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The only Mental Health podcast that shares honest and authentic accounts of living with mental health issues, that's also hosted by individuals fighting the same fight you are!Providing information and resources for help with a heavy dose of humor and entertainment. Helping you find hope and the strength to fight on.
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#215 Dr. Rebecca Ivory of Tactical Psychiatry
In this powerful episode, Dr. Rebecca Ivory, a Doctor of Nursing Practice and Psychiatric Mental Health Nurse Practitioner, shares her journey of supporting the mental health of special operators and veterans. Dr. Ivory discusses the critical need for innovation in addressing mental health challenges, focusing on the unique impact of cumulative low-level blast exposure on the brain and body. She also delves into the widespread issue of sleep apnea within the military community and stresses the importance of seeking treatment.
This episode explores the connection between traumatic brain injuries (TBIs) and the endocrine system, highlighting how untreated TBIs can lead to serious health conditions such as heart disease, anxiety, depression, suicidal ideation, diabetes, and other endocrine problems. Dr. Ivory also emphasizes the importance of peer support, therapy, and raising awareness about the normalization of these symptoms among veterans and special operators.
Together, Deny and Dr. Ivory unpack the critical role of therapy and peer support in managing these challenges within the military community.
Tune in to learn how mental health professionals like Dr. Ivory are creating innovative solutions to support our veterans and special operators.
Chapters
00:00 Dr. Rebecca Ivory's Journey
08:09 The Need for Innovation in Mental Health Support
15:17 The Impact of Cumulative Low-Level Blast Exposure
23:13 Addressing Sleep Apnea in the Military Community
25:04 The Impact of Traumatic Brain Injuries
29:25 Normalizing Symptoms within the Military Community
33:48 The Importance of Peer Support and Sharing Experiences
36:54 The Role of Therapy in Managing Emotional Burden
46:55 The Need for Increased Awareness and Resources
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Instagram: @securityhalt
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LinkedIn: Deny Caballero
Connect with Rebecca today!
LinkedIn: Rebecca Ann Ivory DNP, MS, PMHNP-BC
Instagram: tacticalpsychiatry
Website: tacticalpsychiatry.com
Produced by Security Halt Media
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Speaker 2:Let's go, you're dealing with an expert in guerrilla warfare, with a man who's the best with guns, with knives, with his bare hands a man who's been trained to ignore, ignore weather, to live off the land.
Speaker 1:Job was disposed of enemy personnel to kill period with my attrition isn't why I work so damn hard to become a warrant officer, because in the army that's the only way you will ever earn the title of chief.
Speaker 2:And uh, yeah, yeah look, you don't know that okay that's right, john 117 motherfuckers.
Speaker 1:That's why dr rebecca ivory welcome security podcast.
Speaker 1:Now you know my origin story, let's dive in gotta live up to your uh credentials, your gaming credentials yeah, and you know, speaking of credentials, let's break it down, start off, because one thing that is I love there's so many people want to help soft professionals and veterans dealing with so much, but there is, uh, that makes way for a lot of people with a lot of, you know, uh, ill will and wanting to get rich and wanting to weasel and worm their way into the community and be like I'm a healer. Well, for a lot of things, a lot of things, you do need the institutional and foundational knowledge. So let's start off by letting the people know what and who you are.
Speaker 2:Well hi everyone. I am Dr Rebecca Ivory. I am a doctor of nursing practice. So, as our good friend Hoagie would say, I'm a doctor nurse. My doctorate is actually in the practice of nursing and in the practice of mental health nursing I'm a psychiatric and mental health nurse practitioner. I'm also a nerd. I am a psychiatric and mental health nurse practitioner. I'm also a nerd. I am a professional nerd and the area of my nerdy expertise is operator brain is the operator brain? That is literally what my focus is. I'm a researcher, research scientist, but I also own a business called Tactical Psychiatry, which is a psychiatry practice where I provide mental health support to primarily like 90% of my clients or special operators. I've worked with something like 300 over the last seven years. Holy cow.
Speaker 2:I also work with, like NFL players and some other professional athletes and people who have survived genocide, but my entire focus is on special operators and I also just have to give a disclaimer that I am employed by other organizations. You can easily find out what those are, but I'm only representing myself today. So I'm representing myself as Rebecca from Tactical Psychiatry.
Speaker 1:Awesome. Thank you so much for that. I had the pleasure of sitting in on one of your presentations that was hosted by the Best Offense Foundation at one of the Stronghold Retreats, which was just amazing. It's one thing to stumble upon Dr Free's work while you're in the middle of your own crisis, which is what happened to me, and now, as we move forward with it, it's amazing to find other individuals who are championing this cause and helping us. And I have to say we are amazing individuals. We are people that will run through walls to accomplish the mission, but we are stubborn People, do not?
Speaker 1:Our guys within our community don't want to listen and don't want to listen and don't want to hear that, hey, there's a ticking time bomb in your body, in your brain. They're like no, I've never been blown up. Seriously, there's nothing wrong with me. It's normal to forget how to get home and it's like what? But it's individuals like yourself that, when you finally are able to sit down with somebody and I've said it before when we talked providers such as yourself are like the horse whisperer for the soft professionals we immediately are you're really able to establish this rapport that lets us know that, okay, this is a trusted individual, and I think a lot of that comes from your own experience. You're not somebody that's coming into this having this perfect cookie cutter life. You're somebody that has experienced a lot of the same health issues and, if you were to mind, tell us about your journey.
