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Columns   |    
Personal Accounts: Reaching Out
Donald R. Bramer, LT.J.G.
Psychiatric Services 2012; doi: 10.1176/appi.ps.631010
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Lieutenant Bramer, a native of Louisville, Kentucky, is a decorated naval officer living in Washington, D.C., and a veteran of multiple tours during the Iraq conflict (e-mail: drbjrdc@gmail.com). Jeffrey L. Geller, M.D., M.P.H., is editor of this column.

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By the time I returned from my third deployment in the Middle East, I found myself dealing with my own demons that resulted from posttraumatic stress disorder (PTSD). I realized that when service members return home, we have yet another fight—a personal war within. Like the battles we fight on the front lines, no matter how tough, resilient, or hardened we think we are, this too is a battle that cannot be fought alone. For necessity and survivability, I enlisted in a very aggressive program that included individual and group sessions facilitated by counselors and volunteers. Through this experience, I gained not only a new respect for those who give unselfishly of themselves to help those less fortunate but also realized the rewards and healing power that are possible when giving back to others.

Holding true to my own nature, I used my personal situation as a period of growth and began to research and collect as much data as I could find on PTSD. My counselor threatened in a joking manner that he was going to take my books away if I did not allow him do his job. Yet, each time I arrived for a session, I had my books, growing ever so tattered, each page blanketed with Post-it notes and marked with trails of highlighter. Soon, however, I trusted my counselor to become my teacher, and while I was learning to embrace my own experiences and developing insight about myself, he guided me to a path where I could direct my own training and understanding of human behavior toward something less tactical and more personal.

From my own experiences, both growing up and in the military, I realized that there were several areas where I might be able to make a difference, even if for only one or two people. I had experienced firsthand the failings of our military in their lack of support for the emotional needs of many veterans returning home. I had also dealt with the shame, ridicule, and guilt of growing up as a gay youth in the South. Two projects here in the D.C. metropolitan area that I heard mention of and immediately came to mind were the Trevor Project and the U.S. Veterans Initiative (U.S. Vets). However, taking these on would mean an investment not only of time but of self. To be effective, I would have to once again leave my comfort zone and allow my own vulnerabilities to show, to connect with others and help them through the healing process. I would have to open up and lead the way to that individual or group, just as had been done for me not so long ago.

Each day I drive past a homeless shelter that is ironically only two blocks from the steps of the U.S. Capitol—a route that I have walked or driven more times than I can count since coming here to Washington, D.C. One day, I noticed a young man who appeared to be in his late twenties. What caught my attention was that, as part of his frayed wardrobe, he had a desert Gortex jacket and a pair of desert combat boots. The entire drive to work that day, the memory of this young man weighed heavy on my mind. I thought of our differences and our similarities. I wondered what happened, how had he came to this point in his life, and could that have been me?

It was at that point that I began to further investigate the issue of homeless veterans here in our nation’s capital. My quest brought me to the U.S. Veterans Initiative and a new friend, Emily Button, who is its program director. Emily welcomed me with open arms, and within what seemed no time at all I had developed a program all my own for the group. On Wednesday nights, I lead a weekly program that focuses on returning veterans to employment, by improving their skills and employment potential. Of the many responsibilities that I have acquired, one of them is to work with veterans looking for jobs and provide guidance on their applications and job search issues throughout the week. This small effort helps makes a structured weekly employment service possible for these vets. In addition, I reach out to members of my social and professional network to assist veterans in their employment search and engage others in helping them. This guidance and insight ensure that veterans applying for federal jobs understand how to qualify for veterans’ preference and push forward high-quality applications. This role has helped shape the program’s capacity and had a measurable impact on the stability and progress of the veterans served through the program.

In a letter to my command this spring, Emily Button wrote, “Lieutenant (J.G.) Bramer is an amazing asset to our work. Veterans who sometimes isolate or decline services enjoy working with him and willingly travel across town to seek his support when he leads our workshop. He shows unfailing concern and engagement with veterans who face many challenges and has been of concrete and meaningful help to every veteran he has worked with.” Yet, the biggest reward of all comes to me Monday through Friday of each week as I pass the elementary school in my neighborhood. As I leave for work, I am stopped by a school traffic guard as he directs the children across the street. Most people would not give him a second thought, but he is there in the rain, snow, and sun and always has a smile, a wave, and, for me, a salute. I know him as Mr. Edwards, and I remember him as one of my first vets and am reminded of how we worked on his application and rehearsed his interview.

In retrospect of my time with U.S. Vets, I can say with certainty that there has been an aspect of ethical development in each of the five components described by Craig E. Johnson in his 2006 book, Ethics in the Workplace: Tools and Tactics for Organizational Transformation. It goes without saying that we develop in some areas more than others. For me, the two sections that most resonated with me dealt with discovering one’s vocation and developing character, which I discuss below, but I will first touch on the other three—“Facing the Shadow Side of the Personality,” “Identifying Personal Values,” and “Drawing Upon Spiritual Resources.”

The first concerns the “shadow side” of the personality. This concept reminds me of an old song by Bruce Hornsby, in which he describes a culture of insensitivity that can be seen in many—a sense that if you look the other way, then the situation doesn’t exist. I was no different. Living in a large city, not a day goes by when I am not approached for money while walking around or when I’m in my car stopped at a traffic light. It doesn’t take long for us to dehumanize these people and allow them to blend into the scenery. Overcoming that shadow side of my personality and reaching out to these individuals was a challenge. I recall cringing when I received my first hug or handshake from one of the folks at the center. Now I embrace their affection and the bond of our relationship.

