Why one Canadian military officer set out to change mental-health care for soldiers

In an excerpt from "After the War: Surviving PTSD and Changing Mental Health Culture," Lietenant-Colonel Stéphane Grenier describes the challenges of homecoming and why he decided to seek help
By TVO Current Affairs - Published on March 5, 2018
Lieutenant-Colonel Stéphane Grenier's experience with PTSD upon returning from Rwanda in 1995 inspired him to work to change the system for soldiers seeking help. (iStock.com/Serega)

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Lieutenant-Colonel Stéphane Grenier founded the Operational Stress Injury Social Support program, which provides practical help for soldiers dealing with mental-health issues. Here, he describes his own post-war experiences with PTSD.

Almost invariably, when a soldier first returns from a long overseas deployment, things are at first cheery and positive. After being away from family, dealing with distressing events, experiencing intense culture shock, and lacking many creature comforts, soldiers are happy just to be home. Health concerns, especially mental ones, usually fall pretty low on the priority list during the initial period of euphoria. Some soldiers with mental-health problems crash shortly after this honeymoon phase is over, but I was able to get back into a routine relatively quickly, which somewhat helped ease my transition and keep me going.

And yet, shortly after my return, I started to undergo some changes. It wasn’t any single event that signaled this transition, but rather various subtle shifts that, in retrospect, acted as signs of things to come. In April, I returned to the National Defence Media Liaison Office (MLO) and resumed my pre-Rwanda job as a media liaison officer. One day shortly thereafter, I received a call from the military logistics staff telling me my equipment from Rwanda had arrived in Ottawa. I promptly drove to the airport, signed for it, and brought it back home.

Cover photo for After the War, showing author Stephane Grenier.

The following weekend was unusually sunny and warm for that time of year, so I decided to open up my barracks boxes and equipment bags, and clean and sort through things in my driveway. As I began my work, Veronique was happily taking advantage of the good weather to ride her tricycle around on our dead-end street. After watching her enjoy herself for a few minutes, I opened everything up, attached the hose, and began by cleaning my boots. I picked one up and began spraying the sole, which still had Rwandan soil stuck in it. Just then, Veronique started walking up the driveway with a curious look on her face, to see what I was doing. With the juxtaposition of these two sights — my daughter approaching while the red soil washed down the driveway — I suddenly panicked. The idea of my daughter and the Rwandan soil being in such close proximity to each other symbolized the coming together of two worlds that had to be kept apart, and I was horrified at the thought of my daughter getting even a drop of that tainted soil on her. There were so many thoughts and images going through my head at that moment that I reacted without thinking. In a curt and authoritative tone, I told her to get back on her tricycle and go up toward the house.

I was so focused on spraying those boots and washing away all that red soil — an act of symbolic cleansing — that the gentle father in me had momentarily fled. In another state of mind, I would've been much kinder, would’ve just picked Veronique up, put her back on her tricycle, and sent her on her way. Outwardly, the event wasn’t anything intensely dramatic: anyone watching might have just thought I was in a bad mood. But inwardly, a chasm was already forming between myself and the “normal” people around me. Together with other, similar events, this incident demonstrated that I was sliding down a slippery slope toward a mental break. The problem was I just wasn’t watching for it.

As the weeks passed, nights became increasingly difficult. I was very restless, had numerous nightmares, and often had trouble sleeping. Days weren’t much better. Julie noticed me becoming increasingly impatient, flying off the handle over very slight inconveniences or setbacks. Losing sleep, being tormented by my dreams, and starting my days upset and emotional created a domino effect that impacted my whole social world. I was also very confused. Where, I wondered, did these feelings originate? Did the lack of sleep lead to nightmares, or did nightmares lead to lack of sleep? Where did Rwanda fit into all of this? Was I just experiencing a temporary rough period? Untangling cause and effect wasn’t easy — even in retrospect, it’s tough to sort out these initial experiences. But one thing was clear: my inner core was gradually being altered by the perfect storm brewing inside me — the swirl of emotions, memories of Rwanda, and my recent transition to home and normality.

 

As the fall approached, things became extremely hectic at National Defence Headquarters (NDH). At that time, the Belgian government was coming down really hard on General Roméo Dallaire for the death in Rwanda of 10 Belgian soldiers under his command. They essentially wanted him brought to Europe for questioning. The UN, for its part, refused to send him. My bosses at NDHQ were asked to help, and since I’d served under Dallaire in Rwanda, I was sent to Montreal along with two others to help him with his response to the Belgian government’s questions. This was a busy time, to say the least.

During this period, I worked a lot of evenings, but one day I decided to go home for dinner and eat with the family; I’d have to return to work and finish up later on, but a bit of time at home seemed like a welcome respite. So I drove home, had a nice meal with Julie and the kids, and shortly after headed back to finish my tasks. My mind felt like it was operating normally, but then something strange and unsettling happened: out of nowhere, while driving back to NDHQ, I had a sudden and very strong impulse to wrap my car around a telephone pole.

I was coming down a hill near the University of Quebec, and as the car built up speed, I thought, “I’m going to wrap my car around a pole. That’s it. I’m done.” The idea came in a flash. I had never even thought of the word suicide before — it just wasn’t in my vocabulary. And yet here I was with the overwhelming desire to drive at high speed into a pole. Luckily, the thought quickly disappeared. It was then that the gravity of the situation hit home. I thought, “What the hell am I doing?” It was quite disturbing, the way this destructive thought had arrived without warning and then just as suddenly vanished.

