Healing Combat Trauma

"The Frontiers of Trauma Treatment" - Seminar

Bessel A. Van Der Kolk, M.D., and Dana Moore will be presenting "Frontiers of Trauma Treatment" at Kripalu in Western Massachusetts, from January 9-11, 2009.

The program is designed, according to the informational material,

For licensed therapists, yoga instructors, and other individuals interested in studying the nature and processes of trauma.

Traumatic experiences alter people’s relationship to their bodies in ways that leave them feeling uptight, helpless, disconnected, hurt, on edge, frantic, and at odds with themselves and their environment. Research is demonstrating that physical sensations and action patterns are the very foundation of consciousness. The experience of physical mastery that yoga and other body-based practices provide is often necessary in order to initiate new ways of perceiving reality. By learning to pay close attention to internal experience and working with the felt sense, people can reclaim authority over their lives.

In this weekend, we will explore recent developments in the neurosciences, attachment research, and new psychotherapeutic treatments. This course is not meant to serve as personal trauma treatment but as an introduction to the neuroscience of trauma and attachment. It offers a chance to be exposed to an array of body-centered approaches for dealing with trauma, including EMDR, yoga, theater work, and tai chi. These approaches help in dealing with hyperarousal and processing traumatic memories, and promote mastery over the posttraumatic legacy of constriction and feeling lost in the world.

CE Credits

This program is eligible for :

• 8 credits for nurses (CS, NP, RN, LPN), $20 additional charge
• 8 credits for social workers, $20 additional charge
• 8 credits for certified counselors (NBCC), $20 additional charge
• 8 credits for physical therapists (PT), $20 additional charge
• 8 credits for athletic trainers (BOC), $20 additional charge
• 8 credits for psychotherapists (APA), $20 additional charge
• 8 credits for yoga instructors (YA), $20 additional charge

For further information about the weekend or to register, click here.

"Just in Time for the Holidays" -- Stress-Reduction Exercises for PTSD

Various stress-reduction or relaxation exercises and techniques are available these days in a number of places, online and otherwise; and at least a few of them make a passing reference to PTSD (though rarely combat trauma). 

Relaxation at first may seem to be an impossible goal for those with combat trauma, because jumpiness and hypervigilance appear to be hallmarks of the experience that also have helped keep troops alive. 

However, the continual wearing-down and weakening of the nervous system over years from adrenaline surges and frequent experiences of "fight or flight" shows just how important it is to develop greater familiarity and experience with relaxation exercises. 

Like riding a bike, it's a much better (and more effective) idea to DO these things than just READ about them -- especially if you want to give yourself a chance to "feel" the effects in your own body, and "test" for yourself whether these techniques really "work."  (And don't forget the caregivers, partners or spouses of those suffering from PTSD: They also carry around a fair amount of stress... )

The emerging field of Mind-Body Medicine (ironic since the idea of mind-body medicine is actually quite old) is full of techniques and tools for stress-reduction and relaxation.  Yoga and meditation, among others, are known for their ability to reduce stress.  But occasionally on the Web there's also a good guide for sufferers about how to relax and renew.  Just such a "technique" guide exists here: The subject is "Relaxation and Relaxation Exercises," and the guide was produced at the Trauma Center, with the funding of the Massachusetts Office for Victim Assistance (MOVA), under a federal Anti-Terrorism Supplemental Grant (ATSG), to aid Victims of and Responders to the 9/11 Terrorist Attacks.  Click here for a link to the guide online.

Also look on the left-hand column of this blog to see a number of resources in the form of books, CDs, and DVDs for stress-reduction and relaxation, including music designed to help people relax and de-stress. A section called "Healing Multimedia" is located about 3/4 of the way down the page (if you think of the blog as a single page, and just cursor down to that), or you could do a search (Cntrl F on most computers, or Apple F on Macs) for "healing multimedia" to find that section of recommended resources. Enjoy!

VA is On the Move with Mobile Counseling Centers

VA to Deploy Mobile Counseling Centers Across America

The first of a fleet of 50 new mobile counseling centers for the VA Vet Center program was recently put into service with the remainder activated over the next three months.

"Our widespread distribution of this fleet from coast to coast marks a new chapter in VA's innovation to reach rural and underserved veterans with high-quality readjustment counseling," says VA secretary James B. Peake, MD.

Each vehicle will be assigned to one of VA's existing Vet Centers, enabling the center to improve access to counseling by bringing services closer to veterans. The 38-foot motor coaches, which have spaces for confidential counseling, will carry Vet Center counselors and outreach workers to events and activities to reach veterans in broad geographic areas, supplementing VA's 232 current Vet Centers, which are scheduled to increase to 271 facilities by the end of 2009.

Vet Centers, operated by VA's Readjustment Counseling Service, provide nonmedical readjustment counseling in easily accessible, consumer-oriented facilities, addressing the social and economic dimensions of post-war needs. This includes psychological counseling for traumatic military-related experiences and family counseling when needed for the veteran's readjustment.

The team leader at each Vet Center will develop an outreach plan for use of the vehicle within that region, not being limited to the traditional area of a particular Vet Center. These vehicles will be used to provide outreach and direct readjustment counseling at active-duty, reserve and National Guard activities, including post-deployment health reassessments for returning combat service members.

