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#72 Untreated PTSD

July 10, 2011

Using words in obscure languages, being married to someone of another race (possibly someone you went native with), having a tribal tattoo or Chinese character tramp-stamp, and sporting some sweet Chaco tan lines are all okay… Incorporating the word “Nomad” into a twitter profile or blog URL, putting pictures of war junk up on Facebook, dressing like the locals and conspicuously bitching about HQ are similarly laudable.

But today’s Expat Aid Worker who is truly serious about clarifying her or his field cred for the world will have untreated PTSD.

Few things make the point that this EAW has been around enough to have seen some shit go horribly sideways, yet remains sensitive and feels things very deeply, quite like those subtle and overt signs of PTSD. The guy, just in from someplace ending in “stan” or “ia”, who makes the point of saying, “Can we trade seats? I never sit with my back to the door…” immediately conveys the gravity of his past and also that should armed militants burst into Starbucks in search of fresh hostages, he would not be taken easily. The aid chick who dives under the nearest desk every time a door slams shut is letting those around her know that she’s learned the hard way how to look after herself in some pretty badass places.

A common mistake among newbies and poseurs, however, is trying to pass off as PTSD what is, in fact, simply garden variety personal drama. It’s important to keep in mind that while of course personal drama is one of the key stepping stones that leads to PTSD, it is not the same thing as actual PTSD. (See also below)

For true PTSD to be truly effective as a field cred establishing measure it must be embraced, celebrated and nurtured. Never treated.

This is very important to get right because actually taking a break, taking a less dangerous or stressful job, and maybe getting professional help can make the EAW appear less hardcore – which would never do. “Really, what shrink can possibly get what I’ve been through… what I’ve seen?“, underscores the EAWs’ dilemma. Far better to drink more, smoke (to calm one’s nerves whilst on deployment), adopt socially awkward behaviors and hobbies, and insist at strategic moments that one could never survive in so cushy an environment as, say, Cambodia or Malawi. Second and even more importantly, getting proper treatment would disrupt the natural order of things in the EAW experience:

Putting Aid Work First –> Personal Drama –> Cynicism –> PTSD–> Finding Themselves.

So next time you meet an EAW with a conspicuous eye-twitch, who insists on describing in lurid detail to total strangers traumatic events witnessed and experienced, and who will only consider front-line positions in active war zones, buy him or her another round, offer a light, but above all be sure to envy him or her. You’re talking to someone who has almost achieved EAW nirvana. Like “consumption” in 1800s, untreated EAW PTSD is the mark of intelligentsia, of the elite. You’re in the presence of greatness.

10 Comments leave one →
  1. July 11, 2011 7:09 am

    You’re in the presence of Greatness. Hahahahahahahahaha. Absolutely brilliant :)

  2. July 11, 2011 8:14 am


    I never sit with my back to the door or people, its because I a nosy bastard. My paintball Gun has 500 rounds in the freezer just in case the compound is breached and I don’t trust the local guards; especially when they tell me they are my friend – hey, its non-lethal and legal.

    I used to piss in bursts for years for fear of some strange tropical fish who has the ability to swim up my golden stream and enter.

    I trust my mother to announce my ‘greatness’ (embarrassingly) and hope never to get a STD, and have a ‘degree’ of PTSD as a qualification – keeping me ‘windswept and interesting’.

    Married an Asian; tattoo free, but babble using strange tongues and always bitch about ‘all’ HQ’s- They need kept in check as the Air-con is exuding chemical unbalance (Well, who else can we bitch at?).

    Treatment make you soft, and may make you realize what your doing has risks. (Please don’t take this seriously, get treatment if your stressed – I freak at working with psycho’s, so get treatment – and don’t come back, I have seen my share of ‘going postal’ and suicides).

    Lastly, how can you ever go back to 9-5, where everything works, how would you ever appreciate ‘RR’ and what on earth would you talk about???

