Healing Combat Trauma

No One Who Goes, Comes Back Unchanged

In the category called, "Something Good We've Been Missing," here's a story we entirely missed, in an online publication called "GOOD," which profiles a number of veterans and their experience in wartime. Again, apolitical coverage -- just a little consciousness-raising that the vast majority in this country is sorely in need of, about what it really means to go to war.  It's a photo series, with commentary, introducing us to a number of "typical men and women" who served in combat.  Their stories, and the photos that accompany them, are compelling.  Do yourself the favor of acquainting yourselves with these cool Americans.  The pull quote alone that introduces the article,tells the story: "One-and-a-half million Americans have served in Iraq and Afghanistan. Not one of them came home unchanged."  In the introduction to the article, Paul Rieckhoff, Executive Director of the Iraq and Afghanistan Veterans of America, writes:

The statistics are shocking: more than 11,000 soldiers have been wounded by roadside bombs; more than 50,000 have sought treatment for post-traumatic stress disorder; and 150,000 have submitted a claim for disability. Undiagnosed brain injuries—serious concussions that can cause memory loss, vision problems, and even depression—are affecting as many as 300,000 troops who have come home.

But when you look at the numbers, it’s easy to forget that they represent individual stories: lives put on hold, families under strain—above all, tremendous personal sacrifice.

He also says, compellingly,

I’ve found that the faces of the troops tell us the most about the war. Their eyes reflect their pride in their service, pain at the loss of friends, and the memories that linger long after they return home. In a way the numbers simply can’t, the faces of combat veterans bring the reality of a distant war home. That’s why images like these are so important; they remind us that “the troops” aren’t some abstraction to be supported by a bumper sticker or a catchphrase. The troops are America’s sons and daughters, a diverse group, coming from all parts of the country and every walk of life.

This is great writing, with heartfelt concern behind it, as impetus.  There's kind of a harsh joke circulating lately, with its origins in a photo on a wall in Ramadi, Iraq, that says, in paraphrase, "America isn't at war -- the Marine Corps is at war.  America is at the MALL."

As we get ready for Veteran's Day in America on November 11th, it's not a bad idea to prepare for it in our own hearts, by actually giving a damn about those who served, not only in these wars but in previous ones as well, and what their quality of life is like now.  "Support our troops" can and should become more than just convenient lip service.  It could become heartfelt concern and caring, and best of all, for the veterans' sake -- actual constructive action on their behalf.

Reporters Help Move a Nation to Care, Too

If you were in Harvard Square tonight, you could have gone to hear Dana L. Priest, one half of the outstanding duo of Washington Post reporters, who, along with Anne Hull, have been contributing so many excellent stories on the health care and combat veterans at Walter Reed and beyond.  Until I read the blurb from Harvard's Institute of Politics ("IOP"), part of the John F. Kennedy School of Government, where Priest is speaking, I didn't realize that she had won a Pulitzer Prize last year for her reportage.  Belated congratulations for some truly excellent work.  Here's Priest's bio, according to the IOP:

Dana Priest, the 2006 Pulitzer Prize winner for beat reporting, covers the intelligence community for The Washington Post. She spent the previous eight years writing about the U.S. military. Her book, "The Mission: Waging War and Keeping Peace With America's Military," was published in Feb. 2003. She has worked at the Post for 15 years, where she was the Post's Pentagon correspondent for six years and then wrote exclusively about the military as an investigative reporter.

(Sources: NY Times, PBS, the Washington Post)

And here's a list of articles she's written recently, from the Washington Post.  Also a list of Anne Hull's  articles, which frequently intersect.  Because reporters don't often get treated like rock stars, no matter how many Pulitzers they get, it's cool that Priest is going to be at the IOP.  Her reportage is actually moving society forward on the topic of veterans right to health care.  More power to her, and her reporting team, for the great work they've been doing, sensitizing us to things we wouldn't ordinarily get to see, unless we were intimately involved.  That's part of the power of great reporting.  In the immortal words of the title to Ilona Meagher's book on the subject, it's part of "Moving a Nation to Care."

(Military readers and others often pooh-pooh or villify the "mainstream media" for missing all the good stories, in favor of preferring to read bloggers, who often have no journalism background whatsoever.  However, in defense of the mainstream media -- or at least good journalists like Priest and Hull -- check out what happened AFTER their recent article was published in the Washington Post, one we blogged about here.  The subject of the article, Troy Turner, suddenly went to the head of the line, in a pretty impressive fashion:

In addition to granting Turner a coveted spot in a residential treatment program at the Martinsburg VA Medical Center, the department is increasing his disability rating from 70 percent to 100 percent, according to a VA spokeswoman, raising his monthly check from $1,352 to $2,781. The new rating also means that Turner's wife, Michelle, and their two children are eligible for medical insurance and educational benefits.

Why did this happen?  NOT because Turner was strangely more deserving than other vets, not because the VA had been sitting around with nothing to do and the Post story galvanized them into action, but because the media spotlight made the situation uncomfortable, touched hearts, and spurred action and change.  Would that every returning veteran have the same opportunity.  We really do have reporters like Priest and Hull to thank for that.  Soapbox over.  Read the new article, though, it's great.)

An Overview of Empathy vs. Sympathy

In our ongoing somewhat one-sided "conversation" (blog-servation?) lately about "sympathy" versus "empathy," here's an interesting article, written by a physician, who attempts to contrast the two, while providing pointers to fellow clinicians on how to be more empathic with their patients -- always a good idea.  Click here for the link.  The article, from 2003, is called "An Overview of Empathy," and the author is Colorado-based physician, James T. Hardee, M.D.  (Two previous blog entries about this topic are here and here.)

Into the (Mental Health) Gap - Military Chaplains and Others

I was hunting around on the Web tonight for material for a different post entirely -- one about the rumor that military chaplains are being pressed into service as stop-gap mental health counselors -- and whether this is a good, albeit temporary solution -- or an overly simplistic band-aid with unforeseen complications -- when I came across this news item instead.  It's a pretty good wrap-up, from a good reporter at the Air Force Times, Karen Jowers, about some solutions the military, particularly the Air Force, is offering its servicemembers to cope with combat trauma, PTSD, and long deployments.  The article is worth reading, and is linked here.

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As far as the chaplain topic goes, which I wasn't able to find enough information about to verify that it is indeed contemplated, here are some off the cuff thoughts.  One is, and probably paramount, anything is better than nothing, if it goes to the good of the afflicted servicemember.  If there's too long a wait at the VA to see somebody, provided that the chaplain is generally qualified and perhaps even recently trained in PTSD and related issues, far better to see someone, quickly, than no one, or to have an unduly long wait.  It sounds like too many people can't endure the wait, when they've got troubling topics on their minds.

That said, let's hope that's not being proposed as anything other than a stop-gap solution, while the VA fixes the problem it has of too much demand and too little supply (qualified counselors, able to make appointments with veterans.)  I only know anecdotally of three different chaplains in the military lately, and the stories are mixed.  Story #1, referenced earlier in a blog entry here, is about a chaplain who himself suffered PTSD after being deployed to Iraq, then was sent to Hurricane Katrina while he was still affected, and though he was a middle-aged man with a wife and family, was so stressed out by the experience that he is now divorced and homeless.  That's not a good story, but it was told to me by the mother of an Army soldier who committed suicide after coming back from Iraq, and ironically, it was the chaplain who had been a source of support for him earlier; until the chaplain's own exposure caused troubles larger than what he could handle.  That's Story #1 that I know about, and it's negative.   

Story #2 is the cheery-seeming, snappy-sounding, highly quotable, funny and cool chaplain from the Minnesota National Guard, who's quoted in so many of the NPR stories from 2006.  (References to Chaplain John Morris of the Minnesota National Guard on this blog are here, here, here, and possibly here, not to mention, most recently, here.) He sounds generally delightful, sane and grounded -- and really an asset to those he's around.  That's Story #2, and it's uniformly positive. We don't know the man personally, of course, but he's made a great impression on us, and, it would seem, on NPR as well.

Story #3 I was exposed to the other night, when I was chasing down more information on the Web  about  the wonderful Maxine Hong Kingston and the book she edited, Veterans of War, Veterans of Peace.  I was able to see her and a panel of combat veterans and interested others, whose pieces make up that book, in Santa Rosa, CA recently, and wrote about it on this blog.  I've also watched the Bill Moyers special that aired over Memorial Day weekend last year about her book, which covered a few of the participants as well.  There are only two videos I've found on the Web that relate to Maxine Hong Kingston and her work with the veterans' writing project, and recently I watched both of them.  They're located here and here.  In the second one, one of the panelists at the talk at the Commonwealth Club in San Francisco, in April of this year, is a young Marine named Jim Castellanos, who tells a quite cautionary tale of turning into a conscientious objector as a Marine, and more particularly, for the purposes of this blog entry, about being what amounts to "blamed and shamed" by the chaplain he's required to see, which only serves to further burden the already conscience-stricken young man.  (If you want to watch the video, it's embedded below, and Castellanos starts telling his story at about the half hour point into the video -- minute 30 or so.)  (See Wikipedia, linked here, for a definition and background of what a conscientious objector is, a term familiar to many of us from the Vietnam War.)

Again, the focus of this blog is apolitical, so including this story isn't to be pro-war or anti-war or anything but pro-veteran.  However, his story is pretty troubling, in terms of the communication he had with the chaplain assigned to him.  It sounds like the chaplain was a South Vietnamese guy who had immigrated to the U.S., joined the military, and been deployed several times with the Marines.  Perhaps his OWN experience of living in war-torn Vietnam as a maturing adult contributes heavily to his own bias, but he appears to not be aware of this bias when he is "counseling" Castellanos. 

The synopsis of the story is that Castellanos, who had joined the Marines at 17 in high school, later had a change of heart -- perhaps due to the maturing process, perhaps due to reading more philosophical texts in college, whatever -- and decides that he's really not cut out to be in the military after all -- doesn't want to carry a gun and doesn't want to kill people, for any reason -- in other words, pretty much the poster boy for a well-reasoned, Conscientious Objector -- the chaplain he meets with is someone it's hard to picture has ANY people skills or therapeutic counseling skills.  Castellanos tells the story from his own perspective, of course, but it sounds like the chaplain was pretty harsh with him -- and really taunted him, in a fairly unprofessional way -- about his ideology, to the point that Castellanos apparently felt worse off from meeting with him, than if he never had had the conversation. 

Later, he's able to meet a more reasonable person and talk to him about his feelings -- not that the Marines ever ultimately accept his plea to become a Conscientious Objector -- but to say that the first chaplain "got all up in his grill" is pretty descriptive.  Castellanos was already troubled about his decision, just based on internal pressures he was feeling, and the chaplain did nothing but mock him and essentially increase the external pressures.  Someone like this isn't someone you'd really like to see doling out any pastoral care to troops with sensitive issues and psychological pain.  Don't take my word for it, watch the video, and hear it from Castellanos himself.  So that's Story #3, and the chaplain was very destructive, and insensitive to the point of being actually harmful.  So out of three stories: that's one positive and two negative.  Granted it's a small sample but it's not filling me with confidence on the topic as a whole.  What I'd like to see, and what I'm sure a lot of us would like to see, is the VA just stepping up to deliver the care that's needed, with qualified counselors and speedy wait times for veterans.  Stop-gap measures probably shouldn't be anything but the most temporary solution.  That said, if it brings any veterans needed relief in the meantime, while the system is being fixed, more power to 'em.

Heroes at Home: Emory University Research Project on PTSD

[Editor's note: If this post is a little bit mystifying, it's only because the specifics of this project are a little unclear.]

The Emory Center for Myth and Ritual in American Life ("MARIAL") near Atlanta, Georgia, has a research project underway called Heroes at Home?: Experiences of Combat Trauma among Returning Veterans and Their Families

According to the website,

This research uses a combination of ethnographic and epidemiological methods to consider lived experiences of Post-Traumatic Stress Disorder (PTSD) among Anglo-American, Mexican-American, and African-American male veterans of combat in Iraq and Afghanistan. F ieldwork in San Antonio, Texas will explore how PTSD-diagnosed male veterans and their families understand and respond to trauma-related mental illness, as well as how PTSD illness experiences are shaped by individual and family members’ met and unmet expectations of veterans’ military service and performance of adult male roles within the family, particularly as related to work and economic providership. Interviews and participant observation conducted in clinical, family, and community settings will consider how veterans and their families situate lived experiences of PTSD, combat trauma, and personal and family well-being in the context of lay and clinical ethnopsychiatries around PTSD, expectations and experiences of military service in the “War on Terror,” and cultural norms for successfully functioning as an adult male. Findings will provide insight into individual- and family-level negotiations around illness, work, and gender roles; the negotiation of explanatory models of illness within pluralist cultural settings; and the ways in which cultural representations of war and PTSD are adopted, resisted, and lived out by a multiethnic group of participants.

By examining how patterns of work and socioeconomic status shape the experience of individuals and families dealing with combat-related PTSD, this research contributes to research on working families already ongoing at the MARIAL Center. The planned study will elaborate a multifaceted and diachronic view of how work is done and made sense of within families whose expectations and practices have been shaped by past military work, who have suffered the disruptions of long-term deployment, and whose well-being remains enduringly altered as a result.

Erin Finley, from the Department of Anthropology at Emory University, seems to be conducting the  research study.  Her contact information is available on the website, linked here.

It's Come to This: "PTSD for Dummies" Published Today

It's hard to even believe, but the "For Dummies" book series has come out with a title on PTSD -- c'mon -- you can guess what it's called -- "Post-Traumatic Stress Disorder for Dummies."  The book, which was published by Wiley on October 22, 2007 -- in other words, today -- isn't available on Amazon yet, but it should be shortly. In the meantime, you can order it from the publisher directly, from the Dummies.com website, or request it from a local independent bookseller. (Update: it's now available from Amazon, too.  Click here to go to it directly.)  From the publisher's website:

A plain-English resource for people suffering from the aftereffects of a traumatic experience.  An estimated five percent of Americans-over 13 million people-suffer from Post Traumatic Stress Disorder (PTSD) at any given time, and approximately eight percent will develop it at some time in their lives. Written for PTSD sufferers and their loved ones, this practical guide gives people the lowdown on symptoms, details today's various treatment options, offers practical coping strategies for day-to-day life, and even shows how to help children with PTSD. For the 12 to 20 percent of returning combat veterans who suffer from PTSD, the book offers real-world strategies for dealing with flashbacks, nightmares, and disruptive thoughts.