— Source: Department of Veterans Affairs

Vietnam Veteran Turns to Acupuncture, Qi Gong and Yoga for Relief from PTSD

We've been discussing various forms of Complementary and Alternative Medicine, or "CAM" for short, which seem to have potential therapeutic usefulnessness for treating PTSD.  Here's a mention in a recent article in the Salt Lake Tribune of March 14, 2008, of other Eastern methods, including the energetic medicine, "Qi Gong," which appear to have brought some relief to one Vietnam war-era nurse.  From an article by Matthew D. LaPlante:

Mary Jane Shipley is a 62-year-old former trauma nurse who was stationed at a mobile Army hospital in Vung Tau, Vietnam. 

Shipley's "eyes well with tears," LaPlante writes, at the recollection of the young men she watched die there, burnt and broken and missing pieces of their bodies as they faded away." 

He continues, "Shipley says she knew almost immediately after returning home there was something wrong with her. In part, it was the helicopters. She could hear them, even smell them, ferrying patients to the Salt Lake City hospital where she worked - sometimes minutes before any of her associates could."

Her other symptoms are hallmarks of PTSD: "She had trouble relating to other people. She was restless. She was constantly afraid. Perhaps to the eyes of today's doctors and nurses, Shipley's illness would have been obvious. But back then, no one reached out."

In Shipley's case, according to LaPlante, "It took her 30 years to realize she wasn't alone. Now in treatment for post-traumatic stress disorder, the Western-trained nurse has found Eastern therapies to be most helpful. She practices yoga and qigong. And at least twice a week, she undergoes acupuncture. "It took me so long to figure out what works for me," Shipley laments, "and I still have so much trouble."

The Woman's Bill of Rights to Sexual Intimacy and Pleasure

Periodically we revisit the all-important topic, "Healthy Sexuality for Combat Veterans."  In this installment, we include a "bill of rights" that's essentially written for the woman partner, from Gina Ogden, Ph.D., author of "The Heart and Soul of Sex," and, most recently, "The Return of Desire." The author of five books, Ogden is a marriage and family therapist and a sex therapist.  In a conversation directed primarily to women, she says:

"It's important for you to know what your sexual rights are -- no matter what your age or sexual orientation or physical ability.  Some of us seem to know our rights instinctively and are able to set effective boundaries and ask for what we want.  But many of us have never thought about our rights to intimacy and pleasure -- or even imagined that we had such rights.  When we're unaware, we're extra vulnerable to being taken advantage of by others, whether they intend to take advantage of us or not."

The following advice comes from a guide by Ogden for women about "how to say "yes" to pleasure and "no" to unsafe sex."

My Rights to Intimacy and Pleasure:

1.  I have a right to my own body and all of its sensations, including pleasure and pain;

2.  I have a right to think my own thoughts, whatever they may be;

3.  I have a right to feel the full range of my emotions – excitement, joy and anger, sorrow and depression, love and fear – whether or not my feeling them is acceptable to others;

4.  I have a right to acknowledge my memories, whether they are memories of delight or of abuse, and to base present relationship decisions on them;

5.  I have a right to be – or not to be – a sexual person at all ages and stages of my life, and a right to chose how I define what I mean by sexuality;

6.  I have a right to expect that my partner respect my body, thoughts, feelings, and general well-being, and a right to insist on respect, if necessary;

7.  I have a right to ask for what I want;

8.  I have a right to say “no” to any sexual encounter that feels unsatisfactory or threatening – physically, emotionally, spiritually, or sexually;

9.  I have a right to say “yes” to pleasure that is physically, emotionally, spiritually and sexually safe; and

10.  I have a right to feel good about saying both “yes” and “no.”

-- Source: "The Heart and Soul of Sex," by Gina Ogden, Ph.D.

News from Hell before Breakfast: Journalists, War Trauma and PTSD

"I hate newspapermen. They come into camp and pick up their camp rumors and print them as facts. I regard them as spies, which, in truth, they are. If I killed them all there would be news from Hell before breakfast." -- attributed, perhaps erroneously, to Civil War General William Tecumseh Sherman.

---

A different quote:

"On Thursday, June 26th, I witnessed the immediate aftermath of an Al-Qaeda suicide bomb attack.  Several dozen people lost their lives... children, old men, civilians, police, and military men.  The scene was horrific beyond words, even for someone like me who has a fairly high threshold for such things.

I found it nearly impossible to look through the viewfinder.  What I saw was abhorrently graphic, yet far too important for the world to ignore.  I present images that provide an uncensored view of a terrible event, and some small measure of dignity to those who lost their lives."

-- Zoriah, international humanitarian photographer, whose gripping images from that event were later censored by the U.S. military, and he was evicted from his embed assignment with the Marines. (The link to the post where he talks about those images, and shows them, is here.)

---

PTSD from being a combat journalist of photographer, embedded or otherwise:  Not everyone who's exposed to combat trauma develops PTSD, as we know.  Recently, Kimberly Dozier, CBS correspondent and author of Breathing the Fire, says she didn't develop it from her horrific near-death incident in Iraq in May of 2006, though ironically -- according to Dozier -- almost everyone she interacts with believes thatshe must have.  (See article to that effect by Dozier, linked here.)  However...many do; and for others, the signs and symptoms take time to manifest themselves. 

