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domani spero

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Rachel Schneller joined the Foreign Service in 2001. Following a tour in Iraq 2005-6, she was diagnosed with PTSD. Her efforts to highlight the needs of Foreign Service Officers returning from tours in war zones helped prompt a number of changes in the State Department, for which she was awarded the 2008 Rivkin Award for Constructive Dissent.

Prior to joining the U.S. Department of State, Rachel served as a Peace Corps volunteer in Mali from 1996-98. She earned her MA from the Johns Hopkins School of Advanced International Studies (SAIS) in 2001. We have previously featured Rachel in this blog here, and here.

On Monday, June 29, she will join the forum and answer readers' questions  based on her personal experience with PTSD.  She will be at the forum from noon to 2 pm EST. She will join the forum in her personal capacity. Her views here do not necessarily reflect those of the U.S. Department of State or the U.S. Government.

 
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DS
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Thank you for doing this Rachel.  What are the most common misconceptions about PTSD in the Foreign Service? 

 

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Rachel Schneller
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Thank you, Diplopundit, for setting up this Blog Forum on PTSD.  I look forward to responding to questions posted here beginning noon EST.  I will be responding in my personal capacity as an FSO with PTSD whose views do not necessarily reflect those of the State Department.
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Cimorene
Reply with quote  #4 
I just want to thank you for raising awareness on this subject. I was recently diagnosed with PTSD following my assignment in a war torn African country, and sometimes it's easy to feel alone in this struggle.
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C.
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What was it like to admit or acknowledge your PTSD to your employer and co-workers? What helped you the most in dealing with your PTSD?
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Rachel Schneller
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Hello Cimorene- Everyone's experience with PTSD is unique because everyone has a unique personal background combined with the unique experience(s) that led to the PTSD, so it is completely normal to feel alone.  In a sense, you are alone in your struggle.  Only you can take the steps necessary to deal with your PTSD.

But you are not the only one with PTSD in the State Department.  There are a whole bunch of us. [smile]

I am glad to hear you took whatever steps you did to get the PTSD diagnosis. Sometimes that is one of the hardest steps in the whole struggle.

I found it helpful to only spend time with people I found to be supportive of my struggle with PTSD.  Sometimes it meant I spent a lot of time alone, because for a time most of the people in my life were waiting for the "old me" to come back.  

The people who were supportive did not neccessarily understand what I was going through, but they cared about me or at least there was no judgment involved.  So maybe for you, there is one person, or a few people, who can be there for you even if they cannot be there with you.

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domani spero

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Rachel, can you talk about your experience with -- 1) Diplomatic Security and security clearance, and 2), with medical clearance and worldwide availability as they relate to your PTSD? 
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Rachel Schneller
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Quote:
Originally Posted by C.

What was it like to admit or acknowledge your PTSD to your employer and co-workers? What helped you the most in dealing with your PTSD?


Hello C,

From what I remember back in 2006, I was terribly nervous.  I needed to talk to my supervisor about it because I was taking a lot of time off for medical treatment, and I remember feeling guilty about all the leave slips I was handing to her.  I knew I looked otherwise healthy, so I felt like it must look suspicious.  But she actually was very supportive when I did spit it out.  

It was immensely liberating to simply state the fact out loud, "I was diagnosed with PTSD following my tour in Iraq.  I am getting treatment for it, but it means I need to leave the office no later than 5 pm on Thursdays to get to my therpist's."

After all, who in their right mind would give someone who just said that a hard time?  

I am pretty sure my co-workers already knew.  After all, I was crying all the time at my desk, yelling at people, banging on the walls, that sort of thing.  I had photos pinned behind my desk of people I knew in Iraq who had been killed.  I couldn't sleep and had huge bags under my eyes.  

My revelation was no big news to them, but I am sure on some level they were reassured that at least I knew I was crazy and was doing something about it.

 
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Unregistered
Reply with quote  #9 
Quote:
Originally Posted by DS

 

Thank you for doing this Rachel.  What are the most common misconceptions about PTSD in the Foreign Service? 

 



Hi DS,

Thanks for putting this forum together!  From my personal experience, there are two common misperceptions about PTSD in the Foreign Service.