Speaker 2:Sure. So I had kind of an unusual start getting into psychiatry, psychology, mental health. I was a college athlete. I was a recruited college athlete, my sport was rowing and back in my day, dating myself, you know, title IX existed. But if you were a woman and you were in my particular role, the coxswain who is the boat driver on a rowing team, if you wanted to do that, back in my day there were very few women's college programs, far fewer than men, and we didn't have sort of a consolidation of specific schools that were always very good. So if you want to be a coxswain on the women's national team, if you wanted to go to the Olympics, one of the routes available to you was competing for a spot on a men's team. So that's what I did, because there were far more opportunities for me with men than there were just with women and a women's eight, which is what I would have been.
Speaker 2:Driving on the women's national team weighs over a ton. Driving on the women's national team weighs over a ton and we're going 50 miles an hour down, you know, um uh river that may or may not have a strong current, so you need to be able to maneuver this boat, understand dynamics, water dynamics, all of the things you need to do. And one of the ways to do that is to go Cox men's boats. So that's what I did and I did that for um men's boats. So that's what I did and I did that for about 11 years.
Speaker 2:I was on men's teams and I competed with men at the college level. I went to nationals, I did summer programs where I had to earn a spot on a pre you know, pre-national team kind of team, went to international races, went to national championships and there was only one spot on the women's team and for my role. So I kind of had to wait through a couple cycles to even have an opportunity. I never actually got it but during that time, you know, I coached men Also. I coached men's elites who are post-college like sort of in the sort of minor league minor league team waiting, you know, for their opportunity on the national team. I coached men there. I coached men's college rowing. I even did a stint at west point and coached as an interim head coach briefly yeah yeah, while they
Speaker 2:were waiting. They had one coach who had to leave, unfortunately on short, and they had another coach coming but it was just, you know, getting somebody there for a couple months and I was able to do that for them. So I did all kinds of interesting things, loved my experience. But I learned about the brotherhood and I learned about men's group dynamics and so and what it meant, what you know what it meant for a man or a woman, but, specifically because I was on men's teams, what it really looks like for a man to put aside all else with a single purpose of success in this one area. And you know, overcoming so much to get there.
Speaker 2:And it's not like earning a PhD, you know. It's not like, you know, getting through medical school. It's very different going through a selection process, training for a decade to get to the selection process and then having to survive and thrive through the selection process and then you get to your first unit or team. What does that look like? And being a new guy and all of these things, I just organically learned that as part of rowing and so I became a nurse. Well, I should say my rowing career was cut short. I experienced significant medical problems because I put aside my physical health as well as my mental health, but really my physical health all those years.
Speaker 1:Sounds familiar.
Speaker 2:And it's taken me 12 years to become healthy again. It has taken like I'm literally missing things inside my body because I had to have them removed, because that's how profound my experience was. The crash at the end of my rowing career was amazing. But then I went into um, I decided to pursue my doctorate in mental health and um it. I kind of ended up in this, this area, and it makes sense to me because I lived with men on men's teams for so long that this is just it kind of makes sense in my brain yeah, yeah, yeah it's.
Speaker 1:It's remarkable that we we tend to picture professional athletes or anybody at like a high, high level of sport. We just discount that there's any similarity like they and no way that they're athletes. There's no way that I could uh ever, you know, be compared to those people. But the reality is stress is stress, and when you're in a constant band of stress and high performance, where 100 on a daily basis has to be 100 on a daily basis, human body's going to break down. It's, it's, it's meant to, it's not meant to. You're not a, you're not a an. Even machinery, even machines, break down, but for some reason, in the soft operator hubris, we think nothing will ever go down. And how did you find yourself working with this demographic of individuals?
Speaker 2:So, yeah, really unusual, right. This is like totally not anything that a typical nurse doctoral student would do. But I knew a lot of people in the Navy and I started asking them you know, hey, if I want to work with the Navy, if I want to work with the military, what do you, what do you think? And at the time I was a PhD student, I was on a specialty scholarship and I was, you know, just sort of like I can kind of do anything. And so I started asking around and, um, after a couple, I would say maybe two months, I networked my way up to this guy. I'm not going to say who he was. He's someone who is in charge of a lot of things in the medical community in the Navy. And he, I got this email and he's like you have three minutes, call me at like 1157 and you better call me on time, cause I'm not going to have time. Like he was told by someone above him to like talk to me, and so he was not happy about it and I had sent him ahead of time. You know, here's some ideas I have that I've collected over time it and I had sent him ahead of time. You know, here's some ideas I have that I've collected over time for working with the military, for my dissertation, you know, and most of them were like aging and whatever typical nurse things.
Speaker 2:And he got on the phone. He said you're a nurse, you're a woman, you need to talk to Navy SEALs because they won't effing talk to us. And I bet they'll talk to you. You need to talk to them about their mental health. And I literally was on the phone. I was like sir, no, I have these other ideas, like why are you telling me this? And he said no, you said you want to help the Navy and I'm telling you, if you want to help the Navy or you want to help the military, you're going to talk to the Navy SEALs because they won't fucking talk to us. And he hung up.