---

Journalists bear witness, both to some of the most savage atrocities of wartime, though without the training and the mindset of combatants, and also to the suffering of the survivors, military and civilian.  Says one photographer who served in Vietnam:

It has been very difficult for me [to recount some of his memories from the past] as it has brought back many of the horrible nightmares that I had thought that I had finally put away. It did get them out in the open and off my chest so to speak and now my family now knows why I sometimes have to take those walks out into the woods alone to just get away. Hard to explain. I do have severe survival guilt as I have lost far to many friends in combat in up close and personal confrontations. I have many photos of me smiling and yes there were many good times. However; there were enough bad times to more than compensate for the good ones. I have learned to cope with this new world that I came home to only because I still feel a great need to help my fellow veterans. We 'Nam veterans are all but forgotten in my eyes.

Two significant resources: Dr. Anthony Feinstein's work, and the Dart Center for Journalism and Trauma.

Two excellent books:

Dangerous Lives: War, and the Men and Women Who Report It, by Anthony Feinstein (2002); and Journalists under Fire: The Psychological Hazards of Covering War, by Anthony Feinstein. (2006).  (Recommended by Jonathan Shay, M.D., Ph.D., noted PTSD expert.)  Shay wrote: "the first and only book about the occupational [psychological] hazards of being a war correspondent.  Published in Canada, will come out in the US next year from Johns Hopkins UP with a new chapter on embeds."

Dr. Anthony Feinstein is a professor of psychiatry at the University of Toronto and a neuropsychiatrist at Sunnybrook and Women's College Health Sciences Centre in Toronto. He is an expert on Post-Traumatic Stress Disorder in war journalists. Feinstein received a 2001 Guggenheim Fellowship to pursue his research. Dr. Anthony Feinstein's bio is linked here.  Much better bio, linked here.

For reporters: War, Journalism and Stress: The Self-Assessment Test, linked here. (General description of the test, linked here.)

What Feinstein has to say:

More than anything, says Feinstein, he’s learned that, “War is not good for journalists. They suffer from it.”

Specifically, they suffer post-traumatic stress disorder, substance abuse and anxiety disorders. One in five journalists, over the course of a long (15-plus-year) career, endures significant PTSD, says Feinstein. That means, among other things, bad dreams, flashbacks, numbness, an overly sensitive startle response and an inability to get close to others emotionally. One in four experiences depression. “And a number drink very heavily as well,” says Feinstein, “but I don’t know how many, because I never know for sure what they’re telling me.”

The most surprising revelation of the research for Feinstein? “I didn’t realize that the journalists were in such great danger. You see them when they report the news: cool, collected, with everything seemingly going on behind them. But these people are really right in the middle of it all.”

He is particularly sympathetic to still photographers. More than anyone, he says, these professionals have no choice but to get into the thick of things to do their jobs well.

The Dart Center for Journalism and Trauma, located on the campus of the University of Washington in Seattle, is a particularly good, targeted resource for journalists about reporting and trauma: both externally reporting, and internally experiencing trauma from reporting in war zones.  Click here to look through their extensive offerings, which are really superb.

---

Who's the handsome young man in the photo? 

That's Robert W. "Grif" Griffin.  Griffin says, "I was a combat photographer with the 1st Cavalry Division Airmobile from 1966 to 1968 and 1970. I was in country [in Vietnam] as a photographer from 1966 to 1968, and back again in 1970."  (He was shot down near Quan Loi in 1970.)  He adds that he "spent 20 years in the Army mostly as a photojournalist/motion picture and still photographer."

According to Griffin, "the photographer who took the photo is Jere L. Smith, a fellow combat photographer and a Specialist E5 at the time. We were both assigned to the 13th Signal Battalion, which was part of the 1st Cavalry Division Airmobile."  At the time the photo was taken, Griffin was duplicating some slides for his Command for a Division briefing that was to take place in several locations at the same time: hence, the dupes.

Army General and PTSD: The Courage to Admit All is Not Well

In honor of Veterans' Day -- hey, every day should be Veterans Day, but we're not so lucky -- there's an important story to let people know about, because it so stands out from the crowd, in more ways than one.

In the wake of a recent apparent suicide by a top military officer, Air Force Brigadier General Thomas Tinsley, from unknown causes, this general's admission about his personal struggle with PTSD is all that much amazing. 

"Officers just don't get PTSD," one combat-hardened Vietnam-era veteran told me recently, knowing full well that it's not so much that they don't get PTSD, but that there's no real way to admit that they struggle with it.

---

An Associated Press report from the weekend talks about Army Maj. Gen. David Blackledge's courage to come forward, after returning from Iraq, and getting psychiatric help to deal with the trauma of war.  As the article says, by doing so, Blackledge is (fortunately) "defying the military's culture of silnece on the subject of mental health problems and treatment."

Says Blackledge, quoted in the article, "It's part of our profession ... nobody wants to admit that they've got a weakness in this area," Blackledge said of mental health problems among troops returning from America's two wars. "I have dealt with it. I'm dealing with it now," said Blackledge, who came home with post-traumatic stress. "We need to be able to talk about it."

