I have now successfully attended three sessions of Cognitive Processing Therapy.  This last Wednesday gave me a lot to think about and it has taken me until now to fully think through everything we talked about.  The conversation was nuanced and edgy.  The fundamental question that was asked of us was this:

Is there a difference between acceptance and forgiveness?  If so, why is the distinction so important?

The discussions we had were really raw.  The idea was put forward that acceptance is logical, whereas forgiveness is emotional or spiritual.  We all agreed that this is a good explanation of the difference between the two.  The doc then asked us to think about which one of the two was more important to being able to cope with our PTSD triggers and symptoms.  We all sat there for a while thinking about it when the doc asked us if we could see why acceptance was more important.

Boy did that get a visceral reaction.  We all rejected that idea for different reasons, but the most important aspect that resonated with me is that while acceptance uses logic to deal with our experiences, our experiences were anything but logical.  I explained that whenever someone tries to give me a logical solution to an emotional and spiritual problem, my immediate response is extreme anger.  Even talking about it made me edgy.  I asked how acceptance could possibly be the more important of the two.

The doc said that starting with the way we are thinking is paramount.  We experienced something horrific, responded emotionally and spiritually to it and, as a result, modified the way we think.  If we want to work backwards to get to the core of the issue and learn to control our reactions to outside influence, we need to accept what happened.  We need to to accept that we had no control over what we experienced,  that it would have happened whether we were there to experience it or not.

As I said, it was a lot to digest and is still something that I am mulling over.  I don't know if I agree with the methodology.  Regardless, I do feel that the group therapy is helping.  It is forcing me to ask myself a lot of difficult questions that I hadn't considered before.  I guess we'll see where this leads in the coming weeks and months.

Today is the big anniversary.  I didn't really want to think about this today, but the intrusive recollections didn't really give me much of a choice.  I have to go to work soon.  I just need to make it through the evening.  That's all.  I have the next two days off and I will have the time to reflect and decompress.  Until then...

July 30th, 2003.  The day the course of my life irrevocably changed.  The day that I remember every year with trepidation, sorrow, guilt, anger, and gratitude.  It made me question everything I believed.  It shattered my psyche, shredded my soul.

Quite honestly, I am surprised I survived long enough to make it home.  Every day after became harder and harder to bear.  The horrific scene that haunted my mind, the smell and taste of blood...

Yet here I am, writing about how that experience and others that followed after changed me.  I don't want to remember what I experienced, yet I am afraid to forget.

Change the date and any veteran could have shared this.  The scary truth: Every veteran with PTSD I know has an anniversary.  A day that makes them pause, unwillingly, and remember horrific experiences.  A day they can't reconcile with physically, mentally or spiritually.

I have had many people ask me why I mark this date on the calendar.  They don't understand why, when it is so horrific, that I am forced to remember.  The answer I give them is always the same - Because I still am unable to accept what happened.  That, to me, accepting it would feel like a betrayal of those that died.  After almost a decade, I still feel this way.  I feel this so strongly that you might call it conviction.

My answer leaves many people shaking their heads in incredulity.  They ask me why I punish myself this way.  The answer:  I don't know.  Is it self-imposed punishment for surviving to talk about it when others never had the chance?

I'll make you all a deal.  When I figure it out, I will let you know.

Yet another day and more frustration and anger.  People have a tendency to try to push the boundaries of what is acceptable and what is not.  They just push, push, push...

So I pushed back.

I didn't do anything violent.  I didn't verbally abuse anyone.  I just let people know, unequivocally, what I expected of them.  I think I need to do that more often.  Things went very smoothly after.

The real problem:  I couldn't let the frustration go.  I care too much.  It makes me anxious as hell.  I have already been down this road.  The anxiety and the PTSD continually push me toward the cycle I was in all last year:  gear up for work, exhaust myself, come home useless.  It pushes and pushes...and shoves.

So I push back with all my might.

I will not let this happen again.  I will continue to take my medication, I will continue to do things with my family, I will never stop blogging, and I will learn how to cope by attending CPT.

Next week is going to be a rough one for me.  It always is.  July 30th is the big anniversary.  The one that feeds my nightmares the most.  I have yet to make it through this without the PTSD shoving me squarely on my ass.

But I will push back.  Hard.  And maybe this year, I will maintain my balance.