About the author: Mark Goulston, MD, an expert on PTSD, suicide prevention, and violence intervention, maintains a private clinical practice. He has taught or lectured at UCLA, USC, and Fortune 500 companies and has trained FBI and police hostage negotiators.

ISBN: 978-0-470-04922-8

Paperback

384 pages

US $21.99

(It's also available in e-book, downloadable format -- but unfortunately not at a lower price.  Click here for that link.)

The "For Dummies" series is uniformly very good, comprehensive, and often even written with a certain amount of humor and informality.  It's got to be good news that this book is out there -- if nothing else, it will help people with PTSD and/or combat trauma use it as a reference to share with others they know.  (Thanks to Kathie Costos and her blog, woundedtimes.blogspot.com, for the link about the publication of this book.)

Editor's Note: It's now available at Amazon.com.  See sidebar for books listed, or follow this link to find it at Amazon.)

Blogged Reports from Brown Conference

For those of you who like me are crying salty tears about missing what sounds like it was a stupendous conference at Brown University in Providence, Rhode Island over the weekend, here are a couple of first-person reports from the same blogger about what the conference was like to attend. It really sounds fantastic.  I still wish I'd been able to go.  (Sigh.)  (The conference was on first person narratives coming back from the war in Afghanistan and Iraq, featuring many of the authors who wrote them, as well as interested others.)

First person report about the events of the first day; first person report about the events of the second day.  (Referencing those blog posts here does not imply an endorsement of the rest of the blog's contents -- I'm particularly interested in, as I hope you would be, the impressions from going to that conference itself.)

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If you've never seen "The War Tapes," by Deborah Scranton, one of the featured speakers at the conference, now might be a good time to try to find it on DVD.  Scranton is a filmmaker who put video cameras in the hands of various New Hampshire National Guard members, as the war in Iraq was beginning, and asked them to record what they saw, with the permission of their superiors.  What came back was some interesting footage, which she put together into a documentary that covers how three "regular guys" go to Iraq and get changed by the experience.  I saw the film at one of its first screenings on Cape Cod last year, met one of the featured participants, Sgt. Steve Pink, and really was impressed.  Apparently Scranton was a live wire at the conference, and one of it's most interesting participants.  (Here's a link to Scranton's blog, which includes a link to buying the DVD.) (The movie has since gone on to win a number of awards, including "Best Documentary," Tribeca Film Festival, and "Best International Documentary," BritDoc Festival.)

More Good Reads on Healing from Combat Trauma / PTSD

Continuing the theme from the previous post, on more good reads becoming available on recovering from PTSD and combat trauma.  Remember, we've re-organized our book lists.  Therapeutic titles on the left hand column; first-person narratives -- great for understanding what combat veterans went through -- on the right.  Now back to the list of new additions to our combat trauma and PTSD recovery bookshelf:

Nam Vet: Making Peace with Your Past, by Chuck Dean.  Dean is one of the co-authors, with Bridget C. Cantrell, Ph.D., of Down Range: to Iraq and Back, with a foreword by Lt. Col. Dave Grossman, U.S. Army (Retired), author of On Killing and On Combat.  Nam Vet gets some great reviews from Amazon.  Click here to follow the link.  Dean was one of the first paratroopers sent into Vietnam in 1965.  From the book descriptin: "Although the Vietnam War officially ended in 1975, it still rages in the lives of thousands of veterans and their families. This book not only tells why so many Vietnam veterans suffer from flashbacks, depression, fits of rage, nightmares, emotional numbing, and broken relationships, but it offers solid answers and gives hope. It reveals the way to peace on the subject of post-traumatic stress."

Another story from a Vietnam era veteran:

My Tour in Hell: A Marine's Battle with Combat Trauma, by David W. Powell.  More good reviews on Amazon.  From the editorial reviews: "Powell articulates the healing process very well and has given a tremendous gift to the veteran community of any generation." -- Fr. Phillip G. Salois, National Chaplain, Vietnam Veterans of America.  "This book provides a first-person account of how combat trauma evolves and is a testament to Traumatic Incident Reduction." -- Judy Bronson, PhD, LCSW.

and this one from the wife of a Vietnam veteran, whose PTSD drove him to suicide:

Flashback: Posttraumatic Stress Disorder, Suicide, and the Lessons of War, by Penny Coleman.  This reasonably unsung book got a starred review from in Booklist, from the American Library Association -- a group who we can assume has seen a few good books in their time ;-).  From their review:

Coleman was once married to a Vietnam veteran who committed suicide rather than live with his horrific war memories, and she asserts that the military hasn't learned the most important lesson of all the last century's wars, that the chance of becoming a psychiatric casualty, of killing oneself due to untreated post-traumatic stress disorder (PTSD), is greater than that of death by enemy fire. Some contend that there have been more Vietnam vet suicides than there are names on The Wall. The risk seems even higher for those serving in Iraq, where the army reports a suicide rate three times greater than normal within its ranks. How does Coleman know the lesson she points out hasn't been learned? For starters, the aforementioned army reporting doesn't associate the suicides with combat but instead blames "underdeveloped life coping skills." Further, Coleman cites many reports and experts substantiating that the military downplays the psychic toll of modern combat and routinely denies veterans' requests for psychiatric medical intervention. Punctuating this alarming presentation is a heavily researched history of what was once called shell shock and the tragic, in-their-own-words stories of 12 women, each of whom is a surviving relative of a Vietnam veteran who committed suicide.

and several specifically therapeutically-oriented titles (a bit more expen$ive, too!):

Haunted by Combat: Understanding PTSD in War Veterans Including Women, Reservists, and Those Coming Back from Iraq, by Daryl S. Paulson.

and these (the following ones will cover PTSD and therapeutic approaches more generally -- in other words, not specifically for combat veterans):

Experiential Treatment for PTSD: the Therapeutic Spiral Model, by M. Katherine Hudgins.

Effective Treatments for PTSD: Practice Guidelines from the International Society for Traumatic Stress Studies, edited by Edna M. Foa.

and

The PTSD Workbook: Simple, Effective Techniques for Overcoming Traumatic Stress Symptoms, by Mary Beth Williams.

Recovery Takes -- Patience (Mason, That Is)

It's a nice fall day and our thoughts turn to what else but more BOOKS to read, on combat trauma and/or PTSD.  There really is getting to be quite a crop -- a little TOO large to completey get a handle on.  However, there are some suggestions for worthy additions to that list.

First off, check out Patience Mason's own bookstore, now online at www.PatiencePress.com She sells a copy of her key book, Recovering From the War: A Guide for All Veterans, Family Members, Friends and Therapists, which is slightly hard to find on Amazon and elsewhere -- now you can buy it directly from her. But while you're there, check out her other writings, many of which are available as downloads online.  Here are a few key ones, with descriptions.  This is the link to the bookstore on her site.

•  The War at Home: A Guide to PTSD Symptoms for Veterans and Family Members, by Patience Mason.  PTSD symptoms are often misunderstood and personalized by vets and their family members, leading to a war at home. This pamphlet goes through each symptom to discuss what it did or does for the vet, what it may be doing to the vet, and how the vet's spouse and family might be feeling as a result of each symptom. This can be very healing for everyone involved. 16 pages - $1.00
• After the War: For the Wives of All Veterans, by Patience Mason.  Our best-selling pamphlet is addressed to the wives of veterans of all wars and deployments, from WWII to today's peacekeepers, A simple healing explanation gives courage and hope to an underserved population. Spouses and significant others are often at their wit's end because they do not know what is going on. 12 pages - $1.00
• Have You Seen Someone Blown Away? by Patience Mason.  Written for teens who have been traumatized by school shootings, drive-by shooting, or other forms of violence. It is a simple, clear explanation of the symptoms of PTSD as a normal response to trauma and how to recover. Space is provided on the back to stamp an agency's name, address, and phone number. Pamphlet - $0.25
• An Explanation of PTSD for Twelve Steppers: When I Get Sober, I Feel Crazy, by Patience Mason.  This pamphlet explains the symptoms of PTSD as survivor skills that make sense rather than defective weak or crazy reactions that evoke shame. Most people would rather be drunk than to think they are weak, defective or crazy. All our materials emphasize the necessity of becoming clean and sober as a part of recovery from the effects of war. Safety rather than “being good” is emphasized. You can't make healthy decisions or choices under the influence. 8 pages - $1.00.  Also free online.
• Suggested Format for a Twelve Step Group for Veterans, Their Families, and Friends, by Patience Mason.  Written with the effects of war in mind. It contains opening and closing readings, an adaptation of the steps, information on how to run a meeting, how to rotate leadership, how to share safely, what anonymity is and how to preserve it, suggestions for topics, literature to read, and how to work the steps.  $5.00.  Also free online.
• Suggested Format for a Twelve Step Group for Trauma Survivors, Their Families, and Friends, by Patience Mason. Written with the effects of any type of trauma in mind. It contains opening and closing readings, an adaptation of the steps, information on how to run a meeting, how to rotate leadership, how to share safely, what anonymity is and how to preserve it, suggestions for topics, literature to read, and how to work the steps. 31 pages - $5.00.  Also free online.

It Takes a Village -- But Should It Have To?

In Guerneville, California, a so-called "Veterans Village" -- a four story building on two acres of land, lovingly and recently donated by a World War II veteran who wishes to remain anonymous -- is slated to open in January and start housing soldiers back from Iraq and Afghanistan, who struggle with PTSD and/or combat trauma.  The project is the brainchild of a Gold Star mother, Nadia McCaffrey, who lost her son, Sgt. Patrick McCaffrey, in Iraq three years ago.  Her eventual goal is to build a national "Veterans Village" on land outside of Charlotte, North Carolina, in an ambitious project which will cost over $100 million.  ABC News, Channel 7, in the Bay Area, covered this story in print and with video.  Click here for the link.  The idea, with at least the California location, is that the building will serve returning soldiers with PTSD while they get a chance to acclimate back to being in the U.S. and receive therapy.

It's hard to tell whether this idea is really cool -- or just plain kooky.  It's obviously generous, sincere, and deeply heartfelt, on everybody's part who's involved.  That's all great.

What isn't great, in my mind, are two things:

One, it's never a good precedent to start doing things privately in lieu of getting the government to step up and provide the care they're contracted to give returning veterans.  It's a troubling precedent, and it's becoming too frequent a pattern, to see private citizens step up where the government should be, but isn't, or isn't working fast enough, to take care of problems.  That's a giant problem, in my opinion.  Selfless, altruistic concern and doing good are fantastic, and they're a core attribute of wonderful people in our society.  But the government can do more, more effectively, and needs to be held accountable for the care it's already supposed to be providing.  Doesn't the government have a duty to care for its veterans?  If not, shouldn't it have one?  I can easily see where people get distressed because, in essence, good help for veterans is not coming fast enough, by a long shot.  That's very true.  But it's the government, not private citizens, who needs to to be ministering to the very real needs of returning soldiers.  What private citizens do should be icing on the cake.  Disturbingly, they're trying to provide the cake.  That's not a good situation, or a good precedent.

Secondly, it's hard to tell what the plan here is, and how well thought-through it is, or isn't.  Returning servicemembers, aka veterans, who are affected by PTSD and combat trauma, according to what we know, may not even start showing signs of distress for months afterwards -- so the timing is difficult.  Do veterans themselves decide when it's time to pay a visit to this village?  That could possibly work.  But how would the capacity of the place be balanced to accommodate potentially wide fluctuations in who needed help when?  And what sort(s) of help would be offered?  It's potentially quite chaotic to have a group of any people residing in one place who are at risk for experiencing disturbing episodes, such as PTSD can trigger.  At minimum, trained professionals (psychologists and the like) who are able to manage such an environment would need to be on staff, because that's a job not just anyone is going to be able to do.  It's definitely clear that veterans heal better or best in community with other veterans -- that's a huge check on the "plus" side.  On the minus side, though, is the potential chaos that could ensue with people in close proximity going through flashbacks in a group residential setting.

I don't suppose these are really reason not to do this venture; but just to approach it with caution.  My main concern is that combat veterans suffering from PTSD or combat trauma are, tough as they might be as people, a vulnerable population because of their injuries. It really wouldn't be good at all to offer people at a vulnerable low point in their lives a lifeline that turns out to be too flimsy to support them.  Ultimately, that would add hardship, not create good.  And let's not do things like this in lieu of requiring our own government to care for its veterans.  If the government isn't doing its job to provide the quality of care we should expect for our veterans -- let's lean on the government to do so, not just pitch in and try to do it ourselves.  That would be like having insurance, and when your car gets totalled in an accident, replacing it out of pocket.  Ummmm, no.  Even if it takes a while and is a pain, that's WHY you have insurance.  And the car accident wasn't your fault. 

The Dole-Shalala's Commission's findings showed what the VA needed to do.  Lawmakers and others have let those resolutions linger in some form of limbo.  As they used to say with the justice system, justice delayed is justice denied.  In this case, care delayed is care denied.  If the government isn't doing enough for returning veterans, especially those who suffer from PTSD, let's lean on the government to do more -- to do what it ought to do.  And then we can supplement that care with our own civic goodheartedness, but never in place of what our government ought to be doing.  As taxpayers and voters, we should be very clear about the power we wield to hold our own government accountable for doing what's right by all its citizens, including and especially, for the sake of this conversation, our veterans.

In the sixties, there was a bumper sticker that said something like, "Wouldn't it be nice if schools had all the supplies they needed, and the AIr Force was forced to hold a bake sale to buy its bombers?"  I'm loosely paraphrasing here, but the concept was clear: schools nationally suffered cutbacks and often did hold bake sales so that students received the supplies they needed; whereas the military budget was rarely cut.  Without detouring into any pro-war or anti-war ideology here, which would be seriously missing the point, there's an analogy here with veterans care.  Why are private citizens trying to offset what the government should be doing?  When the government estimates the cost for going to war, what portion do they estimate for taking good care of the veterans who fight?  Or is the focus on weapons and warfare and infrastructure, and very little on caring for those who fight?  If that's the case, that's the first place the wrong should be redressed.  Then private citizens can jump in and add their care to their mix, but as a supplement, not as the essential care veterans should be receiving. 

Minor Site Update -- Book Lists

The recent blog post about "First Person Narratives" from Iraq and Afghanistan was a good opportunity to make a small but needed change to the site.  Now all the books of therapeutic interest about healing combat trauma and PTSD are located in the LEFT column of the website; and all the "First Person Narratives" about wartime -- helpful for understanding what veterans went through and go through -- are located in the RIGHT column.  As time goes on, we will be adding more books to both lists.  A slight qualitative diference.  The therapeutic books are there because they're vetted as all being GOOD and worth reading; the first person narratives don't have that qualification applied.  Maybe they're not uniformly great books -- but they're accurate as far as the participants recall the experience.  Good, bad or indifferent -- they're reflections on the time they served.  So trust the therapeutic book list more for quality, but expose yourself to both sets of books -- you won't be disappointed by learning more about what veterans endure.

