Healing Combat Trauma

Great Quote from Abraham Lincoln

Through the Miracle of the Internet(TM), I've finally tracked down the true, original quote that's been referenced earlier on this bog, and it's a great one:

Honor to the Soldier, and Sailor everywhere, who bravely bears his country's cause.  Honor also to the citizen, who cares for his brother in the field, and serves, as he best can, the same cause -- honor to him, only less than to him, who braves, for the common good, the storms of heaven and the storms of battle.

-- President Abraham Lincoln, letter to George Opdyke and others, December 2, 1863.  The Collected Works of Abraham Lincoln, edited by Roy P. Basler, vol. 7, p. 32. (1953).

Veterans Need Their Own Jonathan Kozol

Years ago, a friend of mine and co-teacher in a summer program for academically gifted public high school students, Ricky Locke, now a full professor at MIT, turned me on to the topic of "radical education" (as it was called at the time), and in particular, the work of Jonathan Kozol.  Kozol is famous for, among other things, blowing the topic of segregration in public schools, and in particular, the substandard treatment of black students, wide open, with his scathing expose of his harrowing year as a new teacher in the Boston public school system, forever known as "Death at an Early Age."  (The subtitle was, "The Destruction of the Hearts and Minds of Negro Children in the Boston Public Schools" -- it was the students' hopes that were dying, basically.)  The book won a National Book Award, and is known now as "the classic indictment of inner-city education."  The work forced serious changes, by first alarming its readers about the true state of affairs they had heretofore somehow been able to ignore.

Now Kozol has spent a lifetime talking about inequalities and social reform, and getting numerous awards for his work.  But, and this is an important but, it's his work in "Death at an Early Age" that I wish the Veterans rights groups could reproduce and emulate.  Too bad there isn't someone as smart and literate as Kozol, experiencing the woes of being pushed through the system trying to recover from combat, and writing passionately about what he sees.  Unfortunately, it's EXTREMELY hard to be both wounded AND lucid.  Advocating for change for YOURSELF and for OTHERS who will follow along behind you, while coping with the tremendous burdens, difficulties and hardships -- physical, emotional, financial -- imposed by trauma, injury and "recovery".  But with average wait times of half a year for veterans to receive disabilty payments, and backlogs in the system every where you look, it's a shame to this writer that no Kozol exists to bring light to the situation at hand, as a passionate participant, drawing the rest of us into his story, so that we're never able to be the same again, or look at the topic the same way.  In a word, what Kozol did is killed complacency.  And that's what we need again, right now.

PBS Show on Veterans & PTSD Tonight

PBS will air a show called "Veterans of PTSD" tonight, on "Now," with David Brancaccio -- familiar to many listeners of "Marketplace."  Streaming video will be available after the show airs.  Click for a link here.  You can also learn more about Matthew Zacchea, featured in the program, in this earlier article on PTSD and veterans, from US News & World Report last year.

About the show:

Bouts of fierce anger, depression, and anxiety that previous generations of soldiers described as "shell shock" or "combat/battle fatigue" now earn a clinical diagnosis: Post-Traumatic Stress Disorder. But the relatively new medical label doesn't guarantee soldiers will get the care they need. NOW looks at how America's newest crop of returning soldiers is coping with the emotional scars of war, and some new and innovative treatments for them.

In the show, we spent time with Iraq War veteran Michael Zacchea, a Marine lieutenant colonel who trained Iraqi troops and led them in the battle of Fallujah. Haunted by the violence he saw there, Zacchea and other soldiers diagnosed with PTSD now face what could be a lifelong struggle to leave the horrors of war behind and reclaim their once-peaceful lives.

In a side note: do you notice how much of the decent reportage on PTSD and combat trauma -- indeed, on veterans issues in general -- is coming from listener-supported public radio and television?  While bloggers and others complain about what the mainstream media does and doesn't cover, I hope someone is paying attention to this trend -- the good information is still out there, it's just a question of where you look.

