thinking it’s that easy. You can’t just pledge to give it your all and then you’ll be well. The commitment is the first step on the journey. But, it’s the most important step.

A WARRIOR’S IDENTITY


I can’t say I really liked the army that much, all the freaking rules and everybody on you all the time. And I hated Iraq. Never been that hot or that wasted in my life. I was just walking around dead . . . a year of that hell. And then they sent me back again. That stuff gets real old. It just wouldn’t let up . . . but for all the nightmare of being there, at least I was something, I was somebody in Iraq.

—PFC Lori Stefano, Iraq War Veteran


Purpose and meaning are the stuff of an authentic life. The military provides one system of meaning in life. It may be a complex system to folks on the outside, but it is absolutely a system that you get to understand and eventually live by. A person’s responsibilities are distinctly outlined. Your loyalties are clearly defined and duties are completely understood. An entire galaxy of belief is laid out and, if accepted, makes for a profoundly organized way of being. Codes are honored, command is respected, and mission is paramount. There’s also the whole military community that you are made a part of. For some of you from military families, this has already been a way of life and a clear identity for a generation or more. For others, it may have been the first sense of true belonging, a family. For some of you, it might just be a community of people that you tolerated. A really big community that you were part of, but didn’t always want to belong to. However, for all, the agreement to live within this military community and the system of ideas and conduct that come with it, is deeply affecting. Being a soldier, marine, airman, or sailor is a distinct and upright identity.


When I was a kid I wanted to be a marine just like my uncle. He was the only one who seemed to have a clear idea about life. It looked like everybody else I knew was just screwing around. He’d run ten miles just for the fun of it. He’d been all over the world and he had the coolest car, a Shelby Cobra, I’ve ever seen. Even when he drank he was in control. He was definitely my hero.

—Lt Gen James Mathews


Being faced with a significant physical or emotional trauma can profoundly affect the identity you have established for yourself. The injuries or stressors that are caused by the trauma of war can change who we are. Most of us have had multiple shifts in our identity imposed on us during our lives, but usually over lengthy spans of time. We go from 10-year-old grade school students to 18-year-olds graduating from high school. We are single, next we’re in a relationship, then married, and sometimes with children. We are students or unemployed after graduation and then we are employed in the workforce or in the military. We are young, middle aged, and then old. Although each of these shifts is profound in scope, for the most part, there has been time to acclimate and the change has been expected. It’s part of nearly everyone’s lives and what we expect. However, sometimes changes in our identities occur rapidly, with little time to adjust, and in ways that we never would have expected. This makes it very difficult to integrate these changes into our identities. For example, we may be employed one day and unemployed the next, or suddenly faced with a life changing illness. Although change is inevitable, it is almost always stressful. This is especially true when it occurs rapidly, unpredictably, or without the input of the person it effects. Changes in how we see ourselves can be the most stressful, particularly when we see a negative or distorted view of ourselves. In someone returning from war with the loss of physical skills, mental abilities, limbs, or loved ones; this radical change in identity; and the sense of helplessness in the face of fate, can be devastating. It also can prove to be an additional crushing burden on top of the consequences of the trauma. This change in identity alone can be the biggest challenge of returning from deployment. You don’t feel like the same person or part of the same group you were before, maybe you even feel like you are nobody.

It’s important to recognize that our identity is fluid in nature. In reality, who and what we are is constantly changing. Although this fluidity of identity may be quite obvious in someone who has suffered an acute trauma, it is also present in the warrior who returns with a more minor issues or significant negative memories of the experiences or of a single, traumatic event. We are all forever changing who we are in life, it’s just not always as obvious. Looking deeply into this truth leads to an expanded sense of self. It’s a way of better understanding that the ability to change and to adjust to change is what may in fact give us our identity. It can give you a better appreciation of possibilities in the way we meet life as it unfolds before us. Perhaps, being a warrior is not a static or fixed identity, but actually a much bigger and more fluid identity than we thought or could imagine. Perhaps, being a warrior is way of approaching life, a way of adapting to what life challenges us with, and a way of meeting death. Maybe it doesn’t require being in a war zone or even being in the service at all. Maybe realizing that the ability to react and to change to the challenges of your mission and of your life is what being a warrior is really about. Maybe being a truly fluid warrior is a way of staking your claim on this earth as a human being. This book is here to help you better see the value of accepting this ability to change to meet the need and to help you to do so in order to get well and to return to your full potential.

DEDICATING TO THE MISSION

To get the most out of this book, we ask you to consider fully dedicating yourself to the mission of recovery. We propose that by dedicating yourself to the art of healing, your mission, your identity, and your sense of meaning grows. The sense of aliveness and power that comes with this dedication cannot be overemphasized and is the force that will allow you to succeed.


Until one is committed, there is hesitancy, the chance to draw back, always ineffectiveness. Concerning all acts of initiative and creation, there is one elementary truth the ignorance of which kills countless ideas and splendid plans: that the moment one definitely commits oneself, then providence moves too . . . Whatever you can do, begin it. Boldness has genius, power and magic in it. Begin it now.

—Johann Wolfgang von Goethe



A good solution applied now with vigor is better than a perfect solution applied ten minutes from now.

