The following is a transcript of the "Chat with Dr. Cantrell" from Thursday, August 11, 2011. Links to additional resources and to order Dr. Cantrell’s books are included to the right.
(Moderator) : Nan
Here we are -- Hi again Bridget!
Dr. Cantrell:
Hello everyone.
Nan:
I wanted to update you on the questions I asked you a few weeks ago -- my son (100% disabled) did go to the reunion of his outfit and it turned our wonderfully. Thanks so much.
Dr. Cantrell:
This is great news. I am glad he felt comfortable. I bet his guys embraced him like crazy!
Nan:
You betcha! All sorts of crazy pictures of them hugging each other and sitting on top of him in his wheelchair. Several brought their g/fs, as he did and they had an awesome time in Vegas. He got triggered a few times with the PTSD but was able to manage fairly well.
Dr. Cantrell:
This is so good, and is great medicine for him. You should be very proud of his courage.
Nan:
I am. I am so very very proud of Ian. Thanks for your input that evening -- I guess it was June. Only a small group -- maybe 15 or so, so not overwhelming either.
Dr. Cantrell:
You are welcome. It sounds like a perfect outcome.
Nan:
Yes. Sue, do you have something for Dr. Cantrell since it’s just us in here?
(Moderator): Kevsproudmom:
Kevin seems to be doing much better. He lost a friend recently actually two in as many days.
Nan:
Oh no.
Dr. Cantrell:
Oh this is very sad.
Kevsproudmom:
SSgt was one of his instructors during SOI and was deployed with the 3/4.
Nan:
Is he deployed or at home?
Kevsproudmom:
Kev is home. Three deployments was enough.
Nan:
I hear ya -- that’s how many Ian did -- 2 too many.
Dr. Cantrell:
That certainly takes it’s tole on every one.
Nan:
Yes... How is he doing with all that?
Kevsproudmom:
Kev is still sitting in the garage a lot but at least he talks to me now.
Nan:
Oh Hon. He just may need that time.
Dr. Cantrell:
This is improvement. It takes time and it is good he has a place he can be that is safe and his mom is right there for him if need be.
Nan:
True. I bet it hurts to have him so near, and yet “so far.”
Kevsproudmom:
He took me to my Dr.’s appointment today.
Nan:
Aww! Score!
Kevsproudmom:
Yeah he was good.
Dr. Cantrell:
This is good that he has something to do that helps him feel more engaged and not so all alone.
Nan:
And that he feels that he is contributing something.
Kevsproudmom:
He told me of his last conversation with SSgt. He just mentions random things but it is something.
Nan:
Yes... He is reaching out in his own way and letting you in a bit.
Kevsproudmom:
Baby steps.
Dr. Cantrell:
Just baby steps. The memories are too painful.
Nan:
Well said. Great minds think alike, you two!
Dr. Cantrell:
So he has to pace himself, so he does not become overwrought with grief.
Kevsproudmom:
I am happy I am the one he chooses.
Dr. Cantrell:
Uh huh!!
Nan:
Yes... I have always felt honored when Ian felt he could share with me -- which wasn’t all that often because he wanted to “protect” me.
Dr. Cantrell:
It is an honor indeed. Now he is seeing the importance of having you near and this must give him a great deal of peace.
Nan:
I wish there was a veteran group or a VFW or something or even another kind of group that he could hang around with.
Dr. Cantrell:
What about the Marine Corps League?
Kevsproudmom:
He wants nothing to do with anything Marine
Dr. Cantrell:
What about a bike group, or other veterans?
Nan:
Ian loves the Leatherneck group even though he doesn’t have a motorcycle.
Dr. Cantrell:
There is camaraderie and it is a safe place to just be in a motorcycle group.
Kevsproudmom:
I wanna join them!
Nan:
Harley Mama over there! We actually have two.
Kevsproudmom:
Do ya think maybe it is the fact I volunteer here that he thinks it is ok?
Dr. Cantrell:
Yes, I think your work gives you a certain sense of credibility and this makes it ok.
Nan:
Hmmm... maybe. I think Ian thinks because I’m a psychologist he can say some things.. but usually he just tries to keep the bad stuff away from me.
