Healing Combat Trauma

Speaking of Catharsis: One Magnificent Quote

Catharsis:

The word comes from Greek katharsis, from kathairein, to purge, from katharos, pure. 

Among other definitions, "catharsis" means: "a purifying or figurative cleansing of the emotions, especially pity and fear..."; "a release of emotional tension, as after an overwhelming experience, that restores or refreshes the spirit;" and "a technique used to relieve tension and anxiety by bringing repressed feelings and fears to consciousness; also, "The therapeutic result of this process."

Catharsis is the unspoken theme, hope and dream for veterans on this blog, but periodically we make it more explicit, as we did here, in a blog entry about art therapy's surprisingly potential for purging combat trauma and PTSD in veterans.

At virtually the same moment I was posting this, friend and apparent psychic twin on all things veteran, Chris Lombardi, was posting this remarkable quote on her blog.  Lombardi is writing a book for the University of California Press on soldiers and dissent (watch for it), and here she is quoting Walter Kirn in the New York Times, reviewing The March, which Kirn called "E.L. Doctorow's heart-squeezing fictional account of Gen. William Tecumseh Sherman's fiery, rapacious last campaign through the cities and countryside of the Confederate South". 

The quote that Lombardi pulls from Kirn offers a stunning perspective on how great catharsis can really be, when veterans (and others) decide that "the only way out [of their suffering] is through":

The rampant destructiveness of Sherman’s march is, of course, the stuff of high school textbooks, but what isn’t so obvious is the way that destruction transfigures and transforms, pulverizing established human communities and forcing the victims to recombine in new ones. Inside the churning belly of Doctorow’s beast, individuals shed their old identities, ally themselves with former foes, develop unexpected romantic bonds and even seem to alter racially. Yes, war is hell, and “The March” affirms this truth, but it also says something that most war novels leave out: hell is not the end of the world. Indeed, it’s by learning to live in hell, and through it, that people renew the world. They have no choice.

From the blog post, "What We Write About When We Write About War,' by Chris Lombardi, at her blog, Incredible Panic Rules, linked here.

When the Marine Corps Misses the Bigger Picture -- Zoriah, Eric Acevedo, and Censorship

It's discouraging to even have to post about this, but there it is.

In a fight between the Marine Corps and freedom of the press, the Marine Corps seems like it wants the win.  According to Google Playfights (see gimmicky graphic illustrating this post) it already has.  (Learn more about Google Playfights elsewhere: it's not central to this post.)

Following the recently embedded independent photojournalist Zoriah's travails recently, on his blog, it seems he's being kicked out of Iraq, and risking being completely blacklisted, because of at least some higher up Marine Corps officers displeasure with images he posted.  Images that centrally could help America to really get a better grip on the true cost of war for its participants.  If you believe the experts (and the poets), no one comes back from war, unchanged.  Whether it's what you've done/seen/participated in or not been able to do/see/participate in, it exacts a tremendous psychic cost.  That doesn't mean we should stop fighting in them - just that we should be more aware of the actual costs.  For every combatant killed, so many more are injured, and will come home with injuries that in many cases will profoundly transform their lives, and that of their families, for decades to come.  It's a shame the Marine Corps doesn't really want to let us, Americans, wrap our brains around this concept more fully.  It would help make us better empathizers with the true cost of war to its participants.

I had my own experience with Marine Corps censorship, earlier, on this blog.  In an attempt to humanize the story of an apparent PTSD sufferer who'd killed his girlfriend, I dug through the Marine Corps (public) archives on their website, and found a little backstory about the Marine, Eric Acevedo, who'd been accused of the crime.  In and amongst the materials were some very key items: a photo that showed the human side of his grief and pain; and some material -- if you knew where to look -- that explained just what he'd been exposed to, in terms of combat trauma, while he was on the deployment that apparently harmed him the most.  It was a tragic tale, but it was public knowledge -- at least, information accessible by the public, that could be pieced together by someone like a journalist, who knows how to dig, and highlight the important parts of the story.  I posted what I found, in an entry linked here -- and within three days, the Marine Corps had taken pains to scrub ALL identifying information about this poor guy, Acevedo, from their site.  The photo was gone, the article about the memorial service he attended, for the multiple guys KIA from his battalion on the tour in question -- all gone.  I learned about this new development when a reporter from the Dallas Morning News contacted me and said that all my links were down (I'd included them in the original piece, so anyone could follow and see what my sources had been).  Together, we backtracked through the Marine Corps archives, and found NOTHING -- the site had been scrubbed clean of multiple mentions of the accused -- and has stayed that way, since then.

