This program is funded in part by the following.

Addiction, anxiety, mental health.

How do we address our traumas?

And how do we begin to move forward?

The path to healing and understanding is through candid conversation.

I'm Aisha Sultan, and this is Things We Don't Talk About.

Many people associate PTSD, post-traumatic stress disorder, with combat, with soldiers coming home from war carrying invisible wounds.

And that can be very true.

But it doesn't tell the whole story.

About 13 million Americans are living with PTSD in any given year.

Most of them have never set foot on a battlefield.

The wound doesn't care where it came from.

It only knows that something happened, something the mind can't let go of.

Today's guest knows that firsthand.

He's a clinical psychologist who spent his career helping others heal from trauma.

He's also a veteran who has lived with PTSD himself.

What he's learned from both sides of that experience is something no textbook could have taught him.

Today, he's gonna share his story and the science of what PTSD actually is and why getting help is not a sign of weakness.

I'm joined by Dr.

Jordan Fields who will share his journey with PTSD.

Dr.

Fields, thank you so much for coming back on our show and for talking to us about this really important issue.

- Thank you for having me.

- Now, I mentioned in your introduction that you have spent some time in the military.

Can you tell us where your interest in that actually began?

- Yeah, I actually can remember very clearly the day that everything changed in my life.

So I was a senior in high school.

I played football and it was after our second game and I was walking into the high school and I saw a group of people standing in front of some TVs in the high school and I put away my gear and I walked back out and as I walked out I saw the second airplane flying to the tower on 9/11 and that was just kind of a transformative moment and I think like so many people in my class that year that kind of changed the way that I was thinking about the world around me about safety and kind of an actual protector and that really changed my trajectory to really want to think about how can I protect my family, how can I protect this country and so that kind of set me on my trajectory towards the military.

- Right, that was a pivotal moment for everyone who was old enough to realize that something hugely traumatic had happened in our country and it changed the lives of I feel like all of us in really profound ways.

Tell me how it changed your path of what you did after high school and in college.

- Yeah, so it was interesting 'cause I actually was at that point thinking about going into one of the military academies.

That was something that I wanted to do at that point.

I said, hey, I could consider going to the Air Force Academy but my parents didn't want me going to the military because we knew there was gonna be a war starting.

- Right.

- But I was a senior, so I went to college and I was away from my family.

I had some autonomy and I decided to join ROTC.

So I didn't tell my parents, I joined ROTC and that kind of set me on the path towards the military.

- What did you study?

- So I studied psychology and Arabic.

- Okay.

- Yeah.

- And then where did that lead you after you graduated?

- Yeah, so it's kind of interesting to me in that I was studying psychology and Arabic and my plan actually at the time was to go into the CIA.

So at the time, you know, the CIA needed Arabic speakers, they were recruiting out of my university and I was going to go into the army, do some work there and then transition to the CIA.

I actually had a significant injury during my football career, had shoulder surgery and ultimately I got disqualified from the scholarship that I wanted to get.

And that kind of didn't dissuade me.

I was still an ROTC even though I couldn't go into the military.

So how did you transition into being able to serve in any capacity or work?

Like what were you able to do?

So I didn't go in at that point, but I decided that what I wanted to do is consider going and studying trauma and PTSD as a graduate student.

So after I got out of college, I decided to go get my PhD in clinical psychology with a focus on PTSD and trauma.

And so while I was in graduate school, the military came recruiting again.

So the Army came recruiting, the Air Force came recruiting.

And at that point, they said, "Hey, we need psychologists, we need doctors."

And they're willing to waive the injury that I had and allowed me to come into the military as a psychologist.

- Oh, wow, I didn't even know that that could be done.

And so how was your family reacting to it at that point?

Because you were still going to go to an active war zone.

- So at that point, my focus was really on treating those who serve, right?

I wanted to serve those who serve, and that was my focus at that point.

So while I was interested in, I wanted to deploy at that point in time, I didn't know for sure, because of the way deployments work, you may or may not deploy.

And it was actually, I didn't deploy until my third year in the Air Force.

So I didn't know, but my family, they were not happy necessarily with the fact that I had chosen to join the military, but it was my life, and this is what I wanted to do to make sure I was taking care of our service members and to take care of the country.

- And this was a purpose that you developed at a really like transformative, pivotal age with a moment that changed the trajectory of your life.

So once you do get deployed, what happened there?

- Yeah, so the deployment of itself was really unique in of itself because I was a traditional hospitalist.

So I was working in the hospital, I was supervising interns in our clinical psychology residency, and I actually got tasked with a special operations deployment to Afghanistan.

So I was in the role of a SEER psychologist.