Front Line, First Person - Iraq War Stories

In the category called, things that make me wish I were in New England this weekend, this has to be at the top of the list.  Check out the topic, the length of the program (two days!!!) and, last but not least, the all-star cast who'll be participating.

The Watson Institute for International Studies, a part of ivy league Brown University in Rhode Island, is sponsoring a two day upcoming seminar on "Front LIne, First Person: Iraq War Stories" from those who served.  Click here for the link.  Cosponsored by Brown University's Nonfiction Writing Program and The Rhode Island Council for the Humanities.  The conference will be held at the the Watson Institute for International Studies, Brown University, located at 111 Thayer Street, Providence, RI 02912.  A live web stream of this event will be available, and archived video will be available shortly after the event.  (A later blog entry of ours references some blogger first person reports about the conference itself.  Click here for that link.)

Here's what the conference brochure has to say:

Over the past four years, the conflict in Iraq and the “war on terror” have divided public opinion in the United States. They have also created a less obvious divide – between the general public and the individuals, families, and communities touched directly by the experience of war. In this climate, voices representing the direct experience of war are often stifled or misheard or hijacked by those who seek to polarize the debate over the war.

Front Line, First Person: Iraq War Stories is a two-day conference that aims to create bridges for conversation across these new fault-lines and to understand better the capacities of different forms of storytelling to reach across boundaries and build connections at the human level.

Featured speakers include Colby Buzzell, the blogger and best-selling author of "My War: Killing Time in Iraq"; Matthew Burden (aka Blackfive), a leading military blogger and author of "The Blog of War: Frontline Dispatches from Soldiers in Iraq and Afghanistan"; former US Senator Lincoln Chafee ’75; Deborah Scranton ’84, the award-winning director of the documentary “The War Tapes”; and Newsweek Senior International Photo Editor Jamie Wellford ’84.

Friday, October 19

2:00pm	The Ground Truth from Iraq to the Beltway and Back
	Colby Buzzell (blogger, author) “My War: Killing Time in Iraq” Iraq vet Senator Lincoln Chaffee (Independent, Rhode Island) Matthew Burden, aka, Blackfive (veteran, blogger, author) "The Blog of War: Frontline Dispatches from Soldiers in Iraq and Afghanistan;" Erick Rodriguez, Iraq vet & current Brown student Moderated by: Deborah Scranton (filmmaker)

4:15pm	What Stories Do and Don’t Get Told and Why
	Podcast with SFC Nunn, author “Northern Disclosure” & soldier currently serving in Iraq, Iraq veteran Deborah Scranton (filmmaker) “The War Tapes” Col. David Lapan, USMC, Deputy Director, HQMC Public Affairs, Iraq vet Matthew O'Neill (filmmaker) HBO's "Alive Day Memories: Home From Iraq,” "Baghdad ER." Jason Christopher Hartley (blogger, author) "Just Another Soldier" Moderated by: Keith Brown

Saturday, October 20

9:00am

Reporters and Rapport

Charles Monroe-Kane (producer, NPR) To The Best of Our Knowledge Tara McKelvey (journalist, author) “Monstering: Inside America’s Policy of Secret Interrogations and Torture in the Terror War” Brian Palmer (embedded photographer, journalist, filmmaker) Trish Wood (journalist, author)”What Was Asked of Us: An Oral History of the Iraq War by the Soldiers Who Fought It” Moderated by: James Der Derian

11:30am

Amplifying Voices and Activism part I

Prof. Matthew Gutmann, Brown University "Breaking Ranks: An Oral History Project on Iraq War Veteran Dissent" Erin Solaro, author "Women in the Line of Fire: What You Should Know About Women in the Military" Paul Rieckhoff (soldier, author, activist) Founder, Iraq & Afghanistan Veterans of America (IAVA) & author "Chasing Ghosts", Iraq Vet Col. (Ret.) Greg Gardner, served with the Coalition Provisional Authority in Iraq as Chief of Staff for the Senior Advisor, Ministry of National Security and Defense, Iraq vet, military analyst for FOX News. Moderated by: Catherine Lutz

2:30pm	Amplifying Voices and Activism part II
	Prof. James William Gibson (California State University, Long Beach) "The Perfect War: Technowar in Vietnam “ Mitty Mirrer (filmmaker) Andrew Woods, Lecturer at Harvard Law School & founder “Soldier's Stories” project SSG Christopher Loverro (soldier, filmmaker) “Hidden Casualties”, Iraq Vet Moderated by: Elizabeth Taylor

5:15pm	Citizen/Soldier Roundtable Dialogue
	Facilitated by Lorelei Kelly, a national security specialist working to educate elected leaders and the public about the national security challenges revealed by 9/11. Her central focus in 2008 will include civil-military dialogue and educating the public about the role of the military in US democracy.

Conference Participants

Keith Brown is a sociocultural anthropologist. He is the co-founder of the Institute's Cultural Awareness and the Military Project, tracing the development of US military interest in culture since the 1990s. He also specializes in the study of twentieth-century Macedonia.

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Matthew Currier Burden ("Blackfive") enlisted in the military at age seventeen. He served first as an Army aircraft crew chief, then a paratrooper, before joining Special Operations. After receiving a commission as a cavalry officer and serving in Europe and Asia, he later became an intelligence officer for the Defense Intelligence Agency (DIA). He left the military in July 2001 as a major in the U.S. Army Reserve. He is now an IT executive in Chicago, and author of the popular military blog, Black Five. He has released a book, “The Blog of War: Front-Line Dispatches from Soldiers in Iraq and Afghanistan”, which captures some of the best blog posts that have been written by active-duty service members in Iraq and Afghanistan and their families. As Mr. Burden says in the introduction, "military blogs were ideal for filling in the gaps that both the media and the military left out."

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Colby Buzzell is an Operation Iraqi Freedom Combat veteran, was an infantryman in the United States Army, served in the Stryker Brigade Combat Team out of Fort Lewis Washington. Served a year in Iraq, from 2003-04, where he started a web-log, and has published a book on his experiences entitled, My War: Killing Time in Iraq, combining narrative, blog entries, and emails that evolved from his blog over time. Referring to My War: Killing Time in Iraq, Kurt Vonnegut said “My War” is nothing less than the soul of an extremely interesting human being at war on our behalf in Iraq”. In 2004, Buzzell was profiled in Esquire magazine's "Best and Brightest" issue and has since contributed regularly. In 2007, Buzzell received the 2007 Lulu Blooker Prize for My War: Killing Time in Iraq.

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Lincoln Davenport Chafee ’75, a former United States senator, was a distinguished visiting fellow during the 2007 spring semester. Chafee was Rhode Island’s Republican senator from 1999 until 2006. Governor Lincoln Almond appointed Chafee to the US Senate in November 1999 to fill the unexpired Senate term of his late father, John Chafee. In November 2000, he was overwhelmingly elected to the seat. As senator, he served as a member of the Committee on Environment and Public Works, the Committee on Foreign Relations, and the Committee on Homeland Security and Government Affairs. During that time, he emerged as a leader on environmental issues and foreign policy, and promoted sensible economic and energy policies.

Before he joined the Senate, Chafee was the mayor of Warwick, RI, from 1992 until 1999. He entered politics in 1985 as a delegate to the Rhode Island Constitutional Convention, and a year later, he was elected to the first of two successive terms on the Warwick City Council.

While at the Institute, Chafee will work with the Global Security Program, lead an undergraduate student study group on US foreign policy, and convene groups of students, faculty, and policymakers to discuss issues in international relations. He will also undertake a variety of writing projects.

Chafee earned a degree in classics from Brown University in 1975. While at Brown, he was captain of the wrestling team and received the Francis M. Driscoll Award for leadership, scholarship, and athletics.

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James Der Derian is a Watson Institute research professor of international studies. In July 2004, he became the director of the Institute's Global Security Program. Der Derian also directs the Information Technology, War, and Peace Project in the Watson Institute's Global Security Program.

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COL (ret) Greg Gardner, retired from the United States Army as a Colonel with 30 years of commissioned service Mr. Gardner, who retired from the United States Army as a Colonel with 30 years of commissioned service, joined Oracle Corporation on March 15, 2004.  During his final military assignment, Mr. Gardner was responsible for Joint Command and Control in the Command, Control, Communications and Computers Directorate of the Joint Staff in The Pentagon.  In this role he developed the prototype of the Joint Protected Environment Network (JPEN) now in wide use by military bases and state and local governments across the country.

From April to November 2003, Mr. Gardner served with the Coalition Provisional Authority in Iraq as Chief of Staff for the Senior Advisor, Ministry of National Security and Defense. He then returned to Washington and coordinated personnel activities for the Authority before leaving government service in March 2004. Mr. Gardner’s military assignments included leadership positions in infantry, airborne, and ranger units and command of the 1st Battalion, 504th Parachute Infantry Regiment, 82d Airborne Division and the 3rd United States Infantry (The Old Guard).

His staff assignments included service as Operations Officer, 3rd Brigade 7th Infantry Division (Light) during Operation JUST CAUSE in Panama, G3, 25th Infantry Division (Light) in Hawaii, and Executive Officer to the Commander-in-Chief, Pacific Command. During his military service, Mr. Gardner received two awards of the Defense Superior Service Medal, three awards of the Legion of Merit, the Bronze Star Medal, Combat and Expert Infantryman’s Badges, Master Parachutist’s Badge, Ranger Tab, and Pathfinder Badge.

Mr. Gardner, a graduate of the United States Military Academy with a Bachelor of Science Degree in Electrical Engineering, also holds Master’s Degrees in Industrial Relations/Personnel Management from the Krannert School at Purdue University, Military Art and Science from the Army’s School of Advanced Military Studies, and Strategy and Policy from the Naval War College.

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James William Gibson, is a professor of sociology at California State University, Long Beach. He is the author of The Perfect War: Technowar in Vietnam (Atlantic Monthly Press, 1986), and analysis of how the U.S. military conceptualized and fought the Vietnam War as a capital-intensive production system in which the officer corps were managers, the enlisted men workers, and "enemy" bodies the product.  Gibson contrasts the abstract managerial knowledge of reported body counts, sorties flown, tons of bombs dropped, etc., found in official documents to what soldiers experienced on the ground and reported in their memoirs and novels. In Warrior Dreams: Paramilitary Culture in Post-Vietnam America (HIll and Wang, 1994), Gibson analyzed how the cultural and political crisis created by defeat in Vietnam led many men to dream of fighting new wars in which evil would be defeated and a pre-Vietnam order restored. In this fantasy culture, epitomized by Rambo films and Soldier of Fortune magazine, men imagined themselves as powerful warriors fighting outside military and police bureaucracies suffering from "restraints" ordered by liberal elites. Gibson is currently finishing a third book, Call of the Wild: The Cultural Enchantment of Nature, for Metropolitan Books/Henry Holt. 

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Prof Matthew Gutmann, is a cultural anthropologist at Brown University.  His publications include Fixing Men: Sex, Birth Control, and AIDS in Mexico (California, 2007); The Romance of Democracy: Compliant Defiance in Contemporary Mexico (California, 2002); The Meanings of Macho: Being a Man in Mexico City (10th Anniv. Ed., California, 2006).  With Catherine Lutz he is writing a book based on oral histories of dissident Iraq-era veterans, Breaking Ranks, and completing a project on sexual exploitation and abuse among UN Peacekeepers.  He is also a former GI organizer - way back when...

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Jason Christopher Hartley joined the Army National Guard at the age of 17 while still in high school in Utah.  He served with the 19th Special Forces Group in Utah until 2000, and now is part of the 69th Infantry based in Manhattan.

Jason spent most of 2004 in Dujail, a small town Shiite town in Iraq located approximately 45 miles north of Baghdad and in the heart of the Sunni triangle.  In addition to their combat tasks, his Infantry Company gathered scores of witness statements from residents who had survived the massacre perpetrated against them in 1982 by Saddam Hussein.  Their work was crucial in the prosecution and conviction of Saddam Hussein.  (Being opposed to the death penalty, he finds this a dubious distinction.)

For the duration of his deployment, he wrote extensively about his experiences and posted the stories along with photographs on his blog, justanothersoldier.com.  When he returned from Iraq, his writings were compiled and published by HarperCollins under the same title, Just Another Soldier.

Jason recently finished work as the military advisor for the film "Memorial Day", directed by off-broadway impresario Josh Fox and produced by Journeyman Films ("Maria Full of Grace", "Half-Nelson").

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Lorelei Kelly is a national security specialist working to educate elected leaders and the public about the national security challenges revealed by 9/11. She is the Policy Director for the Real Security Initiative of  the White House Project, www.thewhitehouseproject.org - an organization whose mission is to increase the influence of women's leadership in media, culture and politics. Her central focus in 2008 will include civil-military dialogue and educating the public about the role of the military in US democracy.

In addition to working with the underground movements of eastern Europe throughout 1989, Lorelei's professional background includes teaching at Stanford University's Center on Conflict and Negotiation, Senior Associate at the Henry L. Stimson Center and more than 8 years working on bipartisan national security education in Congress, where she continues to advise the Progressive Caucus. She has a Grinnell College BA and a Stanford MA. Lorelei has been trained as a professional mediator in both domestic and international conflict resolution settings. She completed the Air Command and Staff College of the US Air Force and also attended programs at the National Defense University and Army War College. Her latest publication is a guidebook for citizens entitled "Policy Matters: Educating Congress on Peace and Security" which is available online at www.stimson.org. She blogs regularly at  democracyarsenal.org  and Huffingtonpost.com.

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Colonel Dave Lapan currently serves as deputy director, Headquarters, U.S. Marine Corps Public Affairs, The Pentagon, Washington, DC.   

Col. Lapan enlisted in the Marine Corps in 1980 and transferred to the Marine Corps Reserve in 1987.  He was assigned to Marine Corps Air Station El Toro (Calif.), working in airfield operations, and was recalled to active duty during Operation Desert Storm.

In 1993, he resumed his undergraduate studies and graduated with honors from the Pennsylvania State University with a B.A. in Journalism and Humanities.

Returning to full-time active duty, he was assigned to Headquarters, U.S. Marine Corps, where he served as head of the Media and Plans branches, from 1997 - 2000.

