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Chat Transcript with Dr. Cantrell, February 27, 2008
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Educational Purpose NOTE: The chat discussion is intended solely for educational and informational purposes and not intended as medical advice. Please consult a medical or mental health professional if you have questions about your health.

No patent liability is assumed with respect to the use of the information discussed. The speakers and/or MarineParents.com assume no responsibility for errors or omissions. Neither is any liability assumed for damages resulting from the participation in the discussion or use of the information discussed.

The following is a transcript of the "Chat with Dr. Cantrell" from February 27, 2008. Links to additional resources and information from the chat transcript are included to the right.

Dr._Cantrell:
I am in Hawaii still, and it is a beautiful place. I have been doing all my reintegration workshops for the returning Warriors, and will be returning in July to do my Predeployment workshops as they are leaving again.

linda038:
We do ask that you ask one question at a time and let Dr Cantrell finish answering her questions

cdp123:
He has been back from his first deployment since October and leaving again in a few months

Misnmyson:
Do you have any questions for Dr. Cantrell?

cdp123:
not yet - just listening-recently finished Dr Cantrell's "Once a warrior ..." book

linda038:
What did you think of the book?

cdp123:
very helpful

Misnmyson:
My Marine hasn't deployed yet (and not foreseeable plans right now) but I've heard so much about this topic recently.

linda038:
Dr Cantrell, is it normal for them to distance themselves from their families and friends when they come back?

Misnmyson:
I presume that the more discussion the better for families suffering

Dr._Cantrell:
Yes, of course it is normal, they don't know how to relate often times, and they need space, they are no longer little boys and girls, but have grown and been into some very intense situations.

Misnmyson:
What are the warning signs to look for that they may be having trouble coping?

Dr._Cantrell:
If they are using alcohol to excess, isolating a lot, anger issues, and not engaging at all this could indicate that they are having issues. Their sleep may be very disrupted, and they may just not be able to engage as you would like

Misnmyson:
Should we approach them and confront this head on?

linda038:
How about their temper, seems my son had a short fuse and he used to be so mellow

Dr._Cantrell:
You can approach them gently, keep your eyes open, if you have a strong bond then they may confide that they are having some issues, but if not they may separate, at this point call the battle buddy, or another veteran and have them take them out for coffee.

Dr._Cantrell:
Tempers are normal, it is an essential part of a warrior, and it takes one above and beyond Fear which is paralyzing, but unfortunately if the anger is not dealt with it can certainly spiral out of control and cause major harm.

Misnmyson:
So they are more likely to open up to a COMRADE than a parent ...Does this "disorder" ever go away?

cdp123:
Dr Cantrell-do the post deployment adjustments get easier with each deployment?

marinemomjuli:
I donít think it will ever go away they have a bond with these brothers that we will never fully understand.

Dr._Cantrell:
Sure, but it depends on if the Comrade can do something to harm their career, they are very cautious of how getting help is going to impact their future. But I think getting them in touch with another person in a creative way may be a good way to do a gentle intervention.

MisnmysonThank you Dr. Cantrell - When the time comes I will read up more and purchase your book. Right now it's all just a little scary to project my son and myself that far...

Dr._Cantrell:
NO the post deployment adjustments do not get easier in most ways, but in some ways yes. For the most part the more they are deployed they know what to expect, so this is a good thing, but they also get more comfortable with being Down Range and away from home, so in that regard they often times get more into themselves and into their military mentality because they want to keep on top of their game and be ready and sharp to go.

Lauren:
Iím just watching until I have a question, my boyfriend will be returning from deployment soon so I want to see if I can "learn" some new things to help him when he returns

Dr._Cantrell:
What do you mean it is all a little scary, LET ME ANSWER THIS QUESTION PLEASE

Mom_Soz:
That's good

Lauren
- jump in when you are ready

linda038:
I think like all of us, we didn't want to think about deployment till we really needed to.

Dr._Cantrell:
Don't wait, get real and start the process of dealing with things before they begin. Sure you can never truly know how it will be but prepare yourself, have your support system intact, have a backup plan in case you need help for your Marine, know the protocol. Knowledge is power and it will go along way in case you need to act quickly.

marinemomjuli:
Dr Cantrell, my son - a purple heart recipient - stood outside the VA with me and said with tears in his eyes 'What if they donít find anything wrong with me, what if they donít believe me...then what, Mom?' What do I tell him, to give him hope? He has all the signs of PTSD & TBI.