So SEER stands for survive, evade, resist, and escape.

And really my primary duty when I was deployed was to go out with our hostage recovery team and to co-lead recovery of our nationals, of service members, and members of our allied nations to help them to transition back into whether it be civilian life or military life.

And then the other part of my job was to take care of the base.

So I saw clients or patients in the hospital, and I was kind of just doing all of that sort of stuff during my deployment.

- So you would go into situations in which someone had been taken hostage or kidnapped in any capacity or taken as a prisoner and then help them transition and process what they had gone through.

- Yes.

- And then also people who were living on the base who were going through things, 'cause it's a very high stress situation, of course.

A lot of trauma around.

Okay, so while you're doing that work, you experienced and saw something that really profoundly affected you too.

Can you tell us a little bit about that?

- So it was about a month into my deployment and it was the most bizarre day.

It was on Veterans Day in 2016.

And it just so happened that they were doing a fun run on that day.

So a fun run deployment is kind of one of those activities that's a multi-service engagement for all of us to just have some camaraderie and socialize.

- So it was like a mile run or a five mile run or something like that?

- Yeah, yeah.

And I was supposed to go to it with my roommate.

And we happened to sleep through it, which I never sleep through things, which is kind of just different.

But we slept through it.

And we woke up to that morning to one of his sergeants, one of his, one of the members of his group, banging on our door, telling us that, "Hey, we're under attack.

You need to get up.

And what are y'all doing?"

So it was kind of bizarre.

So we were kind of surprised because we hadn't heard anything.

- You didn't hear like a loud explosion or anything?

- No, we didn't hear anything.

And we were just kind of like, is this really happening?

So we go through the day and we're starting to learn more and more about the event.

We thought it initially was a mortar round that had come in and had hit something and had hurt some people.

As the day progressed, we start to learn a little bit about what happened.

And it wasn't until the end of the day that we learned that there was actually a suicide bomber that had been, they had been gathering materials to develop a suicide vest over the course of a matter of months.

And they had been sneaking onto base and then they blew themselves up at the fun run.

And at the end of the day, my roommate, who happens to be the public health officer for the base, the criminal investigation division of the army came to public health to ask for help with retrieving items that were left down at the site of the explosion.

And I was with him and that was my battle buddy.

So I decided to go with him.

And so we went down to the site of the explosion to pick up the things that were left behind.

And we didn't know it, but we would also be picking up remains of people.

I can only imagine how difficult that must have been.

How do you get through a situation like that?

Can you tell me a little bit about how?

You know, I think sometimes when you are going through situations like that, you shut off parts of yourself.

Sometimes you have to push down some of your emotional experience so that you can just deal with it.

So you can deal with the things that you're seeing, the things that you're smelling, the things that you're touching.

And I remember very acutely thinking about like having to tap down on my emotional experience and kind of put them in a closet and just do what needs to be done and pick up the different things that I was seeing and smelling.

Yeah.

I mean, how do you prevent yourself from having a response like crying or throwing up or passing out because you're seeing something so graphic and having to, you know, like you said, touch and deal with things that most of us are not equipped to deal with?

Yeah, I will say that there were times when I thought I was going to throw up with certain things that I touched or were shown to me.

I think, you know, in the military, especially during horrible times, you know, humor is something that people use as a coping mechanism.

And that was no different.

There came a point when people were using humor to try to get through this experience.

Because there was 15 to 20 of us out there kind of basically in a line picking up everything that was out there.

And it was, it felt bizarre and strange.

It felt so surreal.

Yeah.

To some extent, because it was outside of the realm of normal human experiences.

Right, right.

And it's not something that anybody can prepare you for, and it's not what you had been prepared for going out as a psychologist, to have to be dealing with the remains of an attack like that.

And so once that experience happened, once you got through that day, how did it affect you?

And what happened after that?

- So I think that's the part that's, I think, most interesting to me, because I was the only Air Force psychologist on the base.

I was embedded in an Army unit that was providing services as well, but I was the only Air Force member.

So one of the things that happens after an attack like that, you know, because so many people are affected, typically a clinic like that will stay open.

So we used to have low-ops days, but they eliminated low-ops days, which there was typically one a week.

And so the clinic was open every single day.

And every day you had people who were at the blast, who were affected by the blast, who were injured, who had friends who were injured or killed in the blast, who were coming in to talk about their experiences.

And I think that made it even more difficult for me because I was, I had my experience.

- Right.

- And then I had the experience of all these people from different perspectives on that day that were kind of feeding into and building into this narrative and this experience that I had.

And it was, that became really difficult to handle.

