Healing Combat Trauma

Hey Mama: Celebrating Mother's Day for Veterans

Happy Mother's Day to the mothers who've served in combat, and to the mothers, stepmothers, grandmothers, and adoptive or foster mothers of those who've served, not to mention the wives and girlfriends of combat veterans.  The veteran pays a heavy price for his or her sacrifice; but so do the generally unsung heroines on the homefront.  They're the ones struggling to make sense of the distance and loneliness; trying to hold down a job to keep the family afloat and tend to the children as well; and they're often called upon to pitch in as 24/7 caregivers or patient advocates when the need arises after injury.  Some of these women who we know personally are truly amazing role models, and due an enormous debt of gratitude and respect.  However, they're ALL worthy of appreciation for the mighty roles they fill.  Let's hope this Mother's Day they get just some of the gratitude they deserve.

-----

One veteran's mother, Frances Richey, did something unusual.  She wrote a book of poetry about being the mother of a son at war, called The Warrior.  Amazon.com, in its product description, calls it "A heartwrenching and powerful memoir in verse from a mother grappling with the reality of her son at war in Iraq."  Richey, a single mother, raised a son who went through West Point and became a Green Beret, serving multiple tours in Iraq.  Recently, the Seattle PI wrote an article about the book, called "Mother's poetry illustrates the pain she felt while her son fought in Iraq."  Click here for a link to the book, and here for a link to the article in the Seattle PI.   

No Surprise Here: Recovery is Expen$ive

USA Today has a story in today's paper about the surging costs associated with veterans care, linked here.  This should come as no surprise to anyone who's been following the topic for the last several years.  Today's veterans are sustaining severe, disabling injuries and they seem less reluctant than their predecessors were to know about or file for the benefits they're due, which is a good thing.  Studies like the recent one from the non-profit Rand Corporation, blogged about here, and books like The Three Trillion Dollar War: The True Cost of the Iraq Conflict, by Nobel prize-winning economist, Joseph E. Stiglitz and Harvard's Kennedy School of Government professor Linda J. Bilmes, taken together show both the number of veterans affected, as well as the cost of caring for the wounded for the rest of their natural lives.  The USA Today article suggests that, according to the VA's own estimates, almost 1/4 of OIF/OEF veterans have filed for some form of disability: 181,000 of 755,000 veterans, which is a pretty substantial portion.  However, the payout to individual veterans is usually anything but huge.  If you've read stories like Army veteran Tony Neff's "All I Want is What I Deserve: A Soldier's Own Story of Service, Injury and Neglect," blogged about here earlier, you've seen the hardship money actually involved.  It's not exactly a "get rich quick" scheme for veterans, who can often not even pay their bills based on the disability pay they receive.  Not to mention, combat injuries like PTSD can make it hard to hold down a job, keep a marriage or a family together, or stay in school.  Truly, the costs are staggering, and it's not surprising that they continue to climb.  That said, as a society, we have no other choice but to pay them, and not with reluctance, either, as a tribute to those who served.  Fair is fair.

Editor's note: I'm curious to know whether military contractors' future disability payments are included in these totals or not; and whether they become part of the Tricare or VA system's healthcare delivery program after they return.  They typically earn much higher pay than deployed military, an understandably sore subject to veterans who serve alongside them; but, contractors are often sometimes former military who are returning to a combat zone after several deployments.  Either way, the injuries are piling up and getting more expensive, and in cases like PTSD, cumulative exposure to combat increases the risk of developing the disability.

The Katz Email: Can We Just Call "Bullshh!it"?!

By far the most distressing revelation from the lawsuit by veterans against the VA, currently making its way through Federal court in San Francisco has to be the toxic email, disgracefully titled, "Shh!" and written by Ira Katz, M.D., the VA's top psychiatrist, about the not-exactly-light 'n humorous topic of veterans suicides.  The email essentially attempts to cover up the severity of the number of veteran suicides that are taking place by those who are undergoing treatment at the VA.  The contents of that email by now are fairly well known -- and the general reaction is to Katz's words, not surprisingly, is revulsion.  Senators Patty Murray (D-WA) and Tom Harkin (D-IA) are two legislators calling for Katz' removal.  There's been just enough stink about his ill-chosen words that Katz has been moved to make a very superficial apology for them, a la Roger Clemens.  An article in today's Seattle PI, linked here, quotes CBS News as saying Dr. Katz now calls his word choice "unfortunate."