The article focuses on the perceived "stigma" in the military culture about admitting there is a problem, seeking help and getting treated -- as well as indications that some positive change is afoot in this area.  Blackledge, who served in Civil Affairs in Iraq, and now works at the Pentagon, is clearly leading by example.  He was involved in several traumatic incidents in Iraq -- his convoy was ambushed, his driver was killed, and he was in a hotel that was bombed by suicide bombers -- and he's successfully sought help dealing with the incidents, help which he believes has strengthened him.

Given that we all pretty much know the statistics of how few people seek treatment vs. the ones who should, as well as how pervasive the culture of silence and fear of retribution is, it's GREAT to see Maj. Gen. Blackledge's openness -- and on this Veterans' Day, we can only hope it encourages many other servicemembers to go for help. The article is linked here. (Thanks to veteran John M. for the heads up!)

Editor's note: That's Maj. Gen. Blackledge 2nd from left in the photo, standing just to the right of Bob Dole, in this picture from a charity fundraiser for the Jericho Project.

"I Had My Hard Lessons in Life" - Ambrose Bierce, Literary Poster Boy for TBI and PTSD

It's getting hard for me to think of Ambrose Bierce as anything but the quintessential, though unrealized, poster boy for PTSD (and secondarily, TBI) from the Civil War era -- in addition to his stature as a journalist and writer of quite macabre short stories...and the funny-as-hell classic, "The Devil's Dictionary."  

(The painting pictured, too, shows Bierce with the human skull he allegedly kept on his writing desk "for inspiration".)

The more I read about Bierce, the more his symptoms jump off the page -- really consistent, too, with the extreme amounts of combat trauma he experienced.

More on that later, as it comes up, but here's an item from an unrelated book I've just been reading, which mentions Bierce's "mentorship" of another San Francisco-based writer, George Sterling.

"This was Sterling's first lesson.  Many more followed.  Bierce...obliged him to visit the city morgue, where he bribed an attendant to display bodies for them to "strengthen the spirit."  When Sterling had to rush from the place and vomit in the gutter after viewing the corpose of a drowned man, Bierce said, "Don't be embarrassed...When I was eighteen, I had to go out and bury soldiers and horses who had been lying in the sun for a week.  I had my hard lessons in life, too."

---

That passage is followed by another in the same book, where a different San Francisco writer -- Jack London -- reinterprets Bierce's fixation with death to the same young writer, George Sterling:

"They walked up Grant Avenue and Sterling told London about the evening that Bierce had dragged him around the city, ending up at the morgue.

"That figures," London snorted.  "Bierce is fascinated with death because he detests life.  He's afraid of it, I think.  He doesn't want to live in the real world. Anyway, I'm not taking you to any damned morgues tonight.."

-- Source: Realms of Gold: The Colorful Writers of San Francisco, 1850-1950, by George Rathmell.

Another intepretation of course is that perhaps Bierce had seen "too much" of the real world... and was still trying to put the pieces together, for himself, even decades later.

Teddy Roosevelt on Veterans - Give 'Em a Square Deal, Afterwards, for Serving

A quotable quote from the 26th president of the United States, who served as a legendary Rough Rider during the Spanish-American War, and also as an Assistant Secretary of the Navy:

"A man who is good enough to shed his blood for his country is good enough to be given a square deal afterwards. More than that no man is entitled to, and less than that no man shall have."

In Honor of Veterans Day: Community Acupuncture Clinics for Veterans

In honor of Veterans Day, Acupuncture without Borders is holding community acupuncture clinics for veterans in the following cities:

Newark, CA;

West Los Angeles, CA;

Stamford, CT;

Ft. Lauderdale, FL;

St. Augustine, FL;

St. Petersburg, FL;

Tamarac, FL;

Boston, MA;

Cambridge, MA;

Albuquerque, NM;

Santa Fe, NM;

Carson City, NV;

New York, NY;

Glenside, PA;

McLean, VA;

Longview, WA;

Seattle, WA; and

Racine, WI.

For more information on these clinics, click here.  NOTE: Do not assume that they are each being held on Veterans Day itself.  Most are held on a day either before or after, so check the schedule first several days in advance by clicking the aforementioned link.

Editor's note: For more on why acupuncture might be a suitable or interesting treatment modality for combat trauma and/or PTSD, click here.

Acupuncture Without Borders: Treating Veterans, Addressing Trauma

An organization called "Acupuncturists without Borders," (after the organization of doctors called Medicins Sans Frontiers) has been treating veterans and their particular concerns regarding combat trauma and PTSD.  Says one veteran:

“I served two tours of combat in Vietnam. I’m 100% disabled because of PTSD. When I first started coming to the AWB clinic in Albuquerque, I had spent years suffering from high anxiety. I believe that because of the acupuncture I have become calmer and my anxiety has drastically come down. I don’t want the new vets to suffer for years like I did. Acupuncture is helping me get my life back.” -- Raul Rojas

Richard H. Thompson, a four star general (retired), adds, "I have participated and believe it can help. I fully support the efforts of this organization."

