January 27, 2014

Name: Mikey Piro
Returned from: Iraq
Milblog: ptsdsurvivordaily

Framed Piro SURVIVOR
Disclaimer up front, I am attempting to watch the Lone Survivor movie after consulting with many family, friends and confidants. I am not acting on a psychologist's advice, or warning, but instead dusting off my skills developed from Prolonged Exposure Therapy and Cognitive Processing Therapy. The idea is to engage in comprehensive preparation for watching movies with stressors and triggers. I expect the result that I am better prepared to watch Lone Survivor, and subsequently better prepared to handle life. I do not recommend this approach without the guidance of a therapist the first time. Let me say that again, go get a therapist for PET or CPT. (Here are some great therapy services). Do not just read a book or blog and do it yourself.

I am attempting this because I feel that, like many skills in life, the ones PET and CPT taught are perishable. I completed both courses and have used their techniques and coaching effectively for some time. Still, tools need maintenance. I do not doubt this will be an unpleasant experience. My first pass through Prolonged Exposure Therapy brought me up close to Restrepo. It was a very emotional experience. Both Prolonged Expose and Cognitive Processing therapy force you to stare down and confront the worst days. And while each day is getting better, part of gaining control over this is not avoiding everything with trigger potential like it is the plague.

A Quick Review of Prolonged Exposure Therapy

The flavor of Prolonged Exposure Therapy I undertook used the Subjective Unit of Distress (SUDs) level to measure progress. From the start, even though it was a subjective feeling, it was quantified and tracked. Over the course of many weeks, after I established my SUDs scale, my therapist and I would systematically tackle and monitor my distress level for my “homework."

We started at the bottom of the scale and worked our way up. The objective of each session was to address and unwind the spike in feelings and raw emotional memories that uncomfortable situations brought out. After enough exposure with positive outcomes, we were able to lower the barrier to gain a level of comfort.

For example, for a long while I would avoid at all costs a crowded place, especially the subway. Being around that many people made me extremely uncomfortable and put me on high alert. There were more than a few days in Iraq where a crowded market or labor line brought a bomb and chaos. We were trained to be on the lookout for anyone suspicious, and to disperse crowds. Well, Manhattan doesn’t care about my view of crowds or suspicious people. If I was forced to ride, I would come home exhausted for days.

So, as part of my homework, I had to ride the subway. For an hour. During the peak. No, this was not an intentional sadistic exercise. I went in with a plan and had a release valve to pull. The point of the exercise was to gain comfort with the SUDs level. The emotions behind my extreme discomfort were just that: emotions. Logic tells me that there is no reason I should not be able to ride a subway. I will admit, it was almost unbearable. But, after a few trips, I realized I could gain my composure more quickly and that the danger was in my mind.

My SUDs for the subway halved by the end of my therapy sessions. That was only part of the homework, but overall, as a follow on to CPT, Prolonged Exposure was the most challenging and rewarding therapy. The initial gains were exponential, though those skills are now a little creaky. It is time to stare them down. As one of my favorite Crossfit phrases puts it: “Get comfortable being uncomfortable.”

Bring On The War Movies

OK, here is the hits list of what I watched and am watching:





Act of Valor :  A Navy SEAL recruiting video. Fiction and SEAL chest-thumping, so a good safe start.

Blackhawk Down :  Here is the first of the true to-life stories. The sucky thing about all these movies is that we know going in how they end. I still have never watched Titanic due to one excuse (aside from Leonardo DiCaprio) -- that I know how it ends.

Zero Dark Thirty : There are intense scenes and it is, again, based on actual events. I think that makes these types harder for me to watch. The end definitely reminds me of a few raids where we walked or flew into the objective, though I am nowhere near the skill level of a Navy SEAL.

Saving Private Ryan : This movie always gets me. The beginning and end are gut-wrenching.

Restrepo :  This is the hardest for me to watch.  As part of my original homework, it took me days to watch this movie. The sounds, sights and action are raw. If Lone Survivor plays this way, I am in for a rough go.


Wish me luck, and thanks for following along.



January 20, 2014

Name: David Stanford, Duty Officer

Sandbox_CoverAt some point in the not-so-distant future we are going to stop posting new content on The Sandbox -- concluding with a final permanent intro that will explain what the site archive is, for those who may find their way to it in due course.

But before we get to that moment I would like to extend an (urgent) invitation to everyone who has posted on the site over the past seven years: If there is one more story you’ve been meaning to tell, one final reflection on your deployment, or your reintegration, or anything else -- please send it to me soon at .

I’m going to write directly to all Sandbox contributors to spread the word, but over the years many of the email addresses have gone bad, so I am posting this public invitation.

And if you are a deployed soldier, returned vet, caregiver, or family member, and you have been meaning to write something for The Sandbox; well, it’s not too late. But it will be soon...