Erm, well, can we just call "bullshit" on this?  Because, really, it's more than the choice of words people are reacting to -- they're sensing the specious and supercilious attitude behind them.  In the immortal lines from Oliver Wendell Holmes, "Even a dog knows the difference between being kicked, and being tripped over." 

The "Shh!" email brings to mind another bureaucratic bumbler of late, Michael Brown, head of FEMA during the Katrina crisis, who ostensibly fiddled while Rome burned, writing superficial emails to his colleagues preening about his choice in ties and lamely wondering if it was time for him to go home yet. "'Can I quit now?' FEMA chief wrote as Katrina raged," according to an article archived here on CNN.com.

Brown certainly seemed to be over his head (no Katrina puns intended) at FEMA; perhaps Katz, because of his psychiatry training is actually not.  However, they both have a world of learning to do in how to project empathic leadership.  There's nothing confidence-affirming about either one of their responses. Wounded warriors deserve a lot better from the top psychiatrist at the VA responsible for their care.  Those aren't just poorly-chosen words, there's an attitude of callous disregard for the patients behind them as well, that no thin veneer of apology really corrects.  Combat veterans struggling with alarmingly high and well-documented rates of PTSD and suicide need compassionate leaders with a vested interest in their care, not someone making light of the size and the severity of the problem.  In anyone but a psychiatrist, whose field after all is mental health, we might find this easier to understand or excuse.  But in a psychiatrist whose professional responsibility is the mental health of veterans?  Absolutely not.  That's a vote of no confidence, in someone who's sworn to uphold the Hippocratic oath to "first, do no harm."  The bumbling and apparent cluelessness of FEMA's Michael Brown in the face of a huge need for crisis management and control spurred calls for him to resign; perhaps outrage over Katz' email will do the same.  There's really no way to spin that into a positive.  The damage has already been done.

-----

Here's the content of the email Katz titled "Shh!" for those who haven't seen it.  According to the article in the Seattle PI, "Our suicide-prevention coordinators are identifying about 1,000 suicide attempts per month among the veterans we see in our medical facilities," Katz wrote in a Feb. 13 e-mail to Ev Chasen, the department's communication director. "Is this something we should [carefully] address ourselves in some sort of release before someone stumbles on it?"

"Abandon Hope, All Ye Who Enter Here..."

It sounded like potentially good news for veterans and their families at the time, but I'm wondering if it ever really happened.  Human guides were proposed to lead wounded veterans through the maze of healthcare.  On November 1, 2007, the Kaiser Daily Health Policy Report published a news item called "DOD, VA Team To Provide Care Coordinators for Servicemembers, Veterans."  These "Federal Recovery Coordinators," as they were termed, were established "to help veterans with health care and recovery." 

According to the Kaiser Daily Health Policy Report, the Department of Veterans Affairs and the Department of Defense would establish “federal recovery coordinators” responsible for helping guide wounded servicemembers and veterans through their health care and recovery.  Apparently this was an idea introduced by the Dole-Shalala Commission, although it also could be a common sensical approach conceived of by any overburdened friend or family member of an injured veteran.  The concept was that ideally these coordinators would not just aid their clients in navigating the healthcare options available to them, but also produce better coordination between the two departments, Defense and Veterans Affairs.  Strangely enough, the goal to have ten coordinators trained and ready to go by January, 2008 -- a mere two months later -- and in place at the largest veterans healthcare installations. 

It's mid-2008, and I don't know about you, but I've not heard another thing about this.  Do they exist?  Was the plan scrapped because it was too ambitious or otherwise untenable?  Are they out there, but keeping a very low profile?  Inquiring minds want to know...