Nobody likes bad publicity, but really, there's so much more at stake than that.  When it comes to combat trauma and PTSD, the focus of this blog -- it's important as a society that we see, learn, and otherwise come to understand what veterans go through -- or we won't have the compassion that we need to, and we won't pull for them to get the services they deserve, otherwise.  We also need to see more clearly the link between instances of combat trauma, and ultimately developing PTSD.   Not so "no one else will join the military" -- not at all.  So that those who do can get the help they need, and those in charge will allocate their resources accordingly.

It's my firm conviction that combat veterans don't "give" PTSD to themselves.  They "get" it from what they've experienced.  And this is a true cost of war, for the Marine Corps and others to "count" in advance, so that the right opportunities for treatment and ideally recovery can be provided.  We can see from the late SSgt. Travis Twiggs' battle with PTSD -- or many others like him -- just how powerful, thorough, and deadly an opponent it really is.  What we're not seeing, unfortunately, from the Marine Corps -- in these two instances -- is a reasonable, big picture view on how the horrors of war are not something the American public needs to shy away from, but embrace.  And where the two may be linked up, as in the Eric Acevedo story, it's crucial that the Marine Corps not distance itself from its warriors, even when they're dented with significant wounds, visible and invisible. Sanitizing war?  Why bother... Actually supporting the troops who go? Oh, definitely.  If knowledge is power -- we need more, not less - in order to do so, more effectively.

In the Zoriah situation, it sounds like someone may have snapped under the strain and started a bad ball rolling with that -- created a polarized position that no one could retreat from, gracefully.  If that's the case, that's a real shame.  There's a much bigger picture here, and finding a workable compromise would be greatly important.  I remember reading one Marine officer's published dispatches from Iraq, which got progressively darker and unpleasantly snappier as his tour went on, to the point that it sounded like another person writing them.  I commented about this to someone who knew that Marine, who told me a little side story that explained a lot.  Things had been going well until that Marine's superior, to whom he was very close, was seriously injured and almost died, taking part in a humanitarian mission with the Iraqi government.  At that point, the junior officer hit a wall, got bitter, and got very angry with the Iraqis who could have done that, while the Americans were just trying to help.  What I had been picking up in the Marine officer's writing reflected the personal struggles he was genuinely going through -- struggles which are highly understandable to anyone interested in human nature.  My guess is here, someone who felt very stressed and angry because of Marines he cared about being injured and dying, snapped down on the whole situation instead of privately (or publicly) processing his natural grief -- and the ultimate impact might be, if this continues to go wrong, to keep the rest of us from being able to experience war a little bit more, even vicariously - in order that we better understand, and grieve, with those who suffer.  I hope the Marine Corps finds a way to resolve this situation that respects the points of view of all sides involved, including the American public, which does have a need to know.  The same goes for the Eric Acevedo situation, and scrubbing the information from their archives.

The American public pays the bill for these wars: we have a right to know what they're like for those fighting them.  And those who fight them pay the ultimate price: and we respect their efforts and the character it takes to be warriors, very much.

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I shared a very bleak, grim quote with a Marine Corps Vietnam vet the other day, from an Italian in the Middle Ages who said, "Life is a voyage on uncharted waters, ending in shipwreck.  There are no survivors."  The former Marine, still struggling all these years later with PTSD, said the quote was almost right, but would be better if we switched out "life" with "combat" or, "war."  Then, he said, it would be more accurate, because, quoting him, there are no true "survivors, only shipwrecked lives..."