—Gen George S. Patton


This book is one possible beginning for you, the beginning of a new way to see yourself, your mission, and your place in the world. It is a new basic training and a new opportunity to look into what it means to be a warrior—a warrior dedicated to healing. It means becoming the captain of your own ship and deciding at every tack what course does or doesn’t work for you. You are at the helm. What doctors and therapists know and suggest is important; you should listen to and weigh what they have to say. It has been their life’s work to study and understand the body and mind and to help us get better when there is illness. But, they are merely consultants in healing, employees if you will. What they know about your body is miniscule compared to what you know. That’s because you live in there. And whether you are listening or not, your body is in direct communication with you at all times—it’s hot, it’s cold, this hurts, I’m freaked, that feels good, this is exciting, I’m pumped, I’m pissed, I’m sad, I’m scared. No one knows you better than you. This same thing may be said about your family and friends. It may even be said about your squad or platoon buddies. All of these people understand some special piece of you. All of them want to do whatever it takes to help and support you. They are there for you. However, no one has got the full picture of just who you are, except for you. This book will show you how you can use your knowledge and wisdom about yourself and turn that into healing. Even more, this book will serve as a guide to help you, your family, your friends, your buddies, and your health care providers to all work together toward the common goals of a return to activity and wellness. But, you’ve got to lead the way.

We suggest you take everything in this book with a grain of salt. Examine everything and take nothing for granted. We want to caution you, however, to keep an open mind. Do not rush to judgment before you have really given the information, the ideas, and the exercises in this book a chance to sink in. Sometimes things can sound or feel strange just because they are new to us. Try things out. Give everything your full effort. Walk around in these ideas for a while. We’ve made sure that none of the recommendations in this book can be of any harm to you. Although not everything in this book pertains to everyone, the information in it can only help you and make you feel better. We have worked directly with many warriors just like you and use these strategies in our own lives. But, it’s important that you feel that these practices are for you. If there is any power in them, it will be because they have become your practices. If they are to help you generate new growth in your life, they have to become part of the rhythm of your life.


The ultimate warrior leaves no openingsexcept in his mind.

—Sei Shin Kan


is a reminder to come completely back to this present moment just as it is. Reread the section or quote. Try out the exercise again. Take inventory of where you are and how you feel right now. Not tomorrow, not yesterday, but today, right now. There’s nothing that is more important than what’s happening now.

We will talk more about this just being later, but let us just say that at the very least, we hope that you will find reading this book a relaxing and pleasurable part of your journey.


, take a moment and reflect on how things are going right now without thinking about the past or the future. Let’s give it a try;

See it? Stop what you’re doing, what you’re thinking. Stop and just breathe. Please enjoy three . . . . . . . long . . . . . . . easy . . . . . . . breaths through the nose. Take your time and really feel each one, in and out. Stop reading for the moment and do nothing but enjoy those breaths. Stop and take three long, slow breaths through your nose with your eyes closed.

How does that feel? Take three more if you wish. This is the beginning of healing. This is how you begin to figure out how you’re feeling. This is how to begin taking steps to bringing your life, your body and your mind back in synch. How does what you’ve read so far sit with you? Really, put down the book—take a moment, take a break—look around at your surroundings, notice your thoughts, enjoy another breath, just be.


A New Basic Training

This new mission requires new basic training. We will be learning about and submitting to a new kind of rigor.

• Do you remember how you felt when you completed basic training?

• Do you have memories of before and after?

• What was it to have come through that challenge?

• What was your inner response?

• Were you ready to engage in that which you had been trained for?

You must summon the strength that got you through that. Training, however, is not a substitute for the learning that takes place in the mission itself. So, in addition to exercises and practice, we will be focusing on the actual mission at hand, returning your life to wellness. We will be acquiring the skills to learn from our life, as we live it. There really is no dividing line between training, and mission, and life. All of it is of utmost importance.


I loved most of basic training. Of course, I was already in pretty good shape even before, but really being pushed; it made me realize I could handle a whole lot more than I thought. I got stronger and stronger. It felt really good to run. I miss that.

—Cpl Leon T. Church


Can you be your own drill sergeant? Can you be your own commanding officer? We are advocating a daily and lifelong commitment to healing and growth. At first, just like basic training, this will require tremendous effort and perseverance, but, eventually, once its effects are felt and a new life rhythm is established, a new sense of flow can emerge. Flow is the secret to your success. It’s your own personal Holy Grail. We wish it for you as we strive for it ourselves.


You must concentrate upon and consecrate yourself wholly to each day, as though a fire were raging in your hair.

—Taisen Deshimaru


HOW TO USE THIS BOOK

Who’s this book for? First and foremost it’s for service members and Veterans. But this book is also for the service members’ and Veterans’ families and friends; for their buddies from the military or at work; for their pastors, rabbis, and other religious leaders; for their doctors and therapists. This book is for anyone else who is part of the service member’s or Veteran’s world. Although there’s not really a right or wrong way to read or to use this book, there are a number of suggestions that we have to help you get the most out of it. Here a few of these suggestions or rules;

Rules of Engagement

1. Keep an open mind.

2. Read this book straight through if you can. But, if that’s too much, it’s okay to skip around and go directly to those parts that are most applicable to you, such as quick treatments for your headaches or sleeplessness.

