I just went and looked at the website Medal of Honor Speakout and I cried.
Then I began looking more closely at the message, which seems to be a script written by a military PR guy, and they all say the same thing, some with compassion and conviction and some like... Well go see for yourself.
I sent the website the following email:
I have played several of your videos and so far, none of the Medal of Honor recipients says that he had problems after he got home, although Audie Murphy said he did and fought with the VA during Vietnam to get help for combat veterans. Audie Murphy was sleeping in a bedroom he had built in his garage with the lights on all night and a gun under his pillow, and having a recurring nightmare. (50th Anniversary Issue of Esquire, article by Thomas Morgan, I believe). I suspect some of the others may have had similar experiences. Talking about them will have more of an effect than this impersonal stay strong message.
This "stay strong" message does not cut it. Unless some of these guys say that they needed help, it will simply keep our current veterans thinking that these guys did not need help because they were stronger!
Please reconsider the message. Drop the " stay strong," and say "get help. I did." Or "I lost three families before I realized it had affected me," or something like that. The idea that you don't want to let the enemy win is good.
Please forward this message to the Medal of Honor guys and let them decide.
I am the wife of a Vietnam veteran helicopter pilot, Robert Mason, who wrote the memoir, Chickenhawk, and we lived with PTSD when it didn't have a name and was not supposed to exist. Bob thought he was a loser, and I thought I was a bad wife or he would not be having problems. If we had known anyone who said they had problems too, it would have helped.
Patience Mason, Editor and Publisher
Patience Press
P O Box 2757
High Springs, FL 32655
352-215-9251
ptg@patiencepress.com
www.patiencepress.com
Publisher of information on recovering from PTSD
Member:
The International Society for Traumatic Stress Studies
American Academy of Experts in Traumatic Stress
" Every gun that is made, every warship launched, every rocket fired, signifies in the final sense a theft from those who hunger and are not fed, those who are cold and are not clothed." --Dwight D. Eisenhower
Thursday, May 13, 2010
Monday, May 10, 2010
Belleruth Naparstek:Note to Colleagues: Please Stop Saying Post-Traumatic Stress Is Incurabel
If this were anyone but Belleruth, I would be going nuts, saying it's bullshit, but I know Belleruth.
She worked with one of the most effective and innovative PTSD programs in the country, (which of course the VA defunded and closed).
Transcend was a twelve week residential joint PTSD and Substance Abuse treatment program at the Brecksville VA in Ohio. There was a workshop on the Transcend Program at the International Society for Traumatic Stress Studies, probably in 1995, which I went to, and believe me these people, Beverly Donovan PhD and Edgardo Padin-Rivera had the right attitude, and so does Belleruth!
I reviewed the Transcend Treatment Manual and their Workbook for Veterans in the Post-Traumatic Gazette (V1N3, free online at http://www.patiencepress.com/patience_press/Free_Samples.html near the bottom of the page. One of Belleruth's CD's is reviewed in V5, N2 of the Post-Traumatic Gazette).
Edgardo and Bev asked Belleruth to make them a guided imagery tape for the guys in the Transcend program. She did. It worked. It helped them. Now that one tape has blossomed into three pages of CD's that can help you heal from PTSD, (http://www.healthjourneys.com/category.aspx?mcid=20&catid=7).
Guided imagery reaches deep into the primitive areas of the brain, the parts that don't really speak English and can't tell time, so they don't know it is over. Those areas are where your non-verbal memories of the trauma are stored, triggering you over and over and over. If you can access them in talk therapy or write about them as Bob did, it turns them into regular narrative memories in your frontal lobes and they are much less distressing. I agree with her that often this is not enough. It can be going at the problem from the wrong end. Get your body calmed down and things will go better in life, and in therapy if you choose to pursue it.
If you can't talk about it (yet), as a lot of vets can't, do yourself a favor and read Belleruth's article and try some of her suggestions. They are working for veterans right now.
And when some future trauma comes along, if you find your symptoms coming back, don't think it didn't work: think it worked once and it will work again, and get more help.