Editor's Note: You can read about Zoriah's developing situation on his blog, linked here.  You can also read previous entries on this blog where we've mentioned him, here and here.  You can read about the Travis Twiggs story here, and in many other entries on this blog; and the Eric Acevedo story here; both as I've blogged about them. 

And while you're at it, considering asking the Marine Corps to put the Eric Acevedo material (and anyone else's they've removed, in similar circumstances) back on their publicly-searchable archives, as it was before.  I'm sure his defense lawyer would appreciate it, because any good defense of this client is going to need to advance theories that involve his extenuating circumstances (combat) and things that speak to his state of his mind (PTSD), both of which it's hard to picture were NOT service-related.  Acevedo's crime?  A  truly terrible one.  The combat trauma he experienced, and the PTSD he likely developed?  Also terrible.  Without war coverage like Zoriah's "tragic and amazing" photography, also a big picture we're likely to miss.

What the VA Needs Is "The Odwalla Effect"

[If this blog were a newspaper, which it isn't, this particular blog post would be an editorial -- found in the opinion section, separate from the rest of the paper.  The editorial section is where the editor "puts together" what the news means to him or her, and sets out a point of view, about what we should do or feel, think or believe about something, based on what else has been in the news lately, that they've been keeping people up to speed on.  It's the opinion section, essentially -- but from the editorial management's point of view.]

Here's ours:

Kathie Costos has a great series of posts over at her blog, linked here, but there's one in particular we'd like to talk about - and we'll leave you the link to it in a minute, so you can read it for yourself.  First, the discussion.  Kathie is conducting a question and answer session with Paul Sullivan, head of Veterans for Common Sense, clearing up "rumors" about the veterans' lawsuit against the VA.  Sullivan's answers are clear and to the point, and contain some fairly galvanizing statements, pro or con.

[I should insert the caveat here, in an effort to be balanced, that I DON'T believe the VA is "all bad," nor do I imagine Costos or Sullivan does.  Every once in a while you DO read about people who are extremely thankful and grateful for the care they're received through the VA - I read an item the other day where a veteran was reminding us that they have one of the best healthcare systems in the world.  True.  But that also brings up a question of which metric you're using, since while they are succeeding in some areas, they are clearly failing in others (and those are the areas which are making the news, frustrating veterans and families, and where they're being sued.)  Highly competent, concerned and caring individuals DO work for the VA -- many of the leading lights of care in the PTSD segment in particular have come from, or worked with, or still do work with, the VA.  People who are tremendously significant in the history of caring for veterans in an extremely high quality, enlightened, empathic way -- so people like that DO work for the VA, and always have.  Look through the "Experts" section on this blog, and see how many people have an affiliation with the VA, past or present: Ray Scurfield, Shad Meshad, Jonathan Shay, as well as others, all come to mind. (For the record, these people were probably "born" (wonderful) not "made" (wonderful) by their association with the VA as caregivers, but still -- they worked there and in some cases, still do.  And God knows, the VA heavily reads this website -- even at odd hours -- including very late at night, on weekends, on national holidays -- times when the rest of America is out grilling a hotdog with their family, throwing a ball in a park, or just snoozing the night away -- so clearly there are some very dedicated individuals there, trying to learn all they can in order to deliver better care to those who are suffering.  (Though they may also be reading to keep up with public opinion, to see which way the wind blows...)

I do sometimes wonder when I see what the VA is searching for, on this site, because it either seems kinda elementary (like they should know about it already), or a little "weak" in the efficacy of treatment department (like things that are waaaaaaaaaaay down the totem pole or triage pile of things to actually try with a demographic of patients who are suffering greatly). To give you an idea of what I'm talking about, frequent searches -- and the topics change regularly -- by the VA include such things as "spirituality for PTSD," "does recreation help?" and things like that, where, really, yes, even if they do -- they're only adjuncts and pretty far down the list at that, compared to more likely things that seem worth trying or are known to have some benefit.  But maybe I should just be patient, and it's more a case of "if you build it, they will come."  Maybe there's a huge lag time afoot, where if the information is laid out there, eventually the searches will catch up -- on the VA's part, that is.]

