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Operational Stress Injuries

Beyond their traditional pastoral duties, modern-day chaplains dedicate a significant portion of their time to counselling individuals. Many of those who approach the chaplains for this service suffer from stress associated with military duties. Accumulated stress or a highly traumatic event can result in serious and debilitating neurological problems such as post-traumatic stress disorder (PTSD). PTSD is defined as a 'psychological injury' caused by 'psychological trauma, such as that experienced on stressful operations or deployments' (Canadian Forces Health Services 2004). Senior officers and counsellors I spoke with noted that chaplains, owing to their close interactions with members, are often the first people to identify personnel who are showing symptoms of operational stress injuries (OSI). When they are trained as psychotherapists and professional counsellors they may be part of a team of professionals helping to treat people with these problems. Even as they attempt to help members coping with mental health concerns, chaplains face many of the same stresses inherent in military life. As a result, chaplains are susceptible to operational stress because of their own duties.

Chaplains are active members of the Canadian Forces Operational Trauma and Stress Support Centres (OTSSC). Canadian Forces Health Services (CFHS) established five of these centres across Canada to complement existing health services available to military personnel. The website for the OTSSCs notes: 'Military operations can expose military members and their families to extraordinary stresses, which can produce problems in their lives. Some of these problems may be characterised as illnesses, and some as normal reactions to abnormal situations. This array of problems can appear in the emotional, spiritual, psychological or social domains. They are sometimes manifested as substance abuse, addiction, depression, anxiety, or a variety of psychiatric disorders, one of which is posttraumatic stress disorder (PTSD)' (Canadian Forces Health Services 2008).

Although some chaplains might be trained as clinical counsellors, psychotherapists, or psychoanalysts, they can offer an alternative perspective for coping with stress and trauma. Increasing numbers of studies show a connection between spiritual well-being and healing from trauma (Brunschot 2006; Grant 1999; Jamieson 2006; Kalayjian 2002; Lancia 2000; Piwowarczyk 2005; Thompson and Vardaman 1997; Van Acker 2006), and chaplains working in these environments noted the connection. One chaplain explained, 'The chaplain is a spiritual part of the treatment to deal with the meaning of life and spiritual ideas. During the course of the psychotherapy they will name some anger at God - that they blame him - "Why is it like this?" "me?" "Why do you let so many people be left like this?" They feel confused. From a religious perspective, the belief that God understands is a big part of the healing. When people can feel that God is with them and that there will be justice at some point, there is comfort in that. On a tour of duty, for sure, we have people who turn away from God and others who turn toward him.'

A chaplain working as a clinical counsellor explained, 'Studies prove that many people who are well grounded in a good religious community and practise their faith are more inclined to have better mental health than those who do not practise at all or those who practise on their own. Chaplains give people opportunities to include spiritual and religious experience [in their treatment] to help them get over their PTSD. They use their religious beliefs to hold off PTSD and to manage it in a positive way.' Another padre said, 'People who have religion have hope. We can help people who are struggling to see that, even though they are having a hard time and they are dealing with something difficult, it doesn't have to be the way forever. Sometimes they just need to be able to talk about the way they are feeling and what they are going through. Sometimes they need medication. I try to listen to them and visit them and let them talk about their experiences.' A psychoanalyst told me, 'I know by my own experience [working with personnel], and I know from the research as well, that a spiritual component helps a lot of people to overcome PTSD. They have to hang on to something or relate to something. They have to see that what they've done over there was useful for the people - that they helped other people. Mainly people who think they have done nothing good suffer a lot and it's harder to treat them for PTSD.'

Chaplains who work in the clinics do not see religious belief as a 'magic bullet' for healing from trauma. Instead, they see it as another resource with the potential to aid in the recovery project. One chaplain explained, 'In some situations they will come away damaged even if they have religion. Religion can help in addition to social services and other resources - it can certainly help. The stronger a person's faith and sense of connection to God, that offers a whole new level of support they can rely on to get them through difficult times. Faith in God gives people a sense that they're not alone. Prayer can be a way to lift people's spirits and they're comforted to know that death is not the end - it's just a movement beyond. Your whole philosophy of life is changed if you believe in life after death and have a view of God.' Another person remarked, 'In the more severe types of stress there is a real sense of hopelessness and meaninglessness for the person. We [chaplains] offer hope and help them find answers. A lot of the time people already have the answers deep within themselves so we just journey with them through their suffering and they find what they need in themselves.' A chaplain working as a full-time member of a treatment centre said, 'We are open to hear about their spirituality or their religious experience. They know that I'm not going to ask them questions about these issues but they know I am open to hear about these issues and I'm not going to judge them. The psychologists are not prepared to hear about spiritual or religious issues. When you see their course of studies, there is nothing at all about human spirituality - it's all about the human sciences. They pretend they are really neutral but they are not neutral at all.'

