Returning to combat trauma/PTSD and personality:  as I said previously, never assume that a combat veteran’s emotional lability (up-and-downness) is a sign of an underlying borderline character organization.  It may be.  It may not be.  As I noted in an earlier post,  a veteran suffering from borderline personality disorder will almost certainly have suffered abuse (physical, emotional, sexual) as a child, usually over an extended period of time.  Combat trauma/PTSD superimposed over borderline personality disorder does happen, and, yes, not infrequently.  When it does, it is not at all a pretty thing.  Think of it as double-trouble with a vengeance.

But what about the men and women who come from “good-enough” backgrounds, who nevertheless return from war only to find themselves at war still, but now with their bodies and emotions?  In other words, what about most combat veterans?  Consider the following:

Step One

As a professional, never forget:  you are dealing with military men and women–and even more importantly, military men and women who volunteered to serve during a time of conflict.  One does not do that if one is a Herman Milquetoast, simple as that.  Again:  there are a heck of a lot easier ways to get your college paid.  Consequently, day after day, as I meet the men and women returning from combat, I find myself returning to one word to describe the emotional lives they bring to me:  intense.

If you enter a physical area dedicated to the care of combat veterans (in Indianapolis, we have an outstsnding new facility–for which we are quite grateful, I might add), be prepared:  you will feel that intensity.  It’ll be in the air.  Emotion is catching, a well-known truth, and the emotion of the young combat veteran (even the middle-aged one) is strong, sharp, and, often, tumultuous, contagious to the nth degree.  Many of these veterans (if not most) were “handfuls” when they were youngsters and teenagers,  active, driven, bundles of energy looking for a place to land and dissipate.  Nobody within a good half mile of them had a lick of problem feeling that energy (and longing, please God, for its rapid disspation, like now!)  Many veterans were attracted to the military precisely because of the intense physical and emotional challenges they were promised.

And in a time of war, have no fear:  there ain’t no recruiter nowhere who cannot deliver on that promise.  In spades.

Unfortunately, in spades cannot even begin to describe what is delivered to these men and women.

Step Two

Before an intense veteran even reaches the combat theater where such challenges are delivered, though, he (and now I am going to shift my focus to the men) has been in basic training, plus then hours upon hours of subsequent training, all in the constant presence of other intense men. (Excuse my generalizations here, but I do believe that the point I’m about to make–the “surprise” of many military men at how such intense bonds develop among camarades–contrasts significantly with the relative ease at relationship-building that most (though not all) women, military or not, bring into their adult relationships.)

So, if you put intense men around each other for intensely long periods of time, performing very intense tasks, with very intense periods of “relaxation” afterwards, what do you get?  The camaradeship of the military, an experience most men had long put behind them when they had traded the hours of hanging out with their school chums, accomplishing gobs of nothing while talking about the most important topics imagineable, such as what makes lightning bugs glow or how mean your big brother can be sometimes–all traded for the more alluring, yet far more complex relationships of romance and status.

But now those hanging-out days are back, military style.  Every guy’s a boy once again.  And although no boy (or military man) would ever be caught dead calling this experience “love” (cooties, remember?), love it is, an intimacy that goes down to the very core of what many men experience as masculinity, a twinship, as some psychoanalysts call it, an intimacy that the men had to give up years earlier, under the pressures of adolescent male culture.  It’s back.  Cool.

Step Three

Now take that intense camaradeship and transfer it halfway around the world, where every day you wonder whether this day might be it, the day when everything changes in an instant; where you’re on guard, 24/7, whether you’re on duty or not, always wondering what might be taped under that wheelchair over there, wondering whether you should stick your hand out to take that flower this kid’s offering you.  Your emotions never turn off.  All those intense emotions, they never turn off.  There’s no such thing as “chilling”–even when you’re doing your best to do just that, for one night, maybe, you know, horseplay, a pick-up game, stuff like that.  But no:  every neuron, every cell in your body is on alert.  Every neuron, every cell in the body of the guy next to you, and of the guy next to him–all of them are on alert.  As engagements intensify, as the risks of just getting some loaves of bread from one spot to another shoot up logarithmically, things get more intense and more intense and more intense, and you know, it’s almost as if you’re all thinking the same thoughts, like you take a crap together and eat this crap together and put up with this crap together, and, look, don’t get me wrong here, but it’s almost like you don’t know where you end and where your buddy begins, you know what I mean?  Weird stuff, but real.  So real.  Real like nothing’s ever been real before, day, night, day, night.

And then all hell breaks loose.

Step Four

Waller’s been hit, God, where’s the morphine, get down, get him out of here, Riggins, look out, over there, now, damn it, Riggins, now . .

Waller made it.  Yahoo-Mountain-Dew Waller, he’s, he’s . . . off to wherever, he . . .

Riggins didn’t.  God, this can’t be happening, this, he . . . he didn’t make it.  His wife’s due in a month.  They just Skyped each other last Monday.  He’s . . . he can’t . . .

Riggins.  God.

Riggins.

Every intense neuron in the body, every intense cell, is turned up seventy decibels, every day, all day, all night, a man can’t even get a decent night’s sleep, you know what I’m sayin’?  But .  . . Waller, Riggins, they . . . they just knew what you were thinking, you know?  Like you didn’t even have to . . .God, it was his first kid, he wasn’t even supposed to be over . . .

Step Five

So now you’re sitting at this damn traffic light.  And this crazy old broad won’t get moving, and . . . and there’s a hole, somewhere inside there, deeper than the heart, the gut, deep . . . Riggins.  And you’re going to kill that woman if she doesn’t get that worthless pile of trash moving, I mean . . .

Oh, God, why are you out of your car?  You’re in the middle of Illinois Street, and you’re out of your car.  Everybody’s looking at you.  The old lady’s nowhere to be found.  They’re just looking at you.  What you looking at, jacka . . .

Riggins.  You haven’t called his wife.  You haven’t written her.  You wonder if it was a boy or a girl.

You’re back in your car.  The parking lot at the Wendy’s, you’re . . . you’re not going to cry, you . . .

Will they ever end, the tears?  Riggins.

Wait, is that . . . no  . . .no.  It’s just the Wendy’s kid taking out the trash.

God, though, remember how Riggins had that limp, just like this kid’s?  Got it after that pick-up game with Rodriguez and Criswell, he was heading up for a . . .

Will the tears ever end?

Emotions.  Up and down.  Over.  And over.  And over.

Wonder why.

Step Six

It’s not the terror, Doc, he tells the examiner.  Yeah, in a way you never get used to it, that’s true, but, in another way, you know, you do.  It’s weird, but you do.

The horror, though?  That you never get used to.

Riggins.

It’s like a part of me is still back over there with him.

Why Riggins?

I can’t turn it off, Doc.  I can’t.

Step Seven

Labile.  Explosive.  Unpredictable.  PTSD, certainly, but also must be borderline as well, the interviewer scribbles down.  Cluster B traits.

Nice how that works.  If the kid’s borderline, you see, the interviewer, always the professional, is in control, doesn’t have to think about Riggins, feel him, feel the hole . . .

Yeah, that must be it.  Borderline.

Next client.