The following is a transcript of the "Chat with Dr. Cantrell" from July 22, 2009. Links to additional resources and information from the chat transcript are included to the right.

Joan
Good evening, Dr. Cantrell.

Dr. Cantrell
hello all thank you

Marine's_Mom
Hello Dr. Cantrell

Joan
Jackie do you have a question or issue to discuss this evening?

Marine's_Mom
Yes, my son when woken by his wife doesn't know where he is or what he is doing and now is getting more aggressive - is this normal? She knows he's still sleeping

Marine's_Mom
she doesn't know what to do.

Joan
That must be very frightening for her.

Marine's_Mom
yes...it reminds her of when he got back from Iraq and it subsided but it's back

Dr. Cantrell
Yes, this is something that many who serve in a warzone experience, they can be very disoriented and maybe coming off a nightmare. Yes, this can be very frightening.

Marine's_Mom
He's under a lot of stress with preparing for Afghanistan tour

Dr. Cantrell
They can be triggered on Anniversary dates etc, so there are many situations which can activate this unrest.

Dr. Cantrell
It is very important that they develop a ritual to end the day with and perhaps this will help them deal with these issues.

Marine's_Mom
he feels terrible when she tells him he yells at her etc and doesn't even know it. Is there something he can do?

Marine's_Mom
He is sleep deprived working hard all day training and then going home to a new family with new baby and the pressures there too..

Marine's_Mom
He's only 19

Dr. Cantrell
As far as the aspects of danger, it is alive and well. Yes, they have a tremendous amount of guilt because they have no intention of inflicting fear in their partner.

Dr. Cantrell
Hold on please let me fully repsond, this is such an important and common situation.

Dr. Cantrell
First off it would be important to understand the time of year, date, etc. like I said it could be an anniversary reflecting back to something that occured Down Range. Next I would want to know if there is any self-medicating going on, and what I mean by that is Alcohol and over the counter or street drugs.

Dr. Cantrell
Then I would want to know what tv programs or video games, conversations that spark anger of unrest.

Marine's_Mom
no no drugs are involved nor is alcohol

Marine's_Mom
Yes, video games are played sometimes...Halo and the like

Dr. Cantrell
how about psyche meds?

Marine's_Mom
no, no medications what so ever

Dr. Cantrell
is he out of the Marines at this point

Marine's_Mom
no - will this info be seen by wrong people with me writing this?

Dr. Cantrell
it is seen by everyone if you want to go on the back channel or write me privately you can sure do that at

bc@XXXXXXX.com

Dr. Cantrell
I would suggest that he talk to someone just to see how his sleep patterns are going. He could have what is called Sleep Apnea and this because of the lack of Oxygen etc. could contribute to his disorientation. Sleep is so critical, so if he could get this all sorted out this would be a great step in a positive direction.

Marine's_Mom
That is what I was thinking too....we'll be on the web cam talking with him and his eyes roll in back of head and wham, he's out cold ...

Marine's_Mom
she is noticing a lack of appetite too lately...they have no support from family out there as we live so far away just to give them a break so I know that stress is playing a large role too.

Dr. Cantrell
He could also have other things going on that need to get further examination. Did he ever have a head injury?

Marine's_Mom
not to my knowledge no head injury

Marine's_Mom
but then again they don't tell you about all injuries sustained

Dr. Cantrell
Well this is not a situation to be put on the back burner. What was his job while he was deployed?

Marine's_Mom
I'd rather not say...but front lines...

Marine's_Mom
never in same spot, always moving around different places in Iraq...

Dr. Cantrell
I understand. I just wanted to get an idea. Is there another family member or another one of his Marines you could ask to provide some support?

Marine's_Mom
That is what his wife is seeking to do...

Dr. Cantrell
There are programs around the country that are able to provide services to your Marine.

Dr. Cantrell
Can you please write to me and there may be some resources I can put him in touch with. I can see that you are clearly concerned, and it is wonderful that you are being proactive. Is he still in the Marines?

Marine's_Mom
How about the Chaplains - is that a good source?

Dr. Cantrell
Yes, the Chaplains are a very good resource and this is certainly an avenue for him. There is also Military One Source, and like I said depending on where he is there are programs in states around the country.