First is the perception that PTSD only happens in war zones like Iraq or Afghanistan. After I spoke out about my experience with PTSD in 2006-8, I met dozens of people in the Foreign Service with PTSD from service in all sorts of places.  People who had served in the Balkans, Sierra Leone and Liberia at the outset of wars there, people who had survived the Embassy bombings in Africa, people who had served in Central America during civil upheaval, and consular officers who had dealt with unspeakable cases.  PTSD can happen in any location.  

The second misconception is a PTSD diagnosis will end your FS career.  Untreated, undiagnosed PTSD could potentially lead to career-ending behavior.  But a PTSD diagnosis in and of itself?  No.
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Unregistered
Reply with quote  #10 
Hi Rachel, 

Thank you very much for posting your experiences on the forum.  I do have a couple of questions for you. 

How did you find a support system?  Did you find it within the State Department or outside? What did you find the best for you as coping mechanisms during work hours?  How did you deal with coworkers and their questions?  

Thank you!


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Rachel Schneller
Reply with quote  #11 
Quote:
Originally Posted by domani spero
Rachel, can you talk about your experience with -- 1) Diplomatic Security and security clearance, and 2), with medical clearance and worldwide availability as they relate to your PTSD? 


Sure.  Again I am speaking from my personal experience and this does not necessarily represent the views of the State Department.  

My PTSD diagnosis did not have any negative impact on my security clearance.  When it was time to renew my security clearance in 2010, I answered all the questions truthfully and did not attempt to hide anything.  After all, I had been all over the place in public with my struggle with PTSD so there was no point in trying to cover anything up.

I seem to remember that by 2010, the infamous question about "have you sought mental health counseling?" had been changed to include service after war zones as a condition for which you did not have to report seeking treatment.  So I believe I was able to check the "no" box on that one.

There was something that came up about medication- I don't remember exactly how. But after I submitted all the paperwork, I was asked to provide information about all the medication I had been prescribed along with contact information for my doctors- for the security clearance.  This I did not do.  I went back and asked why the information was needed, since there was a separate medical clearance procedure.  The issue was dropped.

As for medical clearance, I now have a Class 2 medical clearance.  Basically what it comes down to is having access to a mental health provider when serving overseas.  In an ideal world, all of us would have such access everywhere at every post.  It means getting medical pre-approval for all the posts I bid on.  It is a bit more work, but in my personal experience has worked OK.  I am serving overseas now and am going on to another overseas post.
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Unregistered
Reply with quote  #12 

Hi Rachel. Forgive the long question here. 

I struggled with what was later diagnosed as PTSD for nearly 18 months, during which I was unable to work, nearly went bankrupt, left the Foreign Service, struggled with suicidal thoughts, engaged in high-risk behaviors, and suffered from debilitating panic attacks on a regular basis. It was the hardest period of my life by far. I had no support from DOS until I called and demanded to talk to a psychiatrist, who recommended I seek treatment immediately but offered no concrete support. I took her advice. Within a few months of working with a private psychotherapist who specializes in PTSD, I was functioning again. 

The reasons for the PTSD are complex, but have much more to do with the inescapable abusive work environment in my office in Kabul (particularly my supervisor, whose toxic behavior has been well-documented across posts and bureaus) than with anything that could be blamed on the Taliban. Certain things were triggered by injury and death of colleagues, but the worst of it came from factors well within DOS' control and of which the embassy was well aware. In many ways, this made it harder to deal with. I felt like roadkill, totally abandoned by DOS.

Two years later, I've managed to turn that darkness into light. I don't think I'll ever recover financially from the ordeal, but I think the experience has made me a deeper, more sensitive, and stronger person in the long run. I've used my post-Foreign Service life to create freedom for myself as a creative and a change-maker in my community.

I still have some limitations that I trace to that experience (I'm a consultant; the very idea of having a boss who I can't say no to when conscience calls for it gives me cold sweats), but I try to treat that as a gift. While I often miss my close friends and colleagues, not to mention the work itself (which I loved beyond measure), I have tried to make peace with what I cannot change. It may not in fact be true that my life is better now because of the experience, but I tell myself that every day so that I can keep going. 

