Healing Combat Trauma

June 27, 2010 is "National PTSD Awareness Day"

Amazingly enough -- and suddenly, because the U.S. Senate just passed it -- tomorrow is "National PTSD Awareness Day." Even MORE amazingly, the text of the resolution is very veteran-focused (yippee!).

Here's the full text of the bill. Enjoy! My only quibble is that the numbers seem a little on the low side, but mebbe not. (Actually, the advocacy group Veterans for Common Sense, led by veteran and former VA bureaucrat, Paul Sullivan, lists the numbers as much higher. See link here for current information.)

And, of course, a focus on treatment through integrative medicine would also be nice. It alludes to, but does not mention directly MST (military sexual trauma), which plagues women and men in the Armed Forces AND which unfortunately also leads directly to PTSD. The combination is often too much to bear. With all those caveats, it's still a great bill, and we appreciate any and all emphasis on the topic, as beneficial to veterans, their loved ones, their caregivers, decision-makers, and the general larger community of humankind. 

Thanks especially are due the Vietnam veterans, who never gave up (you're still out there, I know! patiently waiting for it to be your turn; the media, for highlighting the problem and ensuring that greater awareness might result in better options for veterans and their communities; veterans' families, loved ones and employers, for not giving up on the veterans in their midst; and the legislators, who passed this bill and in so doing, created more national focus on the post-deployment adjustment difficulties of those who served. Thank you!

RESOLUTION

Designating June 27, 2010, as ‘‘National Post-Traumatic Stress Disorder Awareness Day’’.

Whereas the brave men and women of the United States Armed Forces, who proudly serve the United States, risk their lives to protect the freedom of the United States and deserve the investment of every possible resource to ensure their lasting physical, mental, and emotional wellbeing;

Whereas 12 percent of Operation Iraqi Freedom veterans, 11 percent of Operation Enduring Freedom veterans, 10 percent of Operation Desert Storm veterans, 30 percent of Vietnam veterans, and at least 8 percent of the general population of the United States suffers from Post-Traumatic Stress Disorder (referred to in this preamble as ‘‘PTSD’’);

Whereas the incidence of PTSD in members of the military is rising as the United States Armed Forces conducts 2 wars, exposing hundreds of thousands of soldiers to traumatic life-threatening events;

Whereas women, who are more than twice as likely to experience PTSD than men, are increasingly engaged in direct combat on the front lines, putting these women at even greater risk of PTSD;

Whereas—

(1) from 2003 to 2007, approximately 40,000 Department of Defense patients were diagnosed with PTSD;

and

(2) from 2000 to 2009—

(A) more than 5,000 individuals were hospitalized with a primary diagnosis of PTSD; and

(B) more than 500,000 individuals were treated for PTSD in outpatient visits;

Whereas PTSD significantly increases the risk of depression, suicide, and drug and alcohol related disorders and deaths;

Whereas the Departments of Defense and Veterans Affairs have made significant advances in the prevention, diagnosis, and treatment of PTSD and the symptoms of PTSD, but many challenges remain; and

Whereas the establishment of a National Post-Traumatic Stress Disorder Awareness Day will raise public awareness about issues related to PTSD: Now, therefore, be it

Resolved, That the Senate—

 (1) designates June 27, 2010, as ‘‘National Post-Traumatic Stress Disorder Awareness Day’’;

 (2) urges the Secretary of Veterans Affairs and the Secretary of Defense to continue working to educate servicemembers, veterans, the families of servicemembers and veterans, and the public about the causes, symptoms, and treatment of post-traumatic stress disorder; and

 (3) respectfully requests that the Secretary of the Senate transmit a copy of this resolution to the Secretary of Veterans Affairs and the Secretary of Defense.

Editor's note: And if you want to know why we do what we do, here it is. It can change someone's life. Here's how the Vietnam vet, Marine, subject of the "Eyewitness to Combat" section of this site, is doing after a year of addressing his 40-year solid case of chronic, severe PTSD. He came, he saw, he conquered. Other veterans can too. We give them HOPE. First awareness, then treatment, and the chance of getting their life back. (H)Oorah. (Here's the link.)