Dr. Cantrell:
To keep what you think is bad, perhaps in his eyes is “sacred”.
Nan:
I hadn’t thought of that Bridget. Ian once said that he wanted me to know only “Ian” and not “Sgt. _____”.
Kevsproudmom:
Omg that is what Kev said too.
Nan:
Really?? Wild.
Dr. Cantrell:
Yes, when they are in their role “Sgt ______” is much different than the son you know and raised.
Kevsproudmom:
Kev wants to be Just Kevin not Kevin the Marine.
Nan:
Yes. The things they’ve done and seen, they don’t think their mamas could love them any more. But I do.
Dr. Cantrell:
Yes, and many times they find it very difficult to love or even like themselves.
Kevsproudmom:
Yes, Kev even asked if I loved him the other day.
Nan:
Ian struggles with that. Doesn’t feel he is worthy to have come home when so many didn’t. Guilty feelings, regrets.
Dr. Cantrell:
Survivor guilt, but one day he will come to terms with all the good, bad, and the ugly and be able to forgive himself if he feels he must, and know that he is still that beautiful little soul you cherish.
Nan:
Oh wow, about Kevin’s question, Sue. As if he could ever wonder about your love.
Kevsproudmom:
I know, but he reminded me that when I had my issue, I didn’t know him. I thought he was my brother Brian. He was afraid I would never remember him.
Nan:
I’m sorry -- your issue?
Kevsproudmom:
I had a brain aneurysm last spring which caused a severe stroke.
Nan:
Oh my goodness! Whoa. I’m so glad you’re okay now.
Kevsproudmom:
Kev was pulled out of Afghanistan by the Red Cross.
Nan:
omg
Dr. Cantrell:
That is very rough, this is a difficult health issue.
Kevsproudmom:
Well my neurosurgeon gave me a good report today.
Dr. Cantrell:
This is lovely. It is important you keep your stress at a dull roar.
Nan:
I bet he was so scared.
Kevsproudmom:
I think that this was part of the issue with Kevin distancing himself from me.
Nan:
I wonder if having you have such a near miss sometimes makes him keep you at arm’s length -- afraid for you.
Dr. Cantrell:
I have veterans whose family members get ill or have surgery and they leave town because they are too afraid of losing them. They distance themselves, this is one fight that they do not run toward.
Nan:
I bet his whole world was shocked again -- first Afghanistan and then your health issue.
Dr. Cantrell:
That is a great deal of upset and unpredictability
Kevsproudmom:
Took him over a week to get home. I cannot imagine the fear he was feeling about getting home in time.
Nan:
Yes... Unpredictability. Wow. Probably couldn’t even compare to combat.
Dr. Cantrell:
Uncertainty.
Kevsproudmom:
Then the guilt of leaving his guys.
Nan:
Feeling helpless to help you or them.
Dr. Cantrell:
It might have been more difficult because he was not pumped up on adrenaline and did feel and have to face that fear. Did he return?
Kevsproudmom:
No the unit returned stateside. It was two weeks before deployment was over.
Dr. Cantrell:
So it all ended in a good way?
Kevsproudmom:
Yes, thankfully there were no casualties in that time.
Nan:
He was just part of the “advance” party to get home.
Dr. Cantrell:
Well this is a major blessing.
dNan:
Gee... so this was 2010?
Kevsproudmom:
Yes, April 2010, Easter Sunday
Nan:
I so proud of you both. Do you divide your life into "before the stroke" and "after the stroke?" My parents do that after a major fire destroyed their home and it's been over 10 years.
Kevsproudmom:
Yes.
Nan:
Ian feels he was stuck -- he was 18 when he left and then stayed in for 8 years. So he feels there is still so much to learn that he didn't learn because he was busy fighting.. He feels very young sometimes, but without the innocence.
Dr. Cantrell:
Yes, they are plucked out of developmental stages that their peers do get to experience, and then on many levels, they miss the opportunities to engage on this frivolous stage. Whereas, on other levels they are much older than their chronological age. This is part of the process that is quite challenging when they get home. They feel like they just don't fit in and this can be a very difficult situation.