Part of my healing has been to let go of my anger toward DOS as an institution for its indifference toward me and take responsibility for my own mental state. I no longer think of myself as a victim. I had to get past that and make myself, not DOS, the primary agent in my life. I could not make my healing conditional upon the institution taking responsibility. I had to let it go.

Today, the hardest thing for me is to describe my experience in a way that honors what I went through as well as the lens through which I choose to see it now. Put bluntly: I am still scared. If I take responsibility, then I fear that DOS and society will just shift the blame onto me (not that anyone's holding DOS accountable as it is), and then how can I explain my financial status or the nearly two-year gap in employment? Part of me still fears that DOS will find a way to come after me. The best way I can describe it is this: I don't feel like I have permission to fully heal. Like healing somehow invalidates what I went through, makes it less credible.

Does this make any sense to you? Does it resonate with your experience (or that of anyone else on this thread)? And if so, how did you deal/are you dealing with it?

Thanks –
Candace

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Unregistered
Reply with quote  #13 
Quote:
Originally Posted by Unregistered

Hi Rachel. Forgive the long question here. 

I struggled with what was later diagnosed as PTSD for nearly 18 months, during which I was unable to work, nearly went bankrupt, left the Foreign Service, struggled with suicidal thoughts, engaged in high-risk behaviors, and suffered from debilitating panic attacks on a regular basis. It was the hardest period of my life by far. I had no support from DOS until I called and demanded to talk to a psychiatrist, who recommended I seek treatment immediately but offered no concrete support. I took her advice. Within a few months of working with a private psychotherapist who specializes in PTSD, I was functioning again. 

The reasons for the PTSD are complex, but have much more to do with the inescapable abusive work environment in my office in Kabul (particularly my supervisor, whose toxic behavior has been well-documented across posts and bureaus) than with anything that could be blamed on the Taliban. Certain things were triggered by injury and death of colleagues, but the worst of it came from factors well within DOS' control and of which the embassy was well aware. In many ways, this made it harder to deal with. I felt like roadkill, totally abandoned by DOS.

Two years later, I've managed to turn that darkness into light. I don't think I'll ever recover financially from the ordeal, but I think the experience has made me a deeper, more sensitive, and stronger person in the long run. I've used my post-Foreign Service life to create freedom for myself as a creative and a change-maker in my community.

I still have some limitations that I trace to that experience (I'm a consultant; the very idea of having a boss who I can't say no to when conscience calls for it gives me cold sweats), but I try to treat that as a gift. While I often miss my close friends and colleagues, not to mention the work itself (which I loved beyond measure), I have tried to make peace with what I cannot change. It may not in fact be true that my life is better now because of the experience, but I tell myself that every day so that I can keep going. 

Part of my healing has been to let go of my anger toward DOS as an institution for its indifference toward me and take responsibility for my own mental state. I no longer think of myself as a victim. I had to get past that and make myself, not DOS, the primary agent in my life. I could not make my healing conditional upon the institution taking responsibility. I had to let it go.

Today, the hardest thing for me is to describe my experience in a way that honors what I went through as well as the lens through which I choose to see it now. Put bluntly: I am still scared. If I take responsibility, then I fear that DOS and society will just shift the blame onto me (not that anyone's holding DOS accountable as it is), and then how can I explain my financial status or the nearly two-year gap in employment? Part of me still fears that DOS will find a way to come after me. The best way I can describe it is this: I don't feel like I have permission to fully heal. Like healing somehow invalidates what I went through, makes it less credible.

Does this make any sense to you? Does it resonate with your experience (or that of anyone else on this thread)? And if so, how did you deal/are you dealing with it?

Thanks –

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RS

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Reply with quote  #14 
Quote:
Originally Posted by Unregistered
Hi Rachel, 

Thank you very much for posting your experiences on the forum.  I do have a couple of questions for you. 

How did you find a support system?  Did you find it within the State Department or outside? What did you find the best for you as coping mechanisms during work hours?  How did you deal with coworkers and their questions?  

Thank you!




Hi, thanks for the question.  I found a support system within the State Department, and I also created a support system outside the State Department, because the two things were very different.

Within the State Department, I would run into people from time-to-time who had been in Iraq with me, or who had been in Iraq at a different time, or who had been in Afghanistan, and we would commiserate.  These were the people whose office extensions I had memorized, so when I was having a bad moment at work, I could call them up and vent for a bit.  And they would do the same with me.