---

This is what the Kaiser Report said at the time:

The departments of Defense and Veterans Affairs on Wednesday signed an agreement to establish "federal recovery coordinators" who will be responsible for guiding wounded servicemembers and veterans through their medical care and recovery, the Washington Post reports. The recovery coordinator position was a key element of a presidential commission's recommendations to help improve health care services for military members and veterans returning from the wars in Iraq and Afghanistan (Vogel, Washington Post, 11/1).

The coordinators will be responsible for overseeing care coordination between the two departments' health care systems, and they will assist family members as well (AP/Contra Costa Times, 10/31). The first 10 coordinators, who will be provided by VA and trained by January 2008, will be assigned to large military health care facilities. Michael Dominguez, principal deputy undersecretary of defense for personnel and readiness, in a statement said, "This agreement will help ensure our nation's wounded warriors and their families receive the care they need and deserve at the right time, right place and by the right person across the continuum from recovery through to their reintegration into their communities" (Washington Post, 11/1).

All we want to know is, then what happened?

----

Editor's note: for all the non-literature majors in the crowd, the title comes from Dante's Divine Comedy, and is supposed to be what the poet imagined was written over the gates of hell.

Dr. Ecstasy Will See You Now

An article in yesterday's Sunday Times (London, UK) talks about the drug, Ecstasy, as having therapeutic potential for treating severe, unremitting PTSD.  The article, which is titled "Ecstasy is the Key to Treating PTSD," by Amy Turner, is linked here.  The drug in question is more properly known as MDMA, or 3,4-methylenedioxy-N-methylamphetamine, pictured here.

The article says that MDMA's potential therapeutically wasn't noticed until 1976, "when the American chemist Alexander Shulgin tried it on himself. He noted that its effect, “an easily controlled altered state of consciousness with emotional and sensual overtones”, could be ideal for psychotherapy, as it induced a state of openness and trust without hallucination or paranoia. It quickly became known as a wonder drug, and began to be used widely in couples therapy and for treating anxiety disorders. None of these tests was “empirical” in the scientific sense – no placebos, no follow-up testing – but anecdotally the results were almost entirely positive."

The therapeutic potential for treating PTSD is apparently to be found, according to the article, "in the trust it establishes."  One researcher familiar with the drug, quoted in the article, states:

“Many people with PTSD have a great deal of trouble trusting anybody, especially if they’ve been betrayed by someone who abused their trust, like a parent or a caregiver,” he says. “MDMA has this effect of lowering fear and defenses. It also allows more compassion for oneself and for others. People can revisit the trauma, feel the original feelings but not be retraumatized, not feel overwhelmed or have to numb out to cope with it.”

This is obviously good news for PTSD sufferers.  The study is still in its early phases, and the reality is, that if PTSD is able to be treated with one or just a few doses of MDMA, versus potentially years of psychotherapy and/or lengthy courses of pharmaceutical antidepressants, etc., this news is likely to be welcomed more warmly by patients eager to get well than by healthcare providers who previously expected to be providing maintenance doses of psychotherapy and/or pharmaceutical care for years to come.

----

The formal study analyzing MDMA's therapeutic effects on PSTD is being conduced by Michael and Annie Mithoefer, under the auspices of MAPS, the Multidisciplinary Association for Psychedelic Studies, linked here.  While this might sound like a highly "hippy dippy" research project, the reality is, the other day I called a research group at the University of Arizona's Department of Psychiatry, and listened to a recorded message about a trial of psilocybin and OCD.  (See article, linked here.)  Mainstream medicine is apparently, if only slightly, open to studying the therapeutic uses of controlled substances.  In the meantime it's important to note that the street drug, Ecstasy, which may or may not be based on MDMA, depending on the purity, is not a substitute for taking part in a clinical trial like the Mithoefers', and there is always considerable risk in attempting to self-medicate any serious health condition, especially with illicit drugs.  Read the Sunday Times article, linked here -- it's quite informative.  And keep track of this ongoing research, which looks promising for some sufferers.

Editor's Note: In a feeble attempt at true-to-life humor, this was the license plate I saw recently on a very nice, late model Acura, parked in the driveway at a state veteran's home.  Perhaps it was just a visiting DJ.

