The Challenge of Dealing with PTSD: Capt. Joseph P. Schweitzer Comes to Terms with a Dramatic Accident

02/19/2014

2014-02-19  Prologue by Ed Timperlake, US Naval Academy, Class 1969

Captain Schweitzer, actually the Mission Commander, not co-pilot, of an ill-fated mission provides a seminal discussion of the challenges and the approach to recovery from a horrible tragedy in Italy in 1998.

He narrates his experience, with brutal honesty at the Naval Academy during a day for soon to be graduating 1st Class, (Seniors). This is the Naval Academy “Capstone” program in which the soon to be Ensigns in the Navy and 2nd Lts. in USMC are exposed to very hard moral, ethical and demanding real world leadership challenges that actually occurred in the Fleet or Marine Corps.

Joe Schweitzer has develop unique insights and in the process makes sure graduating Midshipman know first hand how tragic life altering events can occur and the moral dimension to ones life after such an accident.

The sad tragic loss of life on an Italian Ski slope is being remembered at the US Naval Academy.

In this piece, Schweitzer provides a clear statement of the challenges and the approach to recovery.

Introduction

It was front-page news at the time.

A tragic accident where a USMC crew flew too fast and too low from Aviano Air Base, Italy and severed a gondola cable at a ski resort, killing 20 European citizens.

As an American Forces Press Service article published on March 16, 1998 put it:

Investigators say the pilot and crew of a U.S. Marine Corps EA-6B aircraft flew faster and lower than their mission allowed, thereby causing the Feb. 3 cable car accident that killed 20 skiers in northeast Italy. 

“Aircrew error” was the cause of the mishap, U.S. and Italian investigators announced at Aviano Air Base, Italy, March 12. The air crew disregarded flight rules concerning airspeed and minimum altitude, said Marine Corps Maj. Gen. M. P. DeLong, president of a joint U.S. and Italian investigation board. 

The Aviano-based aircraft was on a low-level training mission when it severed a gondola cable at a ski resort in Cavalese. The gondola and passengers from six countries dropped more than 300 feet to the valley below. 

The aircraft is one of three EA-6B Prowlers assigned to the 31st Air Expeditionary Wing in support of NATO air operations over Bosnia. They are permanently assigned to Marine Tactical Electronic Warfare Squadron 2, Marine Corps Air Station, Cherry Point, N.C.

Aftermath of the February 3 cable car accident. Credit Photo: La Stampa, 7/13/11
Aftermath of the February 3 cable car accident. Credit Photo: La Stampa, 7/13/11

A good sense of what the incident felt like from Schweitzer’s point of view was underscored in these opening lines from a Baltimore Sun story:

When Joseph Schweitzer graduated from the Naval Academy in 1989, classmates wrote in his yearbook that the Marine Corps-bound lacrosse star would “make the world safe for democracy.” 

But a year ago, Schweitzer was co-piloting a jet that caused one of the most gruesome peace-time disasters in U.S. military history: the deaths of 20 civilians aboard a ski resort gondola in northern Italy. His otherwise spotless reputation as a serious, almost shy Marine is now stained by accusations he is a reckless killer.

Schweitzer’s path to recovery from this horrible incident which changed his life and ended those of 20 innocent victims provides insights into the general problem of what is called Post-Traumatic Stress Disorder or PTSD.  Schweitzer has spent many years both navigating through his own struggles and demons but has turned this struggle into an approach to help warriors who suffer from PTSD.

In this piece, Schweitzer provides a clear statement of the challenges and the approach to recovery.

PTSD/Moral Injury 

By Joe Schweitzer, Aviation Mishap Survivor

In this piece, I will focus on the topic of moral injury, a component of PTSD, in an attempt to uncover one of the biggest challenges a survivor faces once he/she begins surviving survival.

I make these observations from my own personal experience— the impact my survivor event had on my life and most importantly my soul.

I am an aviation mishap survivor– I should not be here right now. I was less than 2 seconds and 2 inches form being a smoking hole in the Dolomites.

I was the senior aircrew/ mission commander of a USMC EA-6B that struck an uncharted gondola cable while flying a low-level training mission in Italy in 1998. Our aircraft was severely damaged, miraculously landing yet the most traumatic fact was that 20 people, all European nationals, in the gondola were killed.

