Healing Combat Trauma

Gone Fishin' -- with the Veteran Anglers of New York

Veteran Anglers of New York, Inc., according to its website, "is dedicated to the emotional and physical rehabilitation of disabled active duty military personnel and veterans through fly fishing, fly tying and outings."

They are sponsoring a trip to Eldred Preserve on October 17th, with fly-fishing casting practice sessions on October 12 and 26. Click here for more details.

While a fly-fishing outing certainly won't cure PTSD, it is likely to provide a convivial, relaxing break from the day-to-day worries and concerns of a combat veteran. Thanks to organizations like Veteran Anglers that sponsor trips like this for those who can benefit from them. Wonderful stuff. (Thanks, Merri, for the link!)

"The Hard Part Comes Later" - about PTSD, Grief and Letting Go

The Associated Press had a story on its wire tonight, called "Stream of horrific crimes takes toll on town cops," about the child murder in Tracy, CA. For our purposes, we're going to excerpt just a few lines from the story.  Because while we've talked before about the similarities in how police officers and combat veterans develop PTSD, here too is another similarity: how focus on the mission is paramount, and afterwards -- the grief sets in.

From the story:

"Police were especially stressed by the disappearance and murder last month
of 8-year-old Sandra Cantu. The department's sworn officers and staff pulled
2,966 hours of overtime on that case alone.

And tougher than the intense work is the lull that follows, when the mask of
professional composure comes down and doubts, sadness and anger come
through, said Tracy police chaplain Dan Higgins.

"When they're able to focus on their jobs and do their part, they have an
outlet," Higgins said. "The hard part comes later."

In other words, personal grief and coping with the horrors of the work (be it combat or in this case, police work) can be set aside effectively, sometimes, mostly, to get the job done.  The grief gets sublimated to or displaced by the job.  And that's effective -- as a coping mechanism -- only so long as it lasts.  Afterwards, when it's removed, the full feeling of the grief and the loss starts to creep back in, to the vacuum that's been created.

Again, from the story:

Detective Nate Cogburn worked 200 hours in two weeks in the search for Sandra and then for
her killer, the article said, adding:

"This meant little sleep, no breaks, a canceled second wedding
anniversary weekend in Napa with his cancer-stricken wife and less time with
his 10-year-old stepson.

[Even though police now have a suspect,] Cogburn remains haunted by the case.

"I feel nothing in terms of a sense of relief or solace. I feel nothing but
devastation. Nothing," he said. "It is a good thing that we've identified a
suspect ‹ a good thing for the investigation, for the D.A.'s office, for
being able to close this case, hopefully for the family. But emotionally
it's a vacuum."

Earlier I've written on this blog about a WWII combat veteran who only "noticed" his PTSD in his 80s, when he was finally retired. In other words, when work was no longer front and center in his life, and in the vacuum that removing his prior, sustaining focus on work created, the nightmares and the cold sweats from combat flooded back in.  Decades after his actual service.  This story was told to me by the local veterans service officer, who helped the man to realize that what he might be struggling with was PTSD, and to get some help.

We all know about how combat veterans can seek to numb their pain, whether successfully or unsuccessfully, and perhaps only for a time, with drugs and/or alcohol. We need to also realize how workaholism, Type A behavior, and focus on the job -- even though warranted -- can also be a way to "keep the demons at bay."  Unfortunately, when the focus changes, as it often will, in time, the vacuum that's been created when the main focus gets removed, can also exert a powerfully destructive pull on the individual.  Drugs, alcohol and work -- we can use them all as ways to keep PTSD at bay, however temporarily.  But ultimately, none will be completely successful, or produce thorough, functional results.  Always better to deal with the issues involved, however painful, and however incrementally we might need to do so.

The Good Work of Elmo: Sesame Street Special Supports Military Families

In celebration of April being "Military Family Month," the venerable public television institution Sesame Street rolled out a half-hour special called "Coming Home: Military Families Cope With Change," which they consider one of their most important efforts in a 40-year history.  The show features Queen Latifah,
who mentions on the show that she was raised by a Vietnam veteran with PTSD, who later got help; plus John Mayer and Elmo.

According to press material, "This half-hour special tells stories of service members who return home with injuries, visible and invisible, and explores the heroic struggles their families face in discovering a new way of finding a new normal. It salutes the extraordinary courage and strength of these military families and offers the general public a powerful glimpse into what they often must endure. The special will air on PBS on April 1, 2009 at 8PM (check local listings)." For more information about the program, click here.  To see videos about the behind the scenes making of the special, choose either one of the following links:Behind the Scenes, I and Behind the Scenes, II.