The Doppelganger of PTSD: the Unwelcome Stranger Who Follows You Home from War

Over time, more and more grassroots efforts spring up as veterans try to help one another deal with the effects of combat trauma and PTSD.  Some of these are simply conversations, where those who went share what the experience was like, and how they've suffered since -- and ideally, also what they've been able to do about it that helps.  The Peoria Journal Star in today's paper has an article about just such a conversation, held by local central Illinois veterans in conjunction with a traveling exhibit of the Vietnam Wall.  The article is short but poignant in the reminiscences shared by predominantly Vietnam veterans about how combat trauma and resultant PTSD has changed their lives, and not for the better.  Click here for the link to that story. 

There's nothing particularly "extraordinary" or "dramatic" about these men's PTSD or their comments about it -- but that's the thing.  They've very representative of what actual people go through who weren't expecting the experience to scar them for years after combat.  Just one example: a combat photographer with a Ph.D. talks about his own experience. "Divorce, alcohol, drugs, jail, attempted suicide ... I've done them all," he said.  If combat trauma is the stone thrown into the pond, just think of the ripple effects of every item he just mentioned.  Sadly, combat trauma affects not only the participants, but also many of the people in their lives.  Recently I received an unsolicited memoir from a former Marine and Vietnam veteran about his experiences with war and PTSD, and on practically every page the same thing ran true: the enormous remorse and regret he felt from the pain he'd inadvertently inflicted on his family members, because of what he was going through at the time, and couldn't cope with.  Combat trauma, left untreated (and we don't mean, with drugs and alcohol ;-), can become the uninvited guest in far too many veterans' homes and every family gathering.

The German word "Doppelgänger" or "double-goer" comes to us from literature, but seems to have some application with what veterans go through as well.  The Doppelgänger is a person's double, often but not exclusively seen as an evil twin, and often in ominous contexts (premonition of someone's death, etc.).  But in the straight meaning of a connected but separate other self, a veritable "double" self, it conveys what some veterans seem to go through.  The memory of war they've experienced is so profound and powerful, it's permanently "attached" to them.  When they return to society, and have to "re-integrate," the combat self actually never leaves them, and this seems to produce a lot of the pain that they feel.  They frequently acknowledge being "permanently changed" by war -- but yet when the war is over, or when they come back, they're expected to integrate back into society, and into the lives they formerly led.  Many veterans talk about how almost no attention is paid to this experience by the military: you come back, and have to figure this part out for yourself, but it can be deeply troubling.  You can't shake the person you became in war -- in fact, it's always with you, as a "second self."  But at some point you have to come to terms with the fact that both those selves are you, and there is no separation.  In a lot of the pain you hear, see and feel from Vietnam veterans as they share about their experiences, you get a very profound impression that they are in fact feeling shame (and yet connectedness) with the person they became because of war, as well as a desire to protect their loved ones, however incapably, from that very person.  Tremendously, what you also see is a deep desire for other, more recent veterans to profit from their experience.  The "older brothers" (and sisters, but it's mostly men) want their "younger brothers and sisters" not to have to experience the tremendous pain, ostracizing, and neglect they felt -- as well as the inability to come to terms with what it meant.  The Vietnam veterans seem to have a deep, and laudable, desire to become the "readjustment counselors" for today's OIF/OEF veterans.  However, their own healing has to take place first -- and from the expressions of deep pain that get conveyed, you can tell how difficult that healing really is, and sadly, how infrequently it's been able to take place.  (True healing, after all, means going through the pain, processing it, and integrating it into the whole self.  Many people accomplish a "form" of superficial healing, which turns out to abandon them later, by masking over the pain with other "drugs," from drugs and alcohol, to social isolation, to even workaholism, to keep the pain at bay.)