That is my only problem when people say PTSD has been "cured." I know it can be radically improved by various therapies and treatments, but will it come back? Maybe. We don't know. Trauma is cumulative. So instead of saying it will never come back, tell them if it does, get more of what works! Because otherwise the vets just think they failed and they can't be helped.
BTW, eventually there is always a study saying that some good therapy or technique don't work, and when it comes out you can be sure that the treatment was applied in a rote way by VA staff who didn't believe in it and didn't want to do the work or for the treatment to work and probably thought all vets were whiners. That is why some really excellent treatments work at one VA and not so well at another one.
She worked with one of the most effective and innovative PTSD programs in the country, (which of course the VA defunded and closed).
Transcend was a twelve week residential joint PTSD and Substance Abuse treatment program at the Brecksville VA in Ohio. There was a workshop on the Transcend Program at the International Society for Traumatic Stress Studies, probably in 1995, which I went to, and believe me these people, Beverly Donovan PhD and Edgardo Padin-Rivera had the right attitude, and so does Belleruth!
I reviewed the Transcend Treatment Manual and their Workbook for Veterans in the Post-Traumatic Gazette (V1N3, free online at http://www.patiencepress.com/patience_press/Free_Samples.html near the bottom of the page. One of Belleruth's CD's is reviewed in V5, N2 of the Post-Traumatic Gazette).
Edgardo and Bev asked Belleruth to make them a guided imagery tape for the guys in the Transcend program. She did. It worked. It helped them. Now that one tape has blossomed into three pages of CD's that can help you heal from PTSD, (http://www.healthjourneys.com/category.aspx?mcid=20&catid=7).
Guided imagery reaches deep into the primitive areas of the brain, the parts that don't really speak English and can't tell time, so they don't know it is over. Those areas are where your non-verbal memories of the trauma are stored, triggering you over and over and over. If you can access them in talk therapy or write about them as Bob did, it turns them into regular narrative memories in your frontal lobes and they are much less distressing. I agree with her that often this is not enough. It can be going at the problem from the wrong end. Get your body calmed down and things will go better in life, and in therapy if you choose to pursue it.
If you can't talk about it (yet), as a lot of vets can't, do yourself a favor and read Belleruth's article and try some of her suggestions. They are working for veterans right now.
And when some future trauma comes along, if you find your symptoms coming back, don't think it didn't work: think it worked once and it will work again, and get more help.
That is my only problem when people say PTSD has been "cured." I know it can be radically improved by various therapies and treatments, but will it come back? Maybe. We don't know. Trauma is cumulative. So instead of saying it will never come back, tell them if it does, get more of what works! Because otherwise the vets just think they failed and they can't be helped.
BTW, eventually there is always a study saying that some good therapy or technique don't work, and when it comes out you can be sure that the treatment was applied in a rote way by VA staff who didn't believe in it and didn't want to do the work or for the treatment to work and probably thought all vets were whiners. That is why some really excellent treatments work at one VA and not so well at another one.
Friday, May 7, 2010
Feeling Warehoused in Army Trauma Care Units
I just found out about this. Read the article by clicking on the link.
Fort Carson was originally cited in 2006 as the place where soldiers with PTSD were mistreated, and guess what, they are still doing it! Imagine my surprise.
The fact is that Army psychiatrists, Army doctors, and Army officers and NCO's have a conflict of interest in dealing with PTSD. They want drugs and discipline, so they can send people back to combat. The conflict of interest is that the medical personnel should first do no harm, and sending someone with PTSD back will only make it worse. This was illegal in Vietnam and World War II. Once you had combat fatigue, you could not be sent back to a combat zone. Of course in World War I they sent guys with shell-shock induced paralysis, blindness, etc back to the front after connecting them up to an electrical apparatus and cranking it till, as the report states, the blind see, and the dumb speak and the paralyzed move. I wonder if they have thought of that at Ft Carson? Maybe I shouldn't give them the idea.
There are no randomized clinical trials of whether sending guys back on drugs, who already have PTSD, is even safe. Israeli studies of veterans of several wars show that people with PTSD get it faster and worse in subsequent wars... But you know, they are foreigners...