Dr. Cantrell
It is very important that if there is an issue that has to do with a sleep disorder, or other health issues that they be addresssed before he redeploys.

Marine's_Mom
OK...thank you. I need to run thanks for the information.

Dr. Cantrell
You are sure welcome, please feel free to contact me privately.

Texasdad_and_Mom
We recently found out that one of our son's good buddies was KIA. My question is , do we bring the topic up or not mention it? My husband did say something, and of course due to Opsec, little could be said, but my son did elude to it being one of his close friends. We sent him the address of the family in case he wants to send a card. How are these situations best handled during deployment?

Dr. Cantrell
You must follow protocol on this because of the sensitivity of family notification, and the situation under which the KIA took place. It sounds like you have touched on the topic and your son knows about the death is this correct?

Texasdad_and_Mom
Yes. Our son called and told us he had been to a memorial service, and my husband asked him if it was one of the guys he had sent us a picture of before they deployed. We recognized the name from the news articles.

Dr. Cantrell
I think that the door is open and it is up to you to sit back and allow your son to approch you with what he wants or needs to share with you

Dr. Cantrell
You have offered him the family's address so this is perfect. Just let it be and don't ask questions and just go with the flow. It will all work out and he must do this at his own pace, so he can remain mission focused.

carmen5
what r some signs that let us know that they are not dealing well with the marines kia?

usmcmomandwife
My son lost two of his best friends in Astan this year -

Dr. Cantrell
Each person is different and approach grief in ways that may not be the same as the person next to them. I would just watch and sometimes they put it away until later, and perhaps they have dealt with it in their private moments.

usmcmomandwife
What if you think they are NOT dealing with it at all?

usmcmomandwife
And if it is making them hostile?

usmcmomandwife
hostile'er, in my son's case

usmcmomandwife
not a word - but ............the only way to say it!

Dr. Cantrell
Hostility is a anger, it is all the same and anger is used as a means to push underlying emotions away and people away. There is going to be anger, they feel "if only" "I should have been there" and many have survivor guilt and feel they are to blame for the loss.

carmen5
would they push family away more so that their friends. is that normal?

Dr. Cantrell
In the situation with your son, it would probably be really helpful for him to be befriended by a mature veteran who has been there.

usmcmomandwife
But my son just tells me he doesn't care - like if I ask him about the boys he gets mad and tells me to stop talking about them. But if I say anything that remotely sounds like asking him about his feelings he says "I'm not a pansy Mom!"

Dr. Cantrell
Yes, for sure, they do push those on the homefront away.

Dr. Cantrell
Your son must have his privacy, he is telling you to back off and stop bringing up the painful memories that he has put away until it is right for him to remember. This is one of the things that is so difficult for those who are on the homefront. Of course you want to know more and you are curious but some of your Marines are saying please just let me be now. Anger is used as a form of armor that keeps people at a distance.

usmcmomandwife
The problem is that it comes out in just general meanness - not just to me, to everyone. I think he will get himself in more trouble than he can get out of.

Dr. Cantrell
If you are pursuing him and are not listening to his needs he will get hostile, he is getting frustrated with the demands and expectations that those on at home are imposing.

carmen5
how long does this defense mechanism usually last?

Dr. Cantrell
Yes, many of them get into trouble and this is one of the things I am working on state representatives. They act out sometimes based on their wartime expereinces.

Dr. Cantrell
I would suggest that you and your entire family just sit back and not ask questions, keep it light.

usmcmomandwife
My son watched his friend die from a self inflicted gunshot wound, then the gunner who replaced him in his humvee was killed when the humvee hit an IED - his roommate/best friend also died from his injuries two weeks later.

usmcmomandwife
How can that not cause irreparable damage?

usmcmomandwife
He is 19 years old

usmcmomandwife
And even before this was not exactly "in touch" with his feelings

carmen5
our sons are in the same battalion..they had 12 total kia

carmen5
12 in total..

Dr. Cantrell
These are the wounds of the soul, and they are things that are deep and this is why you who were not there, must respect your Marines boundaries. This is the most painful experience, and it is compounded with a second death.

Dr. Cantrell
Being in touch with feelings can be too much to ask right now, you cannot make someone face these feelings.

usmcmomandwife
I am going to be totally honest here - I know that my son will not reenlist and I feel like he will end up in jail, or worse. It's like he is emotionless now.