Speaking of which, she said somewhat peevishly, we've been blogging about this topic for almost two years now -- well ahead of the current "surge" in popular interest.  That said, there can't be enough interest given to this topic, to help heal those who are struggling with it/suffering from it.  Though frankly this topic should have been on our minds since Vietnam -- or maybe the Civil War, where it also was an issue.  And undoubtedly since combat began.

Minnesota Leads Way in Treating Vets Right

Minnesota seems to be doing some very good things for returning veterans, in terms of raising the bar for the standard of care.  NPR had a story yestoday on "All Things Considered," called "National Guard Works to Ease Soldiers' Return" (in Minnesota).  Click here for the link to read or listen.

What makes Minnesota's approach significant?  As the NPR blurb says, "Minnesota's National Guard is taking some extraordinary steps to help troops returning from Iraq readjust to life at home." 

On this blog, we covered a number of stories about the Minnesota National Guard and its efforts to help troops readjust and cope with transition back to civilian life, all located in the archives from March of 2006.  They were: "Vets Encounter Emotional Rollercoaster Upon Returning from War;" "Straight Talk for the Long Road Home;" "Padding the Canoe Without Tipping It;" "Transition Time from Warrior to Citizen;" as well as a story on Combat Trauma on NPR, from the Diane Rehm show.  Many of these items quote from Chaplain John Morris of the Minnesota National Guard, or in the case of the ABC news story or the DIane Rehm show, have him on as a guest.

One Great Quote

In the spirit of empathy with how the woes of current vets and combat trauma, re-opens old wounds -- well, it's safe to say many of those wounds never actually healed -- from vets of previous conflicts, there's a great quote I came across on a fellow blogger's site this week.  It said,

"It takes me so long to read the paper," said to me a novelist one day hot as a firecracker, "because I have to identify myself with everyone in it, including the corpses, pal." -- John Berryman

For an experience of war that never leaves us, well said.

Wounded Warriors - Lost in a Maze of Care

Social Work Today -- "the Nation's Leading Newsmagazine for Social Workers" -- has an excellent story in its current issue called "Wounded Warriors: Lost in a Labyrinth of Care," by Richard Currey.  The article is online; click here for the link.  It's apparently part two of a three part series, and the article in the current issue examines "the psychological impact of being tanged in an administrative maze of healthcare for veterans with PTSD."  Undoubtedly, the maze of paperwork and arcane bureaucracy vets encounter while gravely ill can't make for a pleasant experience -- and stress obviously makes the suffering from trauma worse.  Not a good situation for the vets or those who care for and with them.

In related news, Ilona Meagher on her blog, "PTSD Combat: Winning the Battle Within," reports that the VA has moved to dismiss a class action lawsuit against it by some veterans rights groups -- arguing, in effect, among other things, that the vets need to plead their cases individually.  Click here for that link.  Speaking of stress...

NPR Story on Jonathan Shay, M.D., Ph.D.

Following up on our coverage of Jonathan Shay, M.D, Ph.D., winning his well-deserved MacArthur Foundation "genuis grant," NPR did a nice story this week on Dr. Shay as well.  Click here to read or listen to the story.  There's also an audio file of Dr. Shay discussing how a scene from the Odyssey "relates to soldiers back from Iraq today."

Jonathan Shay, Longtime Friend of Vets, Wins MacArthur Foundation's Genius Grant

'It's an incredible honor in anyone's life to win the famed "genius grant" -- the MacArthur Foundation's nod to someone who's doing important, creative and interesting work, that comes with a generous stipend to continue pursuing your passion.  It's even doubly an honor when one of this year's recipients is none other than the incomparable, longtime Friend of Vets, Jonathan Shay, M.D., Ph.D., whose groundbreaking work is mentioned frequently on this blog.  Shay wrote two of the key texts in understanding combat trauma and how healing happens in community: both Achilles in Vietnam: Combat Trauma and the Undoing of Character, and Odysseus in America: Combat Trauma and the Trials of Homecoming.  He practices what he calls "preventive psychiatry," and spends much of his time teaching the military how to avoid practices that create more psychological and moral trauma for combatants.  He has worked with Vietnam veterans for the last 12+ years in the Boston area, as a staff psychiatrist at the VA.  His writing, however, has reached a wider audience, and for years his work has been cited by many other prominent figures, including Nathaniel Fick, and has been included on the U.S. Marine Corps Commandant's essential reading list.