And somehow I was responsible for their deaths.

During that week following the mishap I had what is commonly labeled now as a combat stress injury, struggling mightily to cope with survivor guilt– “why did I live and why did they die.”

Following the mishap, the pilot and I were held criminally responsible for the wire strike and the deaths of the 20 civilians. Through a year long trial process we were eventually acquitted of all the flight related charges.

However, I pleaded guilty to conduct unbecoming an officer for destroying a personal videotape I took on the flight to film portions of the low-level. At one point when we were 5’000 feet above the ground I smiled into the camera.

After the flight I could not stop thinking of my smiling face next to the mishap scene– the blood in the snow, visualizing this clip on CNN. At that point in time I could not live with that image as part of an international media spectacle, captured for all to see.

That was my worst nightmare come true so I destroyed the tape.

In 2007, almost 10 years after the mishap, I was formally diagnosed by a Navy psychologist with chronic PTSD. This was after years of anxiety attacks, depression, lost sense of self, unemployment and a stunted professional career.

I had a few jobs, received my MBA in 2004 but that didn’t help me get back on my feet. I still had unanswered questions of what had happened to me and felt like I had missing pieces, a hole in my heart. I couldn’t move forward because I neither knew where to go nor how to get there.

In 2007 I started to tell my story to the first class midshipmen at USNA as part of the Admiral Stockdale Center for Ethical Leadership. Since then I have delivered my presentation over 90 times to over 3000 mids and 500 facilitators, who were mainly former/ retired Navy and USMC officers.

It is from this pathway and journey I make my observations in this article.

PTSD is both a curse and a gift of the survivor experience that many of our veterans face today as a result of their experiences in modern combat operations, particularly Iraq and Afghanistan.

Although the issue is gaining more exposure everyday, it is a battle within the soul that has existed since the beginning of armed conflict and tragedy.  While our society and institutions continue to learn more about this internal battle, there is still a long way to go to develop an effective framework to help those who suffer from it regain a better life and to “refind” themselves.

This is evident in the reported high suicide rates among active duty military and veterans.

One of the reason’s for this current state is that we attempt to put a great emphasis on treating symptoms, a common attribute of modern medicine, instead of understanding and operating on the cause. 

The Battle

The Battle the survivor experiences consists of three components: Threat to Life, Traumatic Loss and Moral Injury (*Shay).

Threat to Life usually occurs in short durations and when the “operator” is engaged in his/her tactical reality. Although it can be a harrowing experience, it is what we are trained for and have prepared to undertake such situations as part of the profession of arms. This component can be told very tactically and matter of factly, although the situation is dangerous and often one second, inch, or decision away from death or severe injury.

Traumatic Loss is a heavier burden. This is where the Death Imprint (*Lifton) is stamped, the memory of the “moment” is seared in the brain, without a time stamp so it continues to play in a live loop. And where survivor guilt kicks in, “the tainted joy of surviving amid another’s death”.

This starts the reflective period, going back to the event with the realization that I walked away from it and other’s did not or I walked away less whole then I was before. It is here where one struggles with the curse of surviving- why me, why did I live and why did they die- as well as start to pick up the pieces of what was shattered.

Moral Injury is the hardest pill to swallow.

It is the undefined moment when what was is no longer.

Given the circumstances, the survivor experiences this as a loss of self. The eco system that was used to perceive the world, make decisions and provide an identity (sense of self) becomes disconnected from the survivor. Reestablishing this connection is often the most difficult component of the healing process.

It is a very internal and personal journey since it is a process of rebuilding vice repairing. The survivor experience is a transformative event that ultimately must strive to regain an individual’s sense of self and reconnect them to the world with a renewed identity.

Healing this component is the biggest challenge yet worthiest endeavor.

Moral Injury presents itself as the most difficult component of PTSD/ survivor experience to address, heal and move beyond.

Moral Injury is best defined by Dr. Jonathan Shay in his book Achilles Returns from Vietnam as the violation of what is right.

This can occur at two levels, internally and externally.

An internal moral injury would occur when the individual has violated what they thought they were capable of doing to act in the right way (Zimbardo- placed in a certain situation and an operating system, the individual may break and not live up to its own perceived or ideal standards).