3. Come to understand this book as a complete system of healing designed to integrate body, mind, and spirit toward a common mission of healing. Although many parts of it are helpful in themselves, the overall approach is what will bring the full measure of wellness.

4. If reading is difficult for you, as it is for many war-weary veterans, read it with someone, or have them read it to you. Maybe have them record parts of it and listen to it that way. The more folks you read it with, the more you will gain from the shared experience of it. Take your time with it, there’s really no hurry.

5. Share this book with all relevant people. If you are a service member, share it with family and caregivers. If a family member, share it with your Veteran and their doctors. And if you are a doctor or therapist, share it with your patients, your staff, and even your family. This book is designed to put everyone on the same page.

6. Form a study and practice group. There is power in community, especially a healing community.

7. Create a physical place in your home or office devoted to the processes outlined. Although many, if not all, of the exercises and activities outlined in the book can be performed almost anywhere with little or no equipment or preparation, it often works best if you have a specific place or two dedicated to your recovery.

8. Obtain the Gear for the Mission listed in Chapter 10.

9. Give each recommended practice at least a 1 week trial period before making any decisions regarding their effectiveness. Although many exercises and practices will make you feel better (and different), some may take some practice and repetition before you can fully benefit.

10. Integrate these practices into your daily life by establishing a regular practice time. This is a key to success in any life system. It must not be something you do only when you have some free time or are feeling up to it. You must see this as the key to everyday activities. To have full effect, these strategies must become ingrained in your day-to-day living.

11. Follow the activities schedules listed in the Chapter 10, they are a menu of what to do and when.

12. None of this will work for you, unless you work for it.

13. If you don’t like these rules, bend them. Creativity rules all. Make the rules to fit who you are and to help you recover. If need be, ignore them.

14. Engage in your mission.

It’s never easy to start something new, to try something you’ve never tried before. It’s much easier to just continue on with what you’re used to. It’s always easiest to just push forward with the mission that you’ve already begun on. For many of you, this perseverance is what has made you a successful warrior all along. It’s what has shaped the inner determination that’s kept you going this far. The traumas and stresses of the combat that you’ve experienced, however, have worked against you. This military deployment has caused you to have a range of symptoms that are preventing you from a return to normal. Through this book, we’ll explain many of the reasons why you are feeling the way you do. We’ll then review what you can do to feel better. As you’ve probably already discovered, there are a range of options available to assist you in your recovery. Some of these options can be found at your local health care center, Veteran’s center, military base, or Veterans Administration hospital. Others may exist in a counselor’s office, your health club, or your local health food store. This book will take a look at many of these options and show you how to incorporate them into an overall system to help you to get well. This book isn’t a stand-alone answer to all of your problems; instead, it’s a way to take charge of your recovery so you can find and take advantage of these answers.

Throughout this book you’ll see comments from a number of Iraq and Afghan warriors who have come through combat with many of the same feelings and difficulties that you have. These quotes are compilations of words and thoughts from service members and Veterans who we’ve had the pleasure of working with directly. Although their names, ranks, and/or exact stories have been altered to protect their identities and to help simplify the message, you’ll see that they feel the way you do, that they are struggling to push through the same way you are. We’ll follow these folks throughout the book and show you the challenges that they have within the system and within their lives. Like you, these warriors have been through the fire and are searching for a way to return to their missions. Some will be able to get back on with their lives, but others will not. As you’ll see, for some of them, this book will give them the guidance and support they need. The help they need to begin this new mission. Read along and see which of these warriors you can relate to, who is most like you. Just as you’ve been trained to provide support to your fellow warriors, the figures described in this book are there to give you the support that you may need. Pick one of them and follow them on their journey through post-deployment. Engage in their new mission and, if you can, make it your own as well.

TO THE FAMILY

He was gone for a long time. You didn’t want him to go at all. Even with the phone calls, the Skypes and the emails, his distance seemed to increase. Over the months and months there was a shift in him and in you. In many cases you shifted together, but in others the changes have made you feel further apart, somehow different. You had put together a life in his absence. It was running smoothly enough. But always there was that sense of dread that that he might be killed, or wounded. Perhaps he was exposed to a blast or other trauma. Or perhaps he just had to face challenges that you can’t even imagine. After these events, you resisted thinking about what it might mean and clenched your whole being with a resounding no. And then he came home.

The first few months you were in crisis mode, but, over time, as grinding as this tragedy was, you may have gotten used to it: the trips to see him or her, the time in VA offices talking to doctors or commanding officers, the stacks of paperwork from the military, the bills you never knew could exist. You’re tired of talking about it with all of his and your friends and relatives. It’s the way life is now. It may suck, but that’s the way it is. Hopefully he can talk now at least, maybe even tell you some things about how he’s doing. All those months of intensive services, or counseling, or trying come to terms with this different person who came back from the war are becoming past history. A new routine is setting in and it can feel like wading in molasses.

Although his physical wounds seem to be healing slowly, his emotional wounds do not. There is bitterness