Dissociation, Trauma and Violence: a Veteran's Tale
Yesterday's rebroadcast of This American Life included a timely piece called "Life After Death." No, we're not talking near death experience here, but, in the last piece at least, something similar. The show presents three stories of guilt following the death of another. Innocence is not really in question for the first story, is somewhat questionable in the second, and for the third...well there's guilt under extreme and extenuating circumstances.
The third story, the one that most engages me, regards the story of a veteran home from war. John, the veteran, had a background of abuse, including sexual abuse, during childhood. He returned from Iraq with PTSD, panic disorder and agoraphobia. He couldn't leave the house. He said he had to pay the dealers on the corner to pick up his groceries from the grocery store. His greatest fear was not so much that he'd be hurt, but that he'd flip out or hurt someone else after being triggered. He spoke of how emotions or situational triggers that had just a minor semblance to his wartime experiences would still send him down the cascade of PTSD symptoms, including dissociation.
He received help from the VA, found a girlfriend and started to venture outside again when tragedy struck once more. During some minor disagreement, the feelings of frustration he had triggered that PTSD cascade, into anger, into rage, turning him into someone else. His dissociative episode ended with him cutting himself and realizing that he'd attacked, actually stabbed, his girlfriend, her mother and almost killed his child.
John doesn't remember how it happened. He only remembers seeing himself cutting himself, what's often called an OBE or out-of-body experience. This is a common phenomenon in dissociation and is a result of the observing and experiencing faculties of the brain separating incoming data instead of merging it into a unified awareness. This does not have to be pathological, but for this veteran, it was the worse kind of pathology, leading to violence against a loved one. John wanted to be locked up. He was terrified he could be triggered that way again. When they wanted to release him, he didn't want to go.
I taught a few students who experienced similar violent episodes. All had a history of abuse. They would describe feeling beside themselves or far away when their rage took over. They also had a hard time pinning down what triggered the rage. They felt very frustrated that no one ever believed them. They wanted to get along with others; they didn't want to be the bullies they were. Few in a position to help thought they were telling the truth. I did my best to advocate, to discuss trauma and dissociation and how these students needed help more than they needed suspension. In the end, sad to say, most dropped out.
In the case of John, the veteran, tiny incidents would set him off, such as being cheated at cards when using Monopoly money. He remembers feeling irritated, then the irritation quickly switched him into a state of rage. A part of his mind thought, What's going on? This is just monopoly money!. Beside himself, he couldn't stop his pummeling fists. This is a good example of a dissociative rage reaction. This violence is unplanned and often horrifies the individual who becomes violent. Training for service personnel is designed to create a kind of functional dissociation, to create a professional killer who can respond in any crisis. Sadly, there is not much training on what to do with this killer state once the service member has returned home.
For John, learning about what triggers him and how to manage himself in situations where he is likely to become triggered is essential. So is having the right support. Thank goodness he has friends at the VA. John continues to get support and will hopefully learn better diplomacy with his internal united states of mind. John's story, Soldier of Misfortune, is the third story of the broadcast which you can check out at: http://www.thislife.org/Radio_Episode.aspx?episode=359.
The third story, the one that most engages me, regards the story of a veteran home from war. John, the veteran, had a background of abuse, including sexual abuse, during childhood. He returned from Iraq with PTSD, panic disorder and agoraphobia. He couldn't leave the house. He said he had to pay the dealers on the corner to pick up his groceries from the grocery store. His greatest fear was not so much that he'd be hurt, but that he'd flip out or hurt someone else after being triggered. He spoke of how emotions or situational triggers that had just a minor semblance to his wartime experiences would still send him down the cascade of PTSD symptoms, including dissociation.
He received help from the VA, found a girlfriend and started to venture outside again when tragedy struck once more. During some minor disagreement, the feelings of frustration he had triggered that PTSD cascade, into anger, into rage, turning him into someone else. His dissociative episode ended with him cutting himself and realizing that he'd attacked, actually stabbed, his girlfriend, her mother and almost killed his child.
John doesn't remember how it happened. He only remembers seeing himself cutting himself, what's often called an OBE or out-of-body experience. This is a common phenomenon in dissociation and is a result of the observing and experiencing faculties of the brain separating incoming data instead of merging it into a unified awareness. This does not have to be pathological, but for this veteran, it was the worse kind of pathology, leading to violence against a loved one. John wanted to be locked up. He was terrified he could be triggered that way again. When they wanted to release him, he didn't want to go.
I taught a few students who experienced similar violent episodes. All had a history of abuse. They would describe feeling beside themselves or far away when their rage took over. They also had a hard time pinning down what triggered the rage. They felt very frustrated that no one ever believed them. They wanted to get along with others; they didn't want to be the bullies they were. Few in a position to help thought they were telling the truth. I did my best to advocate, to discuss trauma and dissociation and how these students needed help more than they needed suspension. In the end, sad to say, most dropped out.
In the case of John, the veteran, tiny incidents would set him off, such as being cheated at cards when using Monopoly money. He remembers feeling irritated, then the irritation quickly switched him into a state of rage. A part of his mind thought, What's going on? This is just monopoly money!. Beside himself, he couldn't stop his pummeling fists. This is a good example of a dissociative rage reaction. This violence is unplanned and often horrifies the individual who becomes violent. Training for service personnel is designed to create a kind of functional dissociation, to create a professional killer who can respond in any crisis. Sadly, there is not much training on what to do with this killer state once the service member has returned home.
For John, learning about what triggers him and how to manage himself in situations where he is likely to become triggered is essential. So is having the right support. Thank goodness he has friends at the VA. John continues to get support and will hopefully learn better diplomacy with his internal united states of mind. John's story, Soldier of Misfortune, is the third story of the broadcast which you can check out at: http://www.thislife.org/Radio_Episode.aspx?episode=359.