Dr. Cantrell
I am so sorry for all the losses and this also affects each and everyone of you.

Dr. Cantrell
Do you have any veteran friends that you can hook him up with?

usmcmomandwife
My hubby is a marine officer who served in Iraq - but my son now hates officers and won't listen to anything my hubby tells him

Dr. Cantrell
Yes, and your husband represents those who may have given orders that resulted in negative events. So you husbands is way to close to and he out ranks yours son so this is not a good option. Even though your husband loves his son these dynamics will interfere with the process.

usmcmomandwife
I have only seen him for a few hours since he got home in June - he got in trouble and had his leave cancelled, but he may come home in August for a weekend when he is off restriction

usmcmomandwife
I just want it to be okay!

usmcmomandwife
When I talk to him, it's like he tries to shock me or upset me

usmcmomandwife
I have no doubt in my mind that this will lead to a substance abuse problem

usmcmomandwife
And I'm helpless to stop it

Dr. Cantrell
I will give you a personal example of how important it is that the person who intervenes is not a family member. I was at a friends house and a young warrior came over and the person who is a VN veteran Marine, layed it on the line and it was an incredible dynamic, so it must be someone where the boundaries are there and the emotions are not related to the parent child relationship.

carmen5
is an "i don't care what happens to me", "i may not make it back next time" attitude normal. what do i say when he expresses those feelings. also, maybe linked to "my friends at home don't care"

Dr. Cantrell
I want it also to go well. It would be good to speak to a Chaplain, talk to someone you trust who can get him hooked up with another veteran.

Dr. Cantrell
Yes, this is something we do see. They know that there are dangers and there are no guarantees, and they do not want fear to interfere with their mission of supporting their fellow comrades. He can no longer relate to those at home, he is essentially saying the "they just don't understand", and how can they?

usmcmomandwife
I feel like he is hanging around with a bad group - and it has deadened his feelings. He said the other day that the guy he is hanging around with went through his phone and was calling the numbers in it and called the number of the Marine who shot himself - his Mom has not disconnected the line and the boy's voicemail came on. Aaron said the kid was laughing about it, and Aaron didn't even seem upset. He kind of laughed and said it was like the movie "white noise"

usmcmomandwife
This was the boy he used to drive home with on weekends

usmcmomandwife
Aaron even avoided the memorial service

Dr. Cantrell
He may be telling you these things to get your reaction. Just don't over mother, and let him deal with it on his own time. Humor is a form of working through things, and dark humor is certainly a coping mechanism that is used in professions where there is physical and emotional truama. It is an outlet that is understood and accepted by those who have a mutual experience.

usmcmomandwife
And his roommates Mom sent him packages that had been returned to her after he waskilled

usmcmomandwife
He wouldnt' even go meet her

Dr. Cantrell
Have you ever attended a memorial service your a friend who died in a traumatic way by taking their own life. To soon as we have heard recently. It is very very difficult for them to go to these services, and they have other ways that they deal with these deaths with their fellow Marines.

usmcmomandwife
I went to the funeral that his parents had -- I mean the service that the Marines did.

usmcmomandwife
All the other marines went

Dr. Cantrell
These are all unfortunate reminders of the reality and finality which is really very sad.

cjv
I have a question I hope it is okay to ask now ......my son recently lost a friend who was home on leave and was killed. He was not able to attend the memorial service on base because he was in the hospital himself and he was not able to go to the funeral in the Marine's home town with the rest of the guys. He said very little about what happened when others were around but when it was just he and I or he and his sister he would say a little bit about it. I worry that because he didnt get to

usmcmomandwife
I guess I just have no doubt that this has changed his life in a bad way - and I hope that WHEN he gets in trouble, that someone will understand.

Dr. Cantrell
Its okay this is very painful, and these are difficult things to get a handle on. But just remember that they are all different and have various levels of resiliency. But do keep an eye on them and if you see that they are withdrawing more or behaviors that concern you please reach out and get some help.

Dr. Cantrell
There are many of them for whatever reason do not get to go to the Memorial service and this is bothersome to them, so it is important for them to think of their own ways of honoring their friend. They must not allow the guilt of not being there overpower them.