If you want to read an interesting bio of Dr. Shay that was published some years ago in the New York Times, go here.  If you want to see his selection by the MacArthur Foundation, along with the other "Genius Grant" recipients, go here.  If you want to hear a short interivew with Dr. Shay by a Boston talk radio station, WBZ Radio 1030 today, go here.  (And if you'd like to see what else the Marine Corps is reading, click here.)

Enormous congratulations to Dr. Shay for this fantastic honor for his essential work.  And apologies for my attempt at cropping a picture of Dr. Shay in with a photo of the Parthenon -- because I really do think we ought to give more social honor to the Friends of Vets -- here's an attempt to enshrine one of the best!

NPR Story on Combat Trauma

National Public Radio ("NPR") has a good story tomorrow (Tuesday) about how news of the Iraq war can make it understandably hard to cope for Vietnam vets with PTSD.  Click here to listen.  NPR stands out for their good, continuing coverage on PTSD.  Here are links to recent stories they've done on the impact of combat trauma and/or PTSD: 

From July 25, 2007, a story about "Veterans Suing for Better PTSD Care Share Anguish."  Click here to read or listen.  From July 7, 2007, a story called, "Former Soldier Helps Others Fight Army for Help."  Click here to read or listen.  And from December, 2006, several good and related stories: "Army to Court-Martial Soldier Featured in PTSD Story"(!!!) and a sidebar entitled, "Soldiers Say Army Ignores, Punishes, Mental Anguish."  Click here to read or listen.

Aphrodite Matsakis Has a New Book Out!

Aphrodite Matsakis, Ph.D., one of the key players in the "treating combat trauma" pantheon, from the last time around -- the Vietnam War -- has a new book out, called Back from the Front - Combat Trauma, Love and the Family.  Literally can't wait to "read all about it."  That's right up there with hearing that Jonathan Shay, M.D., Ph.D., Raymond Scurfield, or Patience Mason has a new book out :-).  Guaranteed to be illuminating, thought-provoking, helpful and well-written.

Here's what the editorial reviews on Amazon say:

Review
Aphrodite Matsakis is a true visionary in the world of healing. Her book is a superb resource that paves the way to hope and healing for returning warriors, their spouses, their families, their medical and mental health professionals, and all those who care about them. Well done, Aphrodite! --Lt. Colonel Dave Grossman, U.S. Army, Ret., Author of On Killing and On Combat

Review
You do not have to be or know a veteran to be helped by this book. Read Back from the Front slowly from front to back. Listen to each and every story and to Matsakis's wise and clear advice. You will see yourself somewhere in its pages, and it will change how you think about the war and about the soldiers and non-soldiers we send off to do our fighting. --Thomas Palaima - Dickson Centennial Professor of Classics at the University of Texas at Austin, MacArthur fellow and specialist in the ancient and modern experience of war and violence

Honoring the Severely Injured - Body, Mind & Spirit

One group deserving of special attention in this war is the severely injured, whether in body, mind or spirit.  We saw the powerful stories of a handful of injured veterans in the fabulous recent HBO documentary, "Alive Day Memories: Home from Iraq."  But others are also telling their stories.  A photographer named Nina Berman first began photographing injured vets when she felt that no one else seemed to be.  Her photographic exhibitions are linked here; her book, "Purple Hearts: Back from Iraq," published in 2004, is listed in sidebar.  Wounded warriors, captured in art by USMC combat artist, Michael Fay, are shown here on his blog.  Those of us who have followed some of the combat veterans stories "as they unfolded" on their blogs on CaringBridge hold a special place in our heart for those we've seen recover before our very eyes.  (Travis, Neil, Tony, Corey, Joey and others.) The road ahead is long, but their courage is palpable, and deserves to be justly celebrated.  Remember: while over 3,500 military have died, over 27,000 have been injured, and will need to be re-integrated with family, friends and loved ones, employers, schools and communities as they heal.