Nan:
Hi agebka -- do you have a question for the doctor?
agebka:
Is this with Dr. Cantrell on the topic PTSD?
Nan:
Yes ma'am!
agebka:
Oh good I just wanted to sit in and get a feel of what to kind of expect when my son returns from Afghanistan.
Nan:
Please thank him for his service.
agebka:
I will as soon as I get a chance to hear from him, its been over a month.
Kevsproudmom:
Kev said something interesting today.
Nan:
I see this all the time with the veterans I work with at Texas A&m at the counseling center. And the irritability level -- whoo! Hard to be around all the freshmen. Tell us Sue.
Dr. Cantrell:
Yes, they can get very annoyed by those who are arrogant and have such little awareness and limited knowledge about life, death, military, politics, etc.
agebka:
I know he is saddened because one of his good friends stepped on an IED and lost both limbs. When I did hear from him the first thing he asked for was him and all I told him was that he was doing fine and that his parents were with him. Then there was silence.
Nan:
Oh my goodness. It's got to be overwhelming... and for such young men.
Dr. Cantrell:
This is tragic. He stepped on an IED? He would probably not be doing so well, and certainly his parents must be devastated. it is a miracle he is still with us. I am so sorry to hear this.
agebka:
He asked before that about his sergeant whom he had carry to a helicopter. And didn't know if he was alive or not so when he asked me if I knew anything about him I told him I had spoken to his wife and he was ok but he had lost a limb.
Kevsproudmom:
Very tragic. Hello nmdad.
Nan:
Welcome nmdad.
nmdad:
Hi.
Nan:
Sue, what did Kevin say today?
Kevsproudmom:
That he didn’t think the back to back deployment did him any good. It came out of no where.
Nan:
I bet it did not -- reminds me of one of Dr. Cantrell's books -- why the PTSD is so hard when there's so little time between deployments. Ian went every spring for three years and they had hardly any down time.
agebka:
Hello Kevin’s mom. How soon was he redeployed back from his first deployment?
Kevsproudmom:
His third deployment came one month and three days after #2.
Nan:
Oh, Geez. No way.
Kevsproudmom:
Yep.
Nan:
And... how awesome that he is sharing these bits and pieces with you.
Kevsproudmom:
He volunteered to go with the 3/4 he was 1/7.
Dr. Cantrell:
Yes, the multiple deployments are very hard on them as well as their families. They get further and further away from home, and feel more at home when they are in the field.
Nan:
Yes.
agebka:
Omg and here I am praying that he comes home safe from this first one and lately I've heard they get sent back again but I was thinking only after they resign with military.
Kevsproudmom:
No, they are on a rotation of 7/11.
Nan:
I remember for Vietnam, you had to Volunteer for a second tour of combat... now it is just expected.
Dr. Cantrell:
This is what is expected now with this war.
Nan:
nmdad -- Do you have a question for Dr. Cantrell? The topic is PTSD and/or issues of returning veterans.
nmdad:
My first visit. Son home in the fall from first deployment. Trying to learn a bit.
Nan:
Please thank him for his service for us. You must be very proud.
nmdad:
Thanks I will and I am.
Nan:
Will you get to go to Homecoming for him? That was so awesome.
nmdad:
Planning on it.
agebka:
My son is due to return in the fall as well. He is in 1/5.
nmdad:
Yes.
Nan:
It is the best! Even better than Graduation, I think. Small world, you two. Both 1/5.
nmdad:
He actually asked us to try to be there when the bus rolls in.
Dr. Cantrell:
Yes, I am sure it is better than graduation.
Kevsproudmom:
Please folks do not mention the time frame in months.
Nan:
Good reminder, Sue.
Kevsproudmom:
This may put them in jeopardy.
Dr. Cantrell:
Yes, indeed.
Nan:
Who knows how secure this chat room is -- good to keep things on the down low.
agebka:
True.
Kevsproudmom:
The enemy does not need to know about troop movements.
nmdad:
Goodbye.
p>Nan:
I remember when Ian would be getting ready to come home.. .such excitement but some anxiety too about keeping him safe until I saw him again.