I had to go to work early this morning and I still had last night on my mind.  I knew that today was going to be a day I just had to get through.  And I did.  I had to fight the depression, the lethargy.  I knew that the changes that returning to work would bring had the potential to put a serious strain on my coping mechanisms.

I had been hoping to have the time to catch up on all that has changed at work.  No such luck.  The basic business strategy has changed and it is a challenge to keep everyone on point.  I also have the challenge of learning to relate to everyone at work again.  While most have forgotten what it is like to have me around, some seem to have forgotten that I was out of work at all.  The learning curve has been intense.

I knew that the change of returning to work would be difficult.  The anxiety and anger have been difficult to keep in check at times.  When it gets tough, I think about my family.  It helps tremendously.  Spending time with my wife and daughter, blogging and advocating for local veterans help me remain positive and leave me feeling fulfilled.  I don't know where I would be without my friends and family.  I know for certain that I wouldn't be sitting here writing this.

So...Here's to Victory.

And everything was going so well...

I had the kind of day that triggered my anger and my PTSD.  I got frustrated a lot and it was hard not to bring it home with me.  When it was time to leave and come home, I got out as quickly as possible and tried to leave work at work.  I was not successful.  I helped my wife get dinner on the table for the little one and talked about the anxiety that I was feeling.  It was the day we both knew was coming but were hoping wouldn't.

My wife convinced me to go for a walk after dinner and it seemed like it was going to help and then I felt and heard a loud concussive explosion.  My wife jumped and I immediately turned toward the source of the sound.  My mind was no longer in Pennsylvania.  The reaction and change in body language was instantaneous.  My wife knew my instinct was to run directly at the source of the explosion.  Her grip on my arm was like a vise.  The only thing that kept me standing there was the absence of screaming.  There was dead silence.  No birds chirping and no cicadas sounding off.  Even the sound of car traffic sounded far away.  With every instinct screaming at me, I turned away from the source of the explosion and continued on our walk.

We never did find out what caused the concussion wave.  I can feel that nagging doubt that everything is OK and it won't go away.

It's gonna be a long night.

Wow, what a whirlwind day and a half.  My meeting last night was an amazing success.  I met with Todd Watkins (Director of the Baker Institute), Anthony Durante (Allentown Economic Development Corporation and Founder of Lehigh Valley Tech), and Rich Hudzinski (Chairman, Veteran Affairs Committee, Lehigh Valley Military Affairs Council).  We discussed my idea of creating a veteran entrepreneurship program in the Lehigh Valley, PA.

Last night's meeting generated the impetus to get the ball moving and we are now exploring how we could possibly make this happen.  This is going to be a long road and I do not want to take away from what I normally write about in this blog, which is my every day struggles with PTSD.  As a result, I have created a subdomain for what I am now naming the 'Lehigh Valley Veteran Entrepreneurship Initiative' (LVVEI for short).  Any further information about this will be covered there.  I am still working on creating it, but it should be live in the next few days.  I will let you all know as soon as it is.

No worries, I have not and will not stop advocating for PTSD.  I am as passionate as ever about it and am looking forward to continuing the conversation as I share my day to day struggles.  My biggest fear is that I am doing too much, but my family, despite my anxiety about this issue, remains the focus and motivation for getting out of bed every morning.  Thank you all for your support.  I hope you continue to find what you need here!

It's my first day off and I'm exhausted.  I had nightmares last night and I didn't sleep well as a result, I am out of it today.  It's not what I needed on today of all days.  I have a meeting with the Director of the Baker Institute and the Chairman of the Veteran Affairs Committee from the Lehigh Valley Military Affairs Council (LVMAC).  We are going to be discussing local veterans' issues, particularly what we can do to create opportunities for veterans in my home town in the Lehigh Valley, PA.  I know that veterans can be the backbone of economic growth and development.  They just need the right tools to make it happen.  That's what this meeting is going to be addressing.  I was hoping that I would have more specific information to bring to the table, but the established programs that are out there already know how to navigate the bureaucracy that is the SBA.  I explored their website and felt completely overwhelmed with the sheer amount of information and options available.

With the lack of sleep, things aren't feeling any easier.  I have been excited about all of this for a long time and now I just feel like I am a fish out of water.  Who the hell am I to try to organize this?  I wish I could just hide in my hole today.  I really do.