Kudos to Sesame Street for taking on this important issue, in such a positive and accessible way.

From a Combat Veteran Himself: A Suggested Guide for PTSD Veteran Charged with a Crime

The other day, we published, with the author's permission, Scott Lee's thoughts as a combat veteran and student of social work, on dissociative PTSD, criminality and the combat veteran.  Today we publish, also with his permission, the guide he wrote for combat veterans and their familiies, when a combat veteran with PTSD has run afoul of the law.  Scott isn't a lawyer, so this isn't legal advice.  But it is wise, compassionate, fellow veteran and fellow PTSD sufferer type advice.  Keep it handy to refer to; it's really, really good.  You can also look through the archives here for things previously written about legal issues and combat trauma.  (See topics like "legal issues," "legal justice," and "crime and punishment.")  Fortunately, in the several years since we started this blog -- at which point there were literally none -- some resources have sprung up in the legal community for helping combat veterans with PTSD to get legal advice for their situations.  There's also a good video by the Norfolk County, Massachusetts' DA's office, which we've blogged about earlier, here, that gives a good overview of the challenges returning veterans face in their communities, including with law enforcement.

 

 

Suggested Guide to Help Your Veteran or Soldier Diagnosed with PTSD, and Charged with a Crime

To whom it may concern,

I would suggest that you start researching about PTSD right away. The mind-body connection and interactions, the psychology of PTSD, defensive mechanisms, how the mind responds to trauma, the symptoms of PTSD, how extended combat (such as multiple tours served) effects soldiers and veterans, legal ramifications of criminal behavior and PTSD, the processes of the psychic split from reality and past combat experiences, how anxiety plays an everyday part of our lives, how ordinary stress can lead to higher levels of stress and extreme responses and flashbacks, the nature of flashbacks, the nature of triggers and how they apply to PTSD, and the mental compartmentalization that happens to a PTSD survivor. This is by no means a comprehensive list, but should give you some kind of idea of where you might want to start.

 

Like it or not, this has consumed your life by no choice of your own, instead of letting that energy overwhelm you and feeling helpless, turn that energy into a useful endeavor and focus it toward finding out as much as possible about PTSD and the effects of combat. You have more passion about this subject than anyone, use this as an opportunity to help your loved one get a fair trial and to force the courts to consider his/her mental illness as a contributing factor in their actions.

 

Do not take no for an answer from his/her lawyer as to your wanting to get involved in your significant others case, jump into his/her pocket and become the "paralegal" and find them the information that needed for fair consideration of the case. Most lawyers will resist this from you, again do not take no for an answer. I am guessing that the lawyer will probably be a public defender; they are overloaded with cases and cannot really give the appropriate attention that their caseload needs. So, you need to assume that role of "defender" and information detective, this can greatly impact the outcome of the trial.

Consider trying to find a high profile lawyer who will take the case on pro bono; this type of case has become a hot topic in the news and media. A lawyer might take a case for this reason and could benefit the outcome. Go to the clerk’s office and get a copy of the court case file, this will help you by becoming familiar with the states perspective on the case and what exactly is being done. Educate yourself in Miranda rights (If they violated his rights here, this could have a considerable impact on the outcome), federal constitutional law concerning 1st, 4th (emphasis here), 5th, 6th and 8th amendments, along with state constitutional law. Educate yourself on how the court works, the proceedings, when and where evidence can be brought, the questioning of witnesses and how that process is different in every aspect of the trial.

Educate yourself on case law concerning PTSD and other mental illnesses where a consideration or precedent has been set, this can be used in your case and can greatly influence what happens. Look into your state laws first as they will have the most sway, because state law guides state cases first, then look to federal law to find precedents and findings where PTSD was considered in the sentencing phase. Concentrate on first on the main trial part where the evidence and witnesses will be displayed then on the sentencing. Both of these parts of the overall court proceedings will be the most important part, your soldier or veteran’s fate will be decided between these two proceedings.