Identifying personal values is probably the area in which I feel my work with the U.S. Vets has had the least impact. I have always had a pretty sound set of moral and ethical values, which I believe come from my faith, military service, and a fairly strict upbringing—I spent 12 years in parochial school. One real change, beyond knowing my personal values, was in acting on them. Life as a whole, coupled with my multiple combat tours, certainly affected my perspective on these values, yet this experience made me realize that some of the simplest things are the most important and, again, put a face on the hardships that life presents us.

In considering Johnson’s component about spiritual resources, my time with the U.S. Vets has probably served both the veterans and myself. For me, this was a process of healing and reward. I discovered a way to capture the skills that I had that concern understanding human behavior and apply them in a completely different area. My perceptions of body language, microexpressions, and neurolinguistic programming allowed me an opportunity to connect with these vets in a way that became a gift to both of us, as together we worked toward a greater good. Each week in our workshops, we shared our experiences and realized that there was still a great deal of work to be done and that we were very capable of doing it. Spirituality can come from many places, even a homeless center—the same peace and comfort can be found there, just as in a church. Through my efforts and the efforts of several other volunteers, many of my vets felt that they were able to redeem themselves of the shame and guilt that they carried, and, once again, they found value in themselves. This process has served me as well as those with whom I have connected. It has been healing and spiritual and even revelatory. Through this experience, I have tapped into one of the most important of Johnson’s components, discovering one’s vocation or calling. The time that I have shared with these vets has provided a self-actualization, in which I found that the skills and abilities that I used in the military theater and in my professional career could be used in another area of my life and perhaps in a more personally rewarding way.

Yet I also found my role in the intelligence field to be rewarding. There is no greater satisfaction than to identify, locate, capture, and prosecute a sniper who has been targeting young service members and triggering improvised explosive devices on a convoy. Apprehending such terrorists and taking them and their associates off the street gave me the satisfaction that at least one more Marine might make it home safely to his or her family. However, intelligence collection and interrogation can be mentally exhausting and over time can lead to questioning one’s personal values. My time with the U.S. Vets restored those values and allowed me to regain faith in my abilities. My service with this group helped vets to find their vocation, and in that, I found my own satisfaction.

Developing character, the final component of the five that Johnson discusses, is to me the most important. When ethics are discussed, it almost always seems that the notions of integrity and character run parallel as elements of virtue. Cases are lost at trial if enough doubt is raised with the jury in regard to a person’s character, elections are won if enough voters believe in the character image a candidate presents, and a father may bless the marriage of his daughter if he has faith in the character of the man who seeks to be his future son-in-law. Character is a commodity. Everything that we do and every action that we take or don’t take reflects our character, and it allows others to define us. For me, my involvement with the vets has allowed me to realize the importance of giving back instead of being one who just takes from life and of sharing the gifts that we have, if for no other reason than it’s for the greater good. It is contributions such as these that set us apart as role models to others so that they may reach their potential.

For many, the notion that a warrior or war fighter can have ethics is a contradiction of terms. Sun Tzu debated it in the Art of War, and General William T. Sherman joked about it in his scourge through the South. To some, the perception of fighting an ethical war eases the conscience and justifies the actions of destruction. War is hell! It leaves many scars in its wake; some visible and some not—wounds that heal or, for some, never heal. I have friends who have lost their limbs or their sense of self, and I have friends who paid the ultimate price of war with their lives. I have decided the fate of men and taken the life of others. Guilt and helplessness are only natural, for we are all human, but we are not alone, and by accepting that, we find peace and satisfaction within ourselves.

If you can walk away from the past, or any simple event for that matter, and still see the human side of our actions, then there is hope, and all is not lost. We must never lose sight of the faces and emotions in them. We must continue to realize that although we may test ourselves and at times put our own values on hold, we remain who we are. Our sense of self will come back, and the incidents we experience, both good and bad, can, if used properly, make us better people. Often, all it takes is the ability to see something through the eyes of another. We must hold our values dear; no matter if we are rich or poor, they can never be robbed from us. Character, integrity, and compassion are what separates us from the others and allows us to lead and be that example. It is a duty.

Having grown up in a fairly conservative Anglo-German Catholic family from Kentucky, I learned early that we did not air our “dirty laundry” outside of the home, nor did we show or discuss emotions. Looking back on this and at the stoicism impressed upon us in the military, I think these are probably the biggest contributory factors to the culmination of my PTSD after my third deployment. Opening up and sharing thoughts, emotions, and experiences were something that a person of my makeup just didn’t do. It was my biggest obstacle in the counseling I sought, and early on in my work with the vets it became difficult again. I found it very easy to get veterans to engage with me, but I realized that true results could only come if I engaged with them and opened up to share my own experiences; it would have to be quid pro quo.

In addition to my weekly workshops and group sessions with U.S. Vets, I have joined its advisory council to assist the program with administrative planning and resource development, in order to help us achieve long-term expansion and service development goals. Taking on this new responsibility allows me to reach out to the community on behalf of the program and ensure that critical support is provided in the organization’s efforts to serve more veterans. I have also become involved in another volunteer effort here in Washington, the Henry Clay Scholarship for Public Policy Intern Program, of which I have become the chairman. This program benefits Kentucky’s college juniors and seniors by providing them an opportunity to spend a semester in our nation’s capital and be assigned to assist in an office in the U.S. Legislative or Executive branch. My efforts not only allow me the chance to mentor some of Kentucky’s brightest but also to reach out to businesses in the Commonwealth of Kentucky to raise funds in support of this program. In many ways, each of these programs—U.S. Vets and the Henry Clay Scholarship—has been extremely rewarding and healing.

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