But the support system outside the State Department was more important, and it was harder to create because like many FSOs, I had started to identify with my job.  But if you never leave your job- even when you leave the office- you never get a break.  Your nervous system never gets a break.  And you just keep re-hashing the stuff that traumatized you in the first place.

In my case, I found one thing not associated with work- yoga- and I created a network around it.  I am not saying everyone with PTSD needs to go do yoga. It is enough to find just one thing outside of work and start there.  From taking one yoga class a week, I started volunteering at the yoga studio, which got me more free classes and workshops.  I met people who only talked about yoga, and learned how to have a conversation about the inner and outer rotation of the thigh.  I took a yoga teacher training course, much to my surprise.  Then I realized I could teach yoga.  This all took time, but by 2010, I had a large network of yoga contacts outside of work.  I had a new identity as well.  I was not just Rachel-who-has-PTSD, but I was also Rachel-the-yoga-teacher.

For me it was yoga.  But for someone else it could be gardening.  Or kickboxing.  Or cooking.  It just has to be something not work related where you interact with other people, legal, and preferably not alcohol-related.

As for coping with co-workers' questions, it really depended.  If the question was coming from someone who cared and was asking from a place of concern, I would try and be as straight as possible with them.  If the person asking did not seem that concerned about my well-being, I sometimes would yell at them (early in my treatment), or ignore them (later in my treatment).
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Unregistered
Reply with quote  #15 
Rachel,
Thank you for making yourself available for this conversation.  I also appreciate you pointing out that PTSD is not exclusive to those who have actively been attacked in a war zone (which sometimes feels like is the only good excuse to have it).  I have a question about the responsibilities/abilities colleagues have to assist someone with PTSD.  No one wants to get too far into someone else's personal business but at the same time I would hate to find out that someone was struggling with something so important and not help.  Do you think it would have been helpful if someone had talked to you about your behavior?  Is it better coming from a supervisor or colleague?  What are the best resources that we can guide people to if they think they need treatment?  
Shelly
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domani spero

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Reply with quote  #16 
Quote:
Originally Posted by Unregistered
Quote:
Originally Posted by DS

 

Thank you for doing this Rachel.  What are the most common misconceptions about PTSD in the Foreign Service? 

 



Hi DS,

Thanks for putting this forum together!  From my personal experience, there are two common misperceptions about PTSD in the Foreign Service.

First is the perception that PTSD only happens in war zones like Iraq or Afghanistan. After I spoke out about my experience with PTSD in 2006-8, I met dozens of people in the Foreign Service with PTSD from service in all sorts of places.  People who had served in the Balkans, Sierra Leone and Liberia at the outset of wars there, people who had survived the Embassy bombings in Africa, people who had served in Central America during civil upheaval, and consular officers who had dealt with unspeakable cases.  PTSD can happen in any location.  

The second misconception is a PTSD diagnosis will end your FS career.  Untreated, undiagnosed PTSD could potentially lead to career-ending behavior.  But a PTSD diagnosis in and of itself?  No.


You're welcome. There was a recent FSGB case about the consequences of hidden PTSD.  I'll have a separate post on that later. I think the idea that PTSD can lead to job loss is real, at least in this specific case, real to a DS agent. 

But what can the FS community do to encourage people with potential PTSD to come forward to get help?  What can supervisors do?


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RS

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Reply with quote  #17 
Quote:
Originally Posted by Unregistered
Quote:
Originally Posted by Unregistered

Hi Rachel. Forgive the long question here. 

I struggled with what was later diagnosed as PTSD for nearly 18 months, during which I was unable to work, nearly went bankrupt, left the Foreign Service, struggled with suicidal thoughts, engaged in high-risk behaviors, and suffered from debilitating panic attacks on a regular basis. It was the hardest period of my life by far. I had no support from DOS until I called and demanded to talk to a psychiatrist, who recommended I seek treatment immediately but offered no concrete support. I took her advice. Within a few months of working with a private psychotherapist who specializes in PTSD, I was functioning again. 