Speaker 1:Great conversation.
Speaker 2:Right, exactly. And you know, I I thought to myself, you know, my, my husband's a fighter pilot, and so I talked with him and I said and I was like, well, I don't, I don't know any SEALs. How would I meet a SEAL? How would I even know like what to ask them? And I was like, okay, well, I guess I should ask the community what they want. So imagine that, asking the community what's going on and how I can help them in an open ended way. And well, how would I meet a SEAL? Well, how would I meet a fighter pilot? And this was like seven years ago and social media was a little bit different seven years ago that the best way to do this was to send DMs to seals that were out that had like medium to small businesses.
Speaker 1:So these, like I, wasn't saying messages to like Jocko you know, I was like.
Speaker 2:I was like okay, dear Jocko.
Speaker 1:Yeah, I want to help carry the boats.
Speaker 2:So I, like I sent messages and I said here are the questions Are you willing to answer these? May I just call you so that I can take notes. I'm not going to use more than five minutes of your time. And so a couple of guys responded and we got on the phone and I said five to 10 minutes, no more. And like, I'm on the phone with them for 90 minutes and they're telling me about the worst day of their life and they're telling me you know, um, I've never told my wife this, I've never told anyone this. The only people who know about this are the guys who were on the ground with me. And so at the end of the call, I'm always asking like are you willing to pass my information to someone else? You don't have to give me anyone's info, will you just pass? Pass it to someone else. And they did so.
Speaker 2:Over two years I talked with over 100 SEALs. Most of them were active duty, and they would just call me and they would always be like hey, I heard that you're a good person to talk to. And this is at like 11 pm on a Tuesday night and they're like hey, I heard that you're someone I can actually talk to. But I heard you're going to ask me some questions. Can I talk to you? I really need to talk right now and I don't have anyone to talk to and I'm like, ok, you know.
Speaker 2:And so, anyway, they told me exactly what was going on in their community. I figured out how to, how I could help them as a nurse. I worked with them on my whole dissertation. They basically told me how to design my project, because there's so many different ways to design research and we figured out I collaborated with over 100 guys on what my project would look like and I researched treating chronic pain and trauma symptoms not PTSD but trauma symptoms among SEALs, using basically non-intervention, like basically just educating them the super straightforward way that they asked for.
Speaker 2:And it was super successful. And by the time I was getting ready to graduate, I thought for sure, I'm never going to work with another Navy SEAL ever again. There's no way, like, what does a nurse practitioner do with Navy SEALs? It doesn't exist. And so I started getting telephone calls from guys I did work with and guys who wanted to take part but couldn't for various reasons, asking me if I would continue doing mental health stuff with their community, and I said I would love to, but I don't know how. So they said we'll figure it out for you, you just have to jump. And so they just started helping me figure out how to do this.
Speaker 1:That's awesome, yeah, yeah, it's. It's remarkable when you're able to, and this is why and it no shade to anybody that's conventional. When you try to bring a program to the larger force, it never works. It's the the amount of bureaucratic loops and hoops that you have to jump through to try to bring something in to address a large force is unimaginable, and filled with so many nefarious people that are involved with other programs that they would rather see get pushed, and it's just ridiculous. But one thing that I've noticed is the smaller the customer, the easier it is, and then you also have the ability to tailor it exactly to what that demographic needs, and that's something that I'm not seeing enough. When it comes to addressing our soft professionals, we need more innovation. We talk about innovation when it comes to Battlefield, talk about innovation when it comes to a new software for targeting bad guys, but what about innovation when it comes to mental health and other resources that can be utilized in the team room? We don't have enough Rebecca's out there.
Speaker 2:No, you could make 10 of me and we would still be overwhelmed, because I don't just do men, I don't just do one-on-one mental health stuff like that. It doesn't even scratch the surface. I mean the number of veteran service organizations. I serve on boards. I'm on the seal future foundation. I work with the um genesis foundation that's out of the schoolhouse on Fort Liberty. I work with Dovetail Landing, which is in Alabama. They just hired me to do mental health work for them. I mean the number of organizations and, of course, the Best Defense Foundation and I'm super involved with them. I'm about to go on another retreat with them. It's like my fourth in three or four months.
Speaker 2:Um, and you know, doing all of these things, that doesn't even scratch the net, doesn't even scratch the surface.
Speaker 2:You know I'm I'm doing like forensics, reviews of um medical files for guys who want to go get an 18 series contract but they were diagnosed with depression when they were 12 or they were diagnosed with anxiety or whatever, and they need a letter from a medical professional, a psych professional, and their recruiter or someone they know recommends me, or someone on Reddit. I've gotten a couple of guys from Reddit recently who went on there and asked like yeah, yeah, I don't know what to do. I was diagnosed with, you know, x, y and Z when I was like eight and the recruiter says that I can't get a contract because I have this on my record. I've never taken medication for it. You know, someone close to me died and I was diagnosed with depression when I was like eight. What do I do? Oh well, you should talk with this woman named Rebecca at Tactical Psychiatry. You can find her on Instagram. I'm like oh okay, that's cool, I love it, you know, but like-.