Paying Tribute at "The Tribute Wall..."

One of the most remarkable experiences, at last week's third annual "The Brain at War" conference in San Francisco, was visiting the Marines' Memorial Club & Hotel in Union Square, where the conference was held.

Unbeknownst to me and many of the other conferences' participants, the Marines' Memorial is both swoon-worthily fantastic as a venue AND happens to house a one-of-a-kind tribute to OIF and OEF veterans who have been killed in action. The so-called "Tribute Wall" is on the 10th floor, mezzanine, and Major General J. Michael Myatt, USMC (Ret.) encouraged us all, during the conference, to take some time and pay honor to those servicemembers who had given the   ultimate sacrifice. 

True to my nonexistent personal GPS, I first mistakenly went to the wrong floor -- the library, on the 11th (which was cool, but not the same) -- and finally found my way to where I was supposed to be. The polished black plaques, listing fallen warriors by name, branch, and date of death, cover the four walls of the memorial room, and then stretch out beyond it, covering a "fifth" wall completely in the adjoining room, and continuing to advance.

If you know when a friend or loved one died in combat, you're able to find the plaque's general location by scanning the wall to find the correct year, then reading vertically to find the approximate location of the date.

If you know only a name, but not the date, it's safest to look up the name of the servicemember in the frequently-updated list kept in a binder in the center of the room, again listing by name, branch of service, and date of death.

In my case, I went to a section of the wall to find those who died on a certain tour of Marines in the Sunni Triangle, back in '05/'06, then went back to find the names of friends of friends and take photos for them of their loved ones' plaques.

There are some surprises. One is, see photo at left, that two "major league" departed heroes, among all the rest of the great departed heroes, Pat Tillman (Army) and Jason Dunham (Marines) died on the same day. Until I saw their plaques resting above each other on the "Tribute Wall," I can't say that I realized that. 

There's also a guest book which people can sign, to leave their memories and condolences; and there's a flag display of the flags of all the branches in the center of the room. There's also a framed photograph of Marine General James T. Conway, (at this writing, current Commandant of the Marine Corps) from the front cover of a Marine magazine, visiting the wall; and another framed "thank you" note he wrote, expressing his appreciation to the Gold Star families for the exhibit.

I found myself returning to this generation's "Wall" time and time again during the conference, sneaking away from the (great) presenters to put myself back in touch with the very great losses of these wars, in terms of men and women who were dearly and deeply loved by those they left behind. I racked my brain and texted friends for the names of friends they had lost on their tours, to make sure I got photos of their loved one's plaques.

In numerous trips to the Tribute Wall ("Room" is more like it, since the plaques cover at least five walls by now), I rarely saw another visitor. Only one couple, the wife or girlfriend tagging behind the husband or boyfriend, who looked like a veteran, searching out key names on the wall. I heard that a number of conference participants also went to pay their respects. I didn't run into them, which doesn't mean they weren't there. What the hushed and reverent silence in the room did mean, though, and the literally thousands of plaques, each representing a servicemember important and loved to many friends and family, is how little we typically recognize the ultimate sacrifice of those who   gave their lives. I feel blessed and honored and frankly, grateful, that I got to pay my respects at the Tribute Wall for those who gave so much.

If you're ever in San Francisco, and you can handle seeing the sheer enormity of OIF and OEF deaths honored in one single "room," you owe it to yourself -- nay, them -- to go by the Marines' Memorial Club & Hotel, head to the 10th floor, Mezzanine, and pay your respects, so that their sacrifice is not in vain.

Editor's note: Servicemembers who were KIA from all branches of the Armed Forces are represented on "the wall," not just Marines.