Dr. Cantrell:
It is probably the reality that they are home when they are home, and the time frame prior to that can be very painful.
agebka:
So when they return home like get off the bus or whatever, do they get to come back home with us as well?
Kevsproudmom:
No.
Nan:
Not sure how it works now.
agebka:
So we have to leave them at their base?
Nan:
I got to hug Ian right away but then he had to do check in stuff and things.
Kevsproudmom:
They have to be debriefed. agebka you may want to ask these questions in the deployment room.
Nan:
Ah yes... they would be able to help you there!
agebka:
Yes, I was thinking same thing.
Nan:
Ian came home in 2003 after his unit pulled down the statue of Saddam.. .His "debriefing" was a pamphlet on the plane back. That was it. I'm so glad things have changed now.
Dr. Cantrell:
That is great, I am just here riding along and it is nice.
Kevsproudmom:
Small group tonight so we are just kinda visiting, I guess.
Nan:
I still think it has been productive... for me for sure.
Dr. Cantrell:
It is perfect, just how it is meant to be for tonight.
agebka:
Last time I spoke with son he said he felt on edge and felt agitated and all I could tell him was to just pray. Didn’t know what else to say to him.
Kevsproudmom:
It is the edge that will help him to survive though.
agebka:
What do you mean “the edge”?
Dr. Cantrell:
Their activities down range get them all activated, and their testosterone and adrenaline feed them and it is difficult to turn this off. So it would be expected that he is experiencing these things, and for operations these are survival mechanisms.
agebka:
Oh I see.
Dr. Cantrell:
They need this edge, A Warrior Always Wants their Edge to Be Sharp, never be caught flat footed.!!! They must anticipate and their senses are all turned up on high volume and this is how they must be to get their jobs done.
agebka:
I see.
Kevsproudmom:
So you want him on edge.
Dr. Cantrell:
Laser sharp in their actions and all of this is maintained through adrenaline.
agebka:
I guess so after hearing this. I’m learning already.
Dr. Cantrell:
They will actually do things and engage in activities once they are out of the warzone to get this "fix" and this can lead to some poor outcomes here stateside, but in the warzone, this is essential.
agebka:
I’m kinda nervous for his return like how do I act, what do I say? I don't want to say something that will set him back or anything.
Dr. Cantrell:
Don't ask questions or at least do this sparingly. Let him come to you, but let him know you are here. Don't expect him to be the same person who does the same things he used to. He may not want to be around people or even family to a large extent. Ask him what he needs and wants. Just be there but don't hover or smother.
agebka:
So I have continue to worry about what he will be doing when he is home with his friends?
Dr. Cantrell:
He is no longer a little boy. He is a man and has done things, and seen things that you would not even want to know. He will more than likely want to spend time with his buddies, this is where he feels comfortable and "normal". This is a very hard thing for parents particularly mothers to accept. He will be all grown up.
agebka:
Good to know because my daughter and I were like the first night he back home we are all going to lay on my bed and watch tv and fall asleep together like he used to do before with us.
Dr. Cantrell:
He may very well love to do that with you. Just go with the flow and don't take it personally if he wants his alone time. Let him set the stage.
agebka:
I’m crying because I don’t want this to be his case even though you’re probably right. We are very close. I raised him all by myself. He really never had a father figure.
Dr. Cantrell:
He will always love you and because of your closeness he may know that this is what you need and he, I am sure, will do his best to make you feel loved in return.
agebka:
I know. I know he is not my little boy anymore. And I will certainly let him set the pace.
Kevsproudmom:
Speaking as a Mom who has been through this. You may grieve the boy that went away but the man who returns will always make you proud and will always love you.
Dr. Cantrell:
He will always be your little boy, but he needs to be respected as a man, and this will also serve you as well because sometimes they feel too smothered and this causes them to distance themselves ever more. Just take it easy, and don't have too many expectations.
agebka:
When I speak to him he sounds ok, just wanting to know what going on with the family since we have a big one and are all very close and you know with big family drama somewhere.