From the article, it seems that the medical staff are being ignored and exploited by the chain of command. Their recommendations are not being followed. I believe this is because it is not designated a hospital where the medical staff would be in charge, not the brass. This needs to be changed.
To get back to my original idea, that those in charge have a conflict of interest: the Army, as represented by the officers and NCO's, is in loco parentis to the soldiers, in the place of a parent. There are abusive parents we all know, but the Army doesn't advertise "We'll use you and then screw you over." They say we'll give you a future. They say join us and be a hero, not that we'll make your life hell if you have a normal reaction to too much combat trauma.
The people who get PTSD have the most traumatic events (including childhood events), the biggest losses (severe wounds, friends, belief in God and country or that the Army will take care of them, their sense of self), the least social support (so these Trauma Care Units, intended to be social support, but staffed with ignorant abusive NCO's simply make PTSD WORSE), the fewest resources (not just money, also emotional skill in dealing with painful events, relationship skills in dealing with friends and family, etc.). Human cruelty and neglect make PTSD worse. So instead of helping these soldiers, what they are doing makes it worse.
Of course, the NCO's who are doing this, are probably acting out their own PTSD, emotional numbing, irritability and outbursts of anger, feeling like these losers just don't understand being a real man/soldier like me, unable to concentrate on information about PTSD because they are concentrating on their own (survival) priorities: getting these bums in line. Can I keep my job if I can't keep them in line. It's a heads you win/tails I lose situation for everyone.
I am so depressed by this that I can't even rant.
Fort Carson was originally cited in 2006 as the place where soldiers with PTSD were mistreated, and guess what, they are still doing it! Imagine my surprise.
The fact is that Army psychiatrists, Army doctors, and Army officers and NCO's have a conflict of interest in dealing with PTSD. They want drugs and discipline, so they can send people back to combat. The conflict of interest is that the medical personnel should first do no harm, and sending someone with PTSD back will only make it worse. This was illegal in Vietnam and World War II. Once you had combat fatigue, you could not be sent back to a combat zone. Of course in World War I they sent guys with shell-shock induced paralysis, blindness, etc back to the front after connecting them up to an electrical apparatus and cranking it till, as the report states, the blind see, and the dumb speak and the paralyzed move. I wonder if they have thought of that at Ft Carson? Maybe I shouldn't give them the idea.
There are no randomized clinical trials of whether sending guys back on drugs, who already have PTSD, is even safe. Israeli studies of veterans of several wars show that people with PTSD get it faster and worse in subsequent wars... But you know, they are foreigners...
From the article, it seems that the medical staff are being ignored and exploited by the chain of command. Their recommendations are not being followed. I believe this is because it is not designated a hospital where the medical staff would be in charge, not the brass. This needs to be changed.
To get back to my original idea, that those in charge have a conflict of interest: the Army, as represented by the officers and NCO's, is in loco parentis to the soldiers, in the place of a parent. There are abusive parents we all know, but the Army doesn't advertise "We'll use you and then screw you over." They say we'll give you a future. They say join us and be a hero, not that we'll make your life hell if you have a normal reaction to too much combat trauma.
The people who get PTSD have the most traumatic events (including childhood events), the biggest losses (severe wounds, friends, belief in God and country or that the Army will take care of them, their sense of self), the least social support (so these Trauma Care Units, intended to be social support, but staffed with ignorant abusive NCO's simply make PTSD WORSE), the fewest resources (not just money, also emotional skill in dealing with painful events, relationship skills in dealing with friends and family, etc.). Human cruelty and neglect make PTSD worse. So instead of helping these soldiers, what they are doing makes it worse.
Of course, the NCO's who are doing this, are probably acting out their own PTSD, emotional numbing, irritability and outbursts of anger, feeling like these losers just don't understand being a real man/soldier like me, unable to concentrate on information about PTSD because they are concentrating on their own (survival) priorities: getting these bums in line. Can I keep my job if I can't keep them in line. It's a heads you win/tails I lose situation for everyone.
I am so depressed by this that I can't even rant.