An external moral injury would occur when another person, outside my WILL, violates the “what is right” in the individuals mind or belief system. Beyond these two definitions one might also argue a moral injury occurs when the unthinkable becomes reality- a harrowing, traumatic event shakes the core beliefs of the survivor.

Irrespective of type, the individual’s belief of what is right, the moral ecosystem they use to define good and bad, is broken. The initial alignment points to one’s moral compass won’t align anymore.

As a result, one gets lost and the moral horizon becomes very basic and individualistic, no longer connected to the norms and waypoints used before.

In essence the survivor’s soul becomes lost and it initiates a potentially daunting quest to regain its sense of place– where it sits inside of me. What is lost in a few seconds or hours, takes years if not a lifetime to recapture. This becomes one of the primary journeys of the survivor odyssey.

This is also why, from a healing aspect, simply going back to school, getting a good civilian job, or just going home won’t fully heal a moral injury.

The soul needs to be explored and operated on to make it whole again. Equally, because this injury impacts one’s core it is hard to lay on the table, especially to peers and family that still believe in the old moral ecosystem, theirs still works yet mine does not.

Key Foundational Elements to Shape Recovery

From my own survivor experience, a journey that has lasted over 15 years, I have made the following observations that I believe are relevant to shaping the course for a positive and systematic healing pathway;

Fragility of Man

A term coined by Admiral Stockdale, this truth is a hard one to accept.

As proud military members, trained in the art of warfare, survival and will, many of us struggle to accept and understand that anyone of us can be dramatically impacted by a survivor moment or catastrophic event. We think we can handle it and don’t want anyone to know we are struggling.

We suck it up, thinking we’ll get over it.

Yet this internal defense is the first barrier to healing. It prevents us from examining and acknowledging our own human condition. Until we can live with truth, we don’t really start to heal because we deny the true pain, the pain in our soul.

Failure to reach out for help– hurts us– we are embarrassed, too proud, etc.

Duality of the Survivor Event/ Experience

PTSD, survivor guilt, whatever you want to call it exits concurrently as a blessing and a curse, something gained and something lost.

The worst moment of your life is interlocked with the best moment.

No matter what happened, you lived, came out on the other side.

My first personal experience with this duality occurred the night of my mishap. I did not sleep that night but did two things.

First I cried like a baby, mourning the deaths of the innocent civilians I was in some way responsible for their tragic end. Then found myself giddy with joy that I had miraculously survived the ordeal.

This duality is even more critical in the recovery process.

Our salvation is embedded in the cross we bear. All the answers we need to move our life forward in a positive way are attached to the survivor event.

We cannot avoid the event but must process it, to find the wisdom and power that is encrusted in the pain, loss and suffering within our soul.

Metamorphosis

The survivor event is a point of no return. In most instances a person’s world is changed forever, irrevocably reshaping they way we feel, think and act. It is like going through a one way check valve.

This “passage” is the reason why many struggle to gain their lives back. Often they try to put the pieces back to a world that was, not knowing it can never be the same.

The pieces don’t fit any more, there is a new positioning of our feelings, attitude, outlook and most importantly, disposition of the soul. These changes are the recasting of our internal gyro- stability system.

With it comes acceptance and understanding of what is new, having mourned for the components of our life that have been lost.

This is where we need to “redefine our civilization”, in the terms of Admiral Stockdale, to reset and regroup our meaning of the world and how we live and grow within it.

Endurance of The Soul

the regroup and refinding of the survivor’s soul is not a linear process.

It is a dynamic one that requires breaking through many transition layers to reach new levels of awareness and enlightenment. This process helps refocus a survivor’s purpose and sense of self.

Often a two steps forward, one step back movement, it requires “endurance of the soul”, another term coined by Admiral Stockdale. The ability to be OK with an internal compass that continues to spin, though increasingly stable with ever decreasing periods of murkiness, as the journey proceeds and a sense of direction is regained.

It is during this process that the survivor develops the confidence and courage to reexamine their soul, to sand away the protective crust that has formed to shield it yet isolate it from the world outside of the individual. This sanding is where we gain a truer understanding of our survivor event, a more objective realization that some things may have been beyond our control or too much for a human being to handle.

With this examination one gain’s a truer understanding of their experience and its meaning. Here is where we gain insight into our own personal human condition, our personal line of good and evil.

