Healing Combat Trauma

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

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

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

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

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

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

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

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

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

Veterans Helping Other Veterans

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

                                                                     

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

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

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

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

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

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

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

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

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

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

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

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

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

Who Bears the Burden of Care Most?

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

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

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

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

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

Good Book about Vet Healing from PTSD

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

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

Good Video about PTSD and Re-Adjustment

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

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

Going to the Wall -- the Vietnam Wall

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

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

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

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

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

Veterans, PTSD and Homelessness: One Man's Story

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

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

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

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

Today's Vets Owe Debt of Thanks to Vietnam Vets

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

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

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

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

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

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

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

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

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

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

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

Writes Hanifen:

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

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

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

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

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

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

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

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

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

How Do Veterans Want Us to Listen to Them?

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

Good Compassion and Bad Compassion - Worry

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

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

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

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

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

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

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

John Powers - Student Advocate for Veterans

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

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

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

Minnesota Leads Way in Treating Vets Right

Minnesota seems to be doing some very good things for returning veterans, in terms of raising the bar for the standard of care.  NPR had a story yestoday on "All Things Considered," called "National Guard Works to Ease Soldiers' Return" (in Minnesota).  Click here for the link to read or listen.

What makes Minnesota's approach significant?  As the NPR blurb says, "Minnesota's National Guard is taking some extraordinary steps to help troops returning from Iraq readjust to life at home." 

On this blog, we covered a number of stories about the Minnesota National Guard and its efforts to help troops readjust and cope with transition back to civilian life, all located in the archives from March of 2006.  They were: "Vets Encounter Emotional Rollercoaster Upon Returning from War;" "Straight Talk for the Long Road Home;" "Padding the Canoe Without Tipping It;" "Transition Time from Warrior to Citizen;" as well as a story on Combat Trauma on NPR, from the Diane Rehm show.  Many of these items quote from Chaplain John Morris of the Minnesota National Guard, or in the case of the ABC news story or the DIane Rehm show, have him on as a guest.

Wounded Warriors - Lost in a Maze of Care

Social Work Today -- "the Nation's Leading Newsmagazine for Social Workers" -- has an excellent story in its current issue called "Wounded Warriors: Lost in a Labyrinth of Care," by Richard Currey.  The article is online; click here for the link.  It's apparently part two of a three part series, and the article in the current issue examines "the psychological impact of being tanged in an administrative maze of healthcare for veterans with PTSD."  Undoubtedly, the maze of paperwork and arcane bureaucracy vets encounter while gravely ill can't make for a pleasant experience -- and stress obviously makes the suffering from trauma worse.  Not a good situation for the vets or those who care for and with them.

In related news, Ilona Meagher on her blog, "PTSD Combat: Winning the Battle Within," reports that the VA has moved to dismiss a class action lawsuit against it by some veterans rights groups -- arguing, in effect, among other things, that the vets need to plead their cases individually.  Click here for that link.  Speaking of stress...

Honoring the Severely Injured - Body, Mind & Spirit

One group deserving of special attention in this war is the severely injured, whether in body, mind or spirit.  We saw the powerful stories of a handful of injured veterans in the fabulous recent HBO documentary, "Alive Day Memories: Home from Iraq."  But others are also telling their stories.  A photographer named Nina Berman first began photographing injured vets when she felt that no one else seemed to be.  Her photographic exhibitions are linked here; her book, "Purple Hearts: Back from Iraq," published in 2004, is listed in sidebar.  Wounded warriors, captured in art by USMC combat artist, Michael Fay, are shown here on his blog.  Those of us who have followed some of the combat veterans stories "as they unfolded" on their blogs on CaringBridge hold a special place in our heart for those we've seen recover before our very eyes.  (Travis, Neil, Tony, Corey, Joey and others.) The road ahead is long, but their courage is palpable, and deserves to be justly celebrated.  Remember: while over 3,500 military have died, over 27,000 have been injured, and will need to be re-integrated with family, friends and loved ones, employers, schools and communities as they heal.