Helping the Warrior to Make Peace (with Himself or Herself)

Catching up on some items worth noting -- here is an Interesting blog post from back in May, by an Anglican priest - referencing the well-known. British World War I poet, Wilfred Owen.  The blog entry focuses on helping the warrior to make peace within, and is well worth reading, about the effects of war on the soldiers who fight them, from a spiritual perspective.

Another Good Read...

Lori Sekela, a librarian at the U.S. Army War College Library in Carlisle Barrracks, PA, produced in 2005 a PDF entitled, "Post-Traumatic Stress Disorder and the Military: A Selected Bibliography."  You can find Ms. Sekela's excellent PDF here.  She seems to have done quite a comprehensive job at listing resources to date (meaning, through 2005).  No idea whether there are plans to bring the bibliography current, but we will keep an eye on this in case it does get updated.

Read All About It: Helping Healthcare Providers Recognize PTSD

The Department of Veteran Affairs has made available something called the Iraq War Clinicians Guide, 2nd Edition, intended to help healthcare practitioners recognize and diagnose Post-Traumatic Stress Disorder ("PTSD") in their patients.  Although the material is intended for mental health care providers, in reality, it's probably useful information for most clinicians to have handy.  A link to the guide's contents is here.

(The Iraq War Clinicians Guide was developed by members of the National Center for PTSD and the Department of Defense, and it was developed specifically for clinicians and addresses the unique needs of veterans of the Iraq war.) 

If you have the latest version of Adobe Acrobat Reader, you can download the entire guide, or you can download specific chapters of interest.  Kudos to the VA for making this information available on the Web. 

Veterans Write Out the Trauma of War

An interesting weekend, to be sure.  Got to meet Maxine Hong Kingston, and hear a panel from the book she recently published, Veterans of War, Veterans of Peace, at a book festival in Northern California.  Apparently Maxine Hong Kingston, a prolific and gifted author, National Book Award winner, and longtime UC Berkeley professor, has been leading a writing group for veterans for the last 15 years.  Out of the group has come the recently-published book, which she and panel members read from - selections of prose and poetry that capsulates the veterans' experiences of combat and beyond.  The incomparable veteran journalist Bill Moyers interviewed Maxine Hong Kingston about her work with veterans in a special showing of his program around Memorial Day of this year.  The program is found in its entirety on the Web, by clicking this link.  You can read the transcript of the interview here.  The book is available from Amazon here.

The program was interesting, the veterans' selections from their own writings were moving, and Ms. Kingston is the epitome of both soulful and completely adorable in person.  More to follow on what the veterans actually said.

Watch HBO's "Alive Day Memories: Home from Iraq"

BTW, now that HBO has shown its excellent special, "Alive Day Memories: Home from Iraq," you can watch the entire film on its website.  Here's the link. 

Well-deserved props to HBO, James Gandolfini, and everyone involved for getting this vital story out there.  Realistically, the film shows nine or ten people's valuable stories -- but nine or ten out of the more than 27,000 military who have been injured in Afghanistan and Iraq, so far.  That's almost 30,000 people coming home and needing to cope with the massive adjustments to their lives, families, living accommodations, pride, and dreams for the future.  And it's just the beginning of the adjustments -- there's a long road ahead.  Let's hope we still are giving this topic the compassionate, effective treatment it deserves in another few years -- and from here on out as well.  The vets, and their families, deserve it.

Heads Up: Traumatic Brain Injury ("TBI") and PTSD

There's a really excellent -- as in relatively comprehensive, considering -- article in today's USA Today called "Doctors Face Rash of Brain-Damaged Vets."  Unfortunately, what doctors are finding is that the two "signature wounds" of the current wars -- traumatic brain injury ("TBI") and post-traumatic stress disorder ("PTSD") can often occur together.  And even more unfortunately, the presence of both in the same person can complicate matters quite a bit.

As the article states, "Odd as it may seem, brain injury can protect against PTSD by blurring awareness of what happened.  But as memory improves, emotional problems can emerge..."

Certain symptoms that show up initially, such as headache, dizziness and balance problems -- perhaps more due to the TBI -- actually subside over time; whereas other symptoms -- including memory problems and 'irritability' -- probably more part of the PTSD complex of symptoms -- actually increase over time, according to data cited in the article, from a study conducted by Walter Reed Army Medical Center.