The reasons for the PTSD are complex, but have much more to do with the inescapable abusive work environment in my office in Kabul (particularly my supervisor, whose toxic behavior has been well-documented across posts and bureaus) than with anything that could be blamed on the Taliban. Certain things were triggered by injury and death of colleagues, but the worst of it came from factors well within DOS' control and of which the embassy was well aware. In many ways, this made it harder to deal with. I felt like roadkill, totally abandoned by DOS.

Two years later, I've managed to turn that darkness into light. I don't think I'll ever recover financially from the ordeal, but I think the experience has made me a deeper, more sensitive, and stronger person in the long run. I've used my post-Foreign Service life to create freedom for myself as a creative and a change-maker in my community.

I still have some limitations that I trace to that experience (I'm a consultant; the very idea of having a boss who I can't say no to when conscience calls for it gives me cold sweats), but I try to treat that as a gift. While I often miss my close friends and colleagues, not to mention the work itself (which I loved beyond measure), I have tried to make peace with what I cannot change. It may not in fact be true that my life is better now because of the experience, but I tell myself that every day so that I can keep going. 

Part of my healing has been to let go of my anger toward DOS as an institution for its indifference toward me and take responsibility for my own mental state. I no longer think of myself as a victim. I had to get past that and make myself, not DOS, the primary agent in my life. I could not make my healing conditional upon the institution taking responsibility. I had to let it go.

Today, the hardest thing for me is to describe my experience in a way that honors what I went through as well as the lens through which I choose to see it now. Put bluntly: I am still scared. If I take responsibility, then I fear that DOS and society will just shift the blame onto me (not that anyone's holding DOS accountable as it is), and then how can I explain my financial status or the nearly two-year gap in employment? Part of me still fears that DOS will find a way to come after me. The best way I can describe it is this: I don't feel like I have permission to fully heal. Like healing somehow invalidates what I went through, makes it less credible.

Does this make any sense to you? Does it resonate with your experience (or that of anyone else on this thread)? And if so, how did you deal/are you dealing with it?

Thanks –



Wow, thanks so much for your comment.  Believe it or not, I know a few other people who could relate to your experience, particularly the financial ruin part.  What you describe sounds so hard and painful, and yet as much as you lost, and these are my personal views of course, not those of the State Department necessarily, the State Department also lost out when it lost you.

No organization wants to lose good employees who value their jobs and love their work. 

It was this belief, and a few others, that motivated me to speak out the way I did back in 2006-8.  I wasn't doing it to get back at or take revenge on the State Department.  I truly believed, and do to this day, that no organization is well served by having a cohort of untreated, traumatized employees in it, particularly an organization that regularly sends their employees into extreme situations where trauma is a distinct possibility.  

I had a period back in 2006 when I also wondered what I was doing working for a place that sent me to a war zone where I could have been killed.  It took me a long to come to the realization that I loved my job and the work I was doing. I might get killed doing it, but I would be killed doing something I loved.  Once I made my peace with that concept, I was able to let go of a lot of the anger.




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RS

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Reply with quote  #18 
Quote:
Originally Posted by Unregistered
Rachel,
Thank you for making yourself available for this conversation.  I also appreciate you pointing out that PTSD is not exclusive to those who have actively been attacked in a war zone (which sometimes feels like is the only good excuse to have it).  I have a question about the responsibilities/abilities colleagues have to assist someone with PTSD.  No one wants to get too far into someone else's personal business but at the same time I would hate to find out that someone was struggling with something so important and not help.  Do you think it would have been helpful if someone had talked to you about your behavior?  Is it better coming from a supervisor or colleague?  What are the best resources that we can guide people to if they think they need treatment?  
Shelly


Hi Shelly,

Honestly, I think if a coworker had suggested I had PTSD back then, I would have yelled at them.  I yelled at everyone.  

Someone with PTSD probably is likely not capable of taking in what you are suggesting.  I had some extremely well-meaning co-workers.  One of them even came to my house because she was concerned about my well-being.  I refused to talk to her and then yelled at her the next time I saw her.  I was mean, irrational, unpleasant, and incapable of reacting normally to such gestures.

A coworker has no responsibility to assist someone with PTSD.  If you are not a licensed mental health care provider you have no ability to.