Although we need to write more about this topic separately, even "workaholism" can be a drug to suppress painful memories and experiences.  This "drug" is better suited to some than others -- probably the 'Type A' types "enjoy" it most -- but it's effective as far as it goes, which of course is never quite far enough.  I heard an amazing story from a veterans service officer the other day about the most elapsed time he'd ever seen between someone suffering from combat trauma and realizing he had PTSD.  That's referred to as "delayed onset" but check out how delayed it really was, because of workaholism, most likely.  A World War II veteran, 84 years old.  Had fought in Normandy, Ardennes, the Battle of the Bulge.  He felt he'd led a "blessed life," and had in fact just retired (at 84!).  But in his retirement, with all sorts of unstructured time on his hands, started experiencing nightmares, and would wake up, having soaked the bed.  The nightmares were about what he'd experienced, over 60 years ago(!!!), but which he'd finally had "time" to start bringing up from the vault of memory.  And he was suddenly in terrific psychic pain from this.  Although I applaud the amazing things this man must have done during the intervening 60 years to consider he'd led a "blessed life," I can only wish that he'd also been able to find some healing during that time as well.  Experiencing delayed onset PTSD in your mid-80s, from battle you saw in your 20s, must be a terrible thing indeed.  It's also another reminder about how combat trauma continues to affect veterans from all wars.  And how extending compassion, wisdom and healing to veterans from every war is part of what we ought to be doing, as a society, and often do quite minimally, if at all.

Know Your Benefits: Get the VA Handbook

The Department of Veterans Affairs has published its annual resource handbook, called Federal Benefits for Veterans and Dependents.  It details the benefits programs available for eligible veterans and their families.  The handbook is a bestseller for the Government Printing Office, which makes hardbound copies of the book available for a fee ($5), or you can download the 153-page book in its entirety as a PDF on the Web (you must have Adobe Acrobat installed, but that's free.)  Click here for the downloadable PDF copy on the Web.

(If you need to order a hardbound copy of the book, you can do that by contacting the Government Printing Office at the following address: Superintendent of Documents, P.O. Box 979050, St. Louis, MO 63197-9000 (stock #051-000-00233-4).  You can also order the book online by clicking this link.  The Government Printing Office accepts credit cards at their toll-free number, (866) 512-1800.  The cost is $5 a book or $67 for 25 copies.  The stock is #051-000-00233-4.)  (Obviously, the downloadable version of the book is free on the Web.)

The good news is, most veterans do qualify for some VA benefits.  As we noted recently in a previous blog entry linked here, often veterans are slow to realize they qualify, for a number of reasons, and this slows down the process of getting them the benefits they have actually earned.  Don't be one of those vets -- order the book today, or download a copy, and keep it on file for the future, if not for today.

Kathie Costos, Chaplain

Kathie Costos, also known as "Nam Guardian Angel," is a certified, ordained Chaplain and member of the International Fellowship of Chaplains ("IFOC").  The daughter of a Korean War veteran, and the wife of a Vietnam veteran, she has been active in veterans issues since the 1970s.  For the last 25+ years, she has focused on Vietnam veterans with Post-Traumatic Stress Disorder.

As a chaplain with a devout Greek orthodox background, Kathie nevertheless believes that "no matter what church people belong to, they belong to the family of God as God's children."  Years of volunteering with Vietnam veterans and their families has taught her to take care of the spiritual needs of people and not just the already "faithful."

Kathie is the author of a well-regarded book, called For the Love of Jack, His War/My Battle -- about how her family coped with the legacy of PTSD that her husband returned with from the Vietnam War.  She self-published the book immediately after 9/11, out of concern that the word needed to get out about what PTSD was, before many more people began to suffer from it.  The book is available for downloading on her website, and Kathie has also produced many educational videos about PTSD that are also available on her website.  A list of those videos include the following, but because Kathie is always expanding the list of videos she's made about this topic so close to her heart, it also makes sense to "favorite" her on YouTube, where a list of all her videos is linked, here.  A list of those videos current as of this writing include the following (each is hyperlinked to YouTube or Google video, so you can watch them directly):

• Wounded Minds: PTSD and Veterans (Google)
• Coming Out of the Dark: PTSD and Veterans
• When War Comes Home, Part One
• When War Comes Home, Part Two
• Hero After War
• Death Because They Served - PTSD Suicides (Google)
• Wounded and Waiting, Part One
• Wounded and Waiting, Part Two
• Women At War
• The Voice, Women At War
• Nam Nights Of PTSD Still
• PTSD After Trauma
• PTSD Not God's Judgment
• Homeless Veterans Day

A link to Kathie's website about PTSD is here.  For a direct link to the book she wrote about her husband and family surviving PTSD, click here. For a link to her ever-expanding list of videos about PTSD and veterans, click here.