"The Brain at War" Conference in San Francisco

Last Thursday I had the opportunity to attend the third annual "The Brain at War" conference, put on by the NCIRE, The Veterans Health Research Institute, in San Francisco, CA. More on that later, because things are really busy around here right now. But it was a great conference, and the second excellent training I'd been able to attend, within the past 30 days. (The first being the superlative clinical training program in PTSD, put on by the National Center for PTSD in Menlo Park, CA. An article about that program is linked here.)

Some personal recaps and observations:

The Brain at War featured a number of interesting speakers, including Heidi Kraft, Ph.D., the author of "Rule Number Two," whose presentation was really the emotional anchor of the day. (Kraft now serves as the Deputy Director of the U.S. Navy Combat Stress Control Program.) She talked compellingly about her experience in Iraq, and in particular the events and emotions surrounding holding the hand of a dying Marine, who later became famous to the nation as Cpl. Jason Dunham, who was posthumously awarded the Medal of Honor. (He's also the subject of an excellent book, "The Gift of Valor," by Wall Street Journal reporter Michael Phillips.) 

Her speech was probably the first time, in almost five years of writing and editing this site, that I got to let the power of the stories I've heard, from various suffering servicemembers, vets and their families, really sink in. As Kraft told her story, of pain, empathy and loss, and the bond it built with Dunham's family, that continues to this day, I tapped into my own reserve of painful memories of stories I know, and couldn't stop crying. Looking around the large conference room, I saw I wasn't remotely alone in that, though; even men in suits were dabbing both eyes with their handkerchiefs and napkins. She also had a powerful, powerful poem that she wrote about the highlights and lowlights of the Iraq tour, called "The List," that she read to those assembled, and which is featured prominently in the book she later wrote, above.

There were many highlights of the program, including hearing from the National Guard about what they're doing to secure better mental health for their servicemembers, who don't have the same access that other branches do. The California National Guard has a good "Combat Stress Control" program, with handouts like this tip sheet, "Helping a Soldier Buddy in Distress," linked here. They've also got a superlative poster, "Never Let Your Buddy Fight Alone (against PTSD)" that emphasizes the importance of Guardmembers in one another's lives. An U.S. Army National Guard leader, Major Paul E. Gonzales, from Kansas' National Guard, talked convincingly about the challenges Guardmembers face after deployment, accessing mental health services, when they're frequently hours away from the nearest facility. 

Another true highlight was, through the miracle of Skype, hearing and seeing USAF Major Jennifer J. Hatzfeld, Ph.D., R.N., report in from Afghanistan about her tour of duty there and what it's been like. And Chris Loverro, a UC Berkeley grad now filmmaker, and part of the U.S. Army's Stryker Brigade from Ft. Lewis, Washington in Iraq, talked openly about his struggles with PTSD upon returning from war, and showed a short film he's made about the "Hidden Casualties" among veterans. The short film's message was raw and powerful, and hit home with many in the audience.

Hidden Casualties from chris loverro on Vimeo.

(Army) Brigadier General Loree Sutton was in attendance at Thursday's program, and seemed to be an enthusiastic supporter of all things health and wellness related to the military and PTSD (and TBI). Sadly, in news that went over the wire yesterday, Sutton resigned her position as the head of the Defense Centers of Excellence (DCoE). See news item, linked here. The timing was significant: it's the same week that the privately-funded National Intrepid Center of Excellence for Psychological Health and Traumatic Brain Injury opened on the Navy campus in Bethesda, Maryland for the treatment of TBI and PTSD. Although the opening was a big deal -- and the fact that the money was raised privately also is -- apparently no cabinet members, no White House representatives, no senators and only two congressmen showed up. So the "war" ... on the brain... at war... appears to continue.

It was gratifying to see a certain portion of the event, as well as a small-group discussion afterwards attended by maybe a dozen participants, devoted to the discussion of integrative medicine and PTSD. (The discussion leader, an M.D., said she was also in the process of leaving the military.) Let's hope that despite the apparent setbacks and detours that progress can still be made on treating PTSD with integrative medicine. 