Soldier's Post-Combat Snap Ends in Suicide

The Louisville, KY paper, the Courier-Journal, ran a very troubling profile in yesterday's paper about the suicide of combat veteran Army Spc. Derek Henderson, who had been struggling with PTSD.  He killed himself by jumping off a bridge, as bystanders pleaded with him to reconsider.  (In a side note, the bystanders are now indirect victims of his combat trauma, too.).  The profile of Derek Henderson's life after combat is dark and frightening: he was in and out of the mental health care system, behaving violently, really unable to get a grip on what was going on inside him, and turning to his faith (e.g., reading his Bible more) as one way among many to try to cope.  Ultimately, the forces inside Henderson were much bigger than he could contain, and he took his own life, after several fairly violent run-ins with family members, one of whom, his mom, tried to have him institutionalized briefly. 

As wrenching as Henderson's story is, especially ending as it does with his death, it also brings up some difficult questions.  With someone who was battling potentially the dual demons of PTSD and psychosis, what else can or should "society" be doing to help cases like this?  It doesn't sound like Henderson was mentally ill before serving tours of duty; but it definitely sounds like he became mentally ill afterwards.  As the VA and other agencies struggle to get a grip on the volume and severity of cases of PTSD, one wonders -- what else can or should be done?  Should recruits be tested for mental health and propensity for mental illness beforehand -- can this even be done?  Are the tests out there and are they at all predictive?  And are we as a society prepared, even from a practical, "are there enough beds?" perspective -- to actually institutionalize people who are violent to themselves and others, if PTSD gets bad enough? 

We've heard and read so many stories over the last several years of veterans who aren't able to get seen for PTSD soon enough or often enough after returning home, some of whom have taken their own lives in the delay -- but what of those returning veterans like Henderson who really aren't able to function adequately in society.  As hard a question as it is to ask, are we prepared, practically speaking, to institutionalize an increasing number of people?  Will mental institutions "enjoy" the building boom that prisons did recently, because of the increase in population needing to be housed?  It certainly seems like today's trend has been to de-institutionalize the mentally ill.  If combat creates PTSD severe enough that it ends up in psychosis, do we have a Plan B at all?  The Henderson story is frankly depressing on that front: it brings up very real concerns about those who are really at the fringes, sadly, of even being able to be helped.

John Powers - Whoever He Is, Rocks!

There's an article cited today on the consistently excellent IAVA blog that's well worth reading -- and celebrating! -- about one John Powers, 23 years old, formerly of Cumberland, RI, a non-veteran/private citizen, who created what sounds like an extraordinarily helpful, and exhaustive veteran's resource guide, as a testament to a veteran friend in need.  Woo hoo!  Here's a link to the Veterans Task Force in Rhode Island, but it's strangely silent about the guide, although ideally in the future there will be more info forthcoming from them on it.  My sense is everyone is gonna want one of these!

Powers' fantastic, selfless work brings to mind the alleged Abraham Lincoln quote, to wit: "Honor...to the citizen who cares for his brother in the field, and serves, as best he can, the same cause." To that we might add, the brother or sister in the field, or returned home from same.

It's as good a time as any, then, to mention some of the other do-gooding efforts by other individuals and organizations on behalf of veterans, some of which have gotten less fanfare than others.  They include: Homes for Our Troops -- building and remodeling specially adapted homes for the most severely wounded of our veterans, like triple-amputee Joey Bozik and his wife, Jayme, who consistently blogged about his recovery; Helmets to Hardhats -- finding construction jobs for returning veterans; the Wounded Warrior Project -- providing disabled sports opportunities for veterans; Quilts for Soldiers -- quilted comfort for veterans and their families; Sew Much Comfort -- volunteers sewing adaptive clothing for injured, hospitalized and rehabilitating troops; and the adorable Jessica Porter's project, begun as a teenager, Operation Homefront Quilts (see also this link) -- a way to make sure every returning veteran's service is honored.  There's also the Minnesota organization, CaringBridge, which provides informational websites free of charge to injured vets (among others) and their families, to keep people posted on their conditions.  And in case all this do-gooding is too hard on the eyes, there's the fundraising calendar of Freedom is Not Free -- featuring the hunkadelic, practically NSFW cover pic of Rudy Reyes, formerly seen with a few more clothes on, in Nate Fick's fantastic book, "One Bullet Away: the Making of a Marine Officer" (see sidebar).