From 2000 - 2003, Col. Lapan served as press officer in the Office of the Assistant Secretary of Defense for Public Affairs, The Pentagon, where, among other duties, he was Public Affairs liaison to U.S. Central Command during Operations Enduring Freedom and Iraqi Freedom.

From 2003 - 2006 he was assigned as Public Affairs Officer, II Marine Expeditionary Force, Camp Lejeune, NC.  In 2004, he served as PAO for Combined Joint Task Force – Haiti during Operation Secure Tomorrow and in 2005, served as PAO for Multi-National Force – West during Operation Iraqi Freedom.

He is a graduate of the Air War College and distinguished graduate of the Naval War College.  His personal decorations include the Bronze Star Medal, Defense Meritorious Service Medal, Meritorious Service Medal, Joint Service Commendation Medal (3), Joint Service Achievement Medal and the Navy/Marine Corps Achievement Medal.

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Christopher Loverro served as an Army Reservist Staff Sergeant in Mosul and Sumarra during the period of 2003-2004 while attached to the Army’s first Stryker Brigade Combat Team (3/2) out of Fort Lewis Washington. During his year in Iraq, he participated in a plethora of missions along the full spectrum of warfare from humanitarian assistance projects to direct action missions. Some of the
many missions his Combat Brigade conducted included building housing, a school, and providing humanitarian supplies for over 2,000 refugees (Operation Blanket) and providing school supplies for over a dozen dilapidate schools (Operation Pencil). Because of his civilian background as a police SWAT team operator, SSG Loverro helped with some of the training for the Iraqi police, and designed and implemented the Defensive Tactics Training program for the basic training battalion in Mosul where he helped train 600 new Iraqi Army recruits.

SSG Loverro has a Bachelor’s degree from UC Berkeley in Peace and Conflict Studies and has studied at the European Peace University’s campus in Austria, Spain, and England. He resides in northern California where he continues to work as a Police Officer and is currently working on the documentary film “Hidden Casualties” with Leave No Man Behind Productions.

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Catherine Lutz is a Watson Institute professor (research) and holds a joint appointment with the Department of Anthropology. Professor Lutz received her BA in sociology and anthropology from Swarthmore College and her PhD in social anthropology from Harvard University.  Her most recent books include Local Democracy under Siege: Activism, Public Interests, and Private Politics (New York University Press, 2007) and Homefront: A Military City and the American 20th Century (Beacon Press, 2001, winner of the Leeds Prize and the Victor Turner Prize). Others include Reading National Geographic (Chicago, 1993) with Jane Collins, and Unnatural Emotions: Everyday Sentiments on a Micronesian Atoll and their Challenge to Western Theory (Chicago, 1988). She is the immediate past president of the American Ethnological Society, the largest organization of cultural anthropologists in the U.S.

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Tara McKelvey is a senior editor at The American Prospect and the author of "Monstering: Inside America's Policy of Secret Interrogations and Torture in the Terror War" (Carroll & Graf; forthcoming in paperback, Basic Books, Spring 2008). She is also a contributing editor at Marie Claire Magazine and a frequent contributor to The New York Times Book Review. In addition, she is a research fellow at NYU School of Law's Center on Law and Security, a  2007 Ochberg Fellow (Dart  Center for Journalism & Trauma) and a 2008 Hoover Media Fellow.

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Mitty Mirrer, a documentarian, is currently gathering the voices of widows, children and other survivors of soldiers lost in Afghanistan and Iraq.  Ms. Mirrer is also a military survivor. Her father, a Marine, was killed in Vietnam. She is documenting the stories of the survivors of this war to create connections and understandings among the survivors themselves and with the general public; connections that were largely unavailable during the Vietnam Era. Currently a research fellow at the William Joiner Center for the study of war and social consequences at the University of Massachusetts in Boston, Mitty spent most of her career as a journalist in New Orleans and Philadelphia. Her most notable journalism awards have come from her work documenting families who have overcome adversity. In Oklahoma City, she recorded the journey of a New Orleans family who lost a loved one during the bombing. In Honduras, she documented the plight of an entire village after the devastation of Hurricane Mitch. Her work helped raise funds for children in a town near Tegucigalpa. In 1997, Ms. Mirrer earned a Regional Edward R. Murrow award for her documentary on her own family’s journey to Vietnam.

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Charles Monroe-Kane's radio background started in Chicago where he was the Executive Producer of LesBiGay Radio, a daily, drive-time call-in program dedicated to the politics and culture of the LGBT community. Charles is currently the producer of Wisconsin Public Radio's To The Best of Our Knowledge distributed by Public Radio International to some 150 National Public Radio stations around the country. He is also the Executive Producer of two other national programs: Calling All Pets and Zorba Paster On Your Health. Charles won the Peabody Award in 2006. Before radio Charles lived Europe where he worked on a variety of projects ranging from starting an Internet Café in Prague to running a record label in Amsterdam (he also did anti-nuke activism in Belgium and even ran a circus). Charles's hobbies include chasing his three year-old son around the house and snuggling his 5 month-old daughter.

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SFC Toby J. Nunn is a Canadian Citizen earning his citizenship for the United States of America. Born and raised in the mountains of northern British Columbia by a single father he moved to the United States to gain an education and obtain opportunities not available to him in Canada. Faced with several adversities in life he turn to the United States military to validate himself as a man and citizen of the nation he is proud to be a part of without taking away from the pride he holds dear about where he is from and family still resides. As a soldier in the US Army he has excelled, gaining rank as fast as legally possible but attaining responsibilities far beyond his pay grade from the start of his career. He has also been blessed with great leadership and wonderful duties. He is a charismatic leader known for his ethically based decisions.

SFC Toby Nunn is a well-decorated veteran of the War on Terror being deployed several times and places. He is also one of the fastest inducted members of the very elite Sergeant Audie Murphy Club being recognized as being in the top percentile of all Non Commissioned Officers in the Army. He has received a spectrum of awards ranging from an Army Commendation for Valor to the Military Outstanding Volunteer Service Medal.

SFC Toby Nunn is married to the lovely Reagan Hutter Nunn, and together they have two boys, Tristan and Jeffrey and are excitedly awaiting the birth in November of their baby girl Scarlet Taylor.

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Matthew O'Neill, filmmaker, HBO's "Alive Day Memories: Home From Iraq", "Baghdad ER" Matthew O'Neill has been working with DCTV in one way or another since he came to paint the walls in 1997 during a college holiday break!

He's traded in his paint can for a video camera and has been producing and directing at DCTV since 2001 working on documentaries for HBO, PBS, the Discovery Channels and others.

For the 2006 documentary he produced and directed with Jon Alpert for HBO - Baghdad ER, he won a Columbia DuPont Award and three Primetime Emmy Awards for Nonfiction Programs - including "Best Directing" and "Best Cinematography." Other programs he has produced and directed include Bolivia: Coca and the Congressman, To Have and Have Not: The Changing Face of China and Turkey's Tigers for the PBS series Wide Angle; Siberian Adoption Story for the Discovery Health Channel and Venezuela: Revolution in Progress for the Discovery Times Channel.

His work closer to home has been awarded five New York Emmy Awards including prizes for "Best Political Journalism" and "Best Societal Concerns Program." His 2002 PBS special about the New York Gubernatorial race, Speak Up New York! won a local Emmy and a Sigma Delta Chi award from the Society for Professional Journalists for Public Service Television Journalism.

Matthew grew up on Long Island and graduated from Yale University.

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Brian Palmer is an independent journalist and filmmaker based in Brooklyn, NY. He is in post-production on his first film, Full Disclosure: A Reporter’s Journey Toward Truth, a feature-length documentary based on his three trips to Iraq with the same US Marine combat unit. Palmer has written for Mother Jones, Newsday, The Huffington Post, Pixel Press, Newsweek International, The New York Times Magazine, US News & World Report, among others. He has worked as a freelance producer for MTV’s True Life documentary series and the Tribeca Film Festival, and produced an Iraq segment in for PBS’s Now with David Brancaccio.

From 2000 to 2002 Palmer was an on-air correspondent with CNN. He was a staff writer at Fortune from 1998 to 2000 and Beijing Bureau Chief for US News & World Report for the two years prior to that. Palmer began his career in journalism as a fact-checker at The Village Voice. He is on the faculty of the MFA Photography, Video, & Related Media Program at New York’s School of Visual Arts. He earned a BA in East Asian Studies from Brown University in 1986 and an MFA in Photography from The School of Visual Arts.

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Paul Rieckhoff is the Executive Director and Founder of Iraq and Afghanistan Veterans of America (IAVA).  A non-partisan non-profit founded in 2004 with tens of thousands of members in all 50 US states, IAVA is America’s first and largest Iraq and Afghanistan Veterans group.  Rieckhoff was a First Lieutenant and infantry rifle platoon leader in the Iraq war from 2003-2004. His unit was attached to 1st Brigade, 3ID and spent almost a year conducting combat operations in Iraq, centered in the Adamiyah section of Baghdad on the Eastern bank of the Tigris River. Third Platoon conducted over 1,000 dismounted and mounted combat patrols. 3/124th INF was the first reserve component unit in the Army to be awarded the Combat Infantryman Badge since the Korean War. All thirty-eight of the men in Rieckhoff's platoon returned home alive.

Honored by Esquire magazine as one of “America’s Best and Brightest” in 2004, he is now a nationally recognized authority on the war in Iraq and issues affecting troops, military families and veterans.  Rieckhoff has appeared on hundreds of radio and television programs. Recent appearances include: ABC’s documentary “To Iraq and Back: Bob Woodruff Reports,” The Charlie Rose Show, 60 Minutes, The NewsHour with Jim Lehrer, Paula Zahn Now, This Week With George Stephanopoulos, Good Morning America, Anderson Cooper 360, Countdown with Keith Olbermann, Hardball with Chris Mathews, The NBC Nightly News, ABC World News Tonight, The CBS Evening News and The Colbert Report.

Rieckhoff’s first book, a critically acclaimed account of his experiences in Iraq and activism afterwards, titled Chasing Ghosts, was published by Penguin in May 2006 (paperback published May 1, 2007). A 1998 graduate of Amherst College, Rieckhoff now lives in New York City.

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Eric Rodriguez, is a senior at Brown University, concentrating in International Relations-Politics, Culture and Identity. He served as an Army Reservist Specialist in Balad and Ba'quba during 2003-2004, and was attached to the 308th Civil Affairs Brigade and the 4th Infantry Division, as a Water Treatment Specialist and Intelligent Analyst.  During the time he spent in Iraq, he participated in various humanitarian missions that  supported the building of schools and medical clinics, and the distribution of school of supplies collected by students from U.S. universities.  This stems from Eric's commitment to public service, which has been illustrated through his participation in Americorps, the University of California Public Policy and International Affairs Fellowship, and his recent receipt of the Derek Canfield Barker Prize for Public Service and Leadership at Brown University.

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Director Deborah Scranton made her feature film directorial debut with the award winning THE WAR TAPES, which premiered at the 2006 Tribeca Film Festival and won Best Documentary Feature. Hailed by the New York Times as "raw, honest and moving … one of the formally most radical films of 2006", it went on to win Best International Documentary at the 2006 BritDoc Festival and was released to critical acclaim in over 120 cities. Currently a visiting fellow at The Watson Institute for International Studies at Brown University working with the Global Media Project in the Global Security Program, Scranton is teaching an undergraduate seminar on documentary filmmaking and international affairs while also in production on "IRAQ - THE SURGE", a one hour film which will air in 2008 on WGBH Frontline that will tell the story of one of the most anticipated American military maneuvers in recent history from the inside out, rather than the outside in, using a similar virtual embed technique integrated with traditional verite documentary style that was developed in making The War Tapes.

Passionate about her innovative "integrative" filmmaking and the new frontier in storytelling: the intersection where web 2.0 meets technology meets documentary, Scranton started her career in television covering a variety of world-renowned events including the Tour de France, the Winter Olympics, and US Open Tennis for ABC Sports, CBS Sports, MTV Networks, ESPN, and was also a special assignment reporter. She graduated from Brown University with a degree in Semiotics. A former member of the U.S. Ski Team, Scranton resides on her farm in the mountains of New Hampshire.

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Erin Solaro, a former professional dog trainer and overeducated DC secretary, went to Iraq and Afghanistan on grants to study American servicewomen, and as an embedded journalist for the Seattle Post-Intelligencer. Women in the Line of Fire  (Seal, 2006) was the first book to combine personal experience with academic and policy analysis. Works-in-progress include To Live -- as If in Freedom, profiles of six women who dared to become politically active in Nazi Germany, Russia, Afghanistan and here; and a novel, Shipping Out. Erin lives in what's left of the woods outside Shelton, Washington, with her partner, writer Philip Gold, and various animals.

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Elizabeth S. Taylor directs the Nonfiction Writing Program in the Department of English at Brown. She teaches creative nonfiction -- literary journalism, historical narrative, memoir, and radio nonfiction, as well as "Writing the Southeast Asian War." She earned her PhD in American Literature from Brown in 1989, then taught at Harvard before returning to Brown. A former feature writer, and now book reviewer, for the Providence Journal, her most recent essays include a reflection on Brown's new Nonficton Writing Program in Composition Studies, "Apprenticing Nonfictionists" in The Journal of Teaching Writing, and "Itches and Scratches" in Brown Alumni Magazine. Her essays on the Vietnam War era include a Pendle Hill pamphlet, "Quaker in Vietnam: Rick Thompson (1943-1973)"; "Fighting Pacifism" in Friends Journal; "Crossing the Line: Finding Butch," in War, Literature, and the Arts; "Lost to Vietnam: Choices and Impact" in the anthology, Friends and the Vietnam War, and on the web site "Writing Vietnam."

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Trish Wood is an award winning investigative journalist and interviewer who has spent the past three years learning the truth about the Iraq War from the men and women who fight there. These stories of the war are collected in an oral history called What Was Asked of Us, a critically acclaimed book excerpted in Harpers Magazine, made a critic’s pick by People Weekly and described as “monumental” and “perhaps the only book about Iraq that matters” by the San Francisco Chronicle.

Ms Wood has been honored by the Canadian Association of Journalists, the Canadian Science Association, the Radio-Television News Directors Association, the National Magazine awards, and the New York Film Festival.

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Andrew Woods is currently a Lecturer at Harvard Law School, where he is editing a book bout the social foundations of international law. Andrew’s work focuses on the role of culture and media, broadly defined, in human rights advocacy. His recent projects include: an interdisciplinary set of workshops on creative human right promotion (humanrightsandmedia.com); GOOD Magazine, where he edits essays (goodmagazine.com); and a web-archive of soldier stories, (soon to be at www.soldiertestimony.org) where he hopes to encourage self-reflection by giving state-agents a human voice. A member of the class of ’02 at Brown, Andrew is also a Gates Scholar at Cambridge University.