We start to understand our vulnerabilities and the arbitrary lot of luck and chance. AND we become open to tell our story, to ourselves, as we listen and learn.

The survivor starts to heal themself.

Reconnection

Once the survivor achieves this better sense of being, a fuller personal awareness of their state in life and how it can be repositioned within their soul, they are able to better reconnect with their world.

This enhanced sense of meaning/ being helps re-establish their connection points with society.

A central component of this repositioned state includes the value and meaning the survivor places with their experience, placing it in a positive manner, leveraging the lessons learned to help others and regain purpose beyond me.

The Central Role of the RIME in Recovery

The Rime is the process of telling your personal survivor story.  It connects the dots of the survivor event as well as living a fuller life beyond it.

Through this process one consolidates and integrates the experience (Fragility of Man + Duality of Event + Metamorphosis + Endurance of the Soul + Reconnection). The Rime is a story of self understanding, not to anyone else but ourself, providing an internal dialogue to what was felt, thought and acted upon, adding deeper understanding to provide a clearer meaning.

The Rime is analogous to Samuel Coleridge’s Rime of the Ancient Mariner, an epic poem that chronicles the struggle of the Mariner’s soul across an incident of misfortune and death.

The Mariner suffers mightily through the process, enduring much pain and agony but eventually he attains salvation when he is finally capable of forgiving himself and tells his story to others. Thus the Rime is a process of placement. Selecting the right home for the survivor experience within the soul, a repositioning of it so it is congruent with the survivor’s new reality.

The Rime provides context, a meaning of the survivor event.

It integrates multiple contexts of the experience; physical, psychological, physiological, emotional, spiritual, moral. This provides a multi-dimensional perspective, a truer, more complete understanding.  One that ties the individual experience to the survivor’s community and the rest of society.

It transitions the feelings of isolation and internal conflict from “only I feel this way” to “this is a normal reaction for someone that has experienced an event like this”.

This shift in context reopens the survivors bonds and links to others (civilization) and kindles a quest for knowledge, a desire to understand more of my experience. It also starts to “reground” the survivor’s internal compass and stability, reestablishing a sense of place.

Once this transition is made we can begin to gain insight into our own personal human condition, our personal line of good and evil. We start to understand our vulnerabilities and the arbitrary lot of luck and chance. AND we become open to tell our story, to ourselves as we listen and learn. The survivor starts to cleanse their soul, unburden it from the negative forces that way it down and ultimately start to heal.

The cleanse is a critical process. It starts to flush out the unhealthy by-products of the survivor journey; guilt, inner conflict, stress, and anxiety and replace them with a renewed sense of purpose, determination and will.

Before the survivor event, the individual is well connected in their society or eco-system. Especially as military members, we know where we plug in, have shared bonds of trust and experiences. One knows where they “fit” and has established a comfort level to thrive personally and professionally. Goals and objectives are clearly defined and aligned, providing a sense of accomplishment and pride. In this state one can understand and navigate their place in the world.

This stability provides positive meaning and fulfillment. My world is good, I know how it works and who I am. This translates to confidence, happiness, reinforcing and cultivating a known sense of self. We are woven into our world, interconnected with our “community”. The soul feels whole, one has context to life, and strong understanding of where my place is.

After the event, the weave that provides belonging to the “community” and a position in life starts to unravel. It often becomes undone. The survivor experience catapults one through a new threshold; a place of no return and one where the world doesn’t make sense. The trauma and impact of the moment fracture or even shatters the inner foundations, the core beliefs of the survivor. Nothing is the same as it was before.

As are result the individuals sense of self starts to tumble. Although the outside world has not changed its meaning to others, it has in the survivor’s mind. One’s view of “my” civilization has been altered irrevocably. Before, the interdependencies of life were known, with an established comfort level. Now there is no rhyme or reason to the world. The survivor’s internal gyro loses its waypoints and cannot re-initialize. The world makes no sense but the more significant inner conflict develops, “my place in the world doesn’t make sense”.

As a result the individual looses connection with their touch points to their ecosystem/community. They no longer feel connected to the people, teams and organizations they had always belonged to.

This psychological retraction makes it difficult to reconnect. No one feels like I do right now, why do I feel this way, I cannot show others that I am weak or vulnerable- I will be letting them down.