Current -- and future -- treatment programs are going to need to be able to effectively treat combat veterans who have undergone TBIs in such a way that they can also catch emerging PTSD, even if it comes out after the brain injury has optimistically "resolved."  Also dangerous: the fact that overall, occupational therapy needed to treat brain injury has been downgraded at many private hospitals and outsourced to nursing homes, according to an insider in the field.  With a growing number of combat veterans who've been exposed to TBIs now returning to civilian life, it's going to be important to care for them both within the VA system and also within the private hospital setting.  Affording treatment is going to be another ballooning cost of the war effort, but one that's crucial for us to get behind, in order to ensure that veterans are treated effectively.

Another issue that the article brings up is the number of times deployed military have been exposed to TBIs.  The article mentions vets experiencing at least "an explosion a month."  A few years back, doctors found that high school and college football players who experienced two or more concussions on the field in succession -- separated by days or even weeks -- were at much greater risk from serious injury, including death -- than had ever been thought.  And they started to talk about the cumulative effect of concussions, and how difficult it is for the body to heal from that.  Essentially, what combat veterans are going through now is the same thing: exposure to explosions, that causes an underlying stress on the brain, followed up sometimes by direct injury, such as TBIs.  Now we need to add into the mix PTSD as well, which can show up later, thanks to the body's own capacity to focus first on the TBI. 

Unraveling the complexities of this increasingly all-too-common scenario is going to take a lot of work, and patience, on everyone's part.  Even physicians in private practice are not used to seeing the level of TBIs that returning vets will be bringing into their practices.  The Centers for Disease Control ("CDC") even has an article on its website for doctors about recognizing and treating TBIs, but it doesn't yet reference the combat connection...Their handout, which might be worth vets and their families reading to familiarize themselves better with the subject, is called "Heads Up: Brain Injury in Your Practice - A Tool Kit for Physicians."

PTSD Civil Incidents Timeline

Deaths like that of Jamie Dean should not go unremarked.  The PTSD Timeline, a prior project of blogger Ilona Meagher, author of the brand-new book, "Moving a Nation to Care: Post-Traumatic Stress Disorder and America's Returning Troops," is an excellent, sobering, and one-of-a-kind repository of incidents that involve combat veterans and PTSD -- that make media coverage for one grim reason or another, after they return from war.  It doesn't make for light reading, but it is vitally important to the conversation -- at least, the conversation we as a country ought to be having, about veterans care after combat.

Active PTSD and Re-Deployed? That's Insane!

(No, that's Jamie Dean's story -- and it doesn't have a happy ending, for Dean or his family.)

Salon has an article this past week that's truly horrifying, by a freelance writer named Julia Dahl, about an about-to-be-redeployed vet named Jamie Dean, whose life ended recently in a co-ordinated assault by the police in rural Maryland.  James Dean is an American icon -- an actor in films like Rebel without a Cause, who died young, in the 1950s, and has remained to this day a symbol of youthful angst.  Jamie Dean, dead at 29, is more likely to be remembered as one of the truly unconscionable casaulties of the current state of veteran care.  Jamie was an Army sergeant on reserve, who'd done a tour in Afghanistan, came back apparently with horrors he didn't care to recount, and was being treated by the VA for PTSD, care he himself had sought, with the help of his new wife, Muriel.  He'd also been drinking intermittenly heavily.  Believe it or not, although he was currently being treated for PTSD, he also received recall orders, putting him back on active status, and ordering him to go to Iraq.  That decision proved too much for Jamie to cope with, and after a night of heavy drinking, he barricaded himself in his dad's farmhouse in Maryland, and talked to his sister, while despondent.  She got concerned and called the cops.  The rest, as they say, is history.  The story is well worth reading, because it tells a terrible tale of two parts of the government that strangely do not talk to each other - the Army and the VA - even when the same subject is involved - and also that having PTSD is not in itself reason enough not to be called back to war.  Seriously?!!