I tried to put this scare out of my mind, and I didn’t tell Julie about it when I got home later that night. But the next morning, as I put on my uniform and prepared to head back to work, I was consumed by thoughts of what might have happened. I had a beautiful wife, two great kids, and a good job. Everything seemed fine. I just couldn’t figure out what was wrong. Although many soldiers felt — and still feel — anxious about seeing a doctor for psychiatric difficulties, largely due to the stigma around mental health in the military, I didn’t even know what stigma was. And so, instead of going to work, I went to the National Defence Medical Centre (NDMC) in Ottawa. It wasn’t the norm at the time for a soldier to seek medical attention for mental-health issues so soon after a deployment, but I didn’t really think about it — I just went.

When I got to the parking lot at the NDMC, that was when the notion of stigma started to kick in. After parking the car, I had to go to what we in the military call “sick parade,” a dedicated time each day when soldiers can report to a doctor. I knew that when I went inside, they were going to ask me to fill out a form with all my information and my reason for visiting. As I thought about the previous night, I didn’t know what I should write. I felt embarrassed. The person behind the front desk was usually a junior non-commissioned officer. I didn’t have a big ego, but as a captain, I found the thought of disclosing to a corporal the fact that I was suicidal slightly humiliating. For about 15 minutes, I sat in the car and contemplated how I would handle things. Finally, I bucked myself up enough to go inside.

Like I expected, a master corporal greeted me at the front desk. We exchanged the customary greetings, and he gave me a form. I filled it out but left the “reason for visit” box blank. When I returned the form, the corporal quickly scanned it and told me I needed to fill in why I was there. I said that it was difficult to explain, that I just wanted to speak with a doctor. He politely repeated his request. My style of command was never based on bullying or browbeating my subordinates, but at that moment, with the feeling of shame and embarrassment forefront in my mind, I just glared at him and said, “If you don’t let me see a doctor without filling out this damned sheet of paper, you’re going to see me back here in a body bag.”

Taken aback by my response, the corporal now understood it was necessary to sidestep protocol, and he allowed me to proceed without finishing the form. The whole waiting room had, of course, heard my outburst, and as I went to find a seat, I felt embarrassed. I picked up a magazine and did my best to cover my face, but I knew those waiting were probably wondering what was wrong with me. I now felt both the stigma of asking for help and the shame of dressing down that poor corporal in front of the whole room. Minutes seemed like hours as I stared blankly at the magazine, waiting for my name to be called.

Within half an hour, I was in front of a female physician. She listened attentively as I explained my situation, and because of her calm, gentle demeanour I felt confident that she’d be able to fix me right up. But after about 10 minutes, she told me that she suspected I might have what she called PTSD. Although I’d heard that term in passing a few times, I had no idea what it meant. She concluded our appointment by saying that my malady was beyond her expertise and that she was referring me to a specialist. A week later, I had an appointment with a military psychiatrist.

I saw that psychiatrist (whose name I’ve omitted) three or four times over the course of about six weeks. On the first visit, he greeted me and mentioned that he had a nursing student doing her practicum in mental-health care; as long as I didn’t mind, she would attend our first session, and perhaps future ones as well. I didn’t know what to say, so I just agreed. All I can remember from my sessions with him are very in-depth, if somewhat mundane, analytical questions: “How’s your life? Do you have any debts? What was your childhood like?” — that sort of thing. This line of questioning sounded to me like something from a Woody Allen movie, and I felt it didn’t really get to the heart of anything. I was a veteran of Rwanda, a country that had seen some of the worst atrocities since the Second World War, and all he could ask me about was my childhood. I had greater concerns, like figuring out what was keeping me up at night, why I had collapsed in the doorway when I got home, and why I had flipped out on my daughter that day in the driveway. I knew nothing about psychiatry or psychology, but I was certain my difficulties weren’t because of a bad childhood or my relationship with my father.

I therefore left my first appointment feeling disillusioned. But I understood Rome wasn’t built in a day, as the saying goes, so I decided to allow time for the process to work. But the second appointment was the same, and then the third, and eventually I was prescribed a bunch of pills. At that point, I was tempted to give up. Right from the get-go there was no therapeutic alliance, which is to say, there was no connection or engagement between us; I was just another patient being given the one-size-fits-all remedy of talk therapy and pills. He might have been a competent clinician, but he appeared to have no people skills and didn’t understand how to get to the root of what troubled me. People knew what happened in Rwanda — why was he asking me about my childhood and how my father treated me? We weren’t talking about what I thought was disturbing me; instead, we were talking about what he wanted to discuss. I went home with very little understanding of even what the pills he prescribed were for. Simply put, I had no confidence in him or in his ability to help me. Later, I flushed the pills down the toilet. I never went to see him as a patient again. And in fact, by a twist of fate, down the road, he became somewhat of a nemesis as I tried to change the military’s mental-health system.

Like numerous soldiers during the 1990s, I’d come into contact with a dysfunctional military health-care system and stale psychiatric methods, not to mention many doctors who were unaware of what war and peacekeeping could do to a person’s mind. The military was completely unprepared to deal with the aftermath of sending thousands of people on peacekeeping missions that involved no peace at all. My initial experiences after seeking help inspired me to try to change what was evidently a broken and archaic system.

From the book After The War: Surviving PTSD and Changing Mental Health Culture by Stéphane Grenier with Adam Montgomery, copyright © 2018. Reprinted by permission of University of Regina Press.

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