Internally one also begins to ask survivor questions- why did this happen, how could I have done that, why did I live and they die?

These existential thoughts question the core of the survivor’s belief system and ultimately this is where survivor guilt can turn to shame– I am wrong. In this position, we find ourselves asking the deepest questions in a very isolated state. In these dark moments, looking over the abyss, searching for meaning of our life and its events, we are emotionally  and psychologically isolated.

To overcome this soul freefall we need to evolve, to transform. We can’t change what happened nor can we wish it away. The only course left is to understand what happened to me, to define my survivor experience, give it a meaning that I can accept and use it as the foundation to create my “own salvation”. In essence one needs to understand and tell my own survivor story.

The story is a journey of meaning. It reweaves us back into society, reconnects us to our fellow human beings. It provides the conduit to deliver the story of how I got to where I am now and to share how I was lost but now I am found…It is analogous to Coleridge’s Rime of the Ancient Mariner described earlier.

The Challenge of Transformation

In order for the story to provide transformative power, it must evolve from its initial state.

This requires time and a multi-dimensional analysis. It must be studied and understood from many lenses; operational, physical, psychological, psychological and spiritually. It explores and recounts “my personal human condition” in an extreme, often no win situation. The story process does not take sides or cast blame but acknowledges we are human, with a soul that is both strong and fragile.

The story always begins at the tactical level, in its rawest format. It is shaped and recounted by real time perceptions of the senses; what I saw, thought, felt and did. It is strung together by a series of moments.

The sensor is not an all knowing lens that never blinks and has 360 vision. It is a human lens that blinks, fixates and has a limited field of view. The story is told matter-of-factly, with raw data and in tactical language. Danger and death may be very close, missed by inches or seconds, but it is discussed as another day at the office. However detailed this story is, it remains fragmented, told in bursts with gaps. It is an incomplete version of the survivor experience. It lacks the full content and meaning to reveal its rightful purpose. It requires further exploration.

The gaps need to be filled. What is missing are the multiple layers that give the survivor experience its multi-dimensional meaning to gain insight, completeness. These gaps are closed by examining the survivor experience from the physiological, psychological and spiritual levels.

Meaning is derived by understanding the experience simultaneously across all these components. From this process we derive knowledge, and start to accept how this event occurred as well as its impact on me as a life altering experience.

The coexistence of the entire human experience of the event is merged together. With this knowledge the story gains a truer, more complete meaning. I start to accept its occurrence with a greater understanding of how– not why. With the gaps filled, the dots connected, one reach’s a sense of peace with the past.

This peace heals the soul, helping it refind its place. It starts to open again to the outside world, with the potential to reconnect. With this reconnection comes new meaning and purpose. The survivor experience transforms the survivor from an identity of fear, guilt and loss to one of positive energy and power; a refound soul with greater understanding, compassion, humility and knowledge.

The Rime’s power emanates from its capacity to fundamentally revector the survivor’s perspective from one stuck in the past to one of looking ahead toward the future.

The Process

The Rime is an outcome of the survivor journey. It is developed through a pathway of reflection, introspection and remembrance.  It is the process of understanding the loss of self, components of me that are gone and never will return. It requires the acceptance of my human condition, my fragility, for that loss and repositioning it within the soul, to a place that is not all consuming nor debilitating.

The deeper one looks and understands the causation of their soul’s injury the better one can create its cure, to help it heal and restore its power.

When one reaches that state, they feel capable to answer a previously unanswerable question, a better understanding of who I am and the special gift of life I have been given. When this state is reached a survivor’s view of the world transitions from looking backwards and longing for “what I was” to looking forward to “what I can be”. This gift has much power and it provides transformational energy.

This positive energy is manifested by a new sense of awareness, insight, compassion and belief.

It is the knowledge of knowing I am going to be all right and I have overcome many obstacles. I did not necessarily make them go away but I am comfortable with how they now fit into my life. I know they are a part of me and am comfortable where they reside in my soul. With this new perspective the survivor can move forward, with new meaning and purpose. With a healing soul, the survivor starts to see a brighter future and better understand their sense of place and purpose in achieving the reality of what is now possible.