Note: Everyone who has contributed a post to The Sandbox site should have received a Sandbox service patch and a copy of the anthology. But I suspect my record-keeping system is flawed; if you did not, please let me know!


January 17, 2014

Name: Mikey Piro
Returned from: Iraq
Hometown: Lindenhurst, NY
Milblog: ptsdsurvivordaily


With the news of Fallujah I can't shake a gnawing emotional agony from reflection. There are a lot of great articles coming out, most focusing on the Marines who fought there. But what's happened in Fallujah can be viewed as the high-profile early-bird precursor to the potential fate of every city across Iraq. I think the question resonates deeply with everyone who fought: Was it worth it?

On top of the Fallujah questions, I have seemingly more people than ever wanting to talk to me about my service because of the movie Lone Survivor. I have not seen it yet. I am by no means close to the caliber of the SEALs and SOAR aviators who fought and died in Operation Red Wings. Still, because of the current Veteran's place as "the other 1%", I am the closest thing most people know to compare to those stellar Soldiers. I don't know how to respond. I told my wife I wanted to see it, but I am honestly afraid of what my reaction will be, and that makes me want to see it more. (As a side note, if you have seen Lone Survivor and it is fucking you up, don't hesitate to reach out.)

Most days, if I get cocky, I think I have this PTSD shit licked. Then the real world interrupts, and the collision of these two public events has sent me back to Earth like an Airborne trooper with a cigarette roll. This past week I am mostly just pissed off and melancholy.

I find myself desperately searching for positives from my war. I turn and look to Vietnam and the similar history of a war both won and lost at the same time. I look to their subsequent actions and their activism to baseline where we have "progressed."  Should I even try to find a positive in such an evil thing as war? Is that the only way to make sense?

Did fewer people die in Iraq and Afghanistan than Vietnam? Statistically I think there is data to support that notion. Though it makes me sad to think of the hundreds of thousands of Iraqis dead because of our intervention, the advances in medical technology certainly saved more people on the battlefield and that can be seen as a positive, right? But despite my fondness for metrics, those numbers don't mean shit to me when the smell of blood and cordite still haunts me in my nightmares. The numbers now do not help the amputees. How many children are now parentless?

Is there strong enough causality to the change this war initiated back home? Equality got a boost because of this war. The men and women sacrificing while having their rights ignored pushed many debates into the open. Hypotheticals became actuals. There is a whole other blog post about just those effects alone. But was it worth it?

We suspected this would be the case. We told ourselves that what we did had meaning and lasting impact and would not be in vain. I remember one of my LT's pointedly questioning the Colonel about the history of "defeating" insurgencies. What made us so special? How were we different? His question echoes today.

Was it worth it?

I resort to the idea that anything anyone thought they went looking for or thought they went fighting for was erased with the first bullet fired in anger. All that was left were the men and women you went to hell with and doing what was asked to get them home. Unfortunately, there is only a small section of the United States who can and will ever understand the sacrifices made by a voluntary few. At this point in history, if I try to understand the value of worth of our efforts beyond that, my head explodes and I am left picking up the pieces.

Was it worth it? At this point, I don't know. I may never know. And that is part of the extreme mindscrew.


January 13, 2014

Name: Charlie Sherpa
Previously embedded:
with former unit in Afghanistan
Boone, Iowa
Milblog: Red Bull Rising

Framed Sherpa COOKIESA couple of years ago, while preparing for deployment to Afghanistan with the Iowa National Guard's 2nd Brigade Combat Team, 34th Infantry "Red Bull" Division, I wrote a few blog posts about tactical fortune cookies.

During breaks in pre-deployment training, the story went, my buddies and I would often lunch on Chinese food. Afterwards, we'd read aloud the predictions found in our complimentary fortune cookies, adding the words "on the deployment" to each. Hilarity ensued.

As I wrote at the time: "Yes, it's awfully similar to the sophomoric practice of adding the words '... in bed.' We have no problem with that."

Good jokes and old habits die hard. To this day, I continue to collect those little slips of fortune-filled paper.

As the pendulum begins to swing back from the regular overseas deployments of an Army at war, to the cut-budget, cut-throat, spit-and-polish chickensh--tery of an Army stuck at home, I thought I'd revisit our pre-deployment practice of quoting cookies. This time, however, with the words "in garrison."

I am pleased to report that the cookies continue to deliver worthwhile results.

Some messages, for example, sound like the comments snarky raters might write on job performance evaluations. Perhaps these should be filed under "damning with ambiguous praise"?

  • "You always find yourself at the center of attention ... in garrison."
  • "You have an active mind and a keen imagination ... in garrison."
  • "You are a bundle of energy, always on the go ... in garrison."
  • "You have the ability to do several things at one time and do them all well ... in garrison."
  • "You are sociable and entertaining ... in garrison."

