Pastors

The War After the War

PTSD touches veterans and their families. How churches can help.

American Sniper is the highest grossing war movie in U.S. history. In one of the film's early scenes, protagonist Chris Kyle receives a Bible as a child. Years later the same Bible appears among Kyle's belongings while he's in Iraq. The movie never answers the question of how the Bible informed Kyle's experiences with trauma. For those of us in ministry, the question is significant. How does faith apply to combat veterans, especially those who've been traumatized?

How can churches best respond to their community's veterans? Specifically, those struggling with post-combat trauma?

American Sniper generated fresh conversations about the challenges veterans like Kyle face, especially since his tragic death occurred at the hand of another troubled veteran.

The drama doesn't surface just in the white-knuckle, adrenaline-pumping snapshots of combat. It emerges in the eerie, lonely, disorienting quest for "normalcy" afterward.

For pastors, a veteran's struggles with family members is the usual way we come across PTSD (post-traumatic stress disorder).

Last year I boarded a small plane with two seats left of the aisle. I took the aisle seat. Moments later a man took the window seat and announced, "I go to your church." I followed with my standard "So how did you find out about Kensington?" He explained he'd fought in Iraq and that in 2010 his marriage began falling apart. He was drinking excessively and his wife finally gave him an ultimatum: he would change or she would leave. He found his way to our church, and four years later, by the grace of God, he made critical course corrections and saw his marriage restored.

When I asked about his combat experience, he said his unit was among the first on the ground in Iraq in 2003. The common assumption was that the action would be quick, decisive, and final. It wasn't exactly that.

When he returned from his first tour, everyone in his unit believed they'd have some time to catch their collective breath before being re-deployed. They were wrong.

When the call came to leave again, men he knew schemed to disqualify themselves from the service. Some failed their drug tests on purpose, but were simply disciplined and deployed anyway. One asked his girlfriend to hit him with her car so he wouldn't have to go back. I never asked what happened in Iraq to warrant this level of response. I did, however, ask, "When guys get overwhelmed or depressed, do you at least talk to each other?" The answer: "No, everybody just kind of guts it out on their own."

This occurs when the person sees something or someone that takes them back to a traumatic experience. It results in distress, a surge in stress hormones and a skyrocketing heart rate.

A state of intense vigilance. It's hard to sleep. Individuals can get angry and jumpy, always watching for threats with an eye on available exits.

The person shuts down, feels numb. It can be difficult to feel positive emotion.

The person avoids situations that elicit bad associations (e.g. going to parties is a problem for someone who can't tolerate noisy, crowded environments) and resorts to self-defeating behaviors such as substance abuse for escape.

4 Critical Markers for PTSD

1. Re-experiencing

2. Hyper-arousal

3. Negative cognition and mood

4. Avoidance

It's taken me a while to recognize the deeper needs of veterans in our midst. Yes, we honor the fallen on Memorial Day weekend and thank our veterans on the Sunday closest to Veteran's Day.

We have a Military Families Support Group and recently mailed a DVD of our Christmas service to a young servicewoman who's deployed. But only recently have I started to ask, "How do we best serve combat vets and their families?"

One of the answers: Learn more about PTSD, what it looks like and current best practices for treatment. I contacted Dr. Deane Aikins, associate professor in the Department of Psychiatry and Behavioral Neurosciences of the Wayne State University School of Medicine,. His research focuses on treatments of combat stress disorders among veterans and military families.

"The bad news is only two drugs are approved for PTSD," he said. And they're only modestly effective. The good news? "A PTSD diagnosis doesn't have to be a death sentence." Researchers are seeing success with therapeutic approaches, for instance, Cognitive Processing Therapy. Aikins explains: "If you're feeling badly, a thought is generating that emotion. Ultimately a different thought leads to relief. Each disorder has a thought that drives it.

"PTSD sometimes comes from a 'just world thought.' It goes: Good things happen to good people. Bad things happen to bad people. Bad things happened to me. I must be bad.