The building the conference was held in -- an A+ facility called "The Marines' Memorial Hotel & Club," in San Francisco's Union Square -- was fantastic. "Like the Harvard Club for Marines!" I exulted, to anyone who'd care. It's worth a return trip to San Francisco just to revel in the exhibits on each floor. (The food was also superb.) There's an excellent library on the 11th floor, many things on other floors I didn't get to see, but a true "draw" and it's quite powerful is the "Tribute Wall" on the 10th floor, Mezzanine, which honors the fallen heroes of every branch who have given their lives in the OIF and OEF campaigns. I'll probably have to reserve writing about that for another time, but I kept stealing away from the presentations to go back to that memorial, taking photos of the plaques commemorating those who died who were important to vets who are special to me. The memorial has black stone plaques, engraved with the servicemember's name, branch of service, and date of death, and they're embedded into the walls (the exhibit covers five walls by now, one full room and stretching outwards from that) roughly chronologically, vertically. There's a guest book in the room to sign, and also a guidebook, which must be updated regularly, listing servicemembers KIA by name, branch of service, and date of death. Once you find the date of death, you know approximately where their plaque on the wall will be located, and you just go looking for it. Pretty impressive, and moving, exhibit, giving honor to those to whom honor is very much due. (For more on that, see link here.)

Praise for "Healing Combat Trauma"

Had a nice surprise at the week-long clinical training in PTSD at the National Center for PTSD. Picked up a copy of Ray Scurfield, Ph.D.'s comprehensive "War Trauma Resources," and in it read something very nice he said about this site: "Lily Casura’s very rich compendium -– she has over 100 categories of information! -- of books, article, commentaries, resources, other readings and information regarding military, veterans and their families. I am most impressed with Lily’s passion, dedication and abilities as an advocate for vets and their families." -- Ray Scurfield, Ph.D.

 Scurfield is and was one of my first heroes in this because of his longtime work with veterans healing from war trauma, so it's extra-nice to hear something like this from him. In addition to the resources he provides nationally, Scurfield is also the author of three key books about veterans and PTSD: A Vietnam Trilogy, Healing Journeys, and War Trauma.

Quotable Quotes -- José Narosky on All Soldiers Are Wounded

 "In war, there are no unwounded soldiers." -- José Narosky

At Last, Some Good News: A Personal "Before" and "After" in the Life of Someone with PTSD...

There's a lot of bad news going around: suicides up, PTSD wrecking lives and families, not much constructive help in sight. But here's a story that's GOOD news...about how much progress one combat vet with severe, chronic PTSD -- for 40 years(!) -- made in just a year of trying integrative medicine techniques and therapies, in addition to his medication. (He was able to lower his psych meds to an absolute minimum as part of the progress.)

At the end of year one, I asked him to write up his experience so he could contrast, for himself, a personal "before" and "after." Knowing him and the story, I know that he left out the highest highs and the lowest lows, but still, it paints a powerful picture of one life substantially freed from the ongoing torment of PTSD.

If you want a little backstory on who Pat is, he's the author of the "Eyewitness to Combat" selections on this site. Read those, linked here, for background about his tours in Vietnam and the after-effects of PTSD in his life. (That's him in the photo at left.)

Here's the letter:

    Healing Combat Trauma

     Re: Alternative Modality Treatments for PTSD

 Dear Ms. Lily G. Casura,

WHAT A DIFFERENCE A YEAR MAKES?  It has been one year ago that I first made contact with the web site “Healing Combat Trauma” in an effort to find out information on the treatment of Post Traumatic Stress Disorder.  As back-story, I was a Disabled Vietnam Combat Vet.  I was attached to “Flames”, 2^nd Battalion, 9^th Marines (Hell in a Helmet) my first tour of duty and with “Bravo” Co., 1^st Battalion, 9^th Marines (Walking Dead) my second tour of duty.  It was during this second tour of combat that I was wounded three different times in a battle with North Vietnamese Army troops on Hill 881 north of Khe Sanh.  I spent another seventeen months recovering in various Navy and VA hospitals and was partially paralyzed for five additional years during which time I married, attended college and received a Bachelors and Masters Degree in Forestry.