First, the Maryland senators, Mikulski and Sarbanes, who represent Jamie Dean and his family should sponsor a bill --heck, they could entitle it "Jamie's Bill" -- making it impossible for someone who has active PTSD and is still recovering from their last deployment to be called up for another deployment.  The bill could also mandate that the military and veterans affairs both communicate and share information about the same people, too.  That seems unbelievably minimal, considering the consequences of not doing so.

Second, police and public safety departments across the country should get training and develop expertise in dealing with PTSD populations during crisis calls.  It would seem that there would be more and more need for such training, as more veterans with combat trauma return to civilian life.  Surviving Afghanistan or Iraq only to be felled by a bullet from your local cops somehow doesn't seem completely...right.  And public servants who are themselves military veterans might need to highlight this need in their communities.

"Alive Day Memories" on DVD in October

"Alive Day Memories: Home from Iraq" -- the sure-to-be-spectacular HBO documentary, scheduled to show this Sunday evening at 10:30 p.m. -- is also scheduled to be released on DVD on October 23, 2007, according to Netflix.  Click this link to learn more about the documentary, and to read the stories of some of the individuals interviewed by James Gandolfini for the film.  Watch the entire ALIVE DAY MEMORIES special on HBO.com beginning Sunday, September 9 at 11:30pm, immediately following the premiere.  Read the interview with executive producer James Gandolfini here.

"Alive Day Memories: Home from Iraq" on HBO

HBO will air a documentary called "Alive Day Memories: Home from Iraq" next Sunday, at 10:30 p.m.  Check their schedule for more details.  This was the description on HBO's website:

A new generation of veterans is returning from Iraq. For these survivors, two days will forever memorialize their lives: their birthday and their Alive Day--the day they narrowly escaped death. This HBO Documentary Films production presents the first-person stories of ten Alive Day heroes as told to Emmy®-winning actor James Gandolfini. From a conflict that has left more than 25,000 Americans wounded, the film explores the physical and emotional cost of war through the simple, heartbreaking words of ten young soldiers who survived near-fatal wounds while serving in Iraq. The stories are augmented by harrowing footage from the war-torn streets of Iraq.

Today's San Jose Mercury-News (San Jose, CA) has an article about one of the soldiers profiled in the documentary, and his struggles after injury (though not particularly PTSD/combat trauma).

Mental Health Care Down, but Prisons Up

In an addendum to yesterday's story, according to NPR today, mental health care all over the world suffers -- nobody does a good enough job at it, or frankly, enough of it.  Here's a link to that story.  It's perfectly possible that in a three-way contest, we just prefer prisons, or outright neglect.  Let's hope not...

BTW, to substantiate the prison remark, here are some facts.  According to a report last month on NPR's excellent Marketplace show, the U.S. prison population is exploding.

"Currently over two million are incarcerated in America, but many cash-strapped states are running out of room for additional inmates. So states are turning to private prisons like the Corrections Corporation of America. The company operates 65 prisons, and it's building as quickly as it can. Late yesterday, the Corrections Corporation of America reported earnings were up nearly 25 percent from last year." 

Additionally, "the U.S. prison population is expected to jump by about 200,000 people over the next five years at a cost of more than $27 billion."

Soldier's Post-Combat Snap Ends in Suicide

The Louisville, KY paper, the Courier-Journal, ran a very troubling profile in yesterday's paper about the suicide of combat veteran Army Spc. Derek Henderson, who had been struggling with PTSD.  He killed himself by jumping off a bridge, as bystanders pleaded with him to reconsider.  (In a side note, the bystanders are now indirect victims of his combat trauma, too.).  The profile of Derek Henderson's life after combat is dark and frightening: he was in and out of the mental health care system, behaving violently, really unable to get a grip on what was going on inside him, and turning to his faith (e.g., reading his Bible more) as one way among many to try to cope.  Ultimately, the forces inside Henderson were much bigger than he could contain, and he took his own life, after several fairly violent run-ins with family members, one of whom, his mom, tried to have him institutionalized briefly. 

