Healing Combat Trauma

PTSD Trauma for Veterans and Their Families is Predictable - "The Generic Effects of Combat"

In an article from Australia, there's a great quote about combat trauma/PTSD, and its very ordinariness.

(The article's topic is how "mental health problems caused by war service afflict veterans' families and children too.)  One of the premises of the article is that, based on a study, "Sons and daughters of Vietnam veterans are three times more likely to commit suicide than those of similar age in the general population (Australian Institute of Health and Welfare 2000, Suicide in Vietnam veterans' children: Supplementary report no.1).  According to the same report, "They are also more likely to die of accidental death, experience depression and abuse alcohol or other drugs."

That's the overall pretext for the article.  However, now comes the excellent quote, with a bit of preamble from the article itself, linked here:

According to Professor Hedley Peach, conducting research into veterans' sons and daughters is vital, not only to examine in detail the reasons behind their poor health but to set up support services that work for them.  He is also eager for doctors to consider war service when treating patients, as in many cases it could help diagnosis ....  Peach, a member of the scientific committee advising the Government on the feasibility study and professorial fellow at the University of Melbourne, says the Government should also consider studying grandchildren of Vietnam veterans to avoid more problems spiralling down through the generations.

''If the sons and daughters have got mental health problems and have young children themselves, what effect will that have on the grandchildren? We have to break the cycle.''

He suggests stressful familial environments could be behind the children's mental health problems, already highlighted by existing research. While many people with mental illness have a genetic predisposition to their condition, veterans were screened for mental illness before they went into the service, making stress a more likely factor in the children's ill health.

''In studies done by clinical psychologists running PTSD clinics for Vietnam veterans, children have reported a high level of dysfunction in families,'' he says. ''When we focused on Agent Orange so much in the past we missed the bigger picture. We are seeing the same sorts of problems in veterans of the Iraq and Gulf Wars, and fighters in World War II are now saying they suffered from the same problems. It is not due to any specific war, it is the generic effect of combat.''

Thanks to Kathie Costos for this reference...

Honor the Dead, but Fight Like Hell for the Living

A suitable slogan to commemorate this past Memorial Day, and not far different from the motto of the Australian Vietnam Veterans Association, "Honor the Dead, But Fight Like Hell for the Living."  If we're ever going to make signficant progress on treating PTSD as a combat injury, that's what we're going to have to do.  And not just for the living, either -- for the ones who died from what they couldn't endure any longer, as well.

Professor Hedley G. Peach (Australia)

BSc(Hons) (Wales), MBBCh (Wales) PhD(London), FFPH(UK)
University of Melbourne

(Retired) Professor, School of Public Health, Queensland University of Technology, Kelvin Grove, Queensland, AUSTRALIA.

Professor Hedley Peach is a Visiting Consultant at the Ballarat Base Hospital, and Professional Fellow at the University of Melbourne.

Professor Hedley Peach qualified as a doctor in Wales where he became interested in the social causes of illness. This interest led him to train in community medicine at the renowned St. Thomas's Hospital in London where he worked for seven years as a lecturer/senior lecturer. In 1985 he migrated to Australia where he was Foundation Professor of Tropical Health at James Cook University for three years and, subsequently, Professor of Community Medicine at Melbourne University for fourteen years. He retired earlier this year but continues as an honorary Professorial Fellow of Melbourne University. He has been interested in the nexus between religion, spirituality and health for a number of years. In 2002, he wrote the first article on this topic to appear in the Medical Journal of Australia to stimulate debate on how the medical profession should respond to research and recommendations from the USA. He has authored book chapters and papers on spirituality and women's health, the religions of rural Australians, and other topics. He has given many radio and newspaper interviews on spirituality and health. He is the author of several books, including The Epidemiology of Common Diseases and Disablement in the Community, as well as the leading author of more than 100 articles in scientific journals. He is a member of the National Heart Foundation's expert group on psychosocial causes of heart disease.

Words of Wisdom for Veterans from Down Under

The Vietnam Veterans Association of Australia -- whose excellent motto, "Honour Those Who Died, But Fight Like Hell for the Living," we strongly agree with -- is a good source of information on the Australian government studies on the health of Vietnam veterans and their families.  These are important studies for any number of reasons, but for our purposes, because they make the point that combat trauma affects not just the veteran but also his or her family, and transfers effects into the next generation.  Their extensive information about the original Australian study, first published in 1998, is linked here.  They comment: "The responses themselves tend to support the hypothesis that the health status of the veteran has an effect on the health status of his immediate family."

Here are some specifics: "36% of veterans report that service in Vietnam, or health problems arising as a consequence of their service in Vietnam, have had a serious adverse effect on current or past partners.  Some 40% report physical or psychological health problems in their partners that they feel may be related to the veterans' Vietnam service.  Stress (40%), anxiety (34%), and depression in partners are the most commonly cited conditions.  Thirty nine percent (39%) of all veterans with partners report that treatment has been required for these conditions.  Those with greater length of service in Vietnam report higher levels of problems."

Though they noted that "the report notes difficulties that may have affected the accuracy of reporting and the accuracy of the comparison data" regarding the children of veterans, they found that settling those difficulties and verifying the results was an urgent matter, because the study concluded that, besides physical consequences to veterans' children (e.g., birth defects, etc.), that "deaths from suicide of children were reported at three times the expected rate, and deaths from accident or other causes were reported at twice the expected rate."

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The Australian Broadcasting Corporation did a news segment on "The 7:30 Report" on June 1, 2006, about these studies, called "Veterans Fear War's Impact on New Generations."  The main reporter was Natasha Johnson, and a key interviewee was Melbourne University professor Hedley Peach, an Australian public health researcher, and adviser to their government's Department of Veterans Affairs, who had spent two years evaluating the study.  Professor Peach remarked, "there's absolutely no doubt that the effects of war [are] not going to be confined just to the person who went to war."  The Australian study showed "significant mental illness among veterans also showed their children had a high rate of accidental death and a suicide rate three times that of their peers in the general community."  The problem with studies, Peach pointed out, is if they serve to simply describe the problem accurately.  It's the government who should "develop strategies in the meantime to promote resilience and break the cycle of mental illness."  The interesting transcript of that short program is linked here.  One result of the studies is that the Australian government has made counseling services available to all veterans and their families. The U.S. House Veteran Affairs subcommittee on health is contemplating expanding veterans' mental health care to families as well.  Read more about the Australian counseling decision in the PDF linked here.