Thursday, May 6, 2010
PTSD: Get tougher soldier
I came upon this letter by a WWII veteran who called Iraq and Afghanistan "so called wars." I could not believe it. I know there were WWII vets who said Vietnam wasn't a real war. Of course they didn't know that the one year tour often meant the Vietnam combat vet was in combat more than they were because they had long periods of retraining after the big battles.
Italy was hell. So this man went through hell. But why is he so incapable of thought and empathy? Well those are symptoms of PTSD. I'm not saying he has it, just that he has a few of the symptoms.
If you don't think, you can't see what might be worse in this war: Not knowing who the enemy is so you can never relax. Multiple tours. IED's. Horrible wounds which are survived. Remember, they don't just heal and then the person is pain free. The pain continues forever in many cases in phantom limbs and body parts.
This man had uniformed enemies and rules of war. They were welcomed as liberators, not attacked as invaders.
It is worth reading all the comments especially the one by pdxbohica about Audie Murphy and others, and of course, you might want to read my rant at the end of the comments.
Italy was hell. So this man went through hell. But why is he so incapable of thought and empathy? Well those are symptoms of PTSD. I'm not saying he has it, just that he has a few of the symptoms.
If you don't think, you can't see what might be worse in this war: Not knowing who the enemy is so you can never relax. Multiple tours. IED's. Horrible wounds which are survived. Remember, they don't just heal and then the person is pain free. The pain continues forever in many cases in phantom limbs and body parts.
This man had uniformed enemies and rules of war. They were welcomed as liberators, not attacked as invaders.
It is worth reading all the comments especially the one by pdxbohica about Audie Murphy and others, and of course, you might want to read my rant at the end of the comments.
Wednesday, May 5, 2010
First Coast veteran’s fall from grace showcases need for PTSD care
This is one of those "heads I win, tails you lose" dilemmas that face veterans and their families. The criminal justice system is rarely interested in the problems of returning veterans.
They need treatment not prison.
We all remember Kojack, the TV detective, saying "Round up all the recently discharged Vietnam veterans," whenever there was a murder. People who were having flashbacks and doing what they were trained to do wound up in prison like Nathan did. And the prosecutor would say to the judge, "This man is a trained killer and a danger to society." One study I read showed that they got longer sentences for the same crimes.
The police didn't know how to deal with veterans in flashbacks or rages, either. Some of them got shot. Some succeeded in committing suicide by cop.
One group, Nam Vets of Alachua County was formed after the cops shot a Vietnam vet who had PTSD. The cops had tried to get help from our local VA Hospital but were told that no one could come talk to him. It was illegal for them to go. Of course, I asked my mother, Constance G. Hartwell, MD, a psychiatrist at the Boston VA Outpatient Clinic, and she said that in Boston they would and could go. Each VA is a feifdom, however, and ours had a bad attitude at the time and the worst PTSD program in the country.
The guys in Nam Vets went out on calls whenever asked. Some of them, and me, took training at the local Crisis Center and worked on the suicide hot line. We need more of that kind of activism.
You can read more about Veteran's Courts here http://www.slate.com/id/2244158 and here http://www.erie.gov/veterans/veterans_court.asp.
We need to work to make changes that allow for the problems of our returning veterans instead of forgetting about them. Years ago I was at a trauma conference and heard William Mahedy, Vietnam vet, priest, and author of Out of the Night told us that in 1972, they did a survey of the bums on skid row in LA, and 75 percent of them were WWII combat vets. Those are the members of the greatest generation you don't hear about. Today we would call them homeless, not bums. We have a chance to intervene and keep them in homes and out of jail and off skid row.
They need treatment not prison.
We all remember Kojack, the TV detective, saying "Round up all the recently discharged Vietnam veterans," whenever there was a murder. People who were having flashbacks and doing what they were trained to do wound up in prison like Nathan did. And the prosecutor would say to the judge, "This man is a trained killer and a danger to society." One study I read showed that they got longer sentences for the same crimes.
The police didn't know how to deal with veterans in flashbacks or rages, either. Some of them got shot. Some succeeded in committing suicide by cop.