 

Educate yourself on and things to do:  

• Do not talk with the police or anyone else until you have talked with your lawyer, what you say will be used against you

• learn your rights and assert them, you do not have any rights if you do not know your rights

• get a copy of court case file

• get a copy of VA file and military file

• jump in your lawyers pocket

• try to find a pro bono lawyer

• individual rights, Miranda and if they were violated

• legal proceedings, structure of court formalities and rules of law

• psychology of PTSD

• case law, state and federal, concentrating on the main trial and sentencing process

• constitutional law

• legal responsibilities of the judge, your lawyer and the prosecutor

• find a support group

• contact your senator, congressperson

• contact your local VFW, AMVETS, or veterans associations

 

I know that this seems like too much, just figure out what is coming next and then concentrate your efforts into that. Take one court proceeding at a time and concentrate on the legalities of that part of the process and use it as a guide to where you need to research and what you should do. The structure of the next proceedings will be your sign post for the direction you need to concentrate on. You can do this, if you accept that you have been put on this earth for this.

 

You were born to do this; this may be your purpose in life, to be the freedom fighter for all veterans and soldiers who will face similar tribulations. You have more vested in this than anyone else, you have more to lose, do not stand by and be a spectator. Get involved and later you will not have the guilt of "I wish I had done something". A most important issue to face would be finding a support group that you feel safe with and trust. You cannot do this alone, enlist the help of as many people that you can. Contact your congressperson, senator and your local VFW, AMVETS, DAV or American Legion. This is only a suggestion for what to do. I have compiled this list and information as a suggested guide for personal empowerment.

  

Thank you for listening and God bless,

 

Scott Lee

 

Editor's note: Scott Lee has an excellent blog, PTSD: A Soldier's Perspective, linked here, where he talks about his own experiences as a Gulf War combat veteran with PTSD, and his reflections as a student of social work, attempting to learn what he needs to learn, in order to help other combat veterans with their suffering.  Go, Scott!

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.

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.

Marching for Suicide Awareness and Prevention among Veterans at Army's Fort Drum

NPR on its Weekend Edition has a good story today about a march held on Sept. 12th at the Army's Fort Drum in upstate New York, to highlight veteran suicide.  The article says that Penny Pierce, who works at Fort Drum, organized the march, in part because the taboo surrounding suicide makes soldiers vulnerable (to not asking for or getting the help that they need.) The article is linked here. Great work, Penny! (And NPR.)

Helping Military Families Cope and Heal from Stressors of Deployment and Combat

(From a press release)

Helping Military Families Help Themselves

For a civilian, it’s hard to fathom the stress a military family faces when a parent or spouse is sent to combat zones. Long and often multiple wartime deployments take a toll not only on the service member on the front lines but on family members back at home. According to recent figures released by the RAND Corporation, one in five veterans of the Iraq and Afghanistan wars may suffer from psychological health problems, which can add the strain on military family members.

Now, a program initiated at the University of California, Los Angeles (UCLA) and supported by the U.S. Navy’s Bureau of Medicine and Surgery is reaching out to military families to help prevent the personal and family problems such stress can bring. Project FOCUS (Families OverComing Under Stress) is now being rolled out to nine military bases across the nation and in Okinawa, Japan.

“There is increasing awareness that military families, especially the children, can be significantly affected when a parent is deployed, and there is even greater psychological wear and tear when there are multiple deployments,” says Patricia Lester, MD, an assistant professor of child and adolescent psychiatry at UCLA and the director of the FOCUS program. “The spouse left behind is suddenly thrust into the role of being a single parent; routines are interrupted; the children may not understand where their mom or dad has gone; and the service member on the front lines is constantly worried about how their family is doing back home.”

The FOCUS program provides parents and children with customized training that will address the impact of wartime deployment on families and helps them learn very specific communication and problem-solving skills to address these challenges. In addition, FOCUS trainers will provide outreach to groups within military communities to raise awareness about the kinds of pressures families face and to let them know help is available to cope with deployment.

“We build resiliency,” Lester says. “It’s a three-pronged approach to restore a psychological balance to the family, promote future resiliency, and increase knowledge and understanding among the military family culture.”

Families meet with counselors in multiple sessions. Some of the sessions are only with the parents, some are only with the children, and the rest are family sessions. Each session focuses on helping family members identify and share their concerns and fears about a spouse or parent being deployed to a war zone. In separate sessions with parents and children, FOCUS trainers teach them skills to help manage their emotions, solve problems within the family, set goals, and communicate with one another.