As wrenching as Henderson's story is, especially ending as it does with his death, it also brings up some difficult questions.  With someone who was battling potentially the dual demons of PTSD and psychosis, what else can or should "society" be doing to help cases like this?  It doesn't sound like Henderson was mentally ill before serving tours of duty; but it definitely sounds like he became mentally ill afterwards.  As the VA and other agencies struggle to get a grip on the volume and severity of cases of PTSD, one wonders -- what else can or should be done?  Should recruits be tested for mental health and propensity for mental illness beforehand -- can this even be done?  Are the tests out there and are they at all predictive?  And are we as a society prepared, even from a practical, "are there enough beds?" perspective -- to actually institutionalize people who are violent to themselves and others, if PTSD gets bad enough? 

We've heard and read so many stories over the last several years of veterans who aren't able to get seen for PTSD soon enough or often enough after returning home, some of whom have taken their own lives in the delay -- but what of those returning veterans like Henderson who really aren't able to function adequately in society.  As hard a question as it is to ask, are we prepared, practically speaking, to institutionalize an increasing number of people?  Will mental institutions "enjoy" the building boom that prisons did recently, because of the increase in population needing to be housed?  It certainly seems like today's trend has been to de-institutionalize the mentally ill.  If combat creates PTSD severe enough that it ends up in psychosis, do we have a Plan B at all?  The Henderson story is frankly depressing on that front: it brings up very real concerns about those who are really at the fringes, sadly, of even being able to be helped.

"Iraq Never Leaves Us" - PTSD & the Military

The Department of Veterans Affairs PTSD Information Center website has a presentation on it these days called "Iraq Never Leaves Us," by Bob Page, Chief Petty Officer, U.S. Naval Reserve.  Here is a link to that presentation.

The VA website says that "In this presentation, Bob Page shares his story to provide the viewer with an “up-close and personal” view of “What’s it like over there?” in the combat theater of Iraq via his personal photos. NOTE: This special feature is not a course, but instead a story of one veteran's experiences."

PTSD 101 - Online Educational Resources

The Dept. of Veterans Affairs has come out with a new curriculum, called "PTSD 101," which they call a "web-based curriculum of diverse topics focusing on issues related to combat stress/PTSD. It is available on-demand for professionals who provide services to individuals who have experienced trauma. Courses are presented by a faculty of recognized experts in the field of traumatic stress. CE Credits are now available!"  Here's a link to the program.

EMDR Books on Combat Trauma / PTSD

To be a little more explicit about the books about EMDR -- eye movement de-sensitization and reprocessing therapy -- referenced in an earlier post, a few of the better and/or more important ones are as follows: "Eye Movement Desensitization and Reprocessing (EMDR), Second Edition: Basic Principles, Protocols, and Procedures," by Francine Shapiro. Ph.D.; and, "EMDR: the Breakthrough 'Eye Movement' Therapy for Overcoming Anxiety, Stress and Trauma," also by Francine Shapiro, Ph.D.

New Film on Troops' Trauma Back from Iraq

An article in Reuters today talks about "Crash" director Paul Haggis' new film, now screening at the Venice film festival, "In the Valley of Elah."  The film, which stars Tommy Lee Jones, apparently powerfully makes the point that scars of trauma do not magically disappear when soldiers return from war. 

"In the Valley of Elah” tells the story of a war veteran (Tommy Lee Jones), his wife (Susan Sarandon) and the search for their son, a soldier who recently returned from Iraq but has mysteriously gone missing, and the police detective (Charlize Theron) who helps in the investigation.

Two excellent quotes from the Reuters article follow.  When the director was asked about the efforts of those deployed, he said he believed "U.S. troops in Iraq were doing a "serious and important" job, but added: "I'd like to see them come home, to be looked after, be nurtured, and nothing would give me more joy than to see them here back in America."  And as to what role a film like this -- Haggis' last film, Crash, won the Oscar -- might play in advancing public consciousness, he said, "During the Vietnam war, we had terrific journalists doing their job, reporting on things that we didn't want to hear ... Now we don't have that."  "I think that when that doesn't happen," he continued, "then it's the responsibility of the artist to ask those difficult questions."  Either way, at least they're getting asked.

Here's a link to the trailer of the movie.