According to Acupuncture without Borders, veterans acupuncture clinics are currently open in the following cities: Fort Myers, Florida; Warm Mineral Springs, Florida; Chicago, Illinois; Portland, Maine; Framingham, Massachusetts; Grants Pass, Oregon; Portland, Oregon; Madison, Wisconsin; Portland, Maine; Portland, Oregon; Rochester, New York; Rockland, Maine; Albuquerque, New Mexico; Pojoaque (Santa Fe area), New Mexico; Times Square, New York City, New York; and Stevens Point, Wisconsin; with future acupuncture clinics for veterans pending in Arlington, Massachusetts; Ann Arbor, Michigan; Ithaca, New York; New York City, New York; Charlotte, North Carolina; Philadelphia, Pennsylvania; and others.

For a list of the currently operating veterans acupuncture clinics, click here.

If you're an acupuncturist who wants to become involved, there are future trainings scheduled in Albuquerque, Los Angeles and Orlando, Florida, in the coming months.  Click here for a list of the trainings.

For a link to the organization itself, click here.

Pilot Study on Mind-Body Medicine Intervention Techniques Looking for Oregon Veterans

A study of mind-body medicine getting underway in Portland, Oregon will test whether veterans with post-traumatic stress disorder can benefit from meditation, neurofeedback and other healing alternatives.

Researchers at Oregon Health & Science University are seeking 45 volunteers, including combat veterans troubled by PTSD and veterans who lack combat experience or have never suffered from PTSD.  They are accepting veterans between the ages of 18 and 70 who are in good health.

The pilot study, which could lead to a larger clinical trial, will measure how stressful and relaxing situations change a subject's hormone levels, heart rate, brain activity, and immune system functioning.  Helané Wahbeh, a naturopathic doctor and postdoctoral fellow at OHSU, is leading the study with funding from OHSU's department of neurology as well as the National Institutes of Health (NIH).

 “Mind-body medicine appears to be an ideal way to help people with PTSD because the disorder affects the body’s immune system, hormone system and nervous system,” says Helané Wahbeh, N.D., a naturopathic physician researcher at OHSU. “I don’t believe you can effectively treat PTSD by only focusing on one aspect of the illness. For example, if we only give people suffering from PTSD anti-depressants, we may only be treating one aspect of the illness.”

The first phase of the OHSU study will measure changes in hormones, heart rate, brain activity and the immune system in both relaxing and stressful situations. Mary Lu, M.D., a psychiatrist with the Portland VA Medical Center, will provide PTSD screening.

Veterans interested in volunteering for the study, which will take up to about six hours of their time (probably broken up over time) can call (503) 494-3528 for more information.

Editor's note: If the study will measure hormone levels, undoubtedly it will measure cortisol levels -- and we've talked about cortisol, stress and sleep quite a bit previously on this blog. Unfortunately, good luck to the study's researchers on finding older vets who are also in "good health," especially ones who suffer from combat-based PTSD. Typically this creates a cascade of other physiological problems as veterans age -- however, on the plus side, mind-body relaxation techniques ideally will help even older veterans with health problems to achieve greater quality of life.  Either way it's an interesting study.

---

Additionally, here's a little more about the study from OHSU's own site, including some goals and a short video, linked here. And here's a description of the study (confusingly saying that it's not yet open for participation yet -- call the phone number instead to be sure) from the NIH's own Clinical Trials site, linked here.

Writing Workshop Planned on "Trauma, Art & Writing" for June, 2009

Plan ahead for this writing workshop, June 15-26, 2009:

Sponsored by the William Joiner Center for the Study of War and Social Consequences and the Creative Writing Program of the University of Massachusetts Boston.

This workshop - open to writers of fiction and nonfiction, poetry, playwriting and translation - involves one or two weeks of working sessions and individual consultations with distinguished writers. The faculty includes Vietnam veterans and others whose lives have been altered by the experience of war, but applicants with diverse interests and backgrounds are encouraged to apply.

Visiting writers will join the teaching staff in a series of readings, seminars, and panel discussions. Special events held at UMass Boston and at other Boston locations will be open to both workshop students and the general public. This year's faculty reading series schedule will be posted.

Editor's note: Additional information about the writing workshop, including faculty bios, course schedule, accommodations, and application (as well as other materials) are linked here.

"Welcome Home" for Student Veterans, Symposium on Veterans Issues Planned at the Joiner Center - UMass Boston

Two upcoming events of special interest to veterans, to be held at the William Joiner Center for the Study of War and Social Consequences, on the campus of UMass Boston (click here for a link to the Joiner Center's events calendar):

Friday, November 14

12:00pm

 Symposium on Veterans' Issues

When: Fri, Nov 14, 12p – 5pm

Where: Chancellor's Conference Room, 3rd Floor, Quinn Administration Building (map)

Further information follows:

The William Joiner Center for the Study of War and Social Consequences will host a symposium for veterans’ advocates to address issues of concerns for veterans on Friday, Nov. 14, from noon until 5 p.m. in the Chancellor’s Conference Room on the third floor of the Quinn Administration Building at UMass Boston. Massachusetts Senator John F. Kerry is the honorary co-chairman; the symposium is organized and chaired by Paul Camacho, director of special projects at the Joiner Center.

Donald Overton of Veterans of Modern Warfare will speak on the issue of the implementation of the new G.I. Bill during a luncheon for participants from noon until 1 p.m. Following the lunch and Overton’s address, a series of issue presentations will be held, with 10-15 minute presentations and a period for questions and comments for each of the topics.