The challenge is to get them to see other ways of thinking. Tragically, for some trauma survivors, they assume suicide is the only way to end their turmoil. Aikins cites a 2012 Department of Veterans Affairs report that 22 veterans per day take their lives, a stark reminder that the stakes for responding to spiritual and emotional needs of our vets are high.

What does this mean for pastors? We have to prepare to walk with vets and survivors in our midst who are asking painful and critical questions.

A military expert once said, "We want to separate war from tragedy, but we can't." Pastoral care for vets isn't unlike the care we offer to others who experience sudden, unexplained tragedy. We can't give easy answers; we must walk with them through the deep questions.

In one scene in American Sniper, Kyle as a boy hears his father explain the three kinds of people in the world: wolves (who do harm), sheep (those threatened by wolves) and sheepdogs (who protect sheep from the wolves). If only the reality of combat allowed for such clean and simple categories.

In the last church I pastored, I met a young man who had served as an intelligence officer during combat in the Middle East.

He told me it was his job to call in air strikes on targets, buildings or residences. I asked if it was ever hard to make such calls, if the decision was ever unclear. He said yes, at times he was only 60 percent certain lethal force should be used. He was essentially wondering what happens when, in an attempt to check the wolves, the sheepdogs end up killing the sheep. Or what happens when sheep and wolves look exactly alike?

When I asked Aikins what pastors can do for those with PTSD who come to our church, he said, "I'd be jumping up and down if a soldier comes to church. Their mere presence is a victory." He said many of those with PTSD can't tolerate being in a crowd, an unpredictable environment they can't control. And if they do come and are willing to engage? Just start by listening to their story.

A few months ago a man approached me for prayer following a Sunday service. He casually mentioned he was a vet with a diagnosis of PTSD. I reached out to him later to hear his story. He told me: "I hate fireworks if I'm not forewarned. I hate the sound of vacuum cleaners." Hearing his combat experience, it made sense.

DO …

• Listen without judgment.

• Create spaces for vets to connect with each other, perhaps hosting an informal event to allow vets to find others who understand.

• Host or refer vets to recovery programs.

• Refer vets and families to counselors you trust.

• Force conversation if someone isn't ready.

• Ask insensitive questions ("Did you ever kill anybody?")

• Be condescending or patronizing ("You just did what you had to do.")

• Judge. Vets need someone who can love them.

Do's and Don'ts for Ministers

DON'T …

He landed in Saudi Arabia just before Christmas 1990 to support the 1st Infantry tank units in Desert Shield. He served through Desert Storm before returning home in May 1991. He heard the bombs from miles away and felt the force of the explosions shake his tent. When his unit went in, they witnessed the unnerving sights and smells of the dead.

He explained that PTSD "is a dirty little secret. I sleep 3-4 hours a night. In the last two weeks, I've had dreams of combat fire. When you have a bad dream, you don't want to go back to sleep.

"For six years I slept with my weapon every night. We nicknamed our M-16s our girlfriends. To this day I can't be around firearms. I'm all for the 2nd Amendment. [But personally] they make me think about what took place. I'm afraid if I'm having a bad day …"

The great challenge is that "vets don't want to talk about it," he told me. "The mentality is 'Suck it up buttercup. Just deal with it.' But you can't. You can't do it … it's impossible."

He acknowledges the bouts of anger and the struggle to stay in control when it gets triggered.

"When you get triggered, you go blank and you lose it. It's like someone punched you in the face." He's been seeing a therapist for the last year, learning breathing exercises, the importance of talking walks, and meditating and praying to redirect his thoughts and emotions.

"I've made progress," he says joyfully as he concedes, "I have a long way to go."

Three major challenges combat vets face with re-entry: anger, isolation, and employment.

