What comes to mind when you think of psychological therapy? Is it the expensive leather couch, a stuffy-looking doctor with a clipboard, and a quiet room that looks like a law office? Or is it a military doctor with an orange pill bottle covered in warning labels?
When you hear someone say, “Let’s talk about your feelings ...” do you picture a circle of people in a church basement, sitting in folding chairs with little foam coffee cups in their hands while a harmless-looking person talks them through breathing exercises? Or is it a chaplain that you can’t bring yourself to trust because he’s part of the same system that put you where you are?
For me, it’s a bit of each. I have been on a couch while a very kind woman tried her best to help. I’ve been given pills that sent me over an anxiety cliff because there weren’t any counselors in network within driving distance or available when I was off work. I have sat in that awkward uncomfortable circle trying not to lose my mind while being embarrassed that I was there in the first place. I have talked to chaplains who essentially told me to stop striving and be happy I exist.
I think we, as first responders and military members, forget that depression, rage, grief, terror, and hopelessness are all emotions. Boiling it all down to sad, mad, glad, scared, or just good and bad is dangerous. Rage has been medically documented to do damage to nerves and the heart. Depression can reduce our reaction time if not block out instincts to act altogether. Fear can lock us up at the worst moment, or drive us into an exhaustive hyper-vigilant state where we can never relax to enjoy a moment.
Forgetting the power of emotions can drive us to confuse “embrace the suck, mission first” with “ignore your problems, and do your job.” Ignorance might be bliss, but ignoring that pain in your lower back might mean you’re medically discharged after your next jump because you’re one bad landing away from blowing out multiple bulging discs in your spine. Refusing to acknowledge your trouble sleeping degrades your effectiveness in high-stress situations because your body is never fully recovered and ready. Compensating for problems with substances or bad habits, instead of attacking them head on, works until you’re too far past the point of no return. Eventually, what could have been prevented can now only be mitigated.
That situation quickly fed into a cycle of depression and self-loathing, which set off another round of anger at myself. It took moving to a unit on the other side of the country and my wife forcing me to face, acknowledge, and deal with my emotions to start breaking that endless rage and hopelessness loop.
Having seen what happened as we withdrew from Afghanistan. Having read and listened to account after account of service members who have been repeatedly failed by senior leadership and a system that claims to support them … Watching what our leaders continue to do to our first responders … I am amazed that we still have a standing military at all. I can’t justify advising someone to become a paramedic or cop or firefighter, not without warning them about the emotional burden they’re going to take on themselves.
Bottom line: emotions, no matter how big or small, have a physiological, chemical component. Love largely consists of dopamine, serotonin, and oxytocin (C8H11NO2 + C10H12N2O + C43H66N12O12S2). Anger releases adrenaline ((HO) 2C6H3CH (OH) CH2NHCH3). The human body reacts to those chemicals. To use a mechanical analogy, if a bunch of high-performance fuel is dumped into an engine and the RPMs are kept way into the red without doing preventative maintenance, eventually gaskets are going to start blowing and critical parts may catastrophically fail. Look up what happens with a “runaway” diesel engine; they rev up until they detonate. People, like the diesel engine, aren’t any different, and when they’re pushed too far out of parameters for too long, they crash hard. When you add on complications like PTSD and traumatic brain injury, a person’s ability to self-regulate these chemicals only gets harder. Therapy is just preventative maintenance. For others of us, it is repair/corrective maintenance as well.
If processing it means therapy, then so be it. Think of therapy as a process if that helps put it in context. Rebuilding and reconditioning a blown engine takes time. Rebuilding our emotional strength does too.
If it means major lifestyle changes, like not spending so much time at the bar or telling that one friend you need to set some boundaries, then do it. You’ve grown so comfortable with your emotional imbalance and pain that they’re like a comfort blanket at this point. Addressing them, and facing them head-on is going to mean stepping well outside your comfort zone. This is no different than when you stepped off that bus at basic training. It will be as hard as your first nightmare shift as a cop. As bad as the first time you were alone in the back of an ambulance with a crashing trauma patient. As exhausting as your first bad structure fire with victims. Those situations are so far outside the comfort zone of the average person that to them, we seem bat [expletive] crazy. While for us, it was just a bad day at work.