One group, Nam Vets of Alachua County was formed after the cops shot a Vietnam vet who had PTSD. The cops had tried to get help from our local VA Hospital but were told that no one could come talk to him. It was illegal for them to go. Of course, I asked my mother, Constance G. Hartwell, MD, a psychiatrist at the Boston VA Outpatient Clinic, and she said that in Boston they would and could go. Each VA is a feifdom, however, and ours had a bad attitude at the time and the worst PTSD program in the country.
The guys in Nam Vets went out on calls whenever asked. Some of them, and me, took training at the local Crisis Center and worked on the suicide hot line. We need more of that kind of activism.
You can read more about Veteran's Courts here http://www.slate.com/id/2244158 and here http://www.erie.gov/veterans/veterans_court.asp.
We need to work to make changes that allow for the problems of our returning veterans instead of forgetting about them. Years ago I was at a trauma conference and heard William Mahedy, Vietnam vet, priest, and author of Out of the Night told us that in 1972, they did a survey of the bums on skid row in LA, and 75 percent of them were WWII combat vets. Those are the members of the greatest generation you don't hear about. Today we would call them homeless, not bums. We have a chance to intervene and keep them in homes and out of jail and off skid row.
Sunday, May 2, 2010
If there are three phonies and 30,000 with real claims...
Click on my title to see the stupid AP article.
In one of the stupider articles I have ever read, Alan G Breed makes it clear how little he understands about the VA Claims process. He tracked down three assholes who suckered the system. Did he track down three guys who had had legitimate claims denied, or thirty, or three thousand, or any of the 391,257 claims that are now waiting adjudication? Apparently not, although he does mention one guy whose legitimate VA claim has been repeatedly denied.
I guess denied legitimate claims are just not that interesting.
My experience of the VA claims process is that the compensation system is not on the veterans side. It is slow. It is ponderous. It is full of psychiatrists running veterans through compensation exams in a few minutes, when it should take hours. They get paid the same no matter how long or short the exam is. So the ten minute exam in which the MD asked Bob how he was, and Bob said "about the same" and then the doctor asked him about flying (as a preliminary to put him at ease, Bob thought ) and then said goodbye, got the psychiatrist the same money as a real exam would have. The doctor's write up of this was "the patient reports no problems." Not "I didn't ask him about his problems because I just chit-chatted with him for ten minutes."
I went with Bob to his last compensation exam, with a tape recorder. The woman psychiatrist pointed out to Bob his original diagnosis was for "nervousness." I said "Look at the date!" 1968. "What difference does that make?" she said. She was totally ignorant that in 1968, the American Psychiatric Association came out with the Diagnostic and Statistical Manual II in which PTSD did not appear in any form.
DSMII dropped the category of Gross Stress Reaction (if you had been through a gross [big] enough stress–combat, concentration camp, POW–it could affect you for the rest of your life) and replaced it with "transient situational disturbance" meaning if a trauma like war affected you for more than six months, you were screwed up before you went. This change was not based on any scientific evidence and no one has ever admitted to being responsible for it. A study of WWII combat veterans, Archibald & Tuddenham, Archives of General Psychiatry, 1965, had just reported that twenty years after the war, combat vets were still experiencing startle responses, wake ups, anxiety, difficulties in memory, etc. This was completely ignored. The men who wrote the DSMII, those completely self-centered REMF psychiatrists, turned their narcissistic theories about how war wouldn't have affected them into a reality which would cause problems for a generation of combat vets and other trauma survivors.
May they rot in hell.
Oh, sorry. I guess I got carried away. But having lived through that era, I don't put too much stock in the current brain-imbalance theory of psychiatry in which pills rule.
Then there was the veteran of Hamburger Hill who called me. He was very upset because the VA compensation psychiatrist (this is not the treating psychiatrist but someone hired by the compensation system to do compensation exams) said to him, "Oh, I saw the movie. It couldn't have been as bad as that," thereby ending the exam. (It's worse when it's real," Bob said to me when I was upset about the wounded in Platoon.) This kind of total lack of information and understanding causes people who actually have PTSD to lose their ability to pursue the claim. It triggers them into painful scary reactions as well as makes them feel disrespected, devalued and hopeless, which is what the VA compensation system wants.