Kevsproudmom:
Same here with Kev. They want to know about "the real world".
agebka:
Your son is in 1/5?
Kevsproudmom:
He was 3/4 and 1/7. Dr. Cantrell, is this a normal question that they ask?
Dr. Cantrell:
Yes, of course, it gives them a touch of reality on the homefront. Some love to know what is happening and others don't. It just depends on the Marine.
agebka:
I would just hate that all my hard work in setting him up to be caring, respectful, humble may come home changed. My son was always quiet and helpful. Always helped me out around the house and went to school and worked and would want to give me his paycheck. I would be so upset if he came back arrogant and uncaring.
Dr. Cantrell:
You will just have to give him space and you will soon discover how is doing with this transition. This is not easy. They just can't turn it off like a light switch. They are very accountable to their Marines who are still serving down range and feel a need to go back to get the job done. This is in their nature now, and so you just need to be flexible and just play this by ear. I am sure he will still have all these beautiful qualities, but he needs time.
agebka:
True.
Kevsproudmom:
Hello Lucy.
Nan:
Hi Lucy.
Nan:
Lucy -- do you have a question for the doctor? I understand your son is going to have some inpatient treatment for his PTSD?
LUCYGIRL:
I know very little about PTSD, this is new for us. One of the things I would like more info on is the confusion he has after a "flashback".
agebka:
How long has your son been home?
LUCYGIRL:
He returned from the sand box in November.
Dr. Cantrell:
Flashbacks come out of no where, and they feel as if you are actually back in a traumatic situation. Many have very strong physical reactions, sweating, breathing, anxiety, crying, anger, acting out and aggression. They sometimes do not know how it was triggered and gives them some fear depending on how they respond. Flashbacks can take place years, decades after an event. It is part of the activation response of a traumatic event. You will also see them have nightmares, startle responses, as well as numbing out.
LUCYGIRL:
Is there a difference between the experiences of flashbacks, hallucinations from PTSD and mental illness.
Dr. Cantrell:
Yes, hallucinations are not real. They are a break from reality. I do not even use the term Mental Illness. PTSD is a reaction to a traumatic event that is outside the realm of a normal human experience. There are psychotic breaks that people have from extreme emotional response. This breaks them from reality. There are hallucinations that are induced by drug abuse, there are hallucinations brought about from a manic episode. There are many types of hallucinations: Auditory, Tactile, Visual.
LUCYGIRL:
Is long term medication needed or will therapy and short term med be helpful, cureable etc.?
Dr. Cantrell:
For psychotic breaks medications are in order. Everyone is different, and the precipitating factor needs to be determined to evaluate the diagnosis correctly and to decide on the best course of action: in patient treatment, medication if so what? And how long, and that is determined by the success of lessening the symptoms, and treatment (therapy). What is best for the individual (cognitive behavioral, solution focused, etc.). Yes, sometimes it is a long term situation and it requires compliance with the treatment protocol and careful monitoring of symptoms.
Dr. Cantrell:
Curable, I never use this term because depression, PTSD, Anxiety, etc. can come in and out of our lives at any time. None of us are free from these situations appearing in our lives. When some one has a broken arm and it has been mended to bring it back to functioning level, it does not mean it will never act up again. If it is tweaked, or the weather changes it will remind us of the fact that it was hurt.
LUCYGIRL:
He is on some meds now that have helped with some of the symptoms, I wonder about the long term of course. I am a nurse and understand there is no black and white answer. It has had some tx already, but from what his new wife tells me he is pretty crippled and has a great deal of trouble leaving his house.
Dr. Cantrell:
It is the same thing with all the emotional wounds. It is very important that we do not pathologize people and especially our warriors. They do not want to be a label. They are self reliant and can do amazing things to survive, so it is ok to have PTSD, etc. It is part of the fabric of being exposed to trauma.
LUCYGIRL:
I am a true believer that one can be a survivor or be a victim of any kind of trauma, Marine or not. He has grown a great deal, but as his parents, we just want to be as supportive as we can, but not make excuses for him or over protect and hover.