Speaker 1:Reddit for the win. Yeah, seriously.
Speaker 1:So, no, when we start talking about the things that are going wrong with the community, a lot of the big ticket items that we're constantly talking and advocating about are PTSD and then TBI. But what a lot of individuals don't understand is that if you look at the symptomology, if you look at PTSD and TBI in a Venn diagram, there's a lot of things that overlap and a lot of guys are getting fed this doctrine that it's all PTSD. It's all PTSD. You were never blown up in a vehicle, you were never exposed to enough blast. It's all PTSD. But the reality is now we know more. Now we know that it's not just one big bang or a penetrative injury. It's completely different.
Speaker 2:You might go into that one big bang or a penetrative injury. It's completely different. You might go into that. Yeah, this is my area of research. As you know, I'm a. Basically mental health outcomes of cumulative low-level blast among special operators. That is literally what I study.
Speaker 1:It's kind of like I just served this up to you in a perfect volleyball serve. Yes, you did.
Speaker 2:Yeah, and I got involved in this area through Dr Free, who is a perfect volleyball serve.
Speaker 2:Yes, you did, yes, you did. Yeah, this is and I got involved in this area through Dr Free, who is a mentor and friend, because of operator syndrome. So let me back up to my doctorate. So I'm talking with all of these SEALs and they are telling me all of these symptoms that they are experiencing and, as an experienced nurse, at that point I can tell that their trauma symptoms are not adding up to PTSD. And yet they're undergoing 10, 12 treatments for PTSD and none of them work.
Speaker 2:Well, of course they don't work because they don't have PTSD. Same with chronic pain. They're undergoing all of these invasive and, you know, sort of pharmaceutically driven interventions which some people need. Right, Like no question, right, but that's still not helping their pain. And they're experiencing this weird you know 30 symptoms I'm just getting with every single dude and I'm talking with nurses, physicians. I'm like what is this? And then Dr Free and his group published operator syndrome, the operator syndrome paper, right after I finished all of my data collection for my dissertation and I was like, oh, this is it, this is it. This describes what is happening. And then, through Operator Syndrome and really sort of getting interested in neurotrauma, that's how I ended up going into this line of work. So here's basically what's happening. Guys, I'm just going to say guys, inclusive of women in special operations, absolutely, but dudes are going out and I mean how many rounds of anything do you fire in a given year? Of anything, I mean?
Speaker 1:countless right.
Speaker 2:If you just think about you know going to a shoot house or wherever else you're going on a workup and you know practicing breaching or practicing clearing a house just this cumulative low level blast over time and what happens and I can share visuals with you if you want afterwards. But what happens is all of that blast from that weapon, it doesn't matter what the weapon is enters your body, and I am focused on the brain. But it also enters your abdomen, your cardiovascular system, your pulmonary, your lungs, your pulmonary system. It enters your abdomen, your cardiovascular system, your pulmonary, your lungs, your pulmonary system. It enters every area of your body and what happens is it causes friction inside your body and it injures everything inside of it. It causes things perforate Just you know things sort of look like a cheese grater After enough blast exposure your blood vessels and things, especially inside your brain.
Speaker 2:They develop little holes, things leak out of your vasculature in your brain. It impacts all of the structures in your brain, the soft tissue, everything inside of it. And what happens over time is your body and your brain start forming scar tissue and that's kind of the best way to describe it. And the injuries over time cause things to just kind of stop working or it sends your immune system places where your immune system, when it gets in there and tries to fix them, it's doing more harm than good. And some of these things, for example, is your hindbrain, and your hindbrain controls your breathing all the time, but also when you're sleeping. If your hindbrain isn't working and it forgets to send signals to tell you to breathe, you end up with sleep apnea.
Speaker 1:Let's just pause there and review one of the most diagnosed things that we have within the community sleep apnea and with the rise and you can see the correlation and the rise in the diagnosis of sleep apnea within the soft community led the VA to do what? Reduce the payout for sleep apnea. Fact Go, check it out. And if you look back and this was right, 2013, 2014, mass amount of guys getting out and the first thing they'll tell you oh, snoring all the time, you got sleep apnea. And that came on the periphery when everybody started hearing about this. And then recently, within the last, I want to say like three or four years, they're like, oh well, we're not going to pay out for sleep apnea anymore. Why is that? Because it's happening to all of us, every single one of us, and if you think it's not malicious, no, they are a very greedy organism. They're going to take money where they can and every single senior nco, every certain major within soft, everybody freaking snores everyone, everyone I mean how?
Speaker 2:unusual is it for you to go to a retreat with a bunch of soft guys like who doesn't have a sleep apnea machine, like if I'm there, I'm the only one who doesn't have a c-pap, I'm like the only one right I got off mine.
Speaker 1:I got off mine recently oh good, yeah, congratulations thank you.
Speaker 1:It hard work, um, hard freaking work. That's to say that there are things you can do to get better, there are things you can do to fight back against this enemy. But understand if your wife can't get a full night's sleep, if you're constantly tossing and turning or you're one of the few that are about to separate and you went and got that sleep study. This is something that is crucial to understand about human anatomy. Breathing is important, and there's many of us out there that are literally close to death at night.