One of the guys in my book (Recovering from the War) was told by the St Petersburg VA Regional Office that although he had been shot at a lot and had found his CO in the jungle with his head cut off by the enemy, it wasn't "outside the range of usual human experience" for an infantryman, so he didn't have a traumatic stressor. (Totally false interpretation of the criteria). Of course the St Pete VARO was famous for fucking over veterans.
I'd love to see Mr. Breed do a story on some of our 300.000 plus veterans who are not getting what they fought for (and in many cases nearly died for) instead of one on three crooks.
Perhaps it would be too much effort.
In one of the stupider articles I have ever read, Alan G Breed makes it clear how little he understands about the VA Claims process. He tracked down three assholes who suckered the system. Did he track down three guys who had had legitimate claims denied, or thirty, or three thousand, or any of the 391,257 claims that are now waiting adjudication? Apparently not, although he does mention one guy whose legitimate VA claim has been repeatedly denied.
I guess denied legitimate claims are just not that interesting.
My experience of the VA claims process is that the compensation system is not on the veterans side. It is slow. It is ponderous. It is full of psychiatrists running veterans through compensation exams in a few minutes, when it should take hours. They get paid the same no matter how long or short the exam is. So the ten minute exam in which the MD asked Bob how he was, and Bob said "about the same" and then the doctor asked him about flying (as a preliminary to put him at ease, Bob thought ) and then said goodbye, got the psychiatrist the same money as a real exam would have. The doctor's write up of this was "the patient reports no problems." Not "I didn't ask him about his problems because I just chit-chatted with him for ten minutes."
I went with Bob to his last compensation exam, with a tape recorder. The woman psychiatrist pointed out to Bob his original diagnosis was for "nervousness." I said "Look at the date!" 1968. "What difference does that make?" she said. She was totally ignorant that in 1968, the American Psychiatric Association came out with the Diagnostic and Statistical Manual II in which PTSD did not appear in any form.
DSMII dropped the category of Gross Stress Reaction (if you had been through a gross [big] enough stress–combat, concentration camp, POW–it could affect you for the rest of your life) and replaced it with "transient situational disturbance" meaning if a trauma like war affected you for more than six months, you were screwed up before you went. This change was not based on any scientific evidence and no one has ever admitted to being responsible for it. A study of WWII combat veterans, Archibald & Tuddenham, Archives of General Psychiatry, 1965, had just reported that twenty years after the war, combat vets were still experiencing startle responses, wake ups, anxiety, difficulties in memory, etc. This was completely ignored. The men who wrote the DSMII, those completely self-centered REMF psychiatrists, turned their narcissistic theories about how war wouldn't have affected them into a reality which would cause problems for a generation of combat vets and other trauma survivors.
May they rot in hell.
Oh, sorry. I guess I got carried away. But having lived through that era, I don't put too much stock in the current brain-imbalance theory of psychiatry in which pills rule.
Then there was the veteran of Hamburger Hill who called me. He was very upset because the VA compensation psychiatrist (this is not the treating psychiatrist but someone hired by the compensation system to do compensation exams) said to him, "Oh, I saw the movie. It couldn't have been as bad as that," thereby ending the exam. (It's worse when it's real," Bob said to me when I was upset about the wounded in Platoon.) This kind of total lack of information and understanding causes people who actually have PTSD to lose their ability to pursue the claim. It triggers them into painful scary reactions as well as makes them feel disrespected, devalued and hopeless, which is what the VA compensation system wants.
One of the guys in my book (Recovering from the War) was told by the St Petersburg VA Regional Office that although he had been shot at a lot and had found his CO in the jungle with his head cut off by the enemy, it wasn't "outside the range of usual human experience" for an infantryman, so he didn't have a traumatic stressor. (Totally false interpretation of the criteria). Of course the St Pete VARO was famous for fucking over veterans.
I'd love to see Mr. Breed do a story on some of our 300.000 plus veterans who are not getting what they fought for (and in many cases nearly died for) instead of one on three crooks.
Perhaps it would be too much effort.
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