Humans love nothing more than a good story. In fact, we ARE stories. Our “self”– our perception of who we truly are — is nothing more than a story we tell ourselves, based on our memories and our perception of the world around us. The human brain is the most complex computer to have ever existed, and its main purpose is to tell us this story about who we are and about our place and purpose in the world.
The movie Memento is about a man named Leonard, who awakens each morning with his memories wiped clean. Using photos, a collection of notes, and his tattoos as a sort of surrogate memory, Leonard spends the first few hours of each day trying to piece together his past. Leonard, however, is not just reconstructing his past; he is also constructing a new identity to take with him into the future. It is this identity that will determine the actions his future self will take. We discover later that the data in the photos and notes is not reliable, and so the identity he constructs from this data leads him to take actions he would not have taken were he able to truly remember the past. PTSD is a real-world dysfunction of memory which can create a similar effect as this movie fiction.
We take photographs at family parties, on the days our children are born, on our wedding days. There were many “never forget” banners and bumper stickers after 9/11. We do this because we define ourselves and create our identities with these things that have happened to us, these things which we experience deeply, and our reactions to those situations. They are the bricks with which we construct our identity; they are Leonard’s tattoos. Normally, we experience events and we integrate the memories into our concept of our “self.” Memories of your children help define you as a father, memories of performing good deeds help define us as “good” or “moral.”
The brain does not only create this “self,” but it also works hard to maintain our current concept of the “self” and of the world around us. When we have new experiences, the brain integrates these experiences into our memory, and fits the experience into our pre-existing concept of ourselves and the world.
War, however, changes everything.
Imagine an 18-year-old soldier’s mind as a filing cabinet. The cabinet is full of folders, and each memory is stored in a folder with a label. His graduation from basic training is filed under “success” and “pride.” Spending Christmas at home is filed under “family” and “love.” His squadmates are filed under “brotherhood” and “unity.”
He is sent to Afghanistan for reasons he doesn’t quite understand, and he is in the backseat of a Humvee that runs over an IED. He is the lone survivor. He sees his best friends dismembered, maimed, screaming in pain but he is powerless to help them. He collects the body parts of Afghani children who were killed when he ordered an airstrike on insurgents, not knowing they were using children as shields.
The young man’s brain struggles to file these experiences, but no appropriate folders exist. In fact, some of the pre-existing folders don’t even make sense anymore. He feels such severe guilt for his actions, even for his survival, but there is no folder called “killer,” and he is beginning to question everything in the “good” or “moral” folder. The “invincible” folder that is so large in most teenagers now seems completely ludicrous, as death has suddenly become something real and tangible. Upon his return home, he may feel betrayed by the very country he swore his life to defend and protect. The trauma of war is so completely destructive to his sense of self that it shatters his perception of the world as meaningful and comprehensible. War has robbed him of who he is on a fundamental level, and decimated his feeling of control over the external world.
For those with PTSD, there are many treatments that alleviate symptoms. Medication helps with panic attacks and anxiety, family and group therapy helps with isolation and detachment, Imagery Rehearsal Therapy helps with nightmares, and Exposure Therapy helps reduce re-experiencing and fear. These therapies help a PTSD sufferer better deal with everyday life, but true healing cannot begin until the veteran is able to reconstruct his sense of self and rediscover meaning in his life.
In 2001, the PTSD program at the Connecticut Veteran’s Hospital realized that many of the veterans under their care were experiencing these existential problems. They incorporated Logotherapy, a therapy centered on finding meaning, into their regular treatment plan. Logotherapy was developed by Victor Frankl, a Jewish Psychiatrist imprisoned in Nazi concentration camps during world War Two. Amidst the horrors of the concentration camp, Frankl noticed that the defining characteristics of the prisoners were not fear or hopelessness, but love, compassion, and “tragic optimism.”
The VA’s Logotherapy program centers around these principles, helping vets rediscover meaning and purpose in their lives- not despite their painful experiences, but because of them. They learn to view themselves not as victims of unfortunate circumstances, but as people who have seen the worst the world has to offer, and become stronger because of it.
Community Service is a mandatory part of the program, and veterans find meaning in helping others. Some Vietnam Veterans raise money for Cambodian schoolchildren. Veterans who have lost friends with children set up scholarships in their name, tutor the underprivileged, or throw birthday parties for foster children. The vets begin to realize that although they lost the “self”` they had been building before the war, their understanding of human suffering, of pain, of horror has led them to create an even better “self,” and that the world around them has become a better place because of their existence. They have become the heroes they intended to be at enlistment. As one vet put it:
“War is about destroying lives and everything beautiful. I was a kid then, but now that I’m older, it just makes me want to create and build things and appreciate the beauty around me.”
Before I was a disability advocate at Hill & Ponton, I worked for years in inpatient psychiatry. Part of my job was designing and leading group therapy sessions for our patients — typically people who suffered from severe and persistent mental illness. Many suffered abuse, addiction, abandonment, tragedy, and hopelessness. The group that most patients responded to best was a discussion about a style of Japanese Pottery called Kintsukuroi. When a beautiful bowl has been broken, the artist uses gold and silver solder to mend the bowl, and the resulting lines of gold and silver make the bowl even more striking than before the break. Like the veterans, it is the bowl’s fragility and vulnerability which ultimately lead to its value and its unique character.
The piece has become more beautiful for having been broken.
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