Speaker 2:Yeah, and over time it causes heart disease. It causes all kinds of problems that people just don't want, so it's better to just use the treatment and work on it while you're using the treatment, I mean right.
Speaker 1:Yeah.
Speaker 2:I mean all of this, all of this blast, all of this stuff causes injuries in your brain. That causes problems like this. It causes anxiety, it leads to depression, it leads to suicidal ideation and we know that now, through being able to test, you know what's called biomarkers, but basically byproducts of the injuries in the blood, products of the injuries in the blood. We know, we see it. And so it's not just in your head, it's not just your anxiety speaking to you, it is literally a brain injury and it's just a low level, insidious change in your brain over time that causes all of this stuff. It causes diabetes, it causes endocrine problems like testosterone. No wonder everyone's testosterone is super low. Your poor pituitary gland is just getting railed by blast and there's so many ways it can be injured, and it's probably being injured in every single way so it stops sending signals to your testes to produce testosterone or to produce sperm. I mean, it's part of the whole. It's part of the whole thing with guys experiencing infertility, erectile dysfunction. It's so normal Erectile dysfunction in the community, yeah.
Speaker 1:It's. It's one of the and I was just going to pause there and reflect on that um, on the endocrine system. The another thing that we're seeing within the soft community is also infertility, which is like, hey, dealt with it. This is a real thing, guys. You have to understand that testosterone and all the other healthy hormones that you need, it's not just in one aspect of your body. A lot of that's up here, it's all in your brain.
Speaker 2:It starts in your brain, all the signals to the rest of your body to produce all of your endocrine stuff or shut off things like cortisol and all of that it starts in your brain and your brain is just getting blasted 24, seven plus plus.
Speaker 2:then you have vehicle rollovers, you have hard openings, you have hard landings, you have all of these other things that produce like the blast, and then all of the things I just listed, like with combatives and things. It's like a sub-concussive TBI where you don't lose consciousness. Maybe the first couple of times you feel like your bell was rung, but eventually your brain is very resilient and you'll stop feeling like your brain was rung. Your bell was rung eventually, and then it takes a harder blast to get that feeling in the future. But just because you don't feel it doesn't mean it's not happening.
Speaker 1:It's so true. And the thing that we have to remember, too, is a lot of us came from other military units that were, just as you know, prone to getting injuries, as being in special operations, you have paratroopers, you have artillery men, you have individuals that were jumping doing mass attack exits out of C-17, c-130s, slamming into the ground as young men and before that. Here's the kicker it's not about just one big time, it's what you've done your entire life. How many of us played football? How many of us were wrestlers?
Speaker 1:How many of us were involved in car accidents, were involved in high impact sports, and now we understand that even things like snowboarding and skiing, yes, but we are so, and I don't know if it's, I don't know if I don't think it's fear, I think it's just like I said earlier. I think it's this idea that, well, I'm still functioning fine. Obviously, that hit wasn't anything, obviously all these injuries, but then you have that one moment, then you have that one extra moment and it could be just the right amount of stress that sends you over the edge, and that's what guys will understand. Yeah, you've been fine all up until you have this one moment.
Speaker 2:You've been fine. Yes, because are they fine, they're not fine.
Speaker 1:They are not fine.
Speaker 2:You know they're not fine. They're probably experiencing some kind of real dark thoughts, suicidal ideation, daily. They're probably, they are in the darkness. They're experiencing some brain static and tinnitus. They're ringing in the ears. That's not normal, guys. That is not normal. It's a sign that you are experiencing this subconcussive brain damage Like that's not normal. But it's so normalized in the community that, well, everyone has it. Everyone doesn't sleep more than three or four hours per night. That's normal. It's not normal. Everyone gets a divorce that's not normal. You know everyone, right? I?
Speaker 1:mean, it's so true, rebecca, it is so true we, we hear these stories from our, our mentors, the guys we look up to, and we don't wear your drums or don't wear your ear pro when you're in a firefight, don't worry about when you're in a machine gun range. And I just thought tinnitus was this thing that you earned. It was a cool man. I got this constant thing and then you get. Then then you're sitting in front of a VA specialist getting fitted for your earpieces.
Speaker 1:I don't know about you guys out there listening, but there's nothing cool about having hearing aids and you're just turned 40. It's not cool. And the tinnitus is something that I didn't have an understanding of what it was. You just think it's like ah, it's just this thing in my ear. It's deeper than that. But again, we lack the advocacy to scream and shout about this stuff. What have you found successful in the way of being able to promote and push the idea of? Hey, be open to looking at all this information and be willing to say maybe I need to talk to somebody.
