The Foreign Service Journal, January 2008

acted like we were in a safe place put us all at risk and sometimes wound up dead. After about a month of therapy, where I talked about what I had gone through in Iraq, I began Eye Movement Desensitization and Reprocessing sessions with my therapist. In my case, however, the therapist used tones instead of eye movements. I won’t go into the details of this kind of treatment because a lot of infor- mation is available on the Internet for anyone interest- ed in EMDR. But, in essence, it involved experiencing the most traumatizing moments of my tour in detail again while listening to tones alternating from one ear to the other — which, I understand, helps the brain process the events. The overall effect was sort of like reliving the worst days of my life over and over again, leaving me wrung out and exhausted after every session. This was by far the most difficult aspect of my treatment. There is nothing enjoyable about reliving traumatic experiences and feeling like you are about to die on a weekly basis. I managed to get through it only because my life had become so unpleasant and unlivable that there wasn’t much difference. Reliving these experiences in a room with a trained mental health professional was, however, preferable to reliving them in the middle of the night alone. Somehow the process helped me focus on the roots of the experiences without actually feeling like my life was in danger at the moment I was reliving the trauma. It helped me gain an objectivity I lacked in the middle of the night or when seized by rage. This was important because it helped me gain control over the horror and the rage and distance myself from the feelings, while still retaining the memory and a certain amount of con- trol over the events themselves. After about two months of EMDR treatment, my sleep improved. Instead of waking up every two hours and pacing around my apartment in a blind rage, I started sleeping for four or five hours before waking up, between 3 and 5 a.m., groggy and confused. Eventually after an hour or so, I would fall back to sleep for another hour or two before work. Looking back, I am sure some of my other symp- toms — inability to focus, confusion and anger — were related to my chronic sleep deprivation. I now know that I was going through a sort of stress hormone withdrawal. I had been living on a chronic high of adrenaline and sleeping fitfully for months on end. Living like this helped get me through my tour in Iraq, but trying to readjust to a Washington work schedule was like enduring never-ending jet lag. It’s actually a form of withdrawal. There were times when, sitting in my new office trying to focus on paperwork, I could feel the adrenaline still racing through me so fast that my skin would itch and I would start to sweat and twitch like a junkie. Accepting My Diagnosis After about three months, I finally internalized and accepted the PTSD diagnosis I had been given on the first day of therapy. I had read through a document on the condition and realized that most of the symptoms applied to me in one way or another. I don’t think I could have come to this realization sooner; I wasn’t able to concentrate long enough to get through a list of 17 symptoms, for one thing. For another, the danger I felt surrounding me was so real that I thought I was getting help to figure out how to convince other people of that danger too, so we could all work together to counter it. Then I wouldn’t have to be so angry all the time. But gradually, I allowed myself to accept that my version of reality, while appropriate in Basrah, was no longer appropriate in Washington. It helped to think of PTSD the way my therapist described it: a normal reac- tion to an abnormal situation. Living in a small com- pound with rockets and mortars raining down at night and my employees being targeted and killed was not a normal situation, and trying to conduct normal busi- ness in that sort of environment was intensely abnor- mal. I came out a bit warped — so what? I started giv- ing myself a break. At least I was still alive. In December 2006, I asked my therapist if could take medication to help me sleep. Now, when I look back at this, I see my request as a sign of progress in itself. I was looking for more options to get better. After all, I knew other people were taking medication, F O C U S 38 F O R E I G N S E R V I C E J O U R N A L / J A N U A R Y 2 0 0 8 It has taken enormous amounts of energy and effort to endure and withstand PTSD treatment.