Dr. Cantrell
this is what we want, is for if and when the trouble happens that they understand where it is coming from. It is best to intervene before he gets to that point, this is why I am strongly suggesting that you call in reinforcements so to speak, reach out and see if there is someone who can reach him.

usmcmomandwife
He won't talk to anyone right now

usmcmomandwife
maybe when he comes home though

carmen5
it is hard to know what they r going thru when they don't communicate with the family

Dr. Cantrell
CJV This is great that he feels like he wants to reach out to you in private, this is where he feels safe and all the egos are not involved.

cjv
so just waiting for him is what we should do?

Dr. Cantrell
Have a veteran take him out for coffee. What state is he in?

Dr. Cantrell
Absolutely let them go at their own pace, no pressure and suspend your expectations of how you think it "should" be

cjv
what state is my son in?

Dr. Cantrell
Yes

cjv
michigan

usmcmomandwife
the survivor of the humvee I was talking about is there

usmcmomandwife
or he was - he may be back at clj by now

Dr. Cantrell
There are very creative ways to get them hooked into veteran groups. For example here in Washington and other states we have Combat Veterans International which is a group of combat veterans from all branches of service and eras who ride motorcycles.

cjv
I think my son will be okay he has a small group from highschool as stationed very close together and they watch out for each other and I think they see it as family away from home

carmen5
my son left home early from his leave and stated he felt better back at base

Dr. Cantrell
Yes, this is very good that he has a group that he can call family.

cjv
usmcmom It is so hard to see our kids hurt. I will keep your son and family in my prayers

Dr. Cantrell
Yes, this going back to base is a sanctuary for them. Some choose to even stay there even though they are married

usmcmomandwife
I like to "fix" things - and this deployment has thrown everything out of whack

usmcmomandwife
I can't help him, I coudlnt' help the Mom's of his friends who were killed.......

cjv
thanks. Dr. Cantrell do you think that family goes through a ptsd too with dealing with all of this... deployments and death

usmcmomandwife
totally helpless

Dr. Cantrell
It is so difficult when we feel we must love them from a distance, but this love is what sustains all of us in these difficult times

Texasdad_and_Mom
It's our job as moms to nurture--it doesn't feel normal to send them to be shot at!!

Dr. Cantrell
You help him more than he will admit. Just keep loving him unconditionally.

cjv
that is forsure standing there at deployment and watching your child get on the bus to take them to war and do nothing is against everything you do as a parent

Dr. Cantrell
It must be the most difficult unselfish gesture in the world as a parent to watch your child get on that bus.

Dr. Cantrell
Yes, this is truly love and you are supporting their dreams.

usmcmomandwife
Ok - here's a question. Since his old humvee hit the IED and the guy who replaced him was killed (as well as his best friend) - I have alternated between just overwhelming relief, and then horrible guilt for feeling relief. How do I stop doing that? It's been 6 months.

Dr. Cantrell
This is something that is very difficult to even admit. This is a form of survivor guilt that is transgenerational.

cjv
I felt that way and still do everytime the news announced another death while my son was deployed

Dr. Cantrell
Those whose loved one survived feel deep inside that they are so grateful it was not their loved one who was killed, but then the guilt sets in and you have a great deal of shame involved in even thinking those thoughts, but this is normal.

carmen5
i think we feel that way even now that they are back..

Dr. Cantrell
The power to survive and live is the most powerful goal we have and it is also extended to the family as well.

usmcmomandwife
It's like I trace the train of events that led to his moving out of that humvee and THANK GOD that he argued with the Sgt so that he was moved out, but then I wonder if the boy who replaced him's family traces the same chain of events that led their son to be there.

Texasdad_and_Mom
Guilty--talk about conflicting emotions!! I'm so relieved I cry, and then I cry and feel guilty because I know someone has lost a son, husband, et.

Dr. Cantrell
Talking about this makes it real and you can see that you all go through these internal conflicts, so you can imagine what your Marines go through.

cjv
me too you feel so guilty about so much of this, I do even sleeping in my bed and wondering where is my son sleeping tonight or is he sleeping tonight,and it just goes on and on

usmcmomandwife
Yeah! During the initial invasion of Iraq in 2003 my husband was in Nasariyah - at that time the news would tell you when something happened. I would sit outside my door for hours and then feel so relieved when no one came - until I realized that somewhere some other wife or mom was getting visited.

usmcmomandwife
And feel guilty for being happy about them getting a visit

usmcmomandwife
One of the wives of another Officer my hubby works with at the Pentagon just did her thesis on the stress that Marine Mom's have!