Nearly all of the operational stresses experienced by personnel in military operations (with the exception of being expected to kill others if necessary) apply to chaplains. These stresses are compounded for chaplains who serve many personnel because they must be available 24 hours a day, leaving them few opportunities to manage their own stresses. Following the intense burst of peacekeeping efforts in the 1990s, the Mental Health Department of the Canadian Forces Support Unit in Ottawa prepared a program called 'Care for the Caregivers' that was designed to help chaplains deal with the stress and trauma associated with peacekeeping missions (Zimmerman and Weber 2000). The program was intended to improve chaplains' abilities to provide care in the field as well as minimize the stresses a chaplain experiences as a result. This program is now a regular element following difficult tours of duty.

Unfortunately, stressful military deployments and high operational tempo have practically become the norm since the program was introduced, and, despite this program, chaplains continue to suffer extreme hardship in the line of duty. A chaplain just returned from operations in Afghanistan remarked, 'The problem with a tour is that it's a long time to be "on" ... The longer the tour, the harder it is to be up and encouraging and positive.' A female chaplain added, 'Being the only person out there doing the job, you aren't allowed to have a "bad day." You've always got to be smiling and happy and up. Everyone else can have a bad day but you just can't and you've got no support out there so it's very hard.' A priest told me, 'The last [mission] was rough because I caught [a tropical disease] and I came back to Canada very burnt out. Physically, psychologically, emotionally, spiritually, I was empty. I was there six months. I was the only chaplain there; there was no social worker, no medical officer at all, for 500 people.' A Protestant chaplain told me that the worst part of his experiences during a combat operation was 'seeing the body bags come back and parading soldiers after the loss of a friend. Theologically, how do you reflect on that when you see how broken these guys are? You have to be able to keep offering pastoral care but seeing these things and being in these situations leaves strong impressions on you.' An Anglican said, 'It's a very lonely job because you can never say how you feel. As a chaplain you have no one to go to, but you learn to cope. You know, you take a little down time or you go off on your own for a while and then you come back ok.' A pastoral associate who had listened to horror stories of cruelty and violence from soldiers who had been deployed to Bosnia remarked, 'Sometimes when they tell you what they've experienced, it never really leaves your head either.' One chaplain who served in Afghanistan said that demands on a chaplain's time during a mission often make it impossible to address personal stress at the time. He explained, 'It's when you come back and start to process things that you realize what you've been through . . . We remain in our roles providing care to people in their grief even as we're going through it ourselves.' He continued, 'The closer you are to the people, the tougher it is to manage. Any chaplain worth his salt wants to be with their people when they're dealing with a loss but it's hard on everyone. You go through the rituals real fast - within 24 hours there's a Ramp Ceremony where the body is placed in the container that ships them home for the funeral, within 48 hours there's a memorial service, and then you're back to work.' Chaplains in these situations have few sources of comfort to rely on when they are on a mission.

As with regular personnel, chaplains understand there is stigma associated with needing professional mental health care. In fact, a chaplain dealing with operational stress noted that if it is difficult for personnel to seek professional mental health care then it is extremely difficult for padres to do so: 'It's hard to go to therapists in the CF when I'm also expected to be a padre to them! I compromise my relationship with them by unloading all my junk on them - then I can't be their padre! We're either going to have a few more guys punching out because they can't get over their experiences - or the attitude to operational stress has to change. There are a lot of CF people that still think PTSD is bullshit. We need to give permission and encouragement - especially for people who are being deployed all the time; we need to normalize ongoing professional self-care. Once that's a normal aspect of the career, I think we'll see chaplains being willing to talk about their issues. It's a crucial issue - it really is. The idea for this job is to have a long faithful run, not a sprint and a crash or to be the walking wounded, and there are some of us like that here now. But why should we be killing ourselves? Why should we hurt ourselves in this way?' However, chaplains do hurt as they subsume their personal needs to their military duties to serve others.