PTSD Among Caregivers

We saw from the recent posts about Dr. Gene Bolles' time at Landstuhl Regional Medical Center in Germany (see previous blog entries) that combat trauma can affect caregivers deeply as well, including experienced medical personnel responsible for the care of injured troops.  A recent story in the Tacoma, WA News Tribune tells how one combat nurse was so affected by her work in a battlefield hospital in Iraq that she herself attempted suicide.  Thankfully, she survived the attempt and is today recuperating and attempting to piece her life back together, including by writing about her experiences.  But it's a sobering tale indeed of the tremendous price paid by those who care for the wounded as well.  Functioning in a combat zone, working incredibly long shifts with little time off, and handling a literal avalanche of horrific injuries day after day, it's not surprising that this work would affect the caregivers deeply.  Read this story of a heroic nurse's reunion with one of her severely injured patients, giving hope to them both.

Paddling the Canoe Without Tipping It

The inimitable Chaplain John Morris, quoted in the equally inimitable Pine Journal of Cloquet, Minnesota, as it wraps up its four part series on returning veterans, called "The Long Road Home," had these highly quotable things to say, in an article published today:

“Going into combat is a little like canoeing across the lake of life,” said Morris.  “When you leave for war, it’s like standing up in the canoe and upsetting the balance of family life.   While you’re gone, your family takes over the paddling, but when you return,  you’re likely to jump out of that canoe and flip it, swamping it.  Many families have been faced with bailing out that canoe, and they suffer extreme duress over something they thought would be joyful.  A lot of families can become exhausted from paddling that canoe through life.”

"He encouraged returning soldiers to seek whatever help they need so they can make a successful adjustment back into the life of the community.  And if the community is committed to helping them, he said, that period of readjustment faces a much greater chance of success."

The article also concluded that it was wiser for "anyone seeking advice and direction ... to contact any of these resources rather than to try to “tough it out” on their own. (The resources are very Minnesota-specific, but the concept is good overall).  Kudos to the Pine Journal on a truly excellent, yet homespun series of practical, well-written articles, that should be a guide for other papers nationally to do the same.

Transition Time from Warrior to Citizen

Here's a link to the second part in the series, "The Long Road Home," from the Cloquet, Minnesota Pine Journal about integrating veterans successfully back into their communities.  What a truly excellent series.  More on this later.  Looks like Minnesota is setting the pace in compassionate treatment of returning vets.  Another article in the paper details the "Sponsor a Soldier" campaign for returning vets.  According to the paper, "This year, area residents have a chance to thank the soldiers personally with a $100 “Sponsor a Soldier” donation, which will offset the cost of dinner for a soldier and a guest, and hotel room for the night.  “They really need this, it’ll be a great night for them,” said Sergeant Jesse Sigurdsen of the Cloquet Army National Guard."

Just amazing.

Straight Talk for the Long Road Home

The Pine Journal, from Cloquet, Minnesota, continues its excellent series on healing from combat trauma with another installment in today's paper, called "The Long Road Home: Community Can Provide Key Support."  As the article points out, Minnesota is doing some progressive work in re-integrating combat veterans by making their adjustment a priority.  At a recent meeting, community service providers and others got some extremely straight talk from a return chaplain and National Guard veteran, John Morris.

A few quotes from Morris:

To law enforcement:  “Don’t lie to me when I get in trouble,” he stated. “Don’t tell me it will be all right. And don’t talk down to me. Instead, we need to work through things together. You might be able to identify me as a combat vet because chances are, I am going to talk tersely. If that is the case, call me by my last name [as they do in the military] and that will help diffuse the situation.  “I need clear and defined guidance from you."

To security guards, in local casinos:  “When you approach me from behind,” he said, “announce yourself, and then tell me what you are going to do.”

To social service providers: “Don’t feel you have to ‘fix’ us. You don’t have to handle our problems alone. You already have training in dealing with trauma, so try to treat us with respect no matter what we may be going through and validate what we perceive ‘normal’ people should be like.”

To local religious leaders: “If you tracked with my family while I was gone, I will give the church a great deal of respect. If not, you will not see me again. Also, before announcing my return in church, ask me first if I’m feeling confident enough to deal with it. Otherwise, let me keep a low profile. Create a safe place for me and offer me hope of forgiveness, and please don’t talk about the politics of war.”

To employers: “Remember we are severely handicapped by what we’ve missed while we were gone,” he said, “and help us pole vault that 18 months.”

And to bartenders, he said, “Be sympathetic when you hear my story, but don’t buy me another drink. Instead, start slowing me down. What I really need is a ride home.”