Dr._Cantrell:
You NEED to have someone go with him, who is a veteran, who will demand to be at his side. This is a very upsetting scenario. I am so sorry your son feels this way. I tell the 7100 soldiers who I have been working with here in Hawaii to be their own best advocate, get all their records, keep them safe, save emails, as these are also documents which can be used for supporting evidence. Right now we are dealing with not only PTSD, and Traumatic Brain Injuries, and it is very much an issue.

marinemomjuli:
I found out that day in the Doctor's office at the VA (he had me go with him) his vehicle took 8 direct hits from IEDs and 50 hits within 100 yards

Dr._Cantrell:
I cannot diagnose on the Chat room, but I would say he needs to have a very good neurological assessment, and there are also ways to deal with these types of injuries, and many of the symptoms are similar to Stress.

marinemomjuli:
I also found out he patrols the parimeters of his house and is hyper sensitive to making sure his house is secure...all of this natural??

Dr._Cantrell:
One does not have to have a direct blast, they can be affected by the Atmospheric pressure change from the blast, and subtle internal injuries can occur.

marinemomjuli:
The VA has him set up for an MRI and CAT scan and they have scheduled a Psych exam

Dr._Cantrell:
Patrolling their homes is very common, they want to assure that they are safe and those in the house are safe. This is because this was essential in maintaining safety on the bases and in their units. This is also a sign of stress. These behaviors are a direct result of their training, and their combat experiences, some are adaptive, and some are not.

marinemomjuli:
Last question, I am hearing the two PTSD & TBI have mirroring symptoms...is this true?

Dr._Cantrell:
Yes, some are similar, but the origin is different. There can be memory issues, sleep disruption, confusion, headaches, and those type of thing with both, but there can also be visual problems, and more cognitive type of issues with a Traumatic Brain Injury. If you know that your Marine has experienced a blast of some sort, or a head injury from a fall or blow to the head from being hit, or a Vehicle situation encourage them to get an assessment and keep a record of what is going on for them.

marinemomjuli:
He has been hit, knocked unconscious for 4o minutes.

Dr._Cantrell:
One of the coping mechanisms is using a notebook to write things down, to jog their memory, this is a good idea, and to have less chaos in their lives, to simplify, and to let people know that they are having a problem with connecting the dots. 40 minutes would certainly qualify as a TBI, and he might find that he gets easily frustrated with himself, because his reaction time might be affected, he might not remember things, and lose items. This in itself increases anger.

marinemomjuli:
EXACTLY...you hit the nail on the head. He canít remember anything, dates conversations, appointments

Dr._Cantrell:
Be gentle with him, and help him get help, we do not know the long term implications of these types of wounds, but we do know that they are the signature wound of this war, so many are being affected in this way. This is nothing new from the wars in the past, but now we have much more awareness, and need to take care of our Warriors.

marinemomjuli:
Thank you so much I read your 1st book, passed it out to family and friends and canít wait to read your second.

ellen:
My son has had 2 tours in Iraq, he is a machine gunner. He is scheduled to end his active duty very soon. He had been in contact with us on a regular basis and now has avoided all contact- will not return phone calls, emails, etc. I am quite concerned about him. Should I leave him alone and not try to contact him?

Dr._Cantrell:
So have him write it down. Even stress will impair their memory, and the way they are coded, so encourage them to use aids, notebooks, keep things in the same place be organized and of course we know how organized our Marines are.

Dr._Cantrell:
Thank you very much, I am glad you enjoyed our first book.

Dr._Cantrell:
What is the protocol? I know in the Army you can contact the Family Readiness Coordinators and they will find out if there is an issue. Sometimes, this is a sign that they are in a place that doesn't have good access to internet or cell phone, or they could be on an operation in which communication could give out information to the enemy, we just don't know. But if you are concerned find out from the conduit if all is well with your son.

gumhealer:
Ellen, is your son stateside?