Dr. Cantrell:
Lucygirl this is so true. You will also never see me use the word "victim". I am really very careful to empower people, and not to minimize them or their experiences. So the words we use are very critical in encouraging wellness and healing.
agebka:
Do these marines that come home with PTSD have to return to duty. Example when my son returns and he has blocked days to come home then he must return to base, but what if I notice he is experiencing some type of PTSD and he doesn't see it or want to admit to it. Then what? I just let him go back to base?
Dr. Cantrell:
Some of the Marines who have PTSD are returned to duty and for some this is the best thing for them and it has be taken on a case by case situation. You will need to let your son decide what is best for him. They rise to the occasion and when they are with their "guys" this is the best medicine for most. They feel good and are challenged to get back in their and do their duty. This is where you must be very careful not to put restrictions on him. He may really resent you - what he may perceive as interfering in his Marine Duties. So be wise and careful and have support system in place for yourself so you can blow off steam and get perspective. I have told many parents to "back off", and guess what? Their warriors softens and comes back in the family fold.
agebka:
I never thought of that. Makes sense and thank you for that piece of mothering information about restrictions.
Nan:
Chat will be ending in 10 minutes. Just wanted you to be aware.
agebka:
Lucygirl, how old is he?
LUCYGIRL:
He is 25, newly married and has a baby on the way. He has had a complete change in our relationship and he calls me almost daily, our relationship was not not an easy one and it certainly has changed for the better. We just feel so helpless as he tells us what is going on and what looks like will end up being a medical separation.
Dr. Cantrell:
With a medical separation, he can also set some new goals for the future. He will have some money coming in, the Gi bill, and Vocational Rehab for a new direction.
LUCYGIRL:
And he is thinking about the future one step at a time.
Dr. Cantrell:
It is so difficult on parents. I admire all of you so much, and I hear from your boys and girls as they sit with me, and they just need to know that they will get through this time and come out the other end with a new skill set. This is my mantra with them, we explore options, we acknowledge that their duties are sacred and they need to have a place that is safe to put these memories and emotions and be able to revisit them on their own time.
LUCYGIRL:
I worry how he will handle it when his company is deployed soon and he doesn't go with them. It will be another stressor.
Dr. Cantrell:
I think you need to determine with him what is acceptable for you. But he is not used to checking in unless it is with his commander etc. So be very careful about this. He need his freedom, he has been working very very hard and needs to let off steam.
agebka:
I have started a scrap book for him from the time he left to boot camp to the time he was preparing for Afghanistan to now. Is that a good thing to show him when he comes home you think?
LUCYGIRL:
agebka, I think its a great idea. We are doing the same. He will always be a marine and we will always honor that.
Dr. Cantrell:
Agebka, be careful, sometimes those pictures remind them of how much they have changed and what parts of themselves they have lost in these transitions. Please be careful not to bring up emotionally ladened memories of the past. Let him come to you and ask to see this. Timing is very important.
agebka:
I know but I worry now about what you said earlier. He may get himself into a situation and get in trouble when he has never been in trouble before. But I guess I have take it one day at a time or one situation at a time. I don't even know how he will come home and just pray that he comes home period.
Dr. Cantrell:
If he gets into trouble he is not alone, and he will need to pay the consequences. He will have a way of keeping himself in check with his buddies around but he probably will not take to you keeping tabs on him. Remember he is now a man, and he sees the world differently than those who have not walked in his boots. Don't worry because this only robs us of the peace of the moment.
Kevsproudmom:
We thank you all for joining us this evening . Thank You so much Dr. Cantrell, always a pleasure and informative.
Nan:
Thank you one and all. God Bless our Troops! This site has some wonderful information. Also remember to get Dr. Cantrell's books, which are also sold on this site.
Dr. Cantrell:
Thank you for having me here tonight, and God Bless you all. You are All amazing parents!! See you next month!
Kevsproudmom:
See you then, have a good month!
Nan:
We'll have to end. Thank you to everyone. A small group but very engaged!
agebka:
Thank you and May the Lord Bless all of our Military.
Nan:
See you in September, Dr. Cantrell for the next chat!
Kevsproudmom:
Amen.
Nan:
Take care all.