--- Thanks to the ever-outstanding John Powers for the notice on this!  Click here and here for two links about John.

Empathy versus Sympathy

It was interesting to read in Kimberly Dozier's story on NPR recently, one comment that she made about empathy versus sympathy.  We've talked about that before on this blog, somewhat obliquely; and it was nice to hear the same sentiment expressed by another.  Dozier, you'll remember, is the CBS news reporter who was seriously injured in a car bomb explosion in Iraq.  She recently published an op-ed piece in the Washington Post, simply entitled, "War's Wounds Need More Study," a topic she could speak about from intimate experience.  In the question and answer session that followed, here's one interesting snippet of what she had to say::

On a personal note, I hate sympathy, thanks, and so do the injured troops I've met. Makes my stomach turn. Empathy is welcome, however, and appropriate for anyone injured in that conflict, whatever any of us think about ...it....

(Click here to read the NPR story; or listen to the audio file.)

What is it about those two words that makes them so different?  Language arts teachers would probably say it has something to do with the difference between connotative and denotative meaning.  What the words literally mean is one thing -- denotative -- but it's the accretion of context that's changed them in our ears, so that when we hear them, we hear something different - perhaps the difference between compassion and pity?  "Sympathy" is basically, "I feel sorry for you," emphasis on "I" (the 'me').  Empathy has come to mean, "I'm sorry with you," emphasis on "you" (the 'other').  There really is a difference.  Some say, as Dozier's comment underscores, that it's a difference you can actually feel.

Veterans Helping Other Veterans

Watch the public service announcement, PTSD is implied, from the National Veterans Foundation, featuring Dan Lauria.  Short and sweet, in the sense of being brief and to the point, constructive and helpful.  The NVF is staffed by veterans, for veterans, and has a toll-free number, available 24/7. That toll-free number is 1-888-777-4443.  The NVF calls itself "The Lifeline for America's Veterans".

                                                                     

Alcohol Abuse as Self-Medication for Stress

The British journal, Public Health News, which has gone out of business(!) since this article was published, last year had a good article by Shannon McKenzie entitled, "Self-Medication through Alcohol May Leave Millions More Vulnerable."  Because we've been talking lately in this blog about how veterans (and others) sometimes can turn to substance abuse as a way to deal with enormous life stressors, such as combat trauma and/or PTSD, we though this article was worth citing.  It was written to a British audience, and does not address combat specifically. It does, however, make the point that society is increasingly turning to numbing as a way of coping.  Unfortunately, as the article indicates, it's not a strategy that works well enough, long enough; and it can ultimately backfire.  Here's what it had to say.  It shouldn't be hard to make the mental leap to the problem of veterans self-medicating for symptoms of PTSD.

Millions of UK adults are using alcohol to deal with stress, anxiety and depression, according to a new report by the Mental Health Foundation ("MHF"). But their efforts to self-medicate could in fact increase their vulnerability to more serious mental health problems.

A National Opinion Poll survey carried out for the MHF showed 48 per cent of respondents aged 35- to 44-years-old said alcohol made them feel less anxious, while 26 per cent of all those questioned reported alcohol made them feel less depressed.

The MHF report – Cheers? – notes that alcohol consumption has doubled over the past 50 years.

Alcohol, it appears, is one of the British public’s favourite coping mechanisms. MHF chief executive Dr Andrew McCulloch said drinking alcohol seemed to be a common response to problems, and this was a cause for concern.

‘The research confirms our worries that people are drinking to cope with emotions and situations they can’t otherwise manage to deal with – feelings of anxiety or depression,’ Dr McCulloch said. ‘Drinking alcohol is a very common and accepted way of coping.’

The report outlines two major problems with such a coping mechanism. Firstly, self-medicating with alcohol can become self-perpetuating. Underlying anxiety can lead to increased alcohol use, which can in turn alter the chemistry of the brain, making people even more anxious and in need of even more alcohol to ‘numb’ their anxieties. Over time this can result in individuals becoming tolerant of alcohol.

Secondly, the report states it is difficult to maintain the right amount of alcohol needed to reduce negative feelings. And, given alcohol is a depressant, feelings of anxiety and depression may rapidly return. Even worse, these negative feelings can be amplified. The report notes that as many as 65 per cent of all suicides have been linked to excessive drinking, and 70 per cent of men who kill themselves have alcohol in their system.

People with psychiatric disorders are also more likely to turn to alcohol to self-medicate.

The coexistence of alcohol and severe mental ill health problems is well-known – the prevalence of alcohol dependence among those with psychiatric disorders is estimated at twice that of the general population. People with severe and enduring mental illnesses, such as schizophrenia, are at least three times more likely to be alcohol dependent. 

Related Links:

The British Mental Health Foundation; and we would add, for our British readers, Combat Stress UK, the "Ex-Services Mental Welfare Society," which has a section of its website devoted to PTSD.  Click here for that link.

"Must Have Been a Real Mean Bottle" - Veterans, PTSD and Substance Abuse

The relationship between trauma and substance abuse, or in our case, PSTD and self-medication through drugs and alcohol, is well-known. Some "sobering statistics" about substance abuse and veterans -- pun quite intentional -- follow here:

• Substance abuse rates are higher among veterans than their non-veterans counterparts.
• 76% of all homeless veterans suffer from drug, alcohol, or mental health problems (National Survey of Homeless Assistance Providers and Clients, 1999).
• According to an Army Post-Deployment Reassessment Study completed in July of 2005, alcohol misuse among soldiers rose from 13% among soldiers to 21% one year after returning from Afghanistan and Iraq.

(These statistics from the excellent fact sheet at the National Veterans Foundation - "The Lifeline for America's Veterans" -- called "Facts about Veterans: Needs and Solutions." Click here for the link to the fact sheet; click here for the link to the organization.)

There's even at least one scholarly book written on the subject, Trauma and Substance Abuse: Causes, Consequences, and Treatment of Comorbid Disorders, edited by Paige Ouimette, Ph.D., and Pamela J. Brown, Ph.D. Washington, D.C.: American Psychological Association (2003).  [Editor's note: "comorbid" means "appearing together."]

In a review of it by psychiatrist Edward J. Khantzian, M.D., of Haverhill, Massachusetts, he writes that his experience, "spanning four decades of clinical work involving patients with substance use disorders," has led him to conclude that "suffering is at the heart of addictions.  Nowhere is this more evident than with individuals who have developed posttraumatic stress disorder (PTSD) and resorted to addictive drugs to medicate the distress and pain associated with PTSD."

In future blog posts, we'll cover this topic in greater depth, but for the present, it's important to note how closely intertwined the two concepts are: if combat trauma or PTSD is a "normal reaction to abnormal events," it's no surprise that so many veterans of combat attempt to medicate the most troubling and painful experiences away through misuse or overuse of drugs and alcohol.

(The blog post's title comes from the country song, originally written by Vince Gill, and performed by Bob Seger and Kid Rock on Seger's latest album, Face the Promise.  To see a video of Seger and Rock singing this in concert recently on YouTube, click here.)

The toll free number for the National Veterans Foundation is 1-888-777-4443.

Self-Treating PTSD with Drugs and Alcohol

The American Bar Association had an article in its GP|Solo magazine -- devoted to general practitioners, solo and small firm practitioners -- late last year about "Returning Veterans."  It's a decent article, covering a variety of topics, from legal services for vets to what happens to lawyers who serve in combat and then need to come back and rebuild their own practices.  Sections of the article address, in a somewhat generic but still helpful way, PTSD, Substance Abuse, and Domestic and Personal Challenges.  It also lists resources for returning vets who struggle with these issues.  Here's what it has to say about problems with substance abuse, a real threat to veterans as a form of self-medication for PTSD and combat trauma:

Substance Abuse

In addition to traumatic stress reactions—and frequently as a means of self-medication to cope with these reactions—veterans may struggle with alcohol and drug abuse or dependence. The military is a zero-tolerance drug-free workplace for both enlisted troops and civilian employees. Regulations state that “drug abuse will not be tolerated and there are serious consequences for such misbehavior.” The Army Substance Abuse Program (ASAP), created by AR600-85, engages in prevention, enforcement (random drug testing is standard), and treatment. Soldiers identified as drug abusers are referred for clinical screening but are also subject to administrative separation, non-judicial punishment, or courts-martial. Those involved in alcohol-related misconduct are referred to ASAP for clinical screening and may be referred to alcohol and drug abuse prevention training, sent to another agency (clergy or marriage counselors), or sent to ASAP rehabilitation treatment, with a possibility of disciplinary action.

At the same time, servicemembers are encouraged to self-report their substance abuse issues. They can receive treatment, and the negative actions that can be taken against them are limited. Attorneys may draw comparisons between the dual enforcement/treatment structures of ASAP and state bar associations that maintain bar discipline (enforcement) programs as well as voluntary, confidential lawyer assistance programs.

Whether self-reporting or mandated to treatment, it’s important to note that 12-Step meetings (such as Alcoholics Anonymous) are available on military bases and among deployed servicemembers, carrying on a tradition of recovery that began in 1935 and was road-tested in World War II.

After discharge, returning veterans can receive treatment for substance abuse from the Veterans Administration (VA). It’s helpful to note that these benefits are not limited to newly returning vets. When alcohol or drug abuse has depleted an individual’s financial resources, determining eligibility for veterans’ health benefits can be a lifesaver when the cost of long-term residential treatment would otherwise be prohibitive.

It also lists some resources for coping with these issues:

Substance Abuse and Mental Health Services Administration (SAMHSA)
SAMHSA’s publications on veterans include several short reports from the Agency’s Office of Applied Studies (OAS). Recent reports include Substance Use, Dependence, and Treatment Among Veterans and Alcohol Use and Alcohol-Related Risk Behaviors Among Veterans (see SAMHSA News , January/February 2006). Visit SAMHSA’s website at www.oas.samhsa.gov/topics.cfm for a complete list under the topic “veterans.” Other SAMHSA resources include:

SAMHSA’s National Mental Health Information Center
800/789-2647 (toll-free)
240/276-2550
www.mentalhealth.samhsa.gov

SAMHSA’s National Clearinghouse for Alcohol and Drug Information
800/729-6686 (toll-free)
800/487-4889 (TDD) (toll-free)
800/767-8432 (Spanish) (toll-free)
www.ncadi.samhsa.gov

SAMHSA’s National Helpline
800/662-HELP (4357) (toll-free)
(English and Spanish)
800/487-4889 (TDD) (toll-free)

With PTSD, When Husband Comes Home from War, Wife's Battle Just Begins

The good ol' Washington Post has another in a series of excellent, needful articles on the hardships of being a returning veteran, or a close family member and/or caregiver, in today's paper.  This story is about Michelle and Troy Turner who live in rural West Virginia, 80 miles from the Department of Veterans Affairs hospital where Troy receives his care for PTSD and other injuries. Troy finished his tour in Iraq in 2003, but Michelle must deal with the fallout. As the Washington Post says in one of its photo captions to the story, "Troy's one-year war has become his wife's endless one."  Thank goodness for more coverage being given to the difficulty of caregiving.  PTSD not only affects returning veterans, but also their families.  Please take the time to read this story and/or watch the slideshow that accompanies it, with an audio file of the couple talking about the hardships they've gone through.  Excellent, responsible reporting from the Post, continuing to focus on veterans and their care.

The Washington Post may requires registration to read the article.  If you need to search for the full-text article, the title is, "A Wife's Battle: When Her Soldier Returned from Baghdad, Michelle Turner Picked Up the Burden of the War," and the byline is Anne Hull and Dana Priest, who were also reporters on the excellent series published previously in the Post.  The whole ongoing series is entitled, "When the War Comes Home: Walter Reed and Beyond."

[Editor's note: Read the epilogue to the Troy and Michelle Turner story, also published in the Washington Post.  Positive results from the harsh glare of the media spotlight, turned on suffering.]

Who Bears the Burden of Care Most?

The short answer is, as a society, we share it.  But the brunt of it is often felt, as we see in the Washington Post piece from this weekend, most directly around home and hearth.

In the front matter of Aphrodite Matsakis, Ph.D.'s original book, Vietnam Wives (she has a new book out this year, which we've recently mentioned), she writes this in the dedication of the book:

"From the beginning of time, men have fought each other and have suffered greatly as a result. Their women, children and other family members have also suffered.  To the "forgotten warriors" -- the wives, children and other family members of Vietnam veterans afflicted with Post-Traumatic Stress Disorder -- this book is sincerely dedicated."

As the recent video from the Norfolk County (Massachusetts) District Attorney's Office demonstrates, when a veteran comes home from combat, he (or she) needs time to re-adjust to the family, workplace, friends, hobbies, neighborhood, community, school and/or place of worship that he (or she) left behind.  Each of those environments and each of those relationships can be a source of friction and frustration, or ideally, and ultimately, some form of refuge.  But the adaptation is real, and so are the difficulties the returning veteran encounters.  What is often left out of the equation, also, is the difficulty encountered by the veteran's primary relationships, who are also affected by what the returning vet is suffering.  In some ways, we don't want to highlight this too much, because one of the triggers of suicide seems to be a sense of being a "burden" on others; but the reality is, the hardships of PTSD and combat trauma weigh on a veteran's loved ones, as they do on the veteran.

Fortunately, a certain amount of supportive material is targeted to a vet's close relationships.  The books of Aphrodite Matsakis, Ph.D. and Patience Mason speak to these needs directly (see booklist in sidebar), as do a few of the resources available through other sources.  Over time, we hope that more and more attention is paid, not just to veterans and what they're suffering as a result of combat trauma, but also to their famiies and friends, who may encounter new pressures, demands and hardships, as they care for their returning veterans.

Good Book about Vet Healing from PTSD

As we continue our modified "look back" at the legacy current, returning combat veterans owe to their Vietnam predecessors, here's another good book worth reading, written by a Vietnam veteran about the experience of homecoming.  It's called Vietnam Veterans' Homecoming: Crossing the Line, by Carey Spearman.  I ran across this fairly unsung book in a list of books that are written and/or read as part of the Memorial Day Writers' Project on the Capitol Mall in Washington, DC.  One veteran has this to say about the book: "Carey spends a lot of time with vets who suffer from PTSD.  This is a candid conversation from one vet to another.  Powerful, penetrating and profound."  It also has five stars on Amazon.  Click here for that link.