WOW.  This is a man, and a newspaper, we'd enjoy hearing a lot more from.

Vets Encounter Emotional Rollercoaster Upon Returning from War

ABC News has a great story today about the National Guard in Cloquet, Minnesota, and the efforts there to make sure that returning veterans are as acclimated and supported as can be, in their transition back to civilian life.  Seems that the effort is spearheaded by leaders intent on seeing that these veterans are as "set up for success" as they can be, and don't experience anything like the reception that met veterans returning from Vietnam.  The article is called "Soldiers Describe 'Emotional Roller Coaster' Upon Return From War," and tellingly subtitled, "Psychological Toll on Battle-Hardened Vets Complicates Switch to Civilian Life."  It's well worth reading, so try the link here while it lasts.

Some of the better comments in the article would be these:

Maj. Gen. Larry Shellito is the father of the program, which works hard to address the emotional toll of returning from a war zone but also covers how to obtain federal benefits.

"We owe them," he said of the Guardsmen. "This country owes them to make sure that we can give them that box of tools to help them reintegrate and be successful." Leaving soldiers to their own devices for the first three months of their return, he believes, courts disaster.

"The ones that we just turn loose on society to fend for themselves," said Shellito, "those are the ones that I'm worried about because I don't know what support mechanisms they have."

Also,

"I don't know that the public understands," [a vet] said in an interview during a break in his presentation. "How can they? And I don't know that they want to know." ... Referring to the public, Morris said, "They don't understand that for most of us, the war is just starting [when we return]."

Similarly,

"If we do a good job reintegrating our combat vets and helping their families," Morris said in an interview, "we're going to have a tremendous citizen here.

"But if we don't. If we repeat what we did in Vietnam and shun or, at worst, shame these veterans, we're going to drive people underground. They're going to manifest terrible problems."

Bruce Ahlgren, the mayor of Cloquet, attended the community briefing a few days ago and said it was an eye-opener.

"We just kind of think they come back and they're in a comfort zone again and everything's hunky-dory." That's clearly not the case, Ahlgren acknowledged. And the words of Chaplain Morris still rang in his ears.

"Please be respectful and welcome us and show hospitality," he told the Cloquet city leaders, "until we get our feet on the ground."

Native Americans Address Healing Combat Trauma

Indian County Today, "the Nation's Leading American Indian News Source," has an article in today's paper about how "Navajo and Hopi veterans of northern Arizona will now receive the counseling, services and traditional ceremonies they may need to help them re-adjust to civilian life after the traumatic stress of combat or military service."

The article states that "The Post Traumatic Stress Disorder Treatment Expansion Program is being funded through a new three-year, $250,000 grant, which has been used to hire three counselors to provide PTSD treatment services to Navajo and northern Arizona veterans."

Interesting article about a great resource now available to Native Americans, many of whom have served in combat.

Community Can Play Role in Healing

The Cloquette, Minnesota Pine Journal had an article in Wednesday's paper about how the combat veteran's larger community can play a role in helping him or her to re-integrate into society.  This article is part one in a series; next week they'll have a follow-up article, Part Two of “The Long Road Home” will take a look at how soldiers are programmed to become warriors on the road to war – and the five critical challenges they face in coming home again. Future articles will address the symptoms of combat stress, the resources available to soldiers and their families, and specific guidelines regarding how the rest of the community can help out.  Good stuff, by Pine Journal reporter and publisher, Wendy Johnson!  Keep it coming... and let's hope this series gets picked up by bigger, national papers as well.

combat veterans to heal. 

Individuals Making a Difference

While this Congressional wife's personal efforts with returning veterans may not rise to the level of an official governmental response on the topic of healing combat trauma, it's heartwarming to see how one individual's efforts can still go far to make a difference.  Read more about this here, as long as the link stays active.

(Beverly Young, the wife of Rep. C.W. Bill Young of Indian Shores, Florida, breaks stereotypes aplenty and warmly encourages the returning wounded at hospitals in the Washington, D.C. area, while her husband (who often accompanies her on these trips), does Congressional business.)

This story is almost as cute as the one the Christian Science Monitor had recently about the crowd of geriatric Mainers who welcome returning vets with as much warmth as they can muster.  It's really pretty adorable.  Kinda makes you want to get up in the middle of the night and go greet a plane.  Read about it here, so long as the link lasts.