Ellen:
Yes, he is stateside now, waiting for discharge from active duty.

marinemomjuli:
Ellen, my son did that also...which triggered my concern because he was always close.

Dr._Cantrell:
Yes, if there is a distinct change in behavior, check it out seriously because he may be crying out for help.

marinemomjuli:
I think the dr is right...in my sons case it was a cry for help. I actually confronted my son on it...

ellen:
I don't know how to contact him, he won't respond to any calls or emails. I thought about flying out to see him

cdp123:
Could he be suddenly getting worried about being discharged and everything in his life about to change as he becomes a civilian again?

ellen:
I think that may be the case, I think he may be scared about his future and leaving his buddies

Dr._Cantrell:
If you think that he is backing off he may be overwhelmed with his own emotions. Get someone else to get in contact with him on a casual basis and see if this will stir up a connection.

ellen:
We think he is a binge drinker, we had a "drink and dial" phone call from him several weeks ago- he sent an email after that that he "felt let down", whatever he heard was in the fog of alcohol.

Dr._Cantrell:
Sometimes they are very concerned about getting discharged, and Once A Marine Always a Marine, and they love their jobs, they love what they do, and there is a lot of remorse and a feeling of loss when they get out. They lose the brotherhood, and their sense of purpose, so they get blue and need to find a new way to be productive and find meaning in their lives. Alcohol unfortunately is a form of self medication. These Marines go through a tremendous amount and they are good at what they do. They have a tremendous amount of pride and have a difficult time admitting to themselves that they are affected by their war zone duties.

ellen:
Should I respect his need for distance right now? He is supposed to be discharged next month.

Dr._Cantrell:
I read just recently where a Marine Lt. Col or Col said "we are an elite group and we don't have PTSD", well I this is not true, they are human being, with hearts and souls, and they are affected by some of the things they must do in order to do their jobs well. It is normal to be affected. Yes, do respect what they are asking for. They must ease into their lives gently and at their own pace. If you impose your expectations upon your Marine, it could cause some distress in your relationships. Give them distance, but keep your eyes open for red flags.

ellen:
thanks for your advice, he is my oldest (age 23), I have 2 teenagers at home and we are all so worried about him.

Dr._Cantrell:
Keep your teenagers at bay and do not let them invade his privacy.

ellen:
I Have "Warrior for Life" but haven't given it to my son yet.

Dr._Cantrell:
Wonderful

marinemomjuli:
I gave my son Down Range but he couldnít stay focused to read it...so he had his girlfriend read it to him...lol

Dr._Cantrell:
Thatís ok, this is why it is written so they can read it and put it down.

ellen:
This has been a long 4 years for us, I was really looking forward to his discharge. I have been so grateful that he survived 2 tours in Iraq, but I am now very fearful for his return to civilian life. Anyway, thanks for your insights and the books you have written.

Dr._Cantrell:
You are welcome, just be there for him, abandon expectations, let him pace himself into the reintegration.

marinemomjuli:
I think the hardeset thing for me was the son I gave to the Marine Corps was not the boy I got back...after I understood that I could deal with things better

Dr._Cantrell:
This is also very good that his girlfriend read it with him, because she is learning as well and gives them a stronger foundation from which to begin their journey

marinemomjuli:
she is good...she's a nurse.

Dr._Cantrell:
Yes, there is no more Square One, as we wrote in our book, they have changed, you have changed. Change can be an opportunity to grow and really know oneself.

ellen:
I think the hard part for me is him being in a world which is so foreign to me. I don't come from a military family, it feels like some "cult" and he has experienced things that we can't relate to - it must make him feel different from us, we have grown in different ways in these years.

Dr._Cantrell:
She has compassion and empathy, Yes, they are different than you, and we will never understand their experience. The military is a culture within a main culture. They have their own language, dress, customs, celebrations, ways of dealing with things within the ranks, so it is a culture and if you are not a part of it you are on the outside of it. This does not mean that you cannot learn about it and honor your Marine for his dedication and commitment.

linda038:
Does anyone have a question for Dr Cantrell?

Dr._Cantrell:
I would like to ask a question.