Chaplains who are not willing to seek professional care have developed a number of methods to cope with the pressures on them and to protect themselves emotionally and psychologically. Some of these methods include recording their thoughts in a journal or on tape, or relying on another chaplain. One said, 'You can learn over time to be more objective - that you don't have to own everybody else's problems. At first it's overwhelming but then you start to realize, yes, people have lots of problems, but you don't have to carry them all. You're there to walk beside them. To journey with them. You only have yourself to offer others. If you're hurting, you don't have anything to offer.' Another explained, 'The job [on a mission] can be challenging and hard but it is what it is. As long as I kept up the things that regenerate me - meditating, writing, etc. - then it was doable. It becomes hard when you don't do the self-care. You need to take that time. You could be busy 24/7 and work yourself to death but you can only last so long doing that. We can't allow ourselves to be overwhelmed by the mission or we don't help anybody.' One person described methods for self-care during a high-stress operation this way: 'I have to take some time and be on my own for a while. Because sometimes what they tell you is devastating and you just need some time on your own to process it. It's after those discussions that it's hard for me.' She described having counselled a soldier who had seen the gruesome death of a child and explained, 'After that I wandered around the camp for a whole day and a night because

I couldn't sleep and I couldn't get the images out of my head. I had to pull away from the group. I called home to my mother - she knows when to just let me talk. I have a few good supports like that - you have the other padres too, but you sometimes need just your own people, like a close friend or a relative. There are times when you have to pull away and be alone. Sometimes I would just leave the camp on my half day off to be away from everyone, but at the same time you reach out to the people that are closest to you, the ones you know you can really trust. I have to stop being a chaplain for a while - in my head at least.'

Like the personnel they serve, chaplains in operations experience all the pressures and strains of the mission environment. Unlike personnel, a chaplain must care for the spiritual and emotional well-being of hundreds of others with little support for him- or herself. On stressful and traumatic missions this becomes impossible and chaplains themselves can become incapable of continuing their military duties because of operational stress injuries. This was the case for some of the chaplains who served with the UNAMIR forces in Rwanda. Their emotional injuries resulted in their eventual release from the CF (Fowler 1996). Subsequently, there is a tremendous need for chaplains to be able to care for their own mental and spiritual needs if they are to remain effective with the troops. While they receive some training for this, they often serve as many as 700 personnel during a mission, meaning that, on a difficult mission, their services can be much in demand. Like personnel, chaplains do repeat deployments and are susceptible to accumulated stress. Further, like those they serve, padres fear the stigma associated with requiring professional mental health services. While there are some support programs in place to help them manage the inherent stresses of their role, it is clear that much more work is required to adequately address operational stress injuries.

The Canadian Forces Chaplaincy has changed much since its earliest days when volunteer clergy enlisted in order to minister to soldiers. Since the end of the Second World War, various sociological trends in Canada and North America have generated the need for new standards and policies to accommodate changing demographics within the CF. The reduction of forces following the Second World War resulted in bureaucratization that made the branch more hierarchical, but also ensured greater equality between religious denominations. Religious ecumenism, new religious individualism (including the loss of denominational identity), and the secularization of society that followed the turbulent years of the 1950s and 1960s created both opportunities for new religious alliances and struggles to meet a greater variety of spiritual needs - including those that are highly subjective and have no connection to an established religious group. New patterns of immigration ensured greater ethnic and religious diversity and engagement in all areas of Canadian society, including the military. The adoption of a policy of multiculturalism as well as a greater attention to human rights created a need to accommodate differences such as those that stemmed from the loss of moral consensus about subjects such as homosexuality.

Since the Great War, the CF Chaplain Branch has moved from predominantly Protestant elitism, to an ecumenical association with Roman Catholics, to an interfaith branch open to non-Christian religious groups, to supposed defenders of all military personnel regardless of creed or 'race or colour or sexual orientation' (Park 2003, 111). Instead of entrenching themselves in tradition and resisting the realities of modernity, chaplains have adapted and changed. By eliminating exclusive aspects of branch traditions, particularly in public settings, they normalized pluralism and acceptance of difference and held it up as an ideal for the rank and file. Further, by taking the lead on these types of potentially contentious issues, chaplains provided an effective example to personnel.

 
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