(Huge digression -- but the point is, the VA's not all bad, and that's NOT the point of suggesting they change, which it certainly seems like they should.)

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Deep in the Q&A between Costos and Sullivan is this exchange, with the comment of importance highlighted:

Do you know about the Freedom of Information request to the VA by CREW and VoteVets?(Which we blogged about earlier here, by the way.)

Yes. It is too bad that VA still plays games with FOIA. VA should be forced to turn over the information. Embarrassing information is never a reason to deny a FOIA, as VA frequently does.

Alrighty now.  That was the warmup (the foregoing).  Here's the pitch:

If the VA wants to control the flow of embarrassing information about it -- such as the Katz and Perez emails have provided us with -- there's one extremely simple way to do it.  It's NOT hiring a PR firm that specializes in crisis management and controlling the spin.  That's morally and ethically disgusting -- when contrasted with the concept of just changing -- and, it's ridiculously expensive -- a true waste of money that could be better spent on taking care of veterans and their families, with the needs the VA already knows about. And by promoting good works, like those of combat veteran Jay White, at the VA Center in Hartford, Connecticut, which we blogged about here.  Those ALSO make the news and contribute to public opinion, though everyone knows, and it's unfortunate that it's true, bad news travels first.  (And bad news here is definitely the Katz and the Perez emails, and the lack of putting patients first they describe, not to mention the rash of veterans suicides, etc.) Denying patients adequate care?  There's just no way to put a positive enough spin on that.  And the extent of the media coverage has been such, yup, we pretty much all know about it by now, if we even remotely care to.  Game over.  What needs to happen next is what happened with the Odwalla juice company -- what the VA desperately needs is the Odwalla effect.

Years ago, Odwalla was a new company with a great product: fresh juice, delivered nationally.  I knew someone whose three college friends had started it, and because of that, I guess I paid attention to what it was, and when I had the chance, tried the juice.  It was great, and for a while, everybody I saw who wasn't carrying some bottled water, seemed to be carrying a container of their juice.  They had, and still have, a number of blended juices, as well as the straight-up orange and apple.  And they had a novel, and in hindsight quite unwise, approach.  Their juice was unpasteurized, which they felt was needed to keep the juice as fresh-tasting and delicious as possible, but which also carried some known health risks, because pasteurization kills bacteria.  Children (particularly babies) and the elderly, as well as a few other groups (those recovering from illness and surgery, etc.) have weaker immunities -- in other words, are more susceptible to bacteria.  And I don't remember that Odwalla plastered their juice labels with big warnings about: "Warning! Our lack of pasteurization makes this juice likely unsafe for children and the elderly!".  They probably just made their juice, concentrated on getting it to market, and hoped people toasted each other with its deliciousness.  But over time, the inevitable happened: a few people who tasted their fresh, delicious (and unpasteurized) juices got sick - and, horribly - died.  And some of the affected were children, which the American public finds of course especially heartbreaking, and worthy of media attention.

In an instant, it seemed -- everyone turned on Odwalla, the juice and the company.  It went from being a media darling, to an object of abhorrence and fear.  How could they have let their juice kill people -- young children, even?  Horrifying...  Based on the immediate and complete backlash in the press and public opinion, I easily imagined Odwalla going under, and my friend's three college friends being put of work, and skulking away in public disgrace.

What happened next was amazing, though: and it shows you the power of good, and of doing the right thing.  (There's a conflicting story on the Web, but if you read the date on it, it's from 1999, which is ridiculously old news -- before the Odwalla success story of managing its PR happened, and before the company was later sold to Coca Cola - another evidence of its success. Plus, the guy who wrote it is by no means is a PR specialist, nor does he even seem to understand how PR works. I did work in PR, though I'm no expert on crisis management - I do get how it works.)  Odwalla didn't go bankrupt, didn't go out of business, didn't leave the marketplace in shame and disgrace.  What DID they do?  Simple as could be, and oh so powerful:

They accepted responsibility.  They apologized and paid the families' bills.  And they changed their process, so more people wouldn't be hurt by it.  They were wrong; they admitted it; they did what it took to make it right; and they changed.

