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...
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.
So yesterday, I traipsed out to the local outpatient clinic to attend my first scheduled group Cognitive Processing Therapy session. I finally made it through the gauntlet of individual assessments to get into the group. There are only a few slots per group so they want to make sure that the person they are bringing in is dedicated to coming and to learning. Well, I finally made it.
As I entered the room, I noticed that I was the first one there, early as usual. I sat down and pulled out my kindle and started to read over some of my book that I had written the night before. I didn't get very far. I started wondering if this was going to be a waste of my time. I started feeling anxious. I wanted this to be a good thing but was afraid to get my hopes up.
As I sat there thinking about all of this, the doc and the other member arrived. Yeah. One other member. Needless to say, the anxiety ratcheted up another notch. Then I found out that a lot of the regulars were not going to be there because the folks that had been attending regularly were in residential inpatient treatment programs of some nature or another. Needless to say, I started to relax a little.
As introductions were made and I learned some about the other member that was there, I recognized that we were both in the same place, relatively speaking. We were both too smart for our own good. We are both introverts and recognize that we have problems and triggers, but we also recognize that things are never going to get better unless we learn the tools to cope with our triggers.
There was one other interesting commonality. We had both been participants in support groups previously and been particularly disillusioned. We had no patience for people that were going to sit around and cry in their soup. We are both solutions guys. We don't focus on the problems and want desperately to add every tool we can in order to best control our PTSD.
For the first time in a long time, I am hopeful that the treatment I am receiving will make a difference for me and my quality of life. As I learn things, I will share them moving forward. Have a great day all!
As I continue my life with PTSD, I will share my challenges and discoveries on this blog.