Dr. Cantrell
Yes the guilt really colors our hearts, and creates a barrier to enjoying aspects of life that others will never have the priviledge of experiencing.

Texasdad_and_Mom
I also worry about my hubby who is a stroke patient. If something happened to my son, I wonder if I would be strong enough to be there for my husband. He does not need extra stress!

usmcmomandwife
I feel guilty everytime I post something "normal" on facebook - b/c Aaron's friends girlfriend and Mom are my facebook friends. I am afraid they will think I have forgotten him.

Dr. Cantrell
You will be strong, you are strong, you are all strong, and it is so incredible what we can all do when we are required to perform and provide!

usmcmomandwife
Sometimes I feel guilty just for DOING something normal!

usmcmomandwife
Because their lives are shattered

cjv
it is amazing how strong you can be when you have no choice.

Dr. Cantrell
It is best to not post things that will cause them to worry. You are doing the right thing.

Dr. Cantrell
Let me talk about this for a second and this is how I work with your Warriors about survival guilt.

usmcmomandwife
Not things that will make them worry - just "normal" things. Things that don't talk about how sad I still am about their son/boyfriend.

Dr. Cantrell
When I am sitting with a warrior who has lost their buddy or has a tremendous amount of survival guilt for the loss of comrades. I will ask them point blank, "If your buddy was sitting here right now, and he/she saw how you are limiting your life, and not enjoying the blessings around you, what do you think your friend would say to you?

usmcmomandwife
But if that boys Mom was sitting next to me - and she saw that I was going on with my life like her son isn't gone, what does that make her think? What would I think?

Dr. Cantrell
They did there and ponder this and say "wow, this is powerful, he would kick me in the rear and tell me to get out there and live my life:" So this is what I say to all of you, there is a reason you are here talking about this. It is time to take your grief into action and this is what your support network is about.

Dr. Cantrell
When you want to express your respect and deep feelings, it would be best to call them, send them a letter, and let them know what you are feeling and that their loss is also your loss.

usmcmomandwife
I would do that everyday if I thought it would be appropriate. But it's not.

Dr. Cantrell
Perhaps that mom could use an arm around her, and the encouragment that you are still our family and WE are going to get through this together.

cjv
I have been working on the condolence books as a book maker and it is strange and hard butdoing the books you get to know the Marines and it does make you feel better that you are doing something that may be of some comfort to that family

Dr. Cantrell
There are times when things are appropriate and times when it is best left, but you are the best judge of that.

usmcmomandwife
the mom of his best friend had SO much support - their whole town. but when they did memorial services, she would go, but she couldn't speak

Dr. Cantrell
cjv this is beautiful thing to do and it gives many an opportunity to heal in their community.

usmcmomandwife
I wanted Aaron to go meet her and talk about his memories, but he won't

cjv
its my deal with God. If I make them I will never need one, I hope.

Dr. Cantrell
When we are hurting it is best to reach out and get out of our pain by doing something to ease the suffering of another. giving back is part of the cycle of life.

Dr. Cantrell
and CJV you know that your efforts have provided healing not only in yourself but others.

Dr. Cantrell
Thank you for what you do, and this is a lovely tribute to the lives that are so precious.

carmen5
Texas, my son came back from afghanistan..just take on day at a time..try not to think about tomorrow. God will help you and your husband through it and give u the strength..

carmen5
correction, texas..take one day at a time..

Dr. Cantrell
yes take it easy and know there will be good and bad days, and tomorrow is new day with a new beginning. We must have hope in our lives.

cjv
there is going to be a funeral in the next week in our town for a Marine who took his life, I dont know what the right thing to do is, do I go as another Marine mom to support her and thank her son for his service or not go since I didnt know him.... what do most people do with this.

Dr. Cantrell
Do what you feel. There is strength in numbers and healing in community. What affects one of your families, affects you as well. We are all affected, even though we may not know the person directly.

Dr. Cantrell
Tell her to reach out and offer herself day or night as support. Ask her to go visit the mother, give her contact info. I am so sorry to hear this.