Topics will include: Health Care and Traumatic Brain Injury to be addressed by Dr. Carlos G. Tun of the Department of Veterans Affairs; Education with Barry Brodsky, director of the Veterans Upward Bound Program at UMass Boston, and John Powers, a student and representative of Veterans of America; Homelessness, with Laurence Fitzmaurice, New England Shelter for Homeless Veterans, and Housing, with a coordinator yet to be determined; Employment, coordinator to be announced; and the Future of Veterans’ Advocacy, to be led by Ron Armstead, executive director of the Black Veterans’ Braintrust of the Congressional Black Caucus.

The symposium will employ a roundtable format to encourage discussion and participation from attendees. At the conclusion of the symposium, participants are welcome to attend a reception and Welcome Home Dinner for Afghanistan and Iraq War veterans in Ballroom A on the third floor of the university’s Campus Center. The reception will be at 5 p.m., followed by dinner at 6p.m.

To register for the issues forum or the dinner, You can register online by clicking this link, or by calling (617) 287-5850. To learn more about the GI Bill visit: http://www.gibill.va.gov

---

5:00pm

 Welcome Home Dinner For Student Veterans

When: Fri, Nov 14, 5p – 9pm

Where: Ballroom A, 3rd Floor, Campus Center, UMass Boston (map)

Description:The William Joiner Center's annual gala dinner to welcome UMass Boston student veterans home from service in Iraq and Afghanistan. The evening will include dinner, cash bar, DJ and speakers. More details to follow.

---
The William Joiner Center is named after William (Bill) Joiner, an African American veteran who served as the university’s first director of Veterans Affairs until his untimely death in 1981 from liver cancer associated with his exposure to Agent Orange while serving in the military.  The center promotes research, curriculum development, public events, and educational, cultural, and humanitarian exchanges which foster greater understanding and innovative means of addressing the consequences of war.  Responding to wars in the 21st century, the Joiner Center has begun to focus on the consequences of the Global War on Terrorism, particularly as manifested in the conflict in Iraq and Afghanistan.

Reserved to Fight: New Documentary Features Young Veterans Realizing "You Are Not Alone"

There's a new documentary out, showing on PBS this month (click here to find your local station), co-produced by the Iraq and Afghanistan Veterans of America (IAVA) and called "Reserved to Fight." This is how the director describes it:

"In May 2003, Fox Company of Marine Reserve Unit 2/23, returned home from front-line combat in Iraq. Reserved To Fight follows four Marines of Fox Company for four years through their postwar minefield of social and psychological reintegration into civilian life. The return to their communities proves as formidable a battle as the more literal firefights of previous months. Living among loved ones who don’t yet understand them and how they have changed, contending with a media focused on the politics rather than the human experience of war, and suffering from a psychological disorder that is difficult to acknowledge, these young veterans grapple to find purpose and healing.

For each Marine, their new status as a young veteran leaves them often without goals, camaraderie, or an immediate channel for the adrenaline that their combat-ready bodies still produce, even many months later. Most significantly, they lack a safe place internally to store the images, sounds, and experiences collected from war. Encroaching civilian reality only serves to widen the painful gap that exists between them and the society in which they live; a gap which they feel so personally and painfully.

Taking anti-war media personally, Mark Patterson returns home adamantly speaking out against those who oppose the war. He is unwilling to admit that the war has affected him, and his life becomes consumed with trying to convince his peers that his actions in Iraq were correct. But when his long-time girlfriend and emotional support, Jana, suddenly breaks up with him, severe depression forces him to confront his past, drastically reshaping his future. Matt Jemmett is immediately diagnosed with Post-Traumatic Stress Disorder (PTSD) after his return home, but when traditional therapy doesn’t work, he decides he needs seclusion and takes a job in a remote desert location
working with at-risk youth.

Raised in a strict religious society, Earl Simmons’ abuse of alcohol to fight traumatic memories of the war leaves him unable to fulfill a two-year church mission. Returning to his community for a second time, shame and seclusion force him to face his demons. Upon returning home, Chris Nibley just wants to be normal: “start a family and have a lot of kids.” However, finding himself depressed, he soon
realizes that he does not fit into this concept of “normal”. As a result he is left feeling isolated and without direction. All attempts to find happiness only leave him hopeless of ever finding his sense of purpose in America again and he makes a rash decision to volunteer for a second tour in Iraq; knowing, almost hoping, he will die.

As the Marines’ individual stories unfold, we discuss the mental stress of war and its affect on veterans of WWII and Vietnam.

Ray Howarth, a prisoner of war and purple heart recipient of WWII, struggled with severe emotional stress resulting in random bursts of rage. Forty years after the war he decided to visit a therapist and found “I was never deprogrammed from war.” Now Howarth has dedicated his life to helping veterans
readjust. Terry Haskell, a Vietnam veteran, reflects on his experience after coming home and shares “I was lost for ten years, I think time finally healed me. I could forgive.”

It is the stories of these veterans that make this film distinctive. While their lives are the vehicles for this story, it is ultimately about all veterans. Today, thousands of veterans walk a similar tight rope hinged on confusion, loneliness, isolation, and despair. This film will help them realize they are not alone, while offering awareness both for the veterans and their communities."