From the time I got back from Vietnam, I suffered from mild to severe to devastating symptoms of what is now known as Post Traumatic Stress Disorder but was not even recognized as a mental disorder much less treated until twenty five years after the fact.  The further I moved from the date of my deployment to Southeast Asia, the more intense the symptoms became and the more aggressive and destructive my behavior evolved into.  Not knowing that I was suffering from a “disorder” which affected all of my fellow combat veterans, I simply assumed I was going “Crazy”, just being a “Marine”, and was of course a “fucked up Vietnam Vet”.  I made no apologies for my behavior because my close friends, all former combat vets, were exactly like me and what we did was “normal” for us.  It was the rest of the “world” that was screwed up including our wives.

However as the years rolled by it became clear that a definite pattern of cyclic behavior, action, response, aggression and consequence began to manifest itself.  Regardless of determination, courage, education, competence, and ability; quality jobs lasted on the average of no more than an eighteen months and no less than one year.  They averaged about thirteen months, the same as the Marine Corps Tours of Duty in “The Nam”.  I was excellent and even exceptional at all of the tasks of my profession but could never become acclimate to following “orders” by anyone in “authority”.   I just wanted to be left alone to “do my job”. 

Not only did the patterns of behavior and consequence continue to recycle in my and my family’s life, they intensified with each cycle and became more and more destructive as time went on.  This resulted in extreme “guilt” and “withdrawal” and developed into a “hatred” for anyone who had not gone into “combat” in Vietnam.  They had not been where I had been and had absolutely not “earned the right” to judge me or criticize me for my actions.  Raising five children was a huge financial burden which weighed heavily upon me because I knew that I was not going to be able to work for anyone but took as many labor jobs and engages in as many “self employment” activities as I could. 

Twenty five years into this self destructive lifestyle and monumental stressor left me broke, unemployed and unemployable, family in constant turmoil, physically ill with heart disease and arthritis, and mentally devastated with depression and constant suicidal thoughts.  It was then that I was told that the VA had identified PTSD in 1976 but was reluctant to let veterans know because of the reality of paying disability to them.  So it was suppressed from us.  Even so the treatment they were then engaged in was a combination of “physiological and therapeutic drug” treatments.  I entered their treatment program in a desperate effort to save my family and my own life.  I was diagnosed with severe PTSD and rated 100%.  And it had already taken its toll on me.  I ended up with two quadruple heart bypasses, congestive heart disease, electro-cardial heart failure requiring radical clinical trial surgery and pacemaker, Rheumatoid Arthritis destroying my body and severe clinical depression.   The VA solution was to continue the “group sessions”, the “psychological counseling”, and increasing the amount of “psych” drugs I was to take.  I literally became a drooling “zombie” unable to carry on a coherent conversation, unable to remember what anyone was saying to me, looking at everything in a blur of fog and sleeping 20 hours per day.  The VA had essentially “locked” me up in a “mental institution” and thrown away the key.

My family went on with their lives and I became an invalid.  Then my almost-grown kids began to experience the exact same symptoms of PTSD that I was having.  I just quit taking the “meds” and actually “awakened” enough to realize that one of them was about to kill himself.  I began to desperately search the interned for anything that could save my boy and me.  If he killed himself, I would do the same but go out in a “blaze of glory”, taking those with me whom I blamed for the hell we were living. 

This is when I came upon a “web blog” called “HEALING COMBAT TRAUMA”.  As I began to read the blogs, I became not only interested but engrossed in and awe struck by the intuitive content of it.  Whoever wrote the blog KNEW what living with PTSD was like and began to cry.  This was not someone who had been educated about it, this is someone who had LIVED with it but was incredibly intelligent and understanding.  As I read, I began to understand what was going on with me, my wife and my children.  I began to “believe” that there really was another way to treat Post Traumatic Stress Disorder besides being quizzed about how bad your father treated you and then prescribed “killer” drugs.  The quality of the web site and the professionalism of it made me believe that this “Company” had a huge staff of Doctors, technical staff and alternative modality practitioners.   They most probably would not even be interested in me.  Hesitantly, I contacted the individual listed on the contact page.  Beyond belief, she answered me.

