Healing Combat Trauma

Army General and PTSD: The Courage to Admit All is Not Well

In honor of Veterans' Day -- hey, every day should be Veterans Day, but we're not so lucky -- there's an important story to let people know about, because it so stands out from the crowd, in more ways than one.

In the wake of a recent apparent suicide by a top military officer, Air Force Brigadier General Thomas Tinsley, from unknown causes, this general's admission about his personal struggle with PTSD is all that much amazing. 

"Officers just don't get PTSD," one combat-hardened Vietnam-era veteran told me recently, knowing full well that it's not so much that they don't get PTSD, but that there's no real way to admit that they struggle with it.

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An Associated Press report from the weekend talks about Army Maj. Gen. David Blackledge's courage to come forward, after returning from Iraq, and getting psychiatric help to deal with the trauma of war.  As the article says, by doing so, Blackledge is (fortunately) "defying the military's culture of silnece on the subject of mental health problems and treatment."

Says Blackledge, quoted in the article, "It's part of our profession ... nobody wants to admit that they've got a weakness in this area," Blackledge said of mental health problems