Sounds worth watching.  In reality, reservists face special challenges unique to them.  Non-career military, they are expected to "resume" normal lives as quickly as possible, but with all the same difficulties, sometimes even more, than those who are active-duty military.  Like the National Guard, special care needs to be paid to the unique challenges of reservists.  Wrenched from the common experience of wartime, they go back to civilian lives separated from their buddies, with whom they could otherwise hope to process the combat experience.  Similarly, they also return to families, jobs and communities that frequently expect them to be more or less "fine," because they're now back from the war, yet with few resources to help them or their families integrate these divergent experiences.

Editor's note: If you want to read about another Marine battalion that served in Iraq, 1/25, also known as "New England's own," read this earlier blog entry, linked here, which mentions and links to the extensive coverage by the Boston Globe -- which gave reporter Charles Sennott a year to follow the battalion -- and the Providence Journal Bulletin. A good video, which we've also blogged about earlier, here, is from the Norfolk County (Massachusetts) District Attorney's office, called "PTSD and Veterans: Beyond the Yellow Ribbon." It talks about various re-adjustment issues after combat and particularly focuses on reservists.  Highly recommended.

Libraries Across America Offer Veterans Information Next Week for Veterans' Day

The American Library Association (ALA) is spearheading a series of activities during the week of Veteran's Day, November 11, 2008 at libraries across the country to make information available to help veterans and their families better understand the education benefits available under the new Post 9/11 GI Bill.

ALA's Office of Government Relations (OGR) is working with a group of four national organizations in this effort, including the American Legion National Headquarters, the American Council on Education, the National Association of Federally Impacted Schools, and the National Military Family Association.

(Realistically, knowledgeable reference librarians are always happy to help veterans and their families with information at their disposal; next week, however, appears to be a special push to get this information into the hands of veterans and their families, in honor of Veterans Day.)

For more about the services available, click this very Wikipedia-looking link, provided by the American Library Association.

Post-Traumatic Stress Disorder Forum This Friday - Monroe, LA

University of Louisiana at Monroe associate professor Mitchell Young will host a post-traumatic stress disorder forum 6-9 p.m. Friday in the ULM Conference Center on the seventh floor of the library. The public is welcome to attend and refreshments will be served.

The event is cosponsored by the ULM Department of Educational Leadership and Counseling and aims to educate attendees about the effects of trauma, common reactions and what treatments are available.

Combat veterans who fought in Korea, Vietnam, Iraq and Afghanistan will share their struggle to rejoin their families and communities when they come home from the battlefields.

He has presented at national conferences on PTSD and conducted training sessions to Veterans Affairs and readjustment counselors in several states. Young has published articles on the subject in research journals and helped hundreds of combat veterans, victims of Hurricane Katrina and criminal violence and other individuals diagnosed with PTSD.

For more information, contact Young at (318) 342-1255.

In Medication We Trust - The Pills and Perils Veterans Face after Combat

I had the opportunity to hold a 100%-PTSD disabled rated combat veteran's "morning" set of medications and supplements recently (as opposed to his or her "evening" set), and it reminded me of another piece of artwork done by Iowa artist John Paul Hornbeck, a veteran whose dad is a disabled Vietnam veteran.We've blogged about John Paul's artwork earlier, particular his sculpture, "Shattered Soldier," about PTSD.

(The handful shown represents a variety of medications to control psychological symptoms of PTSD, as well as to medicate the various physiological ailments, some of them quite serious, which often accompany PTSD in a combat veteran.  Then there are medications to control side effects of other medications, and some supplements to replace nutrients the medications destroy. The handful shown is really just a sample of what this combat veteran takes throughout the day; and other items, such as a pain patch, are not shown. But you get the general idea...)

John Paul has done some other provocative artwork, too: a modified rendition of the classic POW/MIA flag to remind us that homeless veterans are "missing in America" -- meaning, missing in plain sight -- and another lifesize image of a disabled veteran, done as a sculpture, where the face of the veteran is composed entirely of pills.  Pinned to an outside pocket of the vet's camouflage jacket is a pill case, reminding him when to take his medication, and John Paul has depicted it in patriotic colors, resembling the American flag.  Interesting, edgy stuff, from a veteran who is very familiar with his own father's dependence on VA-supplied medication for alleged "quality of life."

(Fortunately, there are other methods for reducing dependence on medication, including mind-body medicine, which we've blogged about earlier -- indexed here.  And there are also ways to evaluate the effectiveness and potential side-effects of common prescription medications, according to other PTSD sufferers. We've blogged about that earlier as well -- linked here.)

John Paul Hornbeck's sculpture, "The Veteran," follows:

Upcoming Workshop on Using Art Therapy in Treating Trauma - Boston, MA

Beyond Words: Creating a New Language for Healing; The Use of Art Therapy in Trauma Work

Date: Friday, November 14, 2008

Time: 9:00 A.M.-5:30 P.M.