Other good books written by Vietnam veterans that focus on or touch on combat trauma and PTSD are Ron Zaczek's Farewell, Darkness: A Veteran's Triumph over Combat Trauma, and the more oblique, but still very interesting Claude Anshin Thomas' book, At Hell's Gate: A Soldier's Journey from War to Peace.  Clicking either of those hyperlinks will take you to the books on Amazon.  Other blog entries in this blog about Claude Anshin Thomas and his book are here and here.

Good Video about PTSD and Re-Adjustment

William R. Keating and the the Norfolk County District Attorney's office in Canton, Massachusetts has put together a wonderful, 10 minute video that's on YouTube about what PTSD is, to raise awareness about the struggles that returning combat veterans may be going through.  The video is ten minutes long; and while it's completely good and effective at what it does, it would be even better if it were the first in a series about the challenges veterans face in readjusting to civilian life.  However, in ten short minutes, it manages to cover many of the issues, show veterans where help can be found, and put a relatable, human face on the topic of PTSD and combat trauma.  Good for Massachusetts -- it makes me proud to be from there.  The title of the video is the fairly generic, but still cool "PTSD and Veterans: Beyond the Yellow Ribbon."  Special thanks to the Norfolk County DA's office for taking the time to make this video available to the public.

(Note: Don't worry -- the video isn't just some guy talking -- it's pretty comprehensive.  They just picked an odd still to illustrate it with.  And while its focus is current returning vets, there is a wide selection of veterans interviewed in the video, including those from previous wars.)

Marines Teach Combat Stress Prevention at Camp Pendleton

There's a good article from last month's San Diego's Union-Leader about a class being taught at the USMC base, Camp Pendleton, about combat stress -- what it is, and how to recognize its effects.  The class is being taught to corporals, junior leaders who are just starting their ascent through the Corps, about what to expect on the battlefield.  (Click here for the link.) 

One quote from the article, referencing Cmdr. Paul Hammer, a Marine psychologist who's served in Iraq, and was teaching the class in question.  "The Marine Corps tries to fully prepare its troops for war, Hammer said, but some things just cannot be replicated, including the trauma of seeing people being maimed or killed. “You are going to experience some intense emotions in combat. A true leader is one who can truly tolerate the truth of war, and the truth is ugly,” he said. “What we want is for you to bend,” Hammer added, “but everyone has a point at which they will break.” 

Kudos to the Marine Corps for teaching something about combat trauma, before it happens, and removing some of the stigma of talking about it.

PTSD Articles in English and Spanish

aContinuing our series of posts on how to find out more about PTSD and combat trauma, in terms of current medical and psychological research being done, here's what a search for "PTSD" on MedLinePlus came up with, as of today: 219 hits, on topics as varied as the following.  (Spanish speakers can find a Spanish-speaking version of MedlinePlus en Espanol here.)  "Hits" from the English language search referenced above included:

• What Can I Do If I Think I Have PTSD;
• How Common is PTSD?
• How is PTSD Measured?
• Discussing Trauma and PTSD with Your Doctor;
• Women, Trauma and PTSD;
• Treatment of PTSD;
• FAQs about PTSD Assessment;
• VA Programs for Veterans with PTSD;
• Coping with PTSD and Lifestyle Changes;
• PTSD and Older Veterans;
• PTSD and Physical Health;
• PTSD and the Family;
• PTSD and Problems with Alcohol Use;
• PTSD and Suicide;
• Sleep and PTSD;

Clearly, these online databases, provided free by the Federal government -- our tax dollars at work! ;-) -- can be invaluable, "one stop shopping" type places to learn more information and to share the information with others (family members, friends, co-workers, healthcare workers, social workers, combat veterans, etc.) who want to learn more about combat trauma and PTSD.  And don't forget this website, where we're trying to keep as current as possible about everything worth knowing on the topic of combat trauma and PTSD, in particular what resources are available for and about healing it.

Where to Find Recent Medical Studies on PTSD and Combat Trauma

Well, the Inner Librarian got a little, er hem, carried away in that last blog post on how to search online databases effectively for articles on PTSD and combat trauma -- and where those articles are to be found -- but, we didn't really get around to telling you WHAT you could find in those searches.  Of course, it's better to do them yourself, but here's just a taste of what you can find by doing a search at the ...

In PubMed, if you do a search for "PTSD combat trauma" -- to pull in articles that talk about both -- important because not all PTSD is combat-related, as of today's date you can find articles such as the sample dozen that follow, all very recent -- in other words, published in the current year.  Many also have "related links" in a sidebar to additionally interesting studies, which are also worth investigating.  Here's a "random sample," no pun intended, of current research, published in medical journals in the U.S. and abroad.  As you can see, the studies cover aspects of health, disease, family relationships, which drugs do or dont show promise, social skills for adapting to PTSD, whether group therapy is effective or not, etc.  Recent articles include:

• Posttraumatic stress disorder, anger, and partner abuse among Vietnam combat veterans.
• Cardiovascular manifestations of posttraumatic stress disorder.
• Vicarious resilience: a new concept in work with those who survive trauma.
• Healing trauma: finding treatments that work. 
• The psychological consequences of combat exposure: the importance of appraisals and post-traumatic stress disorder symptomatology in the occurrence of delusional-like ideas.
• Randomized, double-blind comparison of sertraline and placebo for posttraumatic stress disorder in a Department of Veterans Affairs setting.
• Contemporary group treatment of combat-related posttraumatic stress disorder.
• Assessing late-onset stress symptomatology among aging male combat veterans.
• Psychotic symptoms in combat-related post-traumatic stress disorder.
• Quality of parental relationships among persons with a lifetime history of posttraumatic stress disorder.
• The use of prazosin for the treatment of trauma nightmares and sleep disturbance in combat veterans with post-traumatic stress disorder.
• Interpersonal trauma, war zone exposure, and posttraumatic stress disorder among veterans with schizophrenia.

(Editor's note: we're not dispensing medical advice here.  Use common sense.  Educate yourself and your caregivers if need be about PTSD and combat trauma.  Know where to look to learn more: to share information with your healthcare providers, social workers, family members, combat buddies, co-workers, etc.)

Medical Research Available Free Online

If you're interested in delving deeper into what recent medical research has indicated, however provisionally, about PTSD and combat trauma, you might do well to visit this one catcha-all site on the Web, PubMed.  PubMed is more tax dollars at work: it's a service of the U.S. National Library of Medicine ("NLM"), and the National Institutes of Health ("NIH"), both part of the U.S. Department of Health and Human Services.  (PubMed includes over 17 million citations from MEDLINE and other life science journals for biomedical articles back to the 1950s, often with links to full text articles and other related resources.)

As of just today, searching just got easier -- with the introduction of new technology, that allows for better, more optimized searching of MedLine Plus, an enormous database of medical and health-related articles, MedlinePlus en Espanol, and the entire NLM Library system, referred to above.  (Click here to find out more about the new search engine.)  In other words, good news for searchers, librarians, and even common folk with access to the Web. 

Try doing a search on any of those sites for "PTSD" and/or "combat trauma."  Learn a few simple search techniques for better results, too -- most people seem relatively clueless on how to search (and results are only as good and relevant as the way you looked for them.)  Here's a "How To" article from WikiHow about "How to Get the Most Accurate Results on Search Engines."  It's basic but good.  Click here for that link.  Here's another one to read after you're done with that.  Slightly more in-depth.  Between the two, you'll have a better handle on searching.  That article is entitled, ""How to Search for Expressions and Phrases in Search Engines."  Click here for that link.

(And if you want even simpler suggestions on search -- really basic and foundational -- try these: "How to Search the Internet" and "How to Search Google.")  Don't laugh.  Many don't know, and the rest of us can always learn more.  A good search = good results.  Go forth and search!

Clinical Trials Underway on PTSD

Here's a list from the National Institutes of Mental Health ("NIMH"), government recipient of our tax dollars at work, of the clinical trials presently underway that are studying aspects of PTSD.  Not many of the studies having much to do with combat trauma (yet), it would seem.  In any case, here's a link to them: there are fourteen (14) clinical trials, total, including one with the somewhat rosy title of, "Using Affectionate Communication as a Response to Acute Stress."  Mmmmn, sign me up! :-) We can never have enough of that...  One or two do relate specifically to PTSD and combat trauma, including

• Effectiveness of Virtual Reality Exposure Therapy and D-Cycloserine to Treat Iraq War Veterans With Post-Traumatic Stress Disorder.
  Interventional study. This study will determine whether a combination of virtual reality exposure therapy and D-cycloserine will reduce post-traumatic stress disorder symptoms in Iraq war veterans. Ages 21-65. Location in Atlanta, GA.

Here's a link to a page of worthwhile information about PTSD on the NIMH's website, with links to other information worth reviewing, or keeping on hand to share with others.  One is, "Post-Traumatic Stress Disorder: A Real Illness" -- click here for that; and "Post Traumatic Stress Disorder Research Fact Sheet" -- click here for that.  (Lack of continuity in hyphenating style thanks to the NIMH, not this blogger.)

And, finally, If you're in the Bethesda, MD area, and you'd like to participate in an NIMH study (not necessarily the one above), click this link to learn more about how to participate.  Not all studies looking for participants take place in the D.C. area, though -- many are in other large metropolitan areas such as Atlanta and Boston -- so check the main site above for clinical trial topics and locations.

Upcoming Conference on Complex PTSD

The International Society for the Study of Trauma and Dissociation, mentioned in a previous blog entry, will be holding its 24th annual conference in Philadelphia this year, from November 11th through 13th.  The topic this year is, "Psychotherapy Outcome in Complex PTSD and Dissociative Disorders, from Single Case Studies to Randomized Clinical Trials."  Click here for a link to the Society and its annual conference information.

(NB: A mention here does not imply an endorsement; it merely conveys muted enthusiasm for more and more attention being focused positively on this topic, which is so important.  More attention being paid is the proverbial sound of one hand clapping.  An upgrade to two hands clapping would be, adequate fund, adequate resources, and a more holistic, gestalt mindset about what can heal PTSD and combat trauma, than strictly talk therapy and pharmaceuticals.  We''ll see if we get there...here's hoping that we do.)

PTSD - Normal Reaction to Abnormal Events

Trying to catch up on some blog posting from a while back, here is a link to an excellent article from Salon magazine on PTSD, and why talk therapy doesn't really help it much -- and can actually make symptoms worse, at least initially.  The article, called "My Heart is Back," by Lynn Harris, also includes one of the few great explanations in print of how PTSD happens in the body, and takes a look at some treatments that do offer hope, with quotes from therapists who use them, including ones who were frustrated by what they couldn't offer their patients a few years back.  Quite an excellent, overall article about PTSD and how to overcome it - and worth keeping on hand to share with friends and foes alike who may not understand, or believe, in what PTSD or combat trauma really is.  (And the article, since it came out in 2004, talks about not just combat-triggered PTSD, but PTSD as a reaction to violent events over which we have no control.)

The gist of the article: "Talk therapy only increases the suffering for some trauma victims -- but alternative treatments offer new hope."  (The book highlighted here on the left, Invisible Heroes: Survivors of Trauma and How They Heal, by Belleruth Naparstek -- is written by one of the therapists quoted in the article.)

Some quotable quotes from the article, including these great ones, that sums it up: "PTSD is a normal reaction to abnormal events" -- and "what we do know is that susceptibility to PTSD has nothing to do with, say, cowardice, or weakness of character."

"[A]pproximately 5 million Americans who suffer from post-traumatic stress disorder." "In fact, more people may have PTSD today than anyone ever realized. But because of recent advances in biochemistry, brain imagery and epidemiology, researchers are finding out that all manner of conditions -- some psychiatric, but some also physiological, such as chronic pain -- can be traced to PTSD."

Here's what some of the experts quoted in the article say:

• "...People with PTSD aren't crazy, and they get better," says Belleruth Naparstek.  Today, in fact, their prognosis is the best it has ever been. For many years, "we didn't know how to help trauma survivors in any consistent way," says Naparstek. As she herself discovered while treating Frannie, "Talking about it -- the stock in trade of mental health professionals, pastors, good friends and spouses -- is not necessarily all that helpful, and can sometimes make symptoms worse."
• "PSTD is a normal reaction to abnormal events," says Beverly Donovan, a clinical psychologist at the Veterans Affairs Medical Center in Brecksville, Ohio, who runs an intensive treatment program for combat vets with PTSD.
• "When exposed to trauma, some people will have trouble letting go of the experience, but not because they want to dwell on it," says Steven Gold, Ph.D., director of the Trauma Resolution and Integration Program at Nova Southeastern University in Fort Lauderdale, Fla., and president of the International Society for the Study of Dissociation. "There are various techniques for helping people move beyond it, which may have as much to do with the body's reaction to the experience as with the mind's. A few years ago some of these therapies would have been considered 'alternative, but now the major specialists in treating trauma would consider them more mainstream."

And the patient who they featured in the article, who'd suffered numerous horrific traumas, back to back?  She's doing well. "My heart is back" -- "I'm connected to myself now."  Great news, and what we would wish for all trauma survivors with PTSD.  Be sure to read, and save, the article for future reference.

VA Budget is Overdue - But Veterans Healthcare Can't Wait

Watch the ad, sign the petition...to make sure veterans get the healthcare and services they need, including treatment for combat trauma and PTSD.  More background can be found at IAVA.org and IAVAAction.org.

British Soldier Wins Award for Speaking Frankly about Combat Trauma / PTSD

There's a fantastic article in the British paper, the Guardian, today entitled, "You Can Teach a Man to Kill, but Not to See Dying," by Mark Gould.  (The Guardian, for those who don't know it, is a superb newspaper that frequently wins awards for its design and content, including the National Newspaper of the Year, given by the British press association.)  This article is about an ex-soldier who served in the Falklands War, winning a national mental health award for speaking "frankly and forcefully on the mental distress of war veterans."  You can listen to him talk about combat trauma (called "combat stress" in the UK) in the audio clip here, but be sure to come back and read the article as well -- it's wonderfully written and full of great, quotable quotes from the ex-soldier himself.

The award-winning ex-soldier, Chris Duggan, a Welshman, is remarkably forthright about his experience - what caused it, how far down he spiralled, and what eventually helped pull him back out.  At least in America we've given very little consideration to wars like the Falklands conflict, and even the more recent Gulf War, in which we participated, when it comes to combat trauma.  There's an overall sense that if the conflict didn't go on "that" long, how bad could the experience have been?  Perhaps especially when contrasted with wars that dragged on for years.  However, depending on what the combatants experienced, their pain and suffering is equally raw.  Duggan does a superb job of telling the truth about his own experience, and it's great to see the work won an award.  He also mentions, positively, the group "Combat Stress," which provides assistance to soldiers in the UK who've experienced combat trauma or PTSD.  We blogged about them earlier, in March of 2006.  Click here for that blog entry.