Wounded Warrior Core Values

The Wounded Warrior Core Values are an aid to help those on their journey stay the course and keep moving forward, especially when the pathway gets clouded or difficult. One of the critical components on this journey is WILL, knowing there is a better place for me in this life, I am not there yet but I need to keep moving forward. 

SERVE

I help myself by helping others. Staying connected to my community, whether fellow warriors, my family, my peers. Providing positive influence to my community gives me a mission and reminds me why I wore the uniform and swore an oath to something bigger than myself. (Dealing with your “stuff” we all have a tendency to withdraw from the world— we don’t feel right and not very strong— so we check out and lose connections that have defined us to this point. Isolation keeps the guilt/ shame loop going, focusing on others pushes it away).

OWN

I am the “captain” of my soul. I own its destiny no matter what the world throws at me. Its development, recovery and growth are as important as my physical needs.

(For me this is the biggest area that gets injured/damaged—we can very easily lose our sense of self and this what our quest is about; to feel “whole” again, to “refind me”.. If you can reclaim this HUGE power.)

TRUST

To get to where I need to go, I will need the help of others—to mentor, to listen, to support me.

Trust opens my heart to the world around me and helps draw out my personal strengths and character (Internal and external wounds isolate you, we feel weaker, not worthy, heart got ripped out and shit on. Need to let others get close to us and not stay in the “protection mode” at an arms-length from our world. Equally we need to show our emotions again, to feel the goodness of the sun, laughing with a group of friends, all the fun things we took for granted before “it” happened. I need to let go of the negative things that now define components of my new comfort level, to trust myself to be me again.)

EVOLVE

I am on a journey.

I know and feel new things and see the world with a new lens. They are different then before my “event”. I am open to the opportunity of transformation and the gifts of survival to explore  the possibilities of what “I AM” and what “I CAN BE.”

(The biggest power/gift the wounded warrior has is using the current struggle and dark moments to define and create their salvation. If they work at this and make peace with themselves;  forgive what needs to be forgiven, move forward to explore what their new self can be as opposed to trying to recreate what was, then this is the best drug out there. This is the diamond encrusted in shit. If this can happen wounded warriors can be the driving force to change America, not just a handful of them but thousands of them—no doubt in my mind—this should be the GOAL) 

Shaping a Way Ahead

Moral Injury continues to persist as a major challenge for veterans re-assimilating to society after their service and survivor experience. Unlike physical wounds that have linear and steady state recovery paths, moral injury is an injury of being and of existence.

If the survivor does not have a good context of “where I am” and “how I got here”, recovery of the soul occurs haphazardly and in round about ways. Finding one’s way and reestablishing meaning needs to be a journey of enlightenment and less of treatment. Understanding one’s survivor story, The Rime, in a wider context (physically, emotionally, spiritually, psychological, physiologically, etc) is essential to this “refounding” process.

The Rime recognizes this state while creating a pathway to understand the survivor’s human condition- its strength, its vulnerability, its essence. Ultimately it provides the medium to heal the deepest wounds, to reestablish positive meaning and aspirations for the survivor to reengage once again in the joy of living. Equally since this odyssey proves extremely daunting, those that have been down the survivor path before need to provide guidance, a light in an often dark tunnel, to those that stand at the beginning of the journey.

This Survivors HEAL Survivors approach is critical to success. In doing so, we acknowledge a major component of the responsibility of care is not necessarily directed to the health care or spiritual provider, but a fellow veteran or society of veterans, that have also “seen the beast” of the survivor experience, leveraging their ability to move forward to help their peers.

CALL to ACTION—Develop a delivery framework anchored around The Rime at various organizational levels to functionalize the healing of moral injury, developing a consistent X and O’s playbook.

Once established connect and align across the organization. Start with mental model maps and connect them across a syllabus, developing integrated learning pathways for veterans, treatment providers, supervisors and loved ones to actively increase moral injury situational awareness, develop road maps and share knowledge/ experiences (The Rime) of the journey.

The effort is to increase the human condition connectivity for Survivors to Heal Survivors by developing a medium to interact, share and support at the soul level.

Editor’s Note: This article can be downloaded as a PDF here:

http://sldinfo.wpstage.net/wp-content/uploads/2014/02/The-Challenge-of-Dealing-with-PTSD.pdf