  3. July 11, 2011 2:04 pm

    Hello and thank you for your words. Yes, field workers need to take care of themselves! I always advocate for restorative methods of yoga. love and light! sowmya

  4. morealtitude permalink
    July 13, 2011 10:55 pm

    Heelarious- one of SEAWL’s great posts. Love your work, J.

  5. ann turner permalink
    July 15, 2011 3:45 am

    dunno why, but I had sense of humour failure over this post.

  6. PTSD Treatment Advocate permalink
    July 25, 2011 5:47 pm

    Sadly, I agree with this posting, but I have a really hard time laughing at it. As someone who has been treated for PTSD after living in Haiti before, during, and after the earthquake (perhaps not as bad as some places like Afghanistan, but … certainly not a piece of cake place, either), reading this blog basically reinforces what I feel internally every day when I go to my job (now at HQ…funding for my “development turned emergency” project posting ended about 5 months after the quake). Perhaps I’m not “tough enough,” “can’t hack it” and shouldn’t be a development/humanitarian worker. Perhaps there is something wrong with me. These are the kinds of thoughts that run through my head daily as I struggle with one thing or another. Call it personal drama if you will, but trains rumbling past MILES away from me still startle me awake with their slight vibration at 3:30 a.m. I still feel incredibly uncomfortable in concrete buildings, which, unfortunately, is all that exists in Mali, where I am currently writing this–thankfully (hopefully?) no earthquakes in Mali, though AQIM has certainly increased its activity here.

    Then, another part of me (the smarter part) would like to imagine a world where humanitarian and development workers actually acknowledged that what they see on a daily basis a) is not healthy, b) can affect their health over time, and c) is not meant to be drowned in booze, cigarettes, and sex (despite the fact that those postings makes us laugh on this blog). In my perfect, imaginary world, organizations and people would be more open and supportive to folks who are struggling with mental health issues, etc. (On this note, I have to say that AT LEAST humanitarian orgs offer regular R&Rs…development orgs, who are more frequently working in humanitarian situation countries, like Haiti, Sudan, Somalia, Afghanistan, and Pakistan, often don’t even offer regular R&Rs. I had to fight to have one week off after the earthquake and a paid flight home…and I had to work in HQ for part of that time to “justify” the expense, whereas my expat aid worker friends working for humanitarian orgs jetted off to the States or some other Caribbean paradise every 4-6 weeks–all expenses paid.)

    My hope is that the folks who read this blog won’t feel discouraged from allowing themselves to seek treatment should they need it. Honestly, while I have been to therapy, done EMDR, etc and am doing much better now, I still walk around at work feeling like people think I’m “less than” because I admitted to having a problem, and reading this blog doesn’t help me feel any better. If anything, it kind of makes me feel shittier. But I also still attempt, when possible, to talk about it–in appropriate forums, because ultimately, I want organizations to change their ways. There are some aspects of humanitarian culture/life that, yes, should be poked fun of yet continue, but untreated PTSD isn’t one of them, and glorifying it (even if in jest) is dangerous. And frankly, a bit ridiculous, particularly for those who work providing “psychosocial support” yet continue to ignore their own psychosocial selves.

    The definition of “Greatness” should be transformed in the expat aid worker culture–those who are really “Great” are those who are courageous enough to feel and acknowledge the emotions associated with what they see and experience every day (even if only in between stints–i understand that you can’t go home and cry everyday), no matter how hard it is, to seek help when they need it, and to become stronger along the way without numbing and hardening so much as to turn into stone-cold humanitarian robots.

    Call me a pansy if you want. Perhaps I am. Perhaps I’ll never be “a great presence” as described in this blog. But I hope I’ll be a lot happier for it.

  7. vascalna permalink
    September 17, 2011 11:48 am

    Reading this make me wanna do Aceh and Darfur again. And ALWAYS volunteer for the “essential staff” list. Wuhoo! I’m normal!!


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