Duggan is refreshingly blunt and candid about his experiences, which is part of what makes it so worth listening to.  And he has some unforgettably graphic quotes -- deservedly so -- about combat trauma and its effects on the human mind and body.  Three cheers to Duggan and the British mental health awards for responding so positively to truth-telling from a veteran. 

"The Gentle Heroes Left Behind"

In the Wikipedia entry about the Vietnam Veterans Memorial in Washington, D.C., also and previously known colloquially at least as "the Vietnam Wall" -- and whose 25th anniversary is coming up SOON -- there is a beautiful photo of the back of a Vietnam vet, in silent contemplation at the Wall itself.  The photo, reproduced here, is by French Canadian photographer, Patrick-Andre Perron, whose website is here.  Interestingly, on Perron's website, he "illustrates" this photograph with a poem he must particularly like, that he apparently saw on the wall.  We include it here:

"If you are able, save for them a place inside of you
and save one backward glance when you are leaving
for the places they can no longer go.

Be not ashamed to say you loved them,
though you may or may not have always.
Take what they have taught you with their dying and keep it with your own.

And in that time when men decide and feel safe to call the war insane,
take one moment to embrace those gentle heroes you left behind."

Major Michael Davis O'Donnell
1 January 1970
Dak To, Vietnam
Listed as KIA February 7, 1978

[This poem is not included here to express any particular pro-war or anti-war sentiment, but to honor the feeling of brotherhood among those who fought and died.  It's also possible that in the case of PTSD, veterans and their families consider themselves unfortunately to be "the gentle heroes" left behind on the battlefield...]

Perron also links on his website to a stunning collection of Vietnam war photographs by combat photographer Richard Calmes that are well worth viewing.  We include the link here.  If music is more your thing, the Vietnam Veterans of America is promoting a CD of music that brings back the in-country experience, both good and bad, with classic rock tunes from the era, and proceeds being shared with worthy charitable causes for vets.  That link and more information about the music is here.

The Vietnam Memorial - Sacred Ground

Thinking about the Vietnam Veterans Memorial lately, and how it's coming up on its 25th anniversary, it was interesting to read the following in the uniformly stupendous small book, 365 Tao, by Deng Ming-Dao.  The reading for the other day was about "history" -- and although the Vietnam Wall wasn't built on the battlefields of Vietnam, but thousands of miles away in America, the reality is, there will be much that resonates with what he says, because the outpouring of grief that happens in Washington, D.C. around the Wall must surely be cathartic as well, addressing as it does a very melancholy piece of our recent human history.

The reading was called "History," and it opened, like the other readings in the book do, with a short poem, followed by a more expanded thought.  Herewith the poem and the discourse.

"Autumn trees swept with dawn.  Look as if they've been lacquered.  Rooted around an old battlefield.  The mists linger here like ghosts."

"There are still places where you can walk and feel a profound bloom.  Such is the case with old battlefields.  People died there.  The force of their determination still resonates.

You can find such places in every country.  Often no one builds anything there, even when the land is [expensive nearby.]  We say that we do not want to forget our dead.  We say that there should be a memorial.  Others say that the disturbance there is so great that the living cannot abide with the dead.

History is essential to our understanding of the present.  Unless we are conscious of the way in which we came to this point in time as a people, then we shall never fully be able to plan the present and the future.  We need to know what roots are still alive.  We need to know how things came to be so that we can project from here.  We also need to know the failures of the past so we can avoid repeating them.

History is not always glorious.  Sometimes our history is melancholy.  We must accept that.  This life is terrible and people do terrible things to each other.  If we are to live for the sake of the good and strong, then we should have as much of a background as possible."

Going to the Wall -- the Vietnam Wall

"Honor and Respect" -- the occasion is the 25th Anniversary of the Vietnam Veterans' Memorial, celebrated with an anniversary parade in Washington, DC on November 10, 2007.  Mark your calendar.

To learn more about this event, sponsored by the Vietnam Veterans of America, click this link.  To learn more about the Vietnam Veterans' Memorial, click here for the extended description on Wikipedia, or here to go the official site, part of the U.S. National Parks Service.

It's important to note that the Wall, or the Vietnam Veterans' Memorial, as it alternately called, is not "just" something for Vietnam veterans -- it's for the public, for veterans of other wars, and for current veterans as well.  It's apparently (as it should be) a profoundly moving experience for visitors, almost 4 million of whom visit annually.  Many, especially veterans, go at night -- potentially a dangerous move in Washington, DC ;-) -- but apparently an experience that only adds to the profundity, without experiencing the claustrophobia of a daytime visit, and the throngs of people that implies.  It's probably quite heavy, hard, and healing to experience -- a touchstone for many who survived that conflict, and others who can go to appreciate their sacrifice and give it more than lip service.

Since women seem to rarely get the credit they deserve for societal contributions, it's cheering to this woman that the architect of the Vietnam Veterans Memorial was in fact a woman, Maya Lin.  As the National Parks Service material describes,

"Deliberately setting aside the controversies of the war, the Vietnam Veterans Memorial honors the men and women who served when their Nation called upon them. The designer, Maya Lin, felt that “the politics had eclipsed the veterans, their service and their lives.” She kept the design elegantly simple to “allow everyone to respond and remember."

Veterans, PTSD and Homelessness: One Man's Story

The Duluth News Tribune in Duluth, MN has a heart-rending story in yesterday's paper about a Gulf War and Afghanistan veteran who became homeless because of severe symptoms of PTSD.  On the surface, the story is about Kevan Boman, 52, a decorated veteran, who "walked out on his former home and family several years ago as he struggled with the symptoms of post-traumatic stress disorder."  Earlier, before PTSD, Bowman "had a family, a house and a good job - until his mind was overwhelmed by the guilt and shame from post-traumatic stress disorder, and he walked out on it all."  In the larger sense, though, the story is about homelessness among veterans, which is significant.  It's estimated that nearly one quarter of homeless are veterans.  Says the article, in brief:

On any given night, according to the U.S. Department of Veterans Affairs, there are about 200,000 homeless veterans across the country, and about 400,000 veterans experience homelessness over the course of a year. About 97 percent of them are male, and they account for 23 percent of the total homeless population. Using a VA formula, it’s estimated there are well over 100 homeless veterans in Duluth. There’s no easy answer to why there are so many homeless veterans, though 45 percent suffer from mental health problems and substance abuse.

“Some people develop alcohol abuse or dependence as they try to treat themselves,” said Dr. Ira Katz, the VA’s national chief consultant for mental health. “Then the two conditions together can lead to difficulties with work and social relationships that could lead, in turn, to unemployment, separation or divorce, and homelessness.”

NOTE: the Duluth paper is subscription only on the web, so you may have to register to find the link to the story.  The original title is, "Walking Wounded: Duluth Veteran's Life Shattered by PTSD."  The byline is Brandon Stahl.

Today's Vets Owe Debt of Thanks to Vietnam Vets

Another interesting article that was circulated widely on the Web a while back is this seemingly open letter to veterans from a Marine office reservist serving in Iraq.  The letter was allegedly first published in the Veteran of Foreign Wars publication, "Reveille," and was written by USMC Major (now retired) Brian P. Bresnahan.

Biographical note: Brian P. Bresnahan is a 1992 graduate of UNL and a (retired) major in the United States Marine Corps Reserve who lives near Benedict, Nebraska. A veteran of Operation Iraqi Freedom, Maj. Bresnahan was stationed eight miles west of Fallujah during 2004.  He writes in his letter:

"A guy gets time to think over here and I was thinking about all the support we get from home. Sometimes it's overwhelming. We get care packages at times faster than we can use them. There are boxes and boxes of toiletries and snacks lining the center of every tent; the generosity has been amazing. So, I was pondering the question: "Why do we have so much support?"

In my opinion, it came down to one thing: Vietnam. I think we learned a lesson, as a nation, that no matter what, you have to support the troops who are on the line, who are risking everything. We treated them so poorly back then. When they returned was even worse. The stories are nightmarish of what our returning warriors were subjected to. It is a national scar, a blemish on our country, an embarrassment to all of us.

After Vietnam, it had time to sink in. The guilt in our collective consciousness grew. It shamed us. However, we learned from our mistake. Somewhere during the late 1970's and into the 80's, we realized that we can't treat our warriors that way. So, starting during the Gulf War, when the first real opportunity arose to stand up and support the troops, we did. We did it to support our friends and family going off to war. But we also did it to right the wrongs from the Vietnam era. We treated our troops like the heroes they were, acknowledged and celebrated their sacrifice, and rejoiced at their homecoming instead of spitting on them.

And that support continues today for those of us in Iraq. Our country knows that it must support us and it does. The lesson was learned in Vietnam and we are better because of it.

Everyone who has gone before is a hero. They are celebrated in my heart. I think admirably of all those who have gone before me. From those who fought to establish this country in the late 1770's to those I serve with here in Iraq. They have all sacrificed to ensure our freedom.

But when I get back, I'm going to make it a personal mission to specifically thank every Vietnam Vet I encounter for their sacrifice. Because if nothing else good came from that terrible war, one thing did. It was the lesson learned on how we treat our warriors. We as a country learned from our mistake and now treat our warriors as heroes, as we should. I am the beneficiary of their sacrifice. Not only for the freedom they, like veterans from other wars, ensured, but for how well our country now treats my fellow Marines and I. We are the beneficiaries of their sacrifice.

Semper Fidelis,
Major Brian P. Bresnahan
United States Marine Corps

Three Gifts You Can Give Returning Veterans That Will Last a Lifetime

Three gifts that you can give returning veterans that will last them a lifetime, so says USMC Brigadier General Timothy C. Hanifen, 2nd Marine Aircraft Wing (Forward), are the following: "understanding," "support," and "affirmation."

Writes Hanifen:

The combat phase of the campaign in Iraq is winding down [this was first published in February of 2006] and now the hardest job of all begins-winning the peace. Soon many of our fellow citizen-Soldiers, Airmen, Sailors, Marines and Coast Guardsman-both active and reserve will return home with their units or as individuals. All have served and participated in an extraordinary campaign of liberation that was fought in a manner that reflected not only the determination of the American people to do what was necessary but also reflective of our value to spare life whenever and wherever possible.

As these veterans begin returning home and people are asking themselves what they can do to celebrate their return, honor their service and remember those that have fallen in the performance of their duty. After every war or major conflict, there are always concerns about the emotional state of returning veterans, their ability to readjust to peaceful pursuits and their reintegration into American society. People naturally ask themselves "what can we do or what should we do?" The purpose of this message is to offer that there are three very important gifts that we personally and collectively as a society, can give to these returning veterans. They are "understanding, affirmation and support".

With "understanding", I am not speaking of sympathy, empathy, consoling or emotional analysis.  Rather, I offer that we, to the best of our ability, need to comprehend some of the combat truths learned and experienced by these returning servicemen and women. Their perspectives and their personal experiences will shape each of them and our society in large and small ways for years to come. Though we were not there, our comprehension and respect for their "truisms" will be part of the gift that will truly last them and us for a lifetime.

The truth every combat veteran knows, regardless of conflict, is that war is about combat, combat is about fighting, fighting is about killing and killing is a traumatic personal experience for those who fight. Killing another person even in combat, is difficult as it is fundamentally against our nature and the innate guiding moral compass within most human beings. The frequency of direct combat and the relative distance between combatants is also directly proportional to the level of combat stress experienced by the surviving veteran. Whether the serviceman or woman actually pulled the trigger, dropped a bomb or simply supported those who have, I've yet to meet any veteran who has fought and found their contribution to or the personal act of killing another human being particularly glorious. Necessary-Yes. Glorious or pleasurable-No. In combat, the veteran must psychologically distance themselves from the humanity of their opponent during the fight. The adversary becomes a target or an objective or any number of derogatory epithets that separates "them from us". Combat becomes merely business-a job that has to be done, part of your duty and killing-a necessary result. It's a team job that needs to be done quickly, efficiently, unemotionally and at the least cost in lives to your unit, to innocents and with the most damage inflicted in the least time to your adversaries. Then you and the team move forward again to the next danger area and fight. The only sure way home is by fighting through your opponents as quickly and efficiently as possible. Along the way you quietly hope or pray that your actions will: be successful; not cause the loss of a comrade; the death of an innocent; or that you'll become one of the unlucky casualties yourself. You stay despite your fears because the team-your new family of brothers or sisters, truly needs you and you'd rather die than let them down. You live in the moment, slowly realize your own mortality and also your steadily rising desire to cling to and fight hard for every second of it. You keep your focus, your "game face" on and you don't allow yourself the luxury of "too much reflection" or a moment's "day dreaming" about home, loved ones, the future or your return. You privately fear that such a moment of inattention may be your or worse, because of you, a comrade's last.

So if I may caution, please don't walk up to a combat veteran and ask him or her if they "killed" anyone or attempt well meaning "pop" psychoanalysis. These often-made communication attempts are awkward and show a lack of understanding and comprehension of the veteran. They also reveal much about the person who attempts either one. Instead, please accept there is a deep contextual gap between you both because you were not there. This chasm is very difficult to bridge when veterans attempt to relate their personal war experiences. Actual combat veterans are the one's least likely to answer the question or discuss the details of their experiences with relative strangers. Most likely they will ignore you and feel as though they were truly "pilgrims" in a strange land instead of honored and appreciated members of our Republic. So accept and don't press. One note of personal caution for your awareness- If a combat veteran does answer or appear to openly revel in the number of adversaries they've personally slain then they either haven't or they are likely part of society's 2% sociopaths. In either case, I would recommend you beware and quietly distance yourself. Their enthusiasm and behavior are not normal for a true combat veteran. But here is what you can do. Don't ignore them or the subject. Please feel free to express your "gladness at their safe return" and ask them "how it went or what was it like?" These questions are open-ended and show both your interest and concern. They also allow the veteran to share what they can or want. In most cases, the open door will enable them to share stories of close friends, teammates or some humorous moments of which they recall. Again, just ask, accept but don't dig or press.