Dr._Cantrell:
For those of you who have had your Marines come and go, what are some of the issues you see that concern you the most?

gumhealer:
Drinking is a big one.......I see you addressed that already.

linda038:
Temper is a big one, and drinking and him not wanting to talk about anything

gumhealer:
Yes, that too, Linda..........

linda038:
Says he can deal with it himself

gumhealer:
Mine slept a lot (maybe cause of the partying?), or says he ďisn't that bad"

MaynardsMom:
Mine has gone but hasn't come back so no concerns yet

linda038:
Nightmares. He still wakes up yelling.

gumhealer:
Ben has stopped that.

linda038:
He scares the heck out of his fiancť.

gumhealer:
He says he doesn't dream much anymore either.

linda038:
Is all this normal??

marinemomjuli:
Mine seems hyper sensitive...always apologizing

linda038:
It's been two years.

marinemomjuli:
Itís been a year...

marinemomjuli:
Mine has nightmares all the time, will wake up sweating, he thinks all of everyday problems as the enemy. He deals with things like itís a battle to be fought and won.

Dr._Cantrell:
Yes, it is all normal. They are working through a lot of trauma. The Marines have it pretty hard. They have intense situations. They self medicate, and their nightmares can be intense. Post Traumatic Stress Disorder PTSD see the post word this means it can happen years down the road, but it does not have to take over their lives. I have a friend who says "I have PTSD, but it doesn't have me". I love this saying, because this means that he realizes that he has issues, but he has learned to. Life of death, Black and White, Enemy or Friendly, it is an interesting way of contrasting life in general.

linda038:
BUT, they have to want help. Seems they stay in denial a long time

marinemomjuli:
I had a Vietnam Vet tell me recently that PTSD is an emotional scar from a traumatic event...war. My son was so afraid he had a mental disorder...itís an emotional scar...

Dr._Cantrell:
Yes, PTSD is an emotional Scar, it is a wound of the soul, and often times, it is the soul that is the casualty of War. It is a reaction to something outside the realm of normal human experience. Yes, they must want to get help. You can lead a horse to water but you CANNOT make them drink

barb822:
Is it because they are so indoctrinated into believing that emotion is a sign of weakness?

marinemomjuli:
My son was in the Battle for Fallujah...lost many brothers...how can I help him deal with the loss?

Dr._Cantrell:
Denial is a coping mechanism, and it is adaptive for a while, and we ALL do it. But there comes a point where it no longer is affective. Yes, it is part of the CULTURE. Buck up and be a man, pull yourself up by your boot strings, Men don't cry, these are all belief systems that are given to our sons, by our culture. They are expressions, but they do not take away the wounds of the soul.

linda038:
My son started a job at the VA med center and has run into a few of his friends that he was in Iraq with. He says they seem so different. He doesn't realize he is different too.

barb822:
I truly believe that Dr. Cantrell. My son has said that it is his soul that has suffered most.

Dr._Cantrell:
Help him to do something to remember his brothers. But let him reach out to you on this. Sometimes it is much too fresh to relive. This is extremely painful and sometimes they blame themselves.

Dr._Cantrell:
This is great your son is working. Yes it is sometimes difficult to look into the mirror isn't it?

marinemomjuli:
After he was taken out because of his injury his buddy was put in his place and he suffered a worse injury...when my son is drinking he'll bring this up saying it should have been him.

gumhealer:
My son has called the mothers of his fallen friends on the anniversary dates. He doesn't talk about it to us though.

Dr._Cantrell:
Yes, the soul can endure a lot, but there comes a time when it goes beyond the ability to cope. The human spirit is quite resilient, but to have to do the things they do, and see what they see are inconceivable to us here who will never understand.

HOLD ON PLEASE one at a time.

linda038:
Thatís Dru's favorite saying. Why talk about it, you wouldn't understand anyway.

Dr._Cantrell:
Your dear son, more than likely holds himself responsible for the wounds his friend sustained. This is a very heartbreaking situation, but this is where forgiveness comes into play and he and his friend probably would both benefit from an exchange and discussion. No we won't understand, they feel "well what the heck, why even go there, you don't have a clue", but you don't really need to understand you just need to love them, and be aware of your interactions with them.

linda038:
I had told you before the only person he really connected with was my dad. He is a WW II vet.

barb822:
Your book "Down Range" taught me to reinforce to him that I will never truly understand but I a always here for him.

linda038:
They share a lot.