I waited a while to answer back because I was embarrassed to have even made contact.  It was a “Don’t hang your dirty laundry out in public” sort of thing.  My life was so complicated and I had spent forty years trying to put it down in writing to find the magic answer to it.  I asked if she would be interested in reviewing my much self-edited draft and this lady said YES.  Wow I was excited and flabbergasted.  Maybe there was help coming that I could share with my family, my son in particular to let him know there was real HOPE.  And I could take this “hope” to the remaining Nam buddies who were still alive.  Most had committed suicide, at least fourteen, in the last twenty years.

Lily Casura took a sincere interest in my “story” and in my plight.  Her interest was genuine and not usury.  I knew that if what she said were true, then she needed to take this program to the rest of the mentally wounded souls still living from Vietnam, and to the Desert Storm and Iraq and Afghanistan warriors.  But I had been “screwed” by so many “too good to be true” schemes from religion to insurance that I wanted to be shown.  My challenge to her was: “If you can heal me, you can heal anyone”!  She accepted and our journey into absolute “HEALING” began.  The road was rocky as she got to actually experience the “ups and downs”, the “rages”, the inconsistencies of working with an actual Marine Corps combat vet.  It was a wild ride for both of us to say the least as I “spoofed” most of the treatments as something that a real “Marine” would never do; especially some of the “Yoga” exercises.

However, as I was moved through them one by one, I began to “feel” much differently and I began to “change”.  I felt physically better and mentally at peace.  Something I had not experienced in forty years.  I became a true “BELIEVER” and want to share it with the world.

What a difference a year makes? One year ago I was suicidal, physically dieing from multiple illnesses and immobile.  My heart has stopped eight times and had to be resuscitated.   My family was suffering from depression and my son was on the verge of killing himself.  I had no Hope, no future, no purpose and no reason to live.

One year later, I am disease free; my Rheumatoid Arthritis has been declared in complete remission, my heart has actually healed itself, my arteries are completely free of plaque, the acute pain that I have always had is no longer there, my anger is gone, my mind is at complete peace, my son is fine, my family is happy, I am thrilled at every day I am here, I have hope in a wonderful future for me, my family and my fellow vets.  I was taking over 58 prescribed medications one year ago; I am taking nine now.  I was taking huge doses of prescribed pain medications and ongoing treatments for the same.  I no longer have any pain, do not take any of the medications and no longer need the treatments.

The Difference One Year Makes: I was dead and now I’m alive!  That’s the Difference!

Thank you, Lily, for saving my life and for giving me HOPE and a FUTURE. I am, for the first time in my life, looking forward to the rest of my life, and can't wait to see the difference one more year will make.  

 

Patrick ______________.

Sgt., USMC

Bravo Co., 1^st Battalion, 9^th Marines

Vietnam 1966 and 1967

Week-long Clinical Training Program at the National Center for PTSD

Just back from the week-long and yes, truly fabulous, "clinical training program" at the National Center for PTSD, held on the campus of the VA in Menlo Park, CA. Here's a link to the program. It could not have been better.

We learned so much -- classes ran from 8:00 a.m. to 5:00 p.m. daily, and the stack of handouts, double-sided, ran to 14 lbs. of material. One of the best parts of the program, and there were so many, was the opportunity to observe the men's inpatient residential treatment program for PTSD. That was outstanding. It was hard not to want to follow those guys' progress through the rest of the 60-90 day program. They were working hard at getting better, and it was inspiring.

There'll be more to share about the experiences in the program and what we learned as time goes by, but for right now I just wanted to mention it. It was outstanding...