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Walkin' the Talk (Therapy)

By J. Michael Orange

My left foot was pulsating with a piston-like throb in the waiting room when a man opened the office door. He looked about my age and my height but so thin, especially in the face. "Please, come in and sit down," he said as he motioned toward a simple cushioned chair. "My name is Thomas." Early morning sunlight streaming in the sole window cast a warm glow on the frames that held his psychology degree and psychologist's license. Books filled every remaining available space. It was a comfortable space, a secure place from which to burrow back into dark and dangerous pasts and grapple with questions I didn't want to answer.

Thomas sat, slipped off his shoes, and effortlessly gathered his winnowy legs into a full lotus position. His forte, I soon learned, is his ability to combine Western psychotherapy with Eastern philosophy. I immediately noticed an intensity in his eyes that his wire-rimmed glasses softened only a little; perhaps a vestige of the thousand-yard stare he developed as a Marine grunt walking the point in Vietnam. We had walked the same walks and could talk the same language. The journey back began.

My tour of duty in Vietnam (1969-1970) produced a case of Post-Traumatic Stress Disorder (PTSD) that I now know is very typical for combat vets. The effort necessary to realize this took half a lifetime and excessively taxed the patience and compassion of the people closest to me, especially my wife, Cynthia, and daughter, Jessica. My course of talk therapy (which didn't include the use of drugs) ran forty-four sessions over a nine-month period that started in April of 2003.

By our third session, Thomas reached his diagnosis and the VA agreed six months later that I was partially disabled due to combat-induced PTSD. "PTSD expressed by agitated depression, emotional flooding, intensive traumatic recollections, feelings of detachment and estrangement from others, sense of foreshortened future, difficulty concentrating, chronic stress and fear of physical and emotional breakdown." This was Thomas's diagnosis. I wondered if there was a 32-word cure for this 32-word conclusion.

"Let's start with the things that brought you into this office," Thomas began during our first session. "How did you feel coming home?" My eyes focused on the highly polished oak floorboards. I had no answer. With a series of gentle questions, he teased out of me the memory of the fear I had that my family would not accept the person I had become or forgive me for what I had done and not done in Vietnam. Like some toxic virus morphing in a Petri dish, the war infected my moral DNA. The Marines had trained me in a belief system that appealed to the still-reptilian part of my brain and empowered me to believe deep in my gut that I could kill people because they were the enemy that would be trying to kill me. My mortar rounds did kill people in Vietnam, most of whom had tried to kill me. But some were probably civilians, just caught in the carnage that is war.

"Your soul is wounded." Patrick went on to explain. "When people suffer from moral injury, their core moral identity can be destroyed. They can develop a warped system of internal justice that demands a penance; that says they deserve punishment, to be unhappy, or even to die." Thomas leaned in even further towards me. "The Marines gave you the best training in the world to be a good soldier, even in the moral wasteland of war. But there is no boot camp to restore you as a good civilian." He eased back in his chair. "That's why we're here together. You aren't responsible for having PTSD, but you are responsible for getting the help you need to deal with it." With an assuring smile, he added, "Now we're going to bring you the rest of the way home."

During combat, my emotions became so extreme they created their polar opposites. Terror sparked adrenalized excitement. Panic birthed the resolution required to control it. The unrelenting chaos of a firefight—when I remember screaming into the cacophony, "I want it to stop! I want it to stop!"—led to desperation that finally neutralized these conflicting emotions and left me feeling nothing at all, floating in an undecodable world.

"In Vietnam we had a mantra," I said. It don't mean nothin'. A knowing smirk showed on Thomas' face. It was a necessary, all-purpose lie we used as a bandage to keep our consciences from bleeding out and keep in the rage necessary to fight in Vietnam. We used it as a mask and blindfold to filter out the smell of burning villages and rotting corpses and screen out the faces of children drained of hope, family, and future. It hid our faces from ourselves, each other, and our role as invaders. We got so good at telling this lie that we kept telling it even after we came home to a nation that didn't want to hear our stories. We hung on to it like it was the last chopper out of Saigon.

Vietnam gave me the opportunity to explore the very best in me and to face the very worst. When I came home, I tried to fit back into my former life but I had to restrain my urge to revolt at the triviality of my friends' concerns while my fellow Marines were still fighting back in the jungle. It strained my nerves until I thought they would fry from too much voltage. Instead of screaming, I just went along like a foreigner pretending to understand the conversation. I became a "closet vet."

Thomas asked about my most difficult symptom since Vietnam, and I tried to describe what I call my "crash into my primordial sadness." It is a physical thing—a dark force like a shadowy wraith that lurked waiting to thrust its sword between the plates of the emotional armor I had perfected. A pit opens and I become trapped in an M.C. Escher sketch of stairs that never stop going down. I did not understand it; could not explain it; could not control it. My bawling like a baby so embarrassed me, I only felt safe in Cynthia's tender arms. This would go on and on until I didn't think I had any more tears left in me.

With Thomas's help, I learned to recognize this deep, debilitating sadness as a psychological place with two warring inhabitants: The first is the apprehensive voice of the traumatized twenty-year-old soldier, and the other is the falsely empowered young man who takes on an attitude of contempt for his own pain. To use a male-female analogy, the timid "feminine" voice feels the pain of the trauma and the tears flow, and a moment later the harsh "masculine" voice immediately says to stuff it and quit whining. It was like those two cartoon characters of the devil and angel that sit on opposite shoulders giving opposite directions.

The military (and especially the Marine Corps) promises to make men out of boys. Unfortunately, the experience usually accomplishes half the job. We come out of the fires of war with our masculine halves strong as tempered steel but our feminine halves jailed by our testosterone-driven halves.

Thomas offered an explanation. "The harsh boy had served to protect you from the poison of war and to help you develop a good life. Now you are mature enough and strong enough to take the next step and re-integrate all aspects of your personality, including the tender-hearted boy."

Under the gentle guidance from Thomas, I learned to distinguish between repressing feelings and embracing them by fully acknowledging the consequences of my losses and trauma. We did this extremely difficult work together mindful that I should not use Vietnam and PTSD as a convenient excuse whenever reality did not match up to my expectations. "It's a mental disorder," said Thomas, "not a copout."

Thomas asked if there was a key thing that would keep me on track. It was the easiest question he'd asked. "Cynthia," I said. With saint-like patience and wisdom, she has cared for me with non-judgmental love, patience, compassion, and acceptance since 1973 when we married. Thomas said it well, "Cynthia's such an important person for you, helping you home finally from Vietnam, tear by tear."

J. Michael Orange experienced combat in numerous search-and-destroy missions during his tour of duty. In 2001, he published a memoir, "Fire in the Hole: A Mortarman in Vietnam." https://www.amazon.com/Fire-Hole-Mortarman-Michael-Orange/dp/0595160034