Location:The Trauma Center at JRI, 1269 Beacon Street, Brookline, MA

Cost: $160

Presenters: Erika Lally, LMHC and Michelle Harris, LMHC

Trauma survivors are often challenged by the use of words in communication. The very nature of trauma and the inherent qualities of dissociation may leave the client struggling to articulate his or her exprience. Reliance on a verbal language approach in treatment may, at times, generate even more frustration and distress. With art materials and the art process, it is possible to access the inner experience without reliance on words as the starting place. Art therapy is a treatment modality that utilizes art media, art process and art products as communication within therapy. Art therapists learn to attune to the nonverbal cues of their clients and have a lexicon for the kinesthetic properties of art that help them in the formulation of individualized media interventions and art therapy treatment approaches. The Trauma Center is pleased to offer a one-day training to introduce both these basic art therapy concepts and specific considerations crucial to using an arts-based aproach in trauma treatment. This training is a hands-on, highly experiential workshop with information also presented through slides, case examples, and discussion.

This training will:

-- Integrate the basic tenets of effective trauma treatment within an art therapy framework.

-- Highlight the potential of retraumatization when including image making as part of trauma therapy work.

-- Address safety through increased attunement to client and clinician responses to artmaking.

-- Bring all the senses, movement, and creativity into trauma work with affect regulation as the goal.

-- Structure a creative process that is strength-based for problem-solving, organization of thoughts, naming "what is" and meaning making.

This training is intended for both the art therapist looking for a trauma treatment framework as well as the trauma clinician who is drawn to using art within their treatment. Previous art making experience not required. Participants should be prepared to immerse themselves in art activities and dress comfortably.

About the Presenters:

Erika Lally, LMHC, ATR-BC, holds a Masters in Art Therapy from the School of the Art Institute of Chicago. She is a Licensed Mental Health Counselor in Massachusetts and a Registered, Board Certified Art Therapist as recognized by the American Art Therapy Association. She has provided trauma treatment for both children and adults for fifteen years. Ms. Lally is a clinician, supervisor and trainer at the Trauma Center. She additionally coordinates the Trauma Center's Child Evaluation Services and consults on the Multidisciplinary Assessment Team at the Cambridge Department of Social Services. Erika also is an adjunct faculty member at Lesley University, teaching in their Master's Level Expressive Therapies Division. Erika specializes in treating complex trauma and she is EMDR level two certified.

Michelle Harris, MA, ATR-BC, LMHC, is an art therapist specializing in trauma work with children, adolescents, and adults. She is clinical intake coordinator at the Trauma Center and has been leader of the Positive Sensory Group, a structured skills-building group focusing on self-care and safe alternatives to numbing, avoidance, and shut-down responses in daily life. Ms. Harris also specializes in collaborative community art projects such as the Coast Miwok/Southern Pomo tribe's quilt on faith and tribal identity. She is currently creating a traveling quilt series with incest survivors called "Speaking Truth" to address intergenerational trauma and how trauma survivors can be preventative and proactive when telling their history in a developmentally appropriate frame for children in their life. Ms. Harris is an art tutor at Harvard University and faculty at Lesley University in the Expressive Therapy Department and in the Trauma Center Certificate Program.

For more information or to register, click here.

Editor's note: to read more blog entries about art therapy and combat trauma/PTSD, click here.

"The Black River of Loss, Whose Other Side is Salvation" - Poetry

An excellent poem about trauma, loss and -- ultimately -- survival -- with no implied reference intended to the famed/notorious American defense contractor of the same name (which coincidentally employs a number of combat-traumatized veterans, some of whom are looking for their own exit).

In Blackwater Woods

Look, the trees
are turning
their own bodies
into pillars

 

of light,
are giving off the rich
fragrance of cinnamon
and fulfillment,

 

the long tapers
of cattails
are bursting and floating away over
the blue shoulders

 

of the ponds,
and every pond,
no matter what its
name is, is

 

nameless now.
Every year
everything
I have ever learned

 

in my lifetime
leads back to this: the fires
and the black river of loss
whose other side

 

is salvation,
whose meaning
none of us will ever know.
To live in this world

 

you must be able
to do three things:
to love what is mortal;
to hold it

 

against your bones knowing
your own life depends on it;
and, when the time comes to let it go,
to let it go.

-- by Mary Oliver

Military Sexual Trauma Increases Likelihood of Mental Health Problems, VA Says

From a press release, this fairly obvious conclusion:

Military Sexual Trauma Associated With Higher Rates of Mental Health Problems.

According to preliminary research results from the VA, approximately 15% of recently returned female veterans utilizing the VA healthcare system report experiencing sexual trauma during military service.

The cross-sectional study, presented at the American Public Health Association’s 136th Annual Meeting & Exposition in San Diego, examined healthcare screening data of over 100,000 veterans of Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom who utilized medical care at any Veterans Health Administration facility during a six-year period.

Along with the more than one in seven women, 0.7% of males also reported having experienced military sexual trauma. Both males and females reporting military sexual trauma were more likely to be diagnosed with a mental health condition than patients who did not report military sexual trauma.

“These data highlight the importance of the VA’s universal screening policy,” said Joanne Pavao, MPH, a VA researcher on the study, “as well as early intervention among veterans who have experienced sexual trauma, to prevent long-term consequences.” Veterans Health Administration policy requires that all male and female veterans are screened for experiences of military sexual trauma and that free treatment for military sexual trauma-related conditions is provided at all VA healthcare facilities.

— Source: American Public Health Association