In other words -- EXACTLY what the VA needs to do.

By now, we all know what the problems are, if we've cared at all to listen and learn.  They're kinda obvious.  And no amount of re-spinning the truth is going to make the problem go away.  All the media attention and lawsuit has done is show us the gaps in the system, the problems with care.  And because most caring, compassionate, fair-minded Americans care MORE about their veterans - we "get" the price they've paid -- than we do about hearing excuses and spin -- there's only one real solution here.  Admit the problem(s), apologize to those you've affected (veterans, their families, and the rest of us, who while less directly involved, are nevertheless put off by what we've learned), and fix the process.  Let tomorrow be vastly different from today, because you're starting to work -- really work -- on the problem, now.  The problem that we -- you, me, veterans, their families, the media, Veterans for Common Sense, the IAVA, the Disability Rights Project, Paul Sullivan, Kathie Costos -- all know exists.

Lack of pasteurization, denying veterans care -- and, if you'll allow me -- O.J. Simpson have all have been linked to killing people.  But in a contest between two kinds of OJ -- Odwalla and Simpson -- please, VA, we beg of you: show yourselves to be more like Odwalla, and less like Simpson. Fess up, come clean, do what's right by veterans and their families, make it right.  Now more than ever, what the VA seriously needs to re-create good public opinion is not denial, spin and blocking legitimate FOIA requests, in case something embarrassing gets revealed -- it's a simple thing called "the Odwalla Effect."  Also known as, doing the right thing, for the right reason, makes public opinion bounce right back.

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Editor's note: Kathie Costos' Q&A with Paul Sullivan of Veterans for Common Sense about the veterans' lawsuit is linked here. Kathie Costos' blog, "Wounded Times," is linked here. Veterans for Common Sense is linked here.

Happy Birthday - We're Two!

Happy Birthday to us  - we're two years old!  This blog was started back in February, 2006, with this post, and almost 300 posts later, we're still here, alive 'n kickin'.  That's almost a post every other day.  We've managed to cover a lot of topics, even win a nice award in the process, and be read by people all over the world, including frequent visitors from colleges and universities, the Dept. of Veterans Affairs, the DOD, the Pentagon, the U.S. House of Representatives, the Senate, various major media outlets, including ABC, CBS and NBC, even lately some movie studios.  (Although they're probably looking for references to Rudy Reyes...)  In fact, our readership has increased more than tenfold, just in the last year alone.  And in the first two months of this year, we're on a pace to multiply that by five or six times more.  Other accomplishments we're proud of?  We've built a cool library of veteran-oriented reading material, focused on combat trauma and PTSD, along with first person narratives of war, which are important to read if you want to know what veterans have experienced.  It can't just be head knowledge: it has to be heart knowledge, too.  We've created a group on Facebook for those interested in this topic, as well as a page where you can show that you're a "fan" of this website.  And become friends with some wonderful other bloggers who also cover this territory in able fashion, in particular Ilona Meagher and Kathie Costos. 

In the upcoming months, we want to get back to exploring more of our core purpose of this blog, which is to bring attention to the key medical, psychological and legal remedies for combat trauma, as well as focus on who some of the experts are.  The goal of having this blog in the first place?  That those who suffer from combat trauma will end up being able to find catharsis.  The type of result that involves dealing with it, addressing it, and ultimately, moving through it and beyond it.  And if the injured veteran is in the middle of the concentric circles, the ripples on a pond, that those in the outer rings, from family members, to ultimately, decisionmakers, would understand what combat trauma is -- how to prevent, how to work with it, how to heal it.  And that would be "Healing Combat Trauma," indeed.

USA Today Blogs from "An Emotional" Congressional Hearing on Veterans Suicides

The Congressional hearings on suicide prevention among veterans are going on right now in Washington, DC.  USA Today is blogging about what they're calling "an emotional hearing."  Oh, yeah.  Consider the topic!  And the effect that it has on veterans and their families, not to mention, caregivers.  Here's the link.  The coverage is short and to the point, and very, very current.