That's all later today.  The rest of the day belongs to family.  I am really looking forward to spending some quality time with the little one and momma bear.  I know I am a little distracted because of the particular clarity of last night's nightmares, but I promised myself I wouldn't let my life return to the shambles it was before.  Time to go be a participant in my own life.  Off to the park.

Today I got to test my anger management ability.  I got really angry at work today.  Really angry.  I had to walk away and get something to drink.  I know what set me off and I can't wait until I learn how to disengage the knee-jerk anger reaction.

Here's the beauty of it, though.  I hid it really well and went about my business after drinking down some water.  When push comes to shove, as long as I am able to keep my cool and my professionalism, I can live with a little anger.  The important part of the equation is that I didn't take the anger home with me.  I didn't even keep it with me for the rest of my shift.  I seem to be able to let the anger go a lot better now that my medication is properly balanced.  I am sure restful sleep every night helps too.  I have one more day of work and then I get two days off.  It will be nice to enjoy some time off and write more of my book.  Here's to hoping tomorrow goes well and I can officially put one week back to work securely under my belt!

OK.  I have been almost a week back at it.  Work has been going well and so has home life.  I won't lie and say that it is easy.  I am struggling still with motivation to do the little things.  The difference this time around is that I am not letting myself sit and do nothing.  If I am tired, I don't sit and veg in front of the TV until after Caley is asleep and until I have done all I can to help my wife around the house.  I think, honestly, that it is the harder part.  Work, by nature, tires me out.  I am surrounded by people I don't know all day long and it pushes and prods at me, making me anxious.  I do my best to do my job and not let the little things bother me.

I will say that being able to get a good night's sleep helps me get through the day.  Having my medications stabilized seems to have really paid dividends as well.  My overall physical health is probably better than it has been in ages.  I just need to shed the weight I gained in the interim.

My biggest fear, still, is that I will end up being in absentia when I get home from work and that I will head back down the path I took a year ago.  I think that I am doing all of the right things to ensure I stay focused on what matters.  The other thing that still remains important to me is my blogging and my advocacy efforts.  I make sure that I take a little time out of every day for myself.  We'll see how things continue to go in the coming days and weeks.

Yesterday I attended my second Cognitive Processing Therapy group session.  I think I am really going to like this group a lot.  Two positive experiences in a row.  The doc started by letting those of us who didn't know each other introduce ourselves.  We then talked about what had transpired since the last meeting.  One of the items that came up was how relating my experiences last meeting had reminded one of the other members so much of himself that he had a lot of issues with his PTSD for the two weeks between sessions.  Needless to say, this made me feel really guilty that I had unintentionally caused another veteran distress.  I didn't say anything about it at this point, though.

There was a new guy there I hadn't met before and he described how he and his unit had received intel that sent him into a situation that put him and his unit in the blast radius of an IED.  This was a new facet I hadn't considered much until yesterday, mostly because it is incredibly painful to think about - intel I provided probably sent guys just like him into similar situations.  I know in my heart that some of our boys died as a direct result of intel sent in by me and others like me.  Again, I felt really guilty.  

It was in this context that we talked about what we all had in common - confrontation with death.  An intimate knowledge of death.  We discussed the concept of moral injury as a result of this.  I know a lot of people don't like this term, but it is really appropriate.  We have all been confronted by things that fundamentally violate our moral code.  My response to this was to adhere strictly to my morality, getting angry with anyone who did not adhere to my morality.  Obviously this caused a lot of problems with other service members over in Iraq.  This moral injury is a constant companion and my morality is still just as black and white.

The doc asked to stop the session there and I asked to say one more thing.  I wanted to express my guilt to the other two for having caused the one veteran difficulties and for having sent guys just like the other veteran into harm's way.  They both jumped on me immediately to let me know I was being an idiot.  The one veteran said he was concerned that I may take his regression over the past two weeks as being my fault.  He assured me that it was his PTSD that caused the problems.  Not me.  The other veteran told me that he wished that he would have been sent into a situation backed up by quality intelligence.  Then, at least, he wouldn't be going in blind.  By the time he was serving in Iraq, intelligence collection efforts were hamstrung so severely that we constantly sent our guys into situations without really knowing what awaited them.  He said I was the kind of guy who saved lives with my intelligence.  He said I can't hold myself responsible for combat arms guys going into a situation and doing their job.  Death in combat is one of the risks that they assume is par for the course.  Good intelligence meant less guys got injured or killed.

That was how we ended the session.  Whew. What a day.  More to follow in the coming weeks.