Texasdad_and_Mom
Do you recommend sending cards to parents of Marines KIA, then? I would think the support would be appreciated, but wonder if it would just be a painful reminder?

cjv
so I should go? maybe I could help feed the Marines who are coming into to town? When there was a funeral for the missing soldier from our area we arranged for food for the Army. SHould I call the local recruiter and see if they need ....?

Dr. Cantrell
Yes, for sure. It means so much to know that others share your pain and that they are in your heart.

usmcmomandwife
I think that I would feel like my son had been forgotten - I would want a card.

usmcmomandwife
I can give you the contact info of the Mom's coworker who contacted me if you want

usmcmomandwife
you could talk to her about the funeral

usmcmomandwife
but to feed the marines - prob the recruiter would be better

Dr. Cantrell
If you feel you should go please feel free. I went to a memorial service that I was invited to and I was so overwhelmed with grief and I didn't even know him, but it helped me tremendously to be with the family and group afterwards, this provided closure

usmcmomandwife
I went to the funeral of Aaron's friend who shot himself - it was horrible. I won't lie. I was almost hysterical. But they took us right to his Mom and Dad, and they were REALLY grateful that we were there.

Dr. Cantrell
Connection with others, lifts our burden and this is how we also feel better because we are giving back.

usmcmomandwife
I was glad that we went - as hard as it was

carmen5
these boys or young men are our sons, we grieve for all of them..

Dr. Cantrell
Yes they must have been very appreciative of the respect you extended to them by honoring their son.

usmcmomandwife
she wrote me a letter to apologize that she didnt' get it mailed to him.

usmcmomandwife
I didnt' even mail Christmas cards

usmcmomandwife
but she was apologizing to me

usmcmomandwife
She was so strong

usmcmomandwife
More than I would have been

usmcmomandwife
Way more

usmcmomandwife
More than I WAS

cjv
I have a question about flash backs....

cjv
how long do they last or are they all different

Dr. Cantrell
This here is your community and it extends out there in the bigger world. You are what you are, and there is not need to feel guilt, just know that we all grow from all of these experiences as painful as they are. We all make it through but with each of these losses a part of our hearts live within them.

Dr. Cantrell
Flashbacks come and go and are triggered by different situations. They can last for various time frames.

Texasdad_and_Mom
My husband is a Vietnam veteran--flashbacks have recurred for him 35 years/ later just by watching some war movies.

Dr. Cantrell
It is important to get grounded in reality, in present time. Flashbacks revert someone to a past time, and they are very real to the person going through them

Dr. Cantrell
Yes news, war movies, and other events can trigger them.

cjv
my son was hospitalized and no heavy pain meds I was worried that he might start having them, that the medication might trigger them. Is that reasonable?

Texasdad_and_Mom
Yet, he seems to want to watch them, and especially since our son has deployed, watches the Military Channel sometimes for hours.

Mom_Soz
To[Private] Joan Do we let them know that time is almost up, like we do in the other rooms?

Dr. Cantrell
Medication can trigger different situations, but it is hard to predict. For many medications are necessary to calm down, address depression, anxiety, sleep etc

Dr. Cantrell
Watching war movies allows your husband to live vicariously through his youth in the military as well as relate to your son's experience. It may be his way of staying connected and honoring your son's service

cjv
Dr. Cantrell, thank you so much for answering all our questions tonight, I know you have helped me again. Thanks!

Joan
As always, Dr. Cantrell, we have enjoyed the opportunity to meet with you tonight.

Texasdad_and_Mom
Nearly all of his veteran buddies are on antidepressants. My husband was where they stored agent orange, and started having health problems a few years ago. He still doesn't talk much about Nam, but only recently confessed to having ptsd.

Texasdad_and_Mom
These have been tough topics. Thanks so much for your help!!

Dr. Cantrell
Bless you all, tonight was a heavy night, and just be good to yourselves. Go do something sweet to nutures your souls tonight. Thank you so much for giving me the privilege of walking with you in your journey.

Mom_Soz
Thank you Dr Cantrell

Dr. Cantrell
It is never too late to admit there are some issues, don't let the Agent Orange and PTSD slip by, start a claim for Service Connected Disability.

Dr. Cantrell
I will keep you all in my prayers and will be back in August.