A favorite quote of Kathie's: "The willingness with which our young people are likely to serve in any war, no matter how justified, shall be directly proportional to how they perceive veterans of early wars were treated and appreciated by our nation." -- George Washington.

William P. Nash, M.D.

William P. Nash, M.D., is an active duty Captain in the U.S. Navy Medical Corps, with nearly thirty years of active military service. He is a graduate of the University of Illinois, College of Medicine, in Chicago, and of psychiatry residency training at Naval Medical Center, San Diego. In addition to leading two Navy SPRINT crisis response teams, he has directed two Navy psychiatry residency training programs, and has served as the Director of Clinical Services of the hospital ship USNS MERCY. CAPT Nash has been stationed with the Marine Corps since 2000, including deploying to Iraq in 2004 with the 1st Marine Division as a psychiatrist embedded with ground combat forces. He was awarded a bronze star medal for his service in Iraq in support of combat operations there. Since October, 2005, CAPT Nash has been stationed at Headquarters, Marine Corps, in Quantico, Virginia, where he directs and coordinates combat/operational stress control policies and programs for the United States Marine Corps. He is an Assistant Clinical Professor of Psychiatry at the University of California, San Diego, and has co-edited a book with Charles R. Figley, Ph.D., released in late 2006, entitled Combat Stress Injury.

Senators Harkin and Feingold Introduce Veterans Suicide Tracking Bill

Senators Tom Harkin (D-IA) and Russ Feingold (D-WI) on April 23rd introduced a bill requiring the Department of Veterans Affairs ("VA") to track veteran suicides.  The "epidemic" of veterans' suicides has been in the news recently, both because of the Federal court case being waged in San Francisco this week and next by veterans rights groups against the VA, and because of the recent CBS News investigation into the same.  It turns out the CBS report's high numbers were accurate; and documents produced during the trial implicate the VA's chief psychiatrist, Ira Katz, M.D., Ph.D., in attempting to suppress the true figures.  Various groups have called on Katz to resign.  The proposed legislation, entitled "The Veterans Suicide Study Act" would require the VA to report to Congress how many veterans committed suicide since 1997; and the VA would continue to issue reports annually.  For more information about the bill's introduction, click here.

Aspen Institute Forum on PTSD and Iraq Veterans

Thanks to the miracle of the Internet, the full program from last fall's Aspen Institute's Health Forum on PTSD and Iraq War Veterans is available on the Web.  The program was entitled, "From the Front Lines: Post-Traumatic Stress Disorder and the Legacy of Iraq," and it featured panelists Charles Figley, Ph.D., combat veteran Georg-Andreas Pogany, Jennifer Vasterling, Ph.D., and Barbara Romberg, Ph.D..  Click here for the link to the video, or just watch it below.

Georg-Andreas Pogany

Georg-Andreas Pogany is a retired Sergeant First Class (SFC) and Operation Iraqi Freedom Veteran. After obtaining a bachelor's in criminology from the University of South Florida, he enlisted in the U.S. Naval Reserve. In 1998, he switched services and enlisted in the Army, where he trained as a nuclear, biological and chemical warfare specialist. In 2003, he was deployed to Iraq as part of a Special Forces unit. There, he became incapacitated by toxic drug levels from the anti-malarial drug Lariam/Mefloquine. He was sent to Fort Carson, Colo., where he was diagnosed with a related brain injury. He received treatment and shortly thereafter was honorably discharged.

Since his retirement from the Army, he has worked as a veteran's and active duty service member advocate on health care, combat stress, and military justice. He created and manages "J1W2," Just One Wounded Warrior, which connects veterans and active duty service members with mental health care professionals.