- So you're trying to help people process this horrible trauma that they've gone through, but who was helping you?

- Not a lot of people.

When you're deployed as a psychologist, it's one of the things that they teach you is that you have to be very selective about who you allow to be close to you.

In the military, you can only develop relationships with people who are one rank up, one rank down, with close relationships, that is.

And so there weren't that many people because there aren't as many officers in a combat zone like that.

So I had one friend in particular who was another captain in the Army who was my main source of social support during a lot of that deployment.

And something else happened in the midst of all of this.

Yes.

What else was going on in your life back home?

Yeah, so my best friend died.

My best friend died about two months after the explosion after the after the suicide bombing and I think that it kind of wrecked me and I think that made the experience of trying to heal even more difficult because it was an unexpected death.

It was an undiagnosed condition and it was you know he had just gone through something terribly traumatic just the year before and then now he dies unexpectedly and I wasn't there and you know we had made promises to get together after the deployment and I didn't get to see him.

I'm so sorry that you had to go through not just what the horrific thing that you experienced through your work and your service but then this personal tragedy also like losing a friend I've also lost a friend around you know that time in my life and it is a type of pain that's like hard to kind of describe do you remember what that pain felt like for you I remember during his service his parents were very accommodating they were very kind and they allowed one of our mutual friends to allow us to Skype in to the funeral and I remember sitting into the funeral from Afghanistan and I remember something inside me felt like it broke.

I remember a visceral physical feeling of something breaking inside of me and I think my life changed again after that experience.

When you came back did you notice changes in your behavior or your emotions because of these back-to-back traumatic things that you had been through?

I think you know that's the thing that's kind of interesting and kind of cool but also odd about my expertise also being PTSD is that I I knew things were changing before I was out of the combat zone I knew that I had changed significantly the level of anger that I had the types of thoughts I was having during the deployment there was there were a lot of things about the way I was at the time that were already changing and I knew like this is different for me.

- How did your thoughts change?

Like what were you thinking that you did not think before?

- The word fatalistic comes to mind.

I was more open to the idea of violence.

I didn't care so much about kind of life living, not that I wanted to not be alive or anything like that, but that wasn't a focus of mine.

I felt like I was always on edge.

I kind of wanted something to happen at some points.

I wanted something bad to happen so that I could react and do something to like show that I could fix things.

Or it was significantly different for me at that time.

- Oh my God, it's like, makes me feel anxious just even hearing about it, because it does feel like this level of vigilance that would take so much, it would be so draining.

And so how did that change once you got back?

- Once I got back, it got worse.

I think during deployment, it's kind of a blessing and a curse.

You work all the time.

And so it's a constant distraction.

- Right.

- And so while things were bad and more bad things were happening while I was deployed, you still had the distraction of you're working every day of the week, pretty much.

And you have, I have my mission as a serious psychologist.

I had patients that I was seeing.

I was taking care of the hospital.

I was doing things around base.

So there's a lot of distractions.

And coming home, you lose a lot of that.

You have R&R when you get back and you don't have all the distractions.

You know, I went on a cruise after I got back and, you know, while I enjoyed it, it was odd to not have all of the regimentation that you have on deployment and leisure and people, like civilians aren't as aware of their surroundings.

And that's something that becomes even more noticeable to me.

And it was bizarre to be back and to be around these people who kind of don't know who I am now.

I mean, wasn't it like just being in a completely different world?

Like you go from a reality that's so different.

And when did you start noticing that it was impacting parts of your work or your relationship life?

- I think the thing that started was my relationship with my ex-wife.

That relationship was strained, honestly, before I even left for deployment, but it became even more strained once I returned.

And I think like so many people, it wasn't necessarily the trauma that caused me to go to therapy initially.

It was the relationship with my ex-wife.

Things weren't going the way that we wanted to.

I was angry and so many things that she did irritated me.

And it may not even have been her.

I was on edge and I was very physiologically or hyper aroused.

And I realized that this is not going well.

I don't know if I want to be in this marriage anymore.

And I need to talk to somebody about it.

And I can't talk to my wife about it.

So I went to therapy.

When did you actually get a diagnosis of PTSD?

It was with that first therapist, that first therapist.

We initially started talking about my wife.

But I used that as, or my therapist was good.

And they they use as an inroad to talk about kind of what was a source of my anger, my irritation, and other things I was struggling with.

And they broached the topic of the trauma that I experienced.

And they did eventually give me a diagnosis of PTSD.

So now I'm gonna ask you to put your clinical hat on.

And how did you get treatment to get better?

And how was it different than how you've treated people to help them heal?

- Yeah, so, it was interesting.