Speaker 2:Yeah, that's such a great question. So I've seen a change. So I've been doing this for seven years. I've been talking with operators for seven years and I've seen a change over time. And I think a lot of it is general awareness and some of it is younger generation, you know, gen Z is a little more aware that there might be a problem down the line if they do X, y or Z, because they're sort of growing up in this time when seeking mental health help is a little less stigmatized. But for a lot of the older guys you know who've been in for at least you know five, 10 years they've done, you know at least a full workup and deployment and they come home and they know they're not the same. And I think talking with somebody like myself and just saying to them hey, like dude, like what you're experiencing, like I know this feels like you are bearing your soul to me and thank you for doing that. But everyone says this, your teammates feel the same way you do and especially when guys come to me through like a referral and they've heard my name and they know other guys who, like might follow me on social media or like share something that I share or whatever they are like, oh okay, well, I can trust her. She's talked with all these guys I might know somebody else who she's talked to and she's saying that everyone else feels this way.
Speaker 2:I talked with a guy this week who was telling me he's out now and he's been out for a couple of years and he had a really outstanding career, like truly outstanding. And he's like I don't know how to be normal, how do I be normal in society? And I laughed and I was like I'm not laughing at you, I'm laughing because this is the question that everyone asks me. And he's like they do. And I was like yes, of course they do. So I think it's really the sense of like I'm normal. This is my experience. Like, even though we're not talking about it in the team room, even though, like, maybe it hasn't seeped into conversational culture with the people that I work with, like this guy's probably experiencing the same thing. And Rebecca is telling me direct quotes that someone else said, or she's just using a description that someone else said, and that's exactly what I think. And there's no way Rebecca would know this because she's not like me, so obviously someone told her this at some point. So therefore, yeah, other people must be feeling the same way.
Speaker 1:Yeah, it's not. We at first want to tell ourselves that we're the anomaly, that we're broken and everybody else is fine, and I think that's that inability to have self-compassion talking through a lot of us. Let me tell you I didn't have that my entire life. It wasn't until I started getting better and started digging into my own healing that I understood the power of self-compassion, being able to say hey, man, you're not alone in this. Other people are suffering. They're just at different states of their journey. That's the truth.
Speaker 1:Everybody is going to experience this. It's just about advocating and making the painful parts a little shorter for those that are coming out now. I don't want somebody to feel alienated anymore. I don't want people to feel like they don't have any resources. There are tons of resources out there. Guys, you're not alone. The things that everybody is telling Rebecca and every other professional are across the board. Like we can literally plot it and show it on the graph. Like you're probably sitting there listening to this on your way to work, thinking like, oh fuck, maybe it's just me and Denny's like no man. Like there's a whole fucking regiment of us and we're all going to experience it.
Speaker 1:It's the signature injury of GWAT, tbi, and that should tell you that you're not alone in this. You're not alone in the suffering and, as time has progressed, we now have better resources and better methodologies for treating this, and that's the beautiful part. It's just how do we get your ass into the office to sit down, how do we get you into the treatment centers? Because one thing that I realized is you can't treat this with going to sick call one time. We can't treat this by going to Fort Liberty's WOMAC treatment center. We need specialty care and if we don't start building these systems, we have intrepid centers now. We have a lot of places out in Maryland. We have the VA hospital out in Richmond Virginia, but we need more resources.
Speaker 1:When we start looking at this, how are we going to take care of these individuals that have put their lives on the line for the last 20 years? Like I said earlier, we don't have enough Rebecca for the last 20 years. Like I said earlier, we don't have enough Rebecca. So one of the things I think is really beneficial is having that crosstalk, which is something we talked about a couple of days ago was the importance of providers sharing and talking through their underground railroad of support.
Speaker 1:I'm a benefit of that, I received that I've had doctors that were willing to call up a different treatment center and be like hey, this is the patient you're getting. Here's everything we're going through and breaking our backs to get him there because he needs X, y and Z, and that's something that I am so appreciative of individuals such as yourself that are doing that. But I also know that it comes at a cost and you can't take care of everybody without taking care of yourself, and I want to ask you what? How has this impacted you, because it's so closely related with your own journey.
Speaker 2:Oh, my goodness. So I'm going to tell you a story Um, and this might Um and this might uh. Okay, so I work with you all. I work um seals, green berets, uh, lots of special operators. I work with a federal agency guys, uh, who are typically former special operators.
Speaker 1:Yep, yep.
Speaker 2:And I unfortunately know some people who have died, some operators who have died who I've known through various means. Sometimes I know their wife, not people I've met since I started doing this and I have heard a friend's death story three times from people I was taking care of, from people I was taking care of, and none of them know that I know him and it has been retold to me and I say I've heard it three times. I've had three patients who were there and this is very heavy.
Speaker 2:We are not trained and this is a big thing for mental health we are not trained to hear the kinds of stories that you all tell, and a big part of my practice is I never ask anyone to share stories like that. Typically they come up organically and very early. So I was getting telephone calls at all hours from all of those guys. I figured out that there was just no way I was going to be able to carry this burden. Best practice for someone like me is to go find my own therapist, and so I have actually worked with a series of therapists throughout the time I've been doing this and I don't tell anyone anything that my patients tell me, but they help me figure out how to accept this heavy thing and put it down.
Speaker 1:Yeah.
Speaker 2:So that when I leave a call I might feel a little bit of that emotional tug, but I don't carry it. I think about my patient, my client. I might be worried about them I might, and that's normal for us but also like going through therapy myself and figuring out how to actually take these heavy things so that when I do encounter big things like hearing a friend's death story that, you know, in a way that shocks me every time I hear it, I am able to take that information as a professional.