Barbara V. Romberg, Ph.D.

Barbara V. Romberg, Founder and Executive Director of Give an Hour, is a licensed clinical psychologist who has been practicing in the Washington, D.C., area for 16 years. She specializes in the diagnosis and treatment of children.

Dr. Romberg has spent her career interacting with and coordinating services within large systems, including school districts and mental health clinics. In addition, for many years, she served as an adjunct faculty member at George Washington University, where she trained and supervised developing clinicians. She received her PhD in clinical psychology from the University of Maryland in 1991.

Concerned about the mental health implications of the Iraq War, Dr. Romberg founded Give an Hour in 2005. Give an Hour is a nonprofit organization that is creating a national network of mental health professionals who are providing free services to U.S. troops, veterans and their families.

Editor's note: For a link to Give an Hour, click here.

Jennifer J. Vasterling, Ph.D.

Jennifer J. Vasterling serves as the Chief of Psychology at the VA Boston Healthcare System and as a clinical investigator within the Behavioral Sciences Division of the National Center for PTSD.

Dr. Vasterling also is a Clinical Professor of Psychiatry and Neurology at Tulane University School of Medicine. She obtained her PhD in clinical psychology from Vanderbilt University in 1988. Trained as a clinical neuropsychologist, Dr. Vasterling's research has centered on furthering understanding of the cognitive and emotional changes that accompany war-zone deployment and post-traumatic stress disorder.

Her recent work includes a longitudinal study examining neuropsychological and emotional outcomes of the Iraq War. This effort is unique in that it tracks the mental health of deploying soldiers, starting when they are deployed and following them after they return from Iraq.

Charles R. Figley, Ph.D.

Charles R. Figley, Ph.D. is Director and Professor, Florida State University Traumatology Institute, and Editor of Traumatology (Sage Publications). He has published nearly 200 scholarly papers and 19 books since 1973. His first book, Stress Disorders among Vietnam Veterans: Theory, Research, and Treatment (Brunner/Mazel, 1978), is recognized as the first comprehensive analysis of the immediate and long-term psychosocial consequences of war on the combatants. This was followed by Strangers at Home: Vietnam Veterans since the War (Praeger, 1980). His latest book, with Navy Captain and psychiatrist William Nash, is Combat Stress Injury (Routledge, 2007). He is a former Vietnam veteran and Marine who has worked closely with all branches of the military to help combatants and their families and those who care for them (corpsmen, medics, nurses, physicians, social workers, psychologists, chaplains, and their superiors who evaluate them). The Green Cross Academy of Traumatology, which he founded in 1995, is working with other NGOs to help returning veterans and their families.

For a link to Dr. Figley's home page at Florida State University, click here.  For a downloadable copy of his c.v., click here.  For a link to the Traumatology journal, click here.

Four Reasons Veterans Don't Get Their Benefits

I had a wonderful conversation on Thursday with the local Veterans Service Officer ("VSO"), who's the sole point of contact for 11,000 veterans in the local area, and 34,000 family members, total.  We had a great and wide-ranging discussion, about many things that concern veterans, but one point he made really stood out.  He said something pretty remarkable about why veterans don't take more advantage of the benefits they're entitled to.  (This veterans service officer says the population he serves is composed of WWII veterans, and those from the Vietnam War, the Korean War, peacetime, and the Gulf War -- which includes OIF/OEF veterans -- in that order, rather than predominantly OIF/OEF veterans.  But still, it's illustrative...)  He says the top four reasons veterans don't take advantage of the benefits -- health, educational and otherwise -- that they're entitled to are that:

1. They don't know that the benefits exist;
2. They don't think they'd qualify;
3. They don't know how to apply for the benefits, or assume that applying would be a real "pain in the butt";
4. They rationalize that there are others "worse off than me."  He says he hears that about once a week.  Very noble, truly, but not great when it comes to getting the benefits that service has entitled them to.  As the officer said, enthusiastically, "The veterans have EARNED those benefits!  The sacrifices they've made...!"

More about this conversation later...