Some sound more like philosophical (or maybe political?) advice:

  • "He who walks with wolves, learns to howl ... in garrison."
  • "What you plant now, you will harvest later ... in garrison."
  • "A modest man never talks to himself ... in garrison."
  • "Some folk want their luck buttered ... in garrison."
  • "At 20 years of age, the will reigns; at 30, the wit; at 40, the judgments ... in garrison."

Finally, there are those that sound full of doom and foreboding. Take these as warnings:

  • "You will attend a party where where strange customs prevail ... in garrison."
  • "That one is not sleeping, does not mean they are awake ... in garrison."
  • "People learn little from success, but much from failure ... in garrison."
  • "No man is free who is not master of himself ... in garrison."
  • "Heroism is endurance for one moment more ... in garrison."

Happy New Year! May you find contentment in your cantonment in the months to come!

As always, thanks for your readership of the Red Bull Rising blog! Best wishes for a happy, peaceful, and prosperous 2014!


January 08, 2014

Name: Mikey Piro
Returned from: Iraq
Hometown: Lindenhurst, NY
Milblog: ptsdsurvivordaily

The Lobotomy Files

If you have not followed the Wall Street Journal’s “the Lobotomy Files” I highly recommend it to watch and read. The project chronicles the storied controversy over the use of lobotomies on Veteran Patients just after World War II in the VA system. In a flurry of trying anything to treat then-undiagnosed PTSD, over two thousand Veterans were lobotomized. The stories are both chilling and sad. What I find most troubling is that this is not just a look into the past, but also a glimpse into a report of our future. Tales of failed shock treatment, water treatment and finally a lobotomy depict a horrible life for a returned and committed Veteran with PTSD into the VA system.

Some of the more horrific outtakes:

Shock treatment then the lobotomy:

“Within a month, VA headquarters set guidelines. It ordered doctors to limit lobotomies to cases 'in which other types of treatment, including shock therapy, have failed' and to seek permission of the patient’s nearest relative.”

“At the VA, Dr. Freeman pushed the frontiers of ethically acceptable medicine. He said VA psychiatrists, untrained in surgery, should be allowed to perform lobotomies by hammering ice-pick-like tools through patients’ eye sockets. And he argued that, while their patients’ skulls were open anyway, VA surgeons should be permitted to remove samples of living brain for research purposes.”  

I wonder how many of us are lab rats for the latest batch of lobotomy drugs?

What’s in a Lobotomy?

When I came home from Iraq and got linked into the VA, like countless others, I was prescribed a cocktail of drugs. At any given time, I was on no less than two and at most six different drugs. They were the only alternative to the nightmares and mood swings, as well as the spiraling depression. They propped me up, but I eventually realized that their use was no long term solution. Looking back, I was a blunted shell of my former self. If I did not fight to get off of them, I could easily see myself similarly described as the Veterans in the Wall Street Journal articles.

I am not a doctor. I am not a psychologist. But I feel that these drugs over the long term are harmful. My opinion is they have a window of effectiveness before they become a harmful dependency. Unfortunately, the VA is not mindful of that window and instead hands out drugs like candy. The VA tries to help those that can muster the strength to kick them. These drugs effectively lobotomize a Veteran. At first the effects are temporary and really do help in giving a Veteran a fighting chance at staring down the issues. However, if over the long term, a Veteran with a lobotomy and a Veteran on a cocktail of drugs have the same net behavior, then the VA is still in the business of Lobotomies.

Getting Off the Drugs

I knew that I would not be able to live a normal life without addressing and managing the symptoms of PTSD. It became apparent through that process, that I couldn’t live a normal life with these drugs either. I developed a plan with my therapist to get off the drugs and it was not only a personal goal, but a goal of therapy as well.  Coming down off of my meds was horrible. I could hear my heartbeat in my ears. I was even more irritable than normal. When I found that I was coming down and I was having a hard time, I often ran right back to the medicine cabinet. Cold Turkey was painful, so I started cutting my pills. It was so bad and I was such a bastard, my wife could tell when I was coming down and would often ask.

Ultimately, I went through the full withdrawal by talking with my doctor and flat stopped ordering them from the VA. It was a harrowing month for everyone in my house. Headaches, nausea, the ringing in my ears, erratic heartbeat. Getting to sleep was hell. But, I am so glad now that I was able to kick them. Losing weight was easier. My concentration improved. My creativity returned. Instead of an emotionally blunted existence, I was able to feel deeply again.

The Substitute

The short and easy answer to a drug alternative is pretty simple: stay in therapy (I transitioned out of “one on one” and into group), exercise regularly, and eat right. All of those things make a difference. I was and am regimented about therapy, exercise, and food. When any of them slip, I feel off balance. Attack those three with vigor and you will be well on your way to kicking the meds and living a more fulfilled Post Traumatic life.

Please comment if you are a Veteran or family member and still under the influence of the VA meds or had a similar story. As always, please share, and thanks again for reading.

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