Another member of our church, Karl, was an Army Ranger sniper who served tours in both Iraq and Afghanistan. "The army changed me.," he said. "A friend said I came back 'sharper, with an edge.' I was a boiling, angry person a lot of the time." Eventually Karl enrolled in classes at a local college, which "forced me to reintegrate. I saw other students as tool bags. I wanted to say, 'Come live in my world for four seconds.' College forced me to tone myself down."

Aikins says it's not uncommon for vets taking courses to get angry with students they view as unprepared and disrespectful.

The biggest and most readily identifiable symptom of PTSD is anger. Aikins notes: "The military community comprises ½ of 1 percent of the total population. They tolerate the opinions about war from people who have no idea what they're talking about. We want to say, 'I know what you're going through.' You don't. You have no idea how horrible it is."

In addition to the struggles with anger, vets experience a deep sense of isolation.

"The day after I got out, I was in a different world," said Karl. "In WWII they called it 'shell shock,' but then 11 percent of the generation went to war; now it's less than 1 percent."

Perhaps that's why he says, "Community is huge. Vets tend to congregate around their preferred coping mechanism." Which means drinking. It's a chance to connect, to remember, and to forget with the tiny slice of the population who actually "gets it."

Karl said leaving his unit left such a hole in his life that "3-4 times in the last 10 years I found myself in a recruiter's office" ready to enlist again.

Why? Because "most vets experience camaraderie, support, brotherhood, mission, and focus on a higher level in combat than they will anywhere else."

Vets can also struggle to find steady employment, especially if they're exhibiting PTSD markers, like hyper-arousal and avoidance.

How can local churches best serve combat vets with PTSD? One of Karl's buddies put it this way: "community, and connection to assistance for health and employment needs and recovery programs."

Karl notes, "If somebody's at church, they're recognizing drugs or alcohol isn't doing it."

While veterans may not readily self-identify as needing help, they are looking for the types of care churches can legitimately provide. And they're looking for more than seasonal recognition. They're looking for people who will listen without judgment and walk patiently with their questions.

Steve Norman is a campus pastor of Kensington Church in Troy, Michigan.

Warfare marked church history's veteran-turned-saint

The church has a long history of ministry to, and by, veterans. U.S. Army Chaplain Jeff Matsler's research reveals a picture of a "post-traumatic saint" who bears little resemblance to the "pop-culture icon of Francis as a saintly youth who gave up wealth for the simple life."

Francesco Bernadone, born in the medieval Italian town of Assisi, joined its militia. Four years of violent confrontations culminated in a disastrous assault against the heavily fortified town of Perugia, "a bloody day of fighting crowned by an even bloodier afternoon of extermination." All but a handful of the young men of Assisi were killed. Francis became a prisoner of war. The custom of the time was to use torture to encourage the payment of ransom for prisoners.

When Francis was released after almost a year, he showed signs of severe stress. He stopped eating and sleeping, he "heard voices and saw things that weren't visible to others," and he "wept frequently and uncontrollably." He hid from friends and family, living as a recluse in a dark pit under the floor of a house. He was rumored to have a drug problem and even to be possessed. He was written off as being mad.

On his wanderings Francis happened upon an abandoned chapel. There the figure of Christ on the crucifix appeared to come alive and spoke to him: "Francis, repair my house, which is falling into ruin." Francis spent the next two years repairing abandoned church buildings.

In his desire to respond to the call of Christ, Francis attempted to give away not only his own possessions but his family's as well. Fed up, his father publicly disowned him—but the bishop of the church he had once warred against embraced him and became his champion.

This moment began Francis's healing and "set in motion a movement that salved war-weary souls across Europe and the Middle East." His message "of rigorous discipline and obedience to Christ" was familiar and appealing to soldiers and his first recruits were fellow veterans. Together they created a community where they found not only healing and reconciliation but also a mission that would renew the church and transform society.

St. Francis's Combat Trauma

—Excerpted from an article in the June 2015 issue of Christianity Today by Annalaura Montgomery Chuang.

Copyright © 2015 by the author or Christianity Today/Leadership Journal. Click here for reprint information on Leadership Journal.

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