“If there are five family members, there’s a good chance that there are five different stories of what that most recent deployment experience was like,” Lester says. “Family members often don’t want to ‘burden’ each other with their personal problems, but in these exceptional circumstances of long-term separations, building a shared family narrative can be very helpful in reestablishing a close family identity and building its strength.”

— Source: University of California, Los Angeles, Health Sciences

The Vietnam Veteran as Exile: Missing in America, But Hidden in Plain Sight

My friend the veteran artist John Paul Hornbeck made this flag -- I just love it.  It carries forward the whole issue of POW/MIA into the present day, by asking in effect why the veteran is "still" Missing in America (that's the "MIA" part these days.)  He mocked up this flag, using the old and familiar symbol, to highlight the cause of homeless veterans in America -- a cause worth addressing.

I'm broadening the point, though, to something else:

Why ARE Vietnam veterans, in particular, still exiles in their own land?

And what should we, as a country, be doing about that?

Because failing to address that, failing to welcome back these warriors into their own land, perpetuating their exile both from what they've seen/done/experienced and how they were received when they returned -- has left a gigantic, gaping gash in the "fabric" of the American psyche; and decades worth of not addressing it has not resulted in any pain being healed.  Sure there are sporadic attempts made here and there, but they're relatively weak, lackluster, or involve too few people to really make a difference.

If you read Pat's "Welcome Home" story, or Claude Anshin Thomas', just to use the names of two representative Vietnam vets among thousands -- you find out that they are STRIKINGLY similar, almost verbatim copies of each other (and the rest who haven't written them, I suppose).  The hopes, the dreams, the flat-out fantasies (under the circumstances) of how they were to be received -- combined with the completely dashed, rejected and really shattered realities of how they were -- aie, the mind boggles.  It's surprising the whole generation of warriors didn't go postal, not just a few.  It also explains why so many of them are still living in pain to this day.  Turned into exiles by what they lived, that they had no possible means of integrating -- and shunned by the country they fought for.  If that woudn't give you issues, I'm not sure what would.

---

So let's think outside the box on this, FAR outside the box.  (If the box is the status quo, that is, because that's not particularly impressive.)  What prevents us from giving veterans, in every city across America, down EVERY Main Street -- a true, genuine, and long-overdue "WELCOME HOME"?!

Couldn't we use that psychic energy we'd gain back as a nation -- from repairing the rent in our actual psyche -- to surge forward, and embrace our combat veterans from here on out, with all the services and the help they so desperately need?  We've seen the problem: it's been well-documented.  But even to go forward successfully, in this case, I think we also need to go backwards -- make use of the "invisible bridge" -- and welcome the group of veterans who are STILL waiting, 40 years out, for America to acknowledge their return.

---

I learned a long time ago, that even in personal relationships, there's a big difference between the crappy/weak/self-serving apology -- "sorry IF I hurt your feelings" -- and an actual, gut-level, authentic and genuine apology, that takes responsibility, asks for forgiveness from the injured party, waits for the answer, or renegotiates the situation -- and then moves on, healed.  In the Bible, that's even called the difference between "worldly sorrow" (sorry I got caught) and "godly sorrow" (sorry that I did it, because I know it was wrong).  Without making a point about religion here, I'm merely trying to show that many traditions understand there's a difference between a heartfelt apology, a lame one, and none at all.  It's like the Oliver Wendell Holmes line from a few blog posts back, that "even a dog knows the difference between being kicked, and being tripped over."

---

Let's harness or leverage the momentum from the current groundswell of public "enthusiasm" for veterans' rights, exemplified by support for passage of the new GI bill, and the continuing emphasis on not settling for less in healthcare, particularly PTSD and TBI.  Let's expand that, though, to other issues of concern to veterans, before the "mood" passes -- as it surely will -- to be eclipsed by other different, pressing concerns.  Let's settle our largely unspoken national shame with how we treated Vietnam veterans, while a few of them are still alive to appreciate that our apology is genuine, and acceptance would heal us all to be able to move forward.  What we don't want to do is to create two different classes of veterans: the ones we care about, who get the right treatments for the right reasons; and the ones we don't, because we frankly made such a mess of it it's just easier to overlook it than apologize and move on.  It's time to make things right for ALL veterans.  Let's have those Welcome Home parades NOW...

Editor's note: John Paul Hornbeck is the artist (and veteran) who made "Shattered Soldier," the lifesize scultpture of a veteran with PTSD, that we blogged about earlier, here.  He is the child of an American Vietnam war veteran Army father, and a Vietnamese mother.