War Heros: A Poem

War Heroes

As taught by 500 veterans who have been tormented by their war.
Part 1 How to know you are a war hero
(pick some from the list below)

Believe you didn’t do enough
Believe the real heroes are dead
Have pride in what you did
Despise what you did
Not give a shit about what you did

Believe you should have died
Think you must figure out the secret reason you didn’t die
Be angry at the people who weren’t there
Think of everything you can to keep your kids from going
Love anyone else for going
Think you only did what you had to do
Think you didn’t have to do everything you did
Think this is not how heroes think and feel

Part II How to get over being a war hero

Grieve everything and everyone you lost
Grieve all the yous you think you could have been
Go through the grief until you recognize the impossibility of the other selves

Learn we have an obligation to find serenity
Learn that nobody in their right mind needs you to suffer anymore
Learn that living your life well is the only way to honor the dead
Learn that trying to carry other people’s pain would be an insult, if insults could exist
Stop pretending you are not going to die

Learn that knowing something once is not enough, we must keep coming back to it
We don’t pray once

Part III Where you learned the definition of the word hero

Maybe when you were a kid you learned to look up to someone as a hero
You thought that person had all the answers, all the power, all the skill, and none of your kind of fear
Then you grew up, but still never noticed
that the hero didn’t feel what you thought he felt

Now we know that the courageous are scared,
and the skillful aren’t always courageous

Part IV Summary

There was a new recruit from Maine
who thought he would earn him some fame.
He got in the fight,
and Lord it got tight,
but you better not call him a hero because now he knows
it is much more complex than that, and besides all the heroes are dead

Howard Lipke
(1/6/16 version)

North Chicago Conflict Resolution Institute (NCCRI)

North Chicago Conflict Resolution Institute
(a work in progress)

The nccri is a semi-fictional organization created to help people peacefully resolve internal conflicts and conflicts with others. Sometimes it teaches skills they need to accomplish this, but often times it just reminds them to use what they already know. Of course, the principles can be just simply stated for people to use if they choose, but when ideas are attached to a structure or organization, and practice is encouraged we often find it easier to use them when we need them.

So, the nacre was created as an entity to provide that structure, and is called an institute instead of a club, because of the educational component. The value of this general approach can be demonstrated with an example involving my friend William. He came across a kitten stuck in a tree. He was in a hurry to get where he was going, and was tempted to walk on, however, he remembered he was a member of the Help-A-Treed-Kitten Club (HATKC) and stopped to help poor tabby down.

The nccri was formed out of a concern as serious as the HATKC’s (I hope I don’t get in trouble for saying this) is frivolous. It was developed to help veterans meet the goal of preventing combat solutions to non-combat problems. The military teaches skills for violent resolution of conflict, and the American military does it particularly well. The lessons learned in the military, before and during combat, helped veterans survive there, and may even help veterans survive violent situations in civilian settings. However, when people are so well trained for and experienced in combat, that kind of solution can come out automatically, before other solutions are considered, especially when there is stress involved. It should be said that it is not just the military that teaches aggression, and employs anger to block hurt, many parents and others involved in child raising teach or foster a similar martial approach, which gets absorbed and can dominate reactions to stress.

The internal combat response does not only involve emotions, it also involves thinking patterns. The thinking pattern that becomes most likely to turn non-combat situations violent is rapidly thinking of others as enemies. This may save lives in war, but can be self defeating, increasing rather than limiting risk outside the combat zone.

This institute was originally established, about 25 or 30 years ago , in conjunction with the Stress Disorder Treatment Unit (SDTU) at what is now called the Lovell Federal Health Care Facility. nccri activities partially overlap with SDTU programs for both resident and non-resident participants. It is a principle of the Institute that successful study of peaceful conflict resolution, when appropriate, will go hand in hand with decreases in symptoms of PTSD for those who have these symptoms. However, the distress and disruption of meaningful and pleasurable functioning that may come with having been in war cannot be fully described in terms of psychiatric symptoms. They must also be considered from other points of view, spiritual, philosophical, educational, vocational, and social. These are more the purview of exploration and education than treatment.

To be a member of the nccri one only has to agree that making peaceful conflict resolution, when possible, is a goal. Membership in the Institute is completely voluntary. There is no list of members. However, the founder Howard Lipke, is the only one authorized to decide what is, or is not, an official activity of the nccri. A membership card is offered below, it can be downloaded and printed.