What you and a supervisor can do is talk to your colleague about the specific behaviors that are disrupting the work place.  "When you yell at everyone, you make it difficult for the people around you to concentrate on their work."  Your colleague may at some point realize s/he is the problem, not everyone and everything else.  This may lead to that person getting help.
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RS

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Reply with quote  #19 
Quote:
Originally Posted by domani spero
Quote:
Originally Posted by Unregistered
Quote:
Originally Posted by DS

 

Thank you for doing this Rachel.  What are the most common misconceptions about PTSD in the Foreign Service? 

 



Hi DS,

Thanks for putting this forum together!  From my personal experience, there are two common misperceptions about PTSD in the Foreign Service.

First is the perception that PTSD only happens in war zones like Iraq or Afghanistan. After I spoke out about my experience with PTSD in 2006-8, I met dozens of people in the Foreign Service with PTSD from service in all sorts of places.  People who had served in the Balkans, Sierra Leone and Liberia at the outset of wars there, people who had survived the Embassy bombings in Africa, people who had served in Central America during civil upheaval, and consular officers who had dealt with unspeakable cases.  PTSD can happen in any location.  

The second misconception is a PTSD diagnosis will end your FS career.  Untreated, undiagnosed PTSD could potentially lead to career-ending behavior.  But a PTSD diagnosis in and of itself?  No.


You're welcome. There was a recent FSGB case about the consequences of hidden PTSD.  I'll have a separate post on that later. I think the idea that PTSD can lead to job loss is real, at least in this specific case, real to a DS agent. 

But what can the FS community do to encourage people with potential PTSD to come forward to get help?  What can supervisors do?




This is a tough question.  Until someone comes to the realization they need help and internalizes their PTSD diagnosis, I personnaly don't believe any amount of urging someone to get help is going to work.

At some point, the person with PTSD needs a somewhat rude awakening that their reactions are inappropriate, not that the rest of the world needs to change.  

That said, once that person has come to the realization they need help, everything possible should be done to support that person.  That's when supervisors can play a role in creating a supportive work environment, and co-workers can slap each other on the backs, saying "Good for you, you're doing something about your PTSD. We are so proud of you."  

If someone with undiagnosed PTSD sees this sort of thing happening on a regular basis, perhaps it will make coming out for help a little bit easier.
0
Unregistered
Reply with quote  #20 
Quote:
Originally Posted by RS
Quote:
Originally Posted by Unregistered
Rachel,
Thank you for making yourself available for this conversation.  I also appreciate you pointing out that PTSD is not exclusive to those who have actively been attacked in a war zone (which sometimes feels like is the only good excuse to have it).  I have a question about the responsibilities/abilities colleagues have to assist someone with PTSD.  No one wants to get too far into someone else's personal business but at the same time I would hate to find out that someone was struggling with something so important and not help.  Do you think it would have been helpful if someone had talked to you about your behavior?  Is it better coming from a supervisor or colleague?  What are the best resources that we can guide people to if they think they need treatment?  
Shelly


Hi Shelly,

Honestly, I think if a coworker had suggested I had PTSD back then, I would have yelled at them.  I yelled at everyone.  

Someone with PTSD probably is likely not capable of taking in what you are suggesting.  I had some extremely well-meaning co-workers.  One of them even came to my house because she was concerned about my well-being.  I refused to talk to her and then yelled at her the next time I saw her.  I was mean, irrational, unpleasant, and incapable of reacting normally to such gestures.

A coworker has no responsibility to assist someone with PTSD.  If you are not a licensed mental health care provider you have no ability to.

What you and a supervisor can do is talk to your colleague about the specific behaviors that are disrupting the work place.  "When you yell at everyone, you make it difficult for the people around you to concentrate on their work."  Your colleague may at some point realize s/he is the problem, not everyone and everything else.  This may lead to that person getting help.


This is probably an HR question but if somebody engages in disruptive behavior at work, can supervisors compel her/him to get MED consultations without getting into the disciplinary area? Overseas, I believe COM or DGHR can involuntary curtail or medevac an employee, but what happens if you're back in a domestic assignment?  


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RS

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Reply with quote  #21 
Thanks everyone!  Thanks Diplopundit for setting this up. 
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domani spero

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Reply with quote  #22 
Thanks everyone for your questions. Thanks Rachel for sharing your experience with us and taking the time to answer our questions! 
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