Dr._Cantrell:
Yes, these are the amazing gifts that come out of a Warrior going off to war, those who have served in the past now connect with them. These young Marines and Soldiers have earned the right to hear their eldersí war stories.

gumhealer:
Thatís an interesting way of saying that.......I'll have to rememember that.

Dr._Cantrell:
Wonderful, yes, you want to reinforce that you love him unconditionally, don't focus on what is wrong but praise that which is good and brings joy right?

barb822:
Amen Dr. Cantrell...and thank you for teaching us that in your books

Dr._Cantrell:
You are most welcome. You have no idea how touching it is to hear that these books are helping in some small way. It doesn't get much better than that. Thank you.

marinemomjuli:
THANK YOU! I am so glad there are people dedicated to this cause

cdp123:
Yes, thank you Dr Cantrell.

linda038:
Yes, thank you Dr Cantrell, the book was very informative.

barb822:
Before I read your books I did not really understand how to communicate with my son. Now I have learned to let him communicate with me, I listen

Dr._Cantrell:
We are all in this together. Thank you for being so supportive of your Marines and our service men and women, this is affecting so many families as well. Yes perfect, let him come to you. Asking questions will turn them away. Remember they must crawl at their own pace. Just have a discussion about something not even related to Marines is a really good place to be.

barb822:
Through your books I learned that the less I talk, the more he will open up.....thank you, it has given me my son back

Dr._Cantrell:
Yes, this is also true. They are able to get the picture from just a few words, and we tend to go on and on, and we lose them it is sensory overload to them.

marinemomjuli:
lol....I can relate to that

barb822:
That is so true.....you are definitely echoing his past words to me, Mom you go on and on, it wears me out!

Dr._Cantrell:
Just the facts Maíam!

MaynardsMom:
Not you barb!!!

Dr._Cantrell:
Yes, they get worn out and then they shut down. They speak in Acroynms and all these words are tooooo much!!!

barb822:
So very true....and I would have never known how to adjust if it was not for this site and reading your books that have been highly recommended to me.

Dr._Cantrell:
Thank you, yes this site is fabulous

barb822:
Will you be writing more Dr. Cantrell?

Dr._Cantrell:
Yes, I am writing a third book now. Of course you bet. I am working on getting out there with my workshops to all branches, and since I have been here in Hawaii for four months working with the Army troops it has been good.

wailuku:
One thing I have learned is to take my cue from my son, to be observant, to listen. Talk about anything except the Marine Corps then he'll say something that gives a hint of his real thoughts and it's like a treasure to be kept.

barb822:
I am so jealous Dr. Cantrell, my son is in Hawaii right now, I so wish there was programs for the Marines by you.

Dr._Cantrell:
If the Marines want me to do things for them I am available. I spoke for the Hawaii National Guard a couple of times while here and the Air Force are working out some things as well. I will go anywhere I am called. Yes, to take your cue from your son is perfect. They set the stage. Yes, this is right steer away from Marine stuff, take it somewhere where they can also get away for the Corps. They need an emotional break.

Wailuku, you have very good insight this is very true, listen with both ears and talk less, this is why we have two ears, and only one mouth. ha ha

I have found that the commanders in the Army are really wanting to be open as they see that they cannot maintain their troops if they don't keep them healthy on all levels. Unfortunately, stigmas get in the way of help sometimes

barb822:
Thank you Dr. Cantrell, once again I walk away with more info on how to handle things.

Dr._Cantrell:
Perfect, I am so glad to help out if I can.

barb822:
Goodnight to all of you, juli I will keep your son in my prayers. Sue & Edina.... thanks to you both, and wailuku you are one smart Marine mom!

marinemomjuli:
Thanks barb....this was an awesome group.

Dr._Cantrell:
Good night everyone, and my prayers are with all of you, your families, and your MARINES!!

wailuku:
Aloha and Mahalo

MaynardsMom:
Thank you Dr. Cantrell!!!

Dr._Cantrell:
You are most welcome, until next month take good care of yourselves.

   
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