Howard Lipke, PhD
Revised 4/25/16

On Stigma

Below are two paragraphs from a paper on stigma, especially as it applies to veterans. (Actually there are two papers, one addressed to veterans and one more academically written for MH professionals) In the second paragraph it is suggested that if vets, or anyone with trauma related “symptoms,” is going to get down on themselves they should at least “Get it right.” which is the name of the academically oriented paper these quotes come from.

That stigma (being marked or believing one is marked as disgraced) is a primary barrier to veterans seeking help to overcome the destructive psychological effects of trauma is one of those cultural phenomena which is easy to see, widely acknowledged, and also supported by research (Hoge et al 2004) . As is often pointed out, the stigma has two manifestations, (e.g., Corrigan, 2004) the belief by others that the need for psychological help is a sign of essential inferiority, and the same belief held by the self. Both are important with the self-stigma clearly most damaging.

 Stigma terms

  1. Current stigma term: Crazy Vet 

More accurate term: Stuck Transferer

This is the stigma associated with re-experiencing symptoms. “Stuck Transferer” refers to the idea that flashbacks and reliving nightmares are a manifestation of unprocessed memory. In Horowitz’s terms (1976) memory has not moved (transferred) from short term to long term storage. In the version presented to veterans this is called moving from “reliving” to “historical” or “intellectual” memory.


Understanding Psychological Trauma Through Literature (draft)

As a psychology graduate student, in the 1970’s, I came across an edited volume, The Abnormal Personality Through Literature, by Alan A. and Sue Smart Stone (1966), which presented long passages of great works of fiction to describe psychiatric syndromes and psychotherapeutics. I thought it a great idea then, and still do. The work you are reading attempts to apply their method more specifically, to just the destructive psychological effects of trauma and efforts to overcome them. The other variations from Stone and Stone include the use of shorter passages, and comments on changes in the way trauma has been recognized over the years, since it has been officially acknowledged in the Diagnostic and Statistical Manual (DSM) as the official United States standard.

A reasonably clean rough draft:

Thinking and Feeling About Forgiveness

This is a paper based on work with combat veterans over many years and addresses some of the most difficult and painful concerns people can have, the difficulty of which is magnified by involvement in war. It includes discussion of forgiveness of others and the self, with the decision to forgive, not all or nothing, and not a foregone conclusion.

Recently the phrase “moral injury” has been applied to some of the issues addressed in this paper.  While I’m glad the moral and emotional reactions to participating in combat are being  more fully considered by psychologists who used to only talk about the fear related to traumatic experiences, I’m not sure that the injury metaphor is most useful way to consider them. The term moral injury appears to be about what is already considered when we talk about guilt. Guilt people feel related to trauma, whether  it seems justified to others or not, or necessary or not, has already been subject of much psychotherapeutic work, written about for a long long time and undoubtedly considered even longer.

Brochure: For War Vets and Family

The brochure For War Veterans & Family: On Combat Exposure was written in late 2008 for veterans and their family members who were connected to the Stress Disorder Treatment Unit (SDTU) at what was then the North Chicago VA Medical Center, and is now the Lovell Federal Health Care Center. Although there were many educational materials available on the psychological effects of combat (e.g. National Center for PTSD internet resources available at: http://www.ptsd.va.gov/public/) these appeared to focus on describing PTSD symptoms, attempting to normalize them, and encouraging treatment. They certainly met a need, however, their focus on diagnosis and symptoms failed to address essential issues that would help to clarify a reasonable understanding of how the effects of combat related stress might occur, and what paths might lead toward relieving  them. The standard approach also did not answer many of the questions that had arisen over the years from veterans and family members.

In an effort to meet these needs work began on the brochure. As was the process with many of the clinical materials developed for the SDTU, after a first draft was completed by staff it was presented to groups consisting of residents and some alumni outpatients of the SDTU program. Their feedback was incorporated into subsequent drafts. This process continued until there were two consecutive groups who found no objections to the material. The brochure was then made available to veterans and family members in its completed form.

Overview of EMDR

The attached paper is a variation of my entry in Charles Figley’s (2012) Encyclopedia of Trauma: An Interdisciplinary Approach.

Fighting the Last War: On Courage and Wisdom

This paper comes out of discussions of issues addressed in meetings with combat veterans in the Stress Disorder Treatment Unit at North Chicago VAMC, now named The Captain James A. Lovell Federal Health Care Center.

The Short Version:

The main psychological challenge while in combat is to, minute by minute, find courage to overcome fear and pain. The main challenge of civilian life is to find wisdom to define and meet long term goals. Knowing this is a big step toward overcoming the problems which come with mistaking civilian challenges for combat challenges. 

The Long Version: