Mediaplanet: It has been over twenty years since you served in Rwanda. How has Canada’s awareness of the internal scars of conflict evolved?

Lieutenant-General the Honourable Roméo Dallaire: Twenty years ago there was literally no capability for operational stress injuries like PTSD, or any experience in the Canadian Armed Forces (CAF) of the impacts caused by these new complex and ambiguous missions we stumbled into since the Cold War ended.

"I have lived through all of this and realized that the gravity of this injury could lead too easily to suicide if not cared for through professional therapy."

The capabilities have exponentially increased in proactive pre-deployment, education, in theatre professional and peer support and post-deployment identification and subsequent therapy. However the weakness remains in the follow through of post-deployment and the maturing of the support programs to the members and most certainly the families.

MP: You’ve become an advocate for supporting PTSD awareness in Canada. Why has it become so important for you to raise your voice on this issue?

RD: Operational stress injuries such as PTSD have been on the increase in security forces since we’ve been engaged in a whole new construct of peacemaking, conflict resolution and protection of civilians against mass atrocities. There is a direct link between this injury and the nature of the conflicts and it is only by making Canadians aware of the extreme ethical, moral, and legal dilemmas, let alone the sheer violence of combat that create these traumatic experiences on a scale not seen in previous wars.

I have lived through all of this and realized that the gravity of this injury could lead too easily to suicide if not cared for through professional therapy.

MP: What are some of the most common barriers to finding and getting assistance?

RD: The most damning barrier to finding and getting assistance comes from the injury itself where one is very reticent of speaking or communicating with others of their internal traumas. 

The second barrier is the weakness and even ineptness of those in leadership roles to realize that they must help the injured person to overcome this reticence.

The third barrier is often the inexperienced therapists who are still considered outside of the culture of those they are treating and thus have little credibility in their patients’ eyes.

The last most obvious barrier is the Darwinian milieu and the stigma to such invisible injuries. 

MP: It’s a commonly held misconception that PTSD is a soldier’s disorder. Why is this not necessarily the case?

RD: In all walks of life people face very stressful situations and even dilemmas that have no easy solutions.  From this level of impact on an individual’s psyche, through the accident victim who has survived, through the first responders that are left with the most horrible of situations within our communities, to even the media and their war correspondents, all are susceptible to this injury of the mind, and none should fear a stigma because of it. 

Therefore it is imperative in the leadership structures of organizations and communities that they have amongst them potentially several walking wounded who are in dire need of being recognized as honorably injured, and can expect a support to stabilize if not rectify their situation through the support of their leaders and peers.

MP: What is your advice to Canadians struggling to cope with, or support others with, this disorder?

RD:  The overriding suggestion that I may offer is insuring the availability of a peer that can be there for the person, even in moments of crisis, to spend three, even four, hours drinking coffee and listening to the injured person in need.  The second significant gesture is to convince the injured person that it is ‘’in’’ to have therapists in your inventory of caregivers. 

And lastly, make it a point to be able to discern when the injured person is possibly moving towards suicidal tendencies and thus intervene.