It was seamless in that it was a combination of working on the relationship, talking about the relationship, but then also talking about the trauma, talking about how the trauma is impacting me, my life, and trauma's impacting the relationship.

And given the fact that PTSD is my expertise, and I know the best treatments and the most effective treatments, I knew that something that I could do to help myself, which might be a little different than what you might typically see for traditional therapy, is I wanted to kind of work on the narrative of my experience.

And so what I decided to do was to take what I experienced and put it down pen to paper.

And I decided that one of the ways I would kind of force myself to confront what I experienced was to write a book to start writing a book for myself.

Have you been able to finish that book?

I have finished the book.

And what's it called?

It's called Invisible Battles, The Healer's Burden.

And in the process of writing that, what did you learn and how did it change you?

- I learned that our narratives are one of the most important things that we have in life because the narratives, the stories that we tell about ourselves, to ourselves and about ourselves, it's something that we can control.

There are times in our lives when we allow our narratives to be controlled by things outside of ourselves or by how we feel, but we do have a lot of agency in how we tell our stories.

And there's something very powerful about when writing down your story, telling your story, and deciding what you want to be, but also just being honest with yourself about that experience.

- So what was your narrative about what you had experienced prior, and then what did it become once you did that kind of work?

- So the truth is that, so one of the big symptoms of PTSD or symptom clusters is avoidance.

And so for a long time, I told myself that, I have symptoms of PTSD, but I don't have PTSD.

That was like a narrative that I held for a long time that like, no, I can't have it.

I study this, I treat this.

I can't have PTSD 'cause that's just not me.

And what I realized while writing the book and after writing the book is that this is my experience.

Like I met criteria, I'm having the experiences, it's affecting my life, and I can use that to heal and to hopefully help others.

- Can you talk about what some of the symptoms and criteria are?

- Yeah, so I think the first and most important one is a criterion A event.

So a criterion A event essentially is the trauma.

So that means that you have some experience that involves some threat to your physical integrity.

So that can be something like a car accident, it could be some sort of sexual violence, it could be something that happens in combat.

There's a lot of things that can fit into that criterion A event, but it generally involves a threat to your physical integrity in some ways.

And you can either learn about it, see about it, or it can be something that happens to somebody that's really near and dear to you.

So that's the first and most important one, because you have to have a criterion A event.

Then after that, it becomes a little more variable, because there are four center clusters that are important.

So you have the re-experiencing, previously called re-experiencing, but really intrusive symptoms, where the memories and experiences related to the trauma kind of pervade and invade into your life, can be in wakefulness or while you're asleep.

Then you have avoidance.

Avoidance, to me, I call that the Hallmark symptom cluster of PTSD, because avoidance is the cluster of symptoms that actually perpetuates the disorder.

So when you avoid your experiences, you're unable to resolve them.

And so that's kind of a really important Hallmark symptom.

And then now we have a numbing.

So we have negative alterations in cognition and mood.

So what that means is people have these pervasive and these significant alterations in the way they see themselves, the way they see the world and other people around them.

So maybe they have a decreased ability to feel positive emotion.

Things like that and changes the way they think about themselves, maybe guilt related to the event.

And the final one is hyperarousal symptoms.

So a lot of that irritability, anger that I was experiencing kind of fits into that hyperarousal symptom cluster.

Okay.

And so then what are the most effective ways to feel better?

So the two treatments that I prefer are cognitive processing therapy and prolonged exposure therapy.

Those are two of the most researched and two of the most backed therapy protocols for addressing PTSD symptoms.

And they kind of approach PTSD from different angles.

So cognitive processing therapy, as it says, it's more of a cognitive approach.

So when we talk about the negative alterations in cognitions and mood, we're looking at the ways that the way that we think about the world has changed significantly, and how do we start approaching that in addressing the shifts that have occurred and the way that you're looking at safety in the world, or problematic people or situations?

And then you have prolonged exposure, which kind of approaches it from kind of an emotional and behavioral perspective.

And so that really is putting you face to face with the trauma itself.

And so in terms of prolonged exposure, it's what it sounds like is that you're exposing yourself repeatedly to, to the story that you have created or story of the trauma itself.

And by exposing yourself over and over again, it becomes it loses its salience, it's not something that you're avoiding anymore.

And so that lack of avoidance can help to decrease a lot of the symptomology.

So I feel like your experience and your story is really a testament to the fact that you can experience deeply traumatic things, and get better and heal and feel better and use that into finding meaning and purpose in your life.

And I think that's a message that's going to resonate really strongly with so many people.

I really thank you for coming and sharing your story and your expertise with us.

Thank you.

♪♪ - This program is funded in part by the following.