Speaker 2:And it's not a compartmentalization, I'm simply putting it down yep and that is a skill and that makes this work very challenging for people to step into absolutely.
Speaker 1:That's something that, uh, as a peer-to-peer support you know facilitator myself and somebody advocates for it you have to understand and it's a physical feeling.
Speaker 1:You carry that and I remember some of the nights like I would walk in and my wife would see me. She's like you know, you need to have boundaries, you need to have like understanding of there's support and then there's individuals that just want to relive it and share it and it's like you've got to move past the trauma. Pure to pure support doesn't work if we're re-ashing and opening up the same wound over and over again. And it's one of those things where it's like, hey, I love you like a cousin dog, but we can't relive your experience every time we come and hang out. It's about sharing the success, sharing the failures, and then providing some encouragement and saying, hey, next time don't get out of the car and chase that person. Maybe just say the Lord's prayer and then drive away. But it's true, when you support somebody and you're a person that's of service and you love what you do, it becomes a challenge sometimes. So I'm absolutely thrilled to know that.
Speaker 2:Yeah, therapy is for everyone even healers and healers in some ways. Most of all because there is no way that I or anybody else could continue to do this work without having an outlet for ourselves and truly. And it's not just going for a run, it's not just lifting heavy stuff and putting it down again, which is one of my favorite ways to recover right, but it is literally your own mental health. You cannot pour from an empty cup.
Speaker 1:Yes, thank you. Yeah, you cannot. We, as people, that love to serve. That is a part of you. If you're a part of this community, it's a huge part of your heart. The reason why you're an NCO. There's a reason why you're a leader in an organization you love being of service.
Speaker 1:And oftentimes, when we're going through our own journey, we touch the horrible, traumatic stuff a little bit with a therapist, with a licensed mental health professional, and then we feel good and then we're like, okay, now I'm going to take care of everybody. It's not how it works. And I see those leaders all the time. They're championing the cause, they're trying to tell everybody, go get help, and then they still run home and drink an entire bottle of Jameson or they're cracking some crispy boys on their couch, not dealing with their real issues. And the other thing is venting to the right person, being able to talk to the right person.
Speaker 1:I remember I got to a point where I thought I could vent to my wife and share all the horrible things, and that's also not the answer, because your family, your wives, they don't have a frame of reference for it. They say that a lot. It just you're going to get that look of like what the fuck? So understand, like that's why you want to talk to a counselor, that's why you want to find somebody to talk about and start, and that opens up the gateway for more resources. You know, talking with your wife it's amazing, but understand that some things they won't have the, they won't have the frame of reference.
Speaker 1:They weren't in Afghanistan with you. They weren't in Iraq with you when things fell apart. They arguably never experienced something like that. So you may not get the right reaction and you might stress them out because of that. What I didn't know, and what a lot of guys don't know, is that you bring a lot home. Ptsd comes home with you, your anxiety, all that bleeds off in your family and I'll say it again If you've ever heard the phrase, I feel like I'm walking on eggshells when you're around. That is a huge sign. Please don't get mad at your wife or your kids when you hear that. Take that as a sign from God, that A thank you for being vulnerable enough to say that with me, I'll be right back. Let me get my ass to P3 and start working on some things.
Speaker 2:Exactly, exactly. And I'll tell you, most people who do what I do, we don't do therapy, like I always tell guys like we're not doing therapy. Yeah, I might pull something from a therapy that I was trained in. I mean, that's why the training is so important, that, like, I know how to give you therapy but I can also pull pieces. But most of what I'm doing and most of what people like me do with soft is we problem solve.
Speaker 2:We talk about how to move forward. We're like, okay, this pain exists and I'm not talking about using the pain to move forward. I'm talking about how is it affecting your life right now and how is it impacting your future, and let's figure out a way to move forward anyway, because there will always be pain. This is a burden that you may have to carry and I'm going to help you put some of it down. But also, this is a thing that happened to you. But we are going to move forward anyway and we are going to live our life anyway and I'm going to help you figure out your endocrine stuff. I'm going to help you figure out all of these pieces using, you know, all this education, but also a lot of it is problem solving what? What's coming up for you? Okay, well, let's do it mad, let's do it angry, let's do it anxious. Coming up for you?
Speaker 1:Okay Well, let's do it mad, let's do it angry, let's do it anxious, let's just move forward Absolutely. That's something that a lot of guys need to hear. That little what you just shared, the we, we are going to go through this. It's scary when you finally, when you finally get vulnerable enough to ask for help. There's a brief period in time where everything starts coming out and you start hearing maybe a diagnosis. You start hearing maybe things like hey, we're going to probably need to go to this type of next level care and things get quickly out of control, really fast, and you feel like things are happening to you rather than you're being part of the solution yourself and understanding that, if you've got somebody there with you in this fight, you're not alone. You're going into the unknown with a team. You're going into that house with a team. You're not going to go through this by yourself.
Speaker 1:I say it all the time.
Speaker 1:It's the tagline to the show.
Speaker 1:We get through this together, whether it's your team at the mental health facility, at your base, your team at home, your actual team within your team room, whether you're SEAL Ranger, green Beret, or your Air Force dudes and all your frigging different PJs, tacp, ccts all you nerds, all you guys have amazing resources and you don't need to feel like you're going to go through any of this by yourself, and I will challenge you even your worst critic on your team, the guy that's always ripping on you, he will be there for you when you start getting help, when you start getting better, and you need to feel like you're supported, be vulnerable enough to say something, to ask for help, and then know that you've got a whole room of people, both physically and spiritually, that will be there for you.
Speaker 1:You're not alone in this. It can seem scary, but, trust me, it's like any other thing you've done in your selection processes. Once you start moving, it gets easier and before you know it, you're running and then you're back to thriving, because for a lot of it, it's just barely surviving man, and that's no way to live a life.
Speaker 2:It really isn't no, um, so quick story that illustrates your point. Um, maybe two, three months ago, um, before I went to the very first stronghold, it was like in the weeks leading up to that, um, I'm not going to say what branch of service, um, but but three different guys from the same unit team within a team kind of thing, small group three guys who are all about the same age and absolutely knew each other and were close co-workers individually, called me for suicidal ideation after something happened and I, as a clinician, can't tell them that this guy who they talk to every single day is calling me and speaking with me for the same thing. And I ended up with three guys and I am saying to every single one of them have you talked with anyone else in your group? Have you talked with anyone else? Have you talked with, like, anyone who I don't know, maybe does a similar job as you like, just trying to get them to talk to each other?
Speaker 2:Because I'm sitting here thinking like I don't try, like I'm someone where, if I happen to know that there is somebody else on your base who you can go see, I want you to go see them. I don't keep people for the sake of having clients ever. I want people to be enabled to find the best treatment for them, and sometimes that means that they're going right back to base. But hey, I know somebody who works on your base. I want you to try to get an appointment with this person. I want you to talk to this person. They will help you, whatever. And I'm just sitting there thinking I have these three guys and if they just all talk to each other, or if they just if I could contact someone in this organization and just be like, hey, you need to go have a talk with all the people in this particular team, please go do that. But I can't because I'm a clinician, I'm not allowed to, and so, anyway, that's an example of like please talk to other people.
Speaker 1:Yeah, it's extremely frustrating and it just it goes to show you that you're not alone in this experience. Common humanity people I was there too. You're staring at your own suffering, thinking like I'm the only person going through this. Nobody else in this organization is experiencing. Meanwhile, I now know that same thing within my own company.
Speaker 1:Tons of guys are dealing with the same thing, Like if we can just step outside of our own lived experience for a minute and just reach out and just say, hey, man, are you okay? Because I'll be completely honest, I'm not okay. And that immediately opens the door for somebody to be like you know what man me neither. Like I really have X, Y and Z. And then you're having a dialogue, and then you're talking, and maybe that's enough to get you through the day, and maybe that's enough to have that courage to say why don't we go to P3? Why don't we go to mental health? Real quick, man, let's just talk to team sergeant, let them know we're going to go to P3 and let's just do it. Let's just freaking get this off our chest and figure out where we can go from here, and that's something that is completely within the realm of possibility.
Speaker 1:You have so much more to deal with on your plate than fear about going to talk to somebody. Get out of the way. Talk to somebody today. Be willing to go to the unknown. For goodness sakes, look at all the things you've done. You're a Navy SEAL. You're a Green Beret. You're a Ranger. You're an infantryman, a mortarman. You're just a service member that has made it into the United States military. Service member that has made it into United States military. You've been through some hard stuff. Be bold, Be willing to go into the unknown and ask for help. And hey, if you would rather just reach out anonymously, hit us up PsychHopPodcastgmailcom. I'm just going to forward you to Rebecca or any other programs that I have Mission 22., Heal the Hero Got tons of them guys. We could sit here for an hour and I will just rattle off resources. That's just to say that we have people that are in the fight with us and you're not alone, Rebecca. I can't thank you enough for being here.
Speaker 2:Thank you for having me.
Speaker 1:If our audience members wanted to get a hold of you, what's the best way?
Speaker 2:You can email me, rebecca at tacticalpsychiatrycom, but the best way is to find me on Instagram. I'm tacticalpsychiatry on Instagram and lots of people reach out to me and sometimes they say, hey, send me an email, whatever it might be, but I am available.
Speaker 2:I have a website. You can find me on tacticalpsychiatrycom. But reach out anytime. I'm here to help and even, like I said, I don't keep patients. I don't charge most of the people who work with me. I'm really here to be a resource and help you find the very best person to talk to and figure your stuff out.
Speaker 1:Absolutely, and my video editor is going to hate me, but I'm going to go right there. All the places I'm pointing at. You'll see all her icons, all her contact information. So do that. I'll do one more there. Put it right there, guy, right there. Tactical Psychiatry, rebecca Dr Rebecca Ivory. Thank you for being here and to all you amazing listeners, thank you for tuning in. Thank you for listening. Don't forget to send us to all your friends or anybody you don't like. Send them there. Send us to them as well. We'll help them. I love it. We'll see you all next time. Till then, take care. If you like what we're doing and you're enjoying the show, don't forget to share us, like us, subscribe and remember we get through this together. Take care, thank you.