The second gift is "affirmation". Whether you were personally in favor of the war or against it no longer matters at this point. As a Republic and a people we debated, we decided and then we mustered the political and societal willpower to send these brave young men and women into combat in hopes of eventually creating a better peace for ourselves, for the Iraqi people and for an entire region of the world. More than anything else, the greatest gift you can personally give a returning veteran is a sincere handshake and words from you that "they did the right thing, they did what we asked them to do and that you are proud of them". We need to say these words often and the returning combat veteran truly needs these reassurances. Also please fly your flag and consider attending one or more public events with your families as a visible sign of your support and thanks. Nothing speaks louder to a returning veteran than the physical presence of entire families. Those Americans attending these events give one of their most precious gifts-their personal time. Numbers matter. Personal and family presence silently speaks volumes of affirmation to those you wish to honor.

The third gift is "support". Immediately upon return there will be weeks of ceremonies and public praise applauding the achievements of the returning units and their veterans. But the pace of life in America is fast and it will necessarily move rapidly onward towards the next event. Here is where your support is most needed to sustain the returning veteran and you can make the most difference in their lives for years to come. Continue to fly your flag. If you are an employer, then simply do your best to hire a veteran who is leaving service or if he or she was a Guardsman or Reservist, welcome them back to a new job within the company. All reserve personnel know that the economic life of the company has continued in their absence. It has to do so in order for the company to survive and prosper. They also know it is likely their jobs have since been filled. Returning veterans are always unsure whether or not they will find or have employment upon return. As an employer, if you can't give them an equivalent job because of downsizing then extend them with your company for three to four months so they can properly job hunt. Please take a personal interest in them and their families and use your extensive list of personal and professional contacts to help them land a better job-even if it is with one of your competitors. The gratitude they will feel for you, your personal actions and your company is beyond words.

For everyone else, the greatest gift you can give to continue support will take 10 seconds of your time. In the years to come, if ever your paths cross with one of the hundreds of thousands of veterans of this or any other conflict, then simply shake their hand and tell them "thanks" and that "they did a great job!" Your words show you understand, you affirm their service and you continue to support them. Teach your children to do the same by your strong example. Though veterans may not express it, every one of them will be grateful. If this message rings true with you, then let us each give these returning veterans these three gifts that will truly last them a lifetime.

(This article has been published in a number of places on the Web, but I first ran across it in a posting on MarineParents.com, from 2/24/2006.)

How Do Veterans Want Us to Listen to Them?

As the Christian existentialist philosopher (how do you combine those two widely divergent concepts in a single sentence, or a person? Ahhh, never mind) Paul Tillich once said, "the first duty of love is to listen."  The question of the hour should be, how do returning combat veterans from Afghanistan and Iraq want us to listen to them?  What would that be like? Undoubtedly, with compassion, concern, empathy over sympathy, nonintrusive listening versus active probing, and certainly, without judgment.  As we learn more, we'll share it.  Undoubtedly many veterans (especially from Vietnam, and others who have been home a while) will have ideas on how best to listen and care.  On what listening would look, feel, sound like to them.

Good Compassion and Bad Compassion - Worry

There's such a thing as "good" concern for others -- compassion -- and "bad" concern -- worry.  One of the most interesting explanations for this somewhat obscure or initially hard to follow concept is here, in 365 Tao, by Deng-Ming Dao.  He writes, "Worry is an addiction that inferences with compassion."  And explains it further:

"Worry is a problem that seems to be rampant.  Perhaps it is due to the nature of our overly advanced civilization; perhaps it is a measure of our own spiritual degeneracy.  Whatever the source, it is clear that worry isn't useful.  It is a cancer of the emotions -- concern gone compulsive.  It eats away at body and mind."

So if that's what bad compassion is, and we've taken a look at what good compassion can be -- how do we manifest this best with the veterans in our lives, either personally or as a community among whom veterans live?  For this, we turn to combat veterans for their own advice.  And thank you for providing it, to those who only hope to understand.

Here's a great description from Bay Area poet and Vietnam veteran, Ted Sexauer:

We will soon be welcoming home the first of another generation of emotionally damaged veterans. Many will have trouble relating to people who have not seen what they've seen.

How shall we honor them without endorsing the inhumanity that all war -- including this war -- embodies? They will need deep understanding. If you know returning veterans, don't press them with probing questions, but give them room to talk. Listen even when they tell you things you don't want to hear. Let us, if we can, move beyond "us versus them" thinking.

(Sexauer, who is now a peace activist -- though that's not the point of his inclusion here -- is one of the veterans whose work is featured in the anthology edited by Maxine Hong Kingston, entitled Veterans of War, Veterans of Peace -- listed in our sidebar, and featured in a recent Bill Moyers documentary on PBS.)

Compassion and Empathy

"Once or twice this side of death, things can make one hold his breath" -- from "Crystal Moments," a poem by Robert P. Tristam Coffin.

Last summer when I had moved back briefly to New England, I made a point of every weekend going to art museums in the area, because there are so many and they're each so good -- and art is one of those treats I always want but rarely allow myself.  So it was a great experience "catching up," so to speak.  I saw a lot of great work that summer, but one item in particular stands out.

As I rounded the corner in the basement of the Isabella Stewart Gardner museum in the Boston's Fenway, a museum a fellow "Books for Soldiers" volunteer had told me not to miss, I saw something that absolutely took my breath away, and on reading the inscription, the experience only sharpened.

What I saw was a full-size, or maybe even slightly larger than full size, wooden statue, covered with gilt, of an androgynous-looking woman, with a very open body posture much like the statue in this photo.  Like a person in deep conversation with someone, listening intently but with concern and feeling for who she was speaking with.  Remarkable!  And like nothing else I've seen in art.  Who was it?  Well, it turns out to be "Kuan-Yin" - a diety of compassion - and the statue is from the 11th century in China.  It turns out "she" has a long and storied history, being also known as the "Bodhisattva Guanyin."  Wikipedia provides more information about who she is, but one of the most salient parts is that she is one who "observes the cries of the world," in suffering.

This brings up the question of what is "compassion," really.  Sometimes in the West we've mistaken that, wrongly, for pity.  The original meaning, in the Latin, seems like it has more to do with "suffering with."  What do veterans need from us?  They need to be heard, and more from empathy even than sympathy.  I once had a veteran tell me that what he appreciated most about my concern was that it came from empathy -- feeling with -- not sympathy -- feeling for. He said there were way too many people wanting to offer sympathy -- and if they really wanted to offer sympathy, they should have gone.  But someone who takes the time to understand what they've gone through -- that's more valuable, in the veterans eye.  Interesting and thought-provoking.

The dictionary says compassion is "deep awareness of the suffering of another coupled with the wish to relieve it."  From the Latin, it means something like, suffering with.  The reality is, we can't always relieve others' suffering -- but at least we can listen, and care what others have gone through.

NOTE: Sadly, the gift shop at the Gardner Museum didn't sell anything to do with this statue, not even a postcard.  Perhaps the fact it was positioned outside the Ladies' Room had something to do with its respective honor among the diverse collection.  But apparently the Nelson-Atkins Museum of Art in Kansas City also has a statue like this, and there may be others.  And here's a link to a physical statue online that can be purchased, along with a little more description of who the statue represents -- large statue and smaller statue.  Ironically, a stylized version of this statue is the cover art of the Tao of Healing, a cd by Dean and Dudley Evenson that we've listed in the sidebar, that's highly rated for its therapeutic properties.

Film on PTSD from "Saigon to Baghdad"

The Nevada News, a publication of the University of Nevada at Reno,  had an article this week entitled, "The Battle Continues: Life after War," about the screening of a social work graduate student's documentary film about veterans and PTSD, called "Saigon 1965 to Baghdad 2007.P  The film by Michial Nolan examines Post Traumatic Stress Disorder (PTSD) in veterans from previous wars (i.e., Vietnam) in the context of delayed activation or reactivation of PTSD as a result of the current war in Iraq.

Says the article:

Nolan’s film depicts service personnel experiences in Vietnam, the Gulf War, Afghanistan and Iraq. Two veterans will attend the screening to talk about their experiences. One gentleman will talk about his journey to self-discovery over the last 40 years.

“In conducting the research to produce my film, I found that many veterans from wars other than the war in Iraq were experiencing a reactivation of PTSD based off of images they saw via media,” Nolan said. “In 1999 there were 90,000 cases of PTSD reported. By 2004 that number had increased to 161,000. The projected cost of treating this condition over the last 40 years is between $350 and $700 billion.”

Based on a suggestion from University of Wisconsin professor Craig Werner, Nolan included music in his film to assess PTSD reactivation in Vietnam veterans based on popular music listened to during that time. Some of the songs included are “Another Saturday Night,” by Sam Cook, “Lodi,” by Credence Clearwater Revival, “A Little Help From My Friends,” by Joe Cocker as well as “Chain of Fools,” by Aretha Franklin.

“I want veterans to know that I appreciate their service and have a commitment to understanding the impact war takes on them,” Nolan said. “The film came together so well; I can’t watch it without being moved.”

Gimme Five: Can EMDR Work in as Few as Five (5) Sessions?!

Here's an interesting concept or challenge: what if something like EMDR ("Eye Movement De-Sensitization and Reprocessing" therapy, to the uninitiated) were able to improve symptoms of PTSD / combat trauma within as few as five (5) sessions?  What if, even further, the benefits of treatment continued, even after treatment was discontinued?  Those are two pretty heady claims -- but one researcher says they're actually both true.  And cites two internationally-published studies that support those assertions.  Click here for the link to discussion of the studies.  Hmmmn.  At the very least, what a good way to improve people's baseline level of health, while they're continuing to recover from trauma.  Worth a look...

John Powers - Student Advocate for Veterans

In the spirit of Abraham Lincoln and caring for his brother in the field (and beyond), here's an item about a fellow American who's making a difference, not just on his university campus, but in a much broader field.  About a month ago, we published a blog entry here entitled, "John Powers -- Whoever He Is, Rocks!" -- which was essentially following up on a great story by Bob Kerr, Vietnam veteran and journalist, in the Providence Journal Bulletin.  Click here for a link to Kerr's original article, for as long as it stays up on the Web.

Since then, we've had the pleasure to get to know Powers, as well as read more of his writing about veterans issues, a topic about which he's clearly passionate.  Powers just started graduate school in Rhode Island this fall, and his guide to veterans resources in Rhode Island is about to be published.  But if you want to know more about where his commitment to veterans comes from, read this quite moving article online at Orato.com, about why as a recent college graduate, new grad student, and foremost private citizen, he's also a Veterans Advocate.  Here's the link.

If you're on FaceBook, Powers has several veteran-related interest groups, as well as a his own website, through which you'll shortly be able to order copies of his veterans resource guide (primarily focused on Rhode Island resources.) 

A Little History about the VA

We read and hear so much, pro and con, about the Department of Veterans Affairs (the "VA") -- formerly known as the Veterans Administration -- these days, and how well it is or isn't serving the broad needs of veterans as they return from combat.  But how well do we really know what the VA is or does or is responsible for?  Or even how long it's been around?  In order to learn more, we did a little digging for the benefit of our readers.  (Ironically, one of the former directors of the VA, the decorated Vietnam war hero and amputee, Max Cleland, is himself a combat trauma sufferer.  He acknowledged his fight with PTSD several years ago, and we chronicled it on the blog here.)

The VA takes its motto or mission statement directly from Abraham Lincoln's second inaugural address, delivered on March 4, 1865, at the start of his second term as president of the United States, just as the Civil War was coming to a close.  Lincoln famously said, "With malice toward none; with charity for  all; with firmness in the right, as God gives us to see the right, let us strive on to finish the work we are in; to bind up the nation's wounds; to care for him who shall have borne the battle, and for his widow, and his orphan -- to do all which may achieve and cherish a just and lasting peace, among ourselves, and with all nations."  (The words in bold are the VA's actual motto.)

If you want to know more about the VA's actual origins, here's an interesting link:

That article tells us:

This benefits system traces its roots back to 1636, when the Pilgrims of Plymouth Colony were at war with the Pequot Indians. The Pilgrims passed a law which stated that disabled soldiers would be supported by the colony.

The mission of caring for veterans traces its roots to benefits administered by the first U.S. Congress in 1789. The country's recognition of its responsibility followed precedent set by English law and enacted in 1736 by the Pilgrims of colonial America. It read "If any man shall be sent forth as a soldier and shall return maimed, he shall be maintained competently by the colony during his life." The concept of service earned through service has long been part of the American consciousness. It is for this reason that the first U.S. Congress in 1789 passed a law to provide pensions to disabled veterans and their dependents.

The Continental Congress of 1776 encouraged enlistments during the Revolutionary War by providing pensions for soldiers who were disabled. Direct medical and hospital care given to veterans in the early days of the Republic was provided by the individual States and communities. In 1811, the first domiciliary and medical facility for veterans was authorized by the Federal Government. In the 19th century, the Nation's veterans assistance program was expanded to include benefits and pensions not only for veterans, but also their widows and dependents.

(You can also read highlights from the VA's history here.)

Today, the V.A. is an enormous, complex and complicated hierarchy, with a substantial budget and on any given day, tens of thousands of patients.

The sheer size of VHA -- the largest integrated health system in this country -- would not doubt stagger those early VA pioneers. Today, VA provides care through 172 facilities, 126 nursing homes and 32 domiciliaries. It has 200,000 employees, treats 1.1 million inpatients and has an average daily inpatient census of 87,504. -- Source: History of Veteran's Healthcare

A complete list of Veterans Affairs facilities in the U.S. is here, courtesy of Wikipedia.

Louisa May Alcott -- Beloved Author, and Early Friend of Veterans

Many people know Louisa May Alcott (1832-1888) as a famous American woman writer, from the 1800s, the author of the beloved children's classic, Little Women, and a contemporary of Emerson and Thoreau, who were friends of her family in Concord, Massachusetts.  What many people don't know is that Louisa May Alcott was an early "FOV" -- or Friend of Veterans.  Readers of Little Women may remember that the family sewed bandages for Civil War veterans, regardless of the side on which they fought; but Alcott the author also travelled to Washington, D.C. to see how she personally could aid the veterans of the Civil War.  She ended up serving as an Army nurse in the so-called Union Hospital, in Washington, D.C., from 1862 to 1863.  Her little known book, Hospital Sketches, which predates her other works, is a compilation of journal entries, etc., from that time.  Alcott actually became gravely ill ministering to the soldiers, and was given a medication that ultimately resulted in her death, in her mid 50s.  I've got a copy of Hospital Sketches: An Army Nurse's True Account of Her Experiences During the Civil War, ordered from Amazon, and am eager to read what her reflections were on caring for the wounded, when nothing but her conscience and her interest prompted her to get involved. (The photo on the right is "Orchard House," where Alcott and her family lived for years.)