The 22 — Veteran Suicide from the Inside Out

Trying to heal and then transform the brittle fragility at the core of veterans with PTSD into emotional strength and resilience with transactional solutions is like putting lipstick on a pain.

— Mark Goulston

I am the author of PTSD for Dummies.

In fact, since its publication I have been fighting an uphill struggle to get PTSD renamed to what people with it actually live.

That is a name that my late mentor and suicide pioneer, Dr. Edwin Shneidman, told me. It’s RTA which stands for Re-Traumatization Avoidance.

In my work and research with traumatized individuals, including not only veterans, but rape and violence victims, and even people who have survived cancer, nearly all the symptoms of PTSD are an effort to avoid re-traumatization.

What underlies RTA?

When you say to a veteran (or rape victim, etc) who has survived a horrendous trauma, “How courageous you are that you got through and over it?” and look them in the eye as you’re speaking to them.

They’ll look you back in your eye and respond, “I got past it, I never got over it.”

If you ask them what they mean by that, they’ll look back at you intently and speak their truth, “I’m not the same as I was before. I’m tentative and don’t put two feet into anything. I’m jumpy and it takes very little to trigger incredible emotion in me that takes all my energy to keep a lid on.”

If you then ask them, “Do you think you could go through it again?”

They’ll will often reply, “F — — no! I don’t know how I made it through the first time. I left a piece of myself back there and if I go back there and the second shoe drops, I won’t get through it the next time.”

You might ask, “What about our military who may believe that, but do go through subsequent traumas and do survive?”

Every time that happens there vulnerability builds and they do everything they can to numb it while they’re on active duty, because they don’t have a choice.

https://www.youtube.com/watch?v=ImpNLGKgBoY

But when they leave the military, hell literally breaks loose inside their heads and minds and the unfelt feelings start to push through to be felt. When that happens, their minds go through these eight steps until they can no longer avoid feeling they will fragment and never come back. When that happens and they’re on the brink of losing control, they kill themselves as a last ditch effort to regain control.

The Eight Steps to Suicide

1. Cumulative Vulnerability — As they go through their lives and more and more stress is added to them that they get past but not fully over, it builds up and they cross over into distress where their focus is relieving that distress in any way possible.

2. Fragile — The point at which the distress so overwhelms them that they are no longer able to attack it by fight (getting angry at others or themselves) or run away from it by flight (into frenetic activity, busyness or mania) and instead freeze and begin to feel internal cracks in their minds.

BTW this is also the point where when they can’t escape the mounting vulnerability as their anxiety increases (as in feel increasingly awful and there is no escape) and depression increases (with no escape and no longer able to cope by being angry outward, they follow Freud’s explanation that “Depression is anger turned inward”).

3. Brittle — The point at which the internal cracks intensify and they feel brittle and as if they could shatter at any moment and they make a last ditch effort into escaping into alcohol and/or drugs — especially opiates.

4. Shattered — The point at which their minds feel as if it has shattered but is still in place (like a shattered windshield which has not yet fallen apart).

5. Terror — The feeling that the next step will be that their minds will fragment.

6. Fragmented — The point at which their minds feel as if it has exploded and will never come back.

7. Panic — The point at which they will do anything to get away from the continued fragmentation.

8. Suicide — The point at which they end their life because they cannot exist in a state of terror and panic.

What to do?

Pain is pain, suffering is feeling alone in pain and terror is feeling alone in pain that is so horrendous that you will do anything to end it.

But here’s the deal. Take away the aloneness and suffering and terror that you can’t survive often ratchets back down to pain that you can.

One way to do that is to have groups of veterans meet with trained facilitators who can help them each share their stories of having gone through the eight steps about.

The following graphic entitled “The Road Back from Hell” has also been a helpful catalyst for groups of veterans with PTSD/RTA to graphically share their stories.

And below is a graphic with the sequence that people going through trauma go through in their mind (source: Why Cope When You Can Heal? by Mark Goulston and Diana Hendel).

A useful observation to keep in mind is that when a person shares a story so clearly that the listener can actually see it, the first person re-experiences it and that is when the unfelt feelings — as awful as they are — have a chance to be felt and with time veterans have a chance to not just get past their traumas, but over them.

Resources:

* Mission 22 — United in the War Against Veteran Suicide

• National Suicide Prevention Lifeline — Veterans
• Veterans Crisis Line
• Lifeline for Vets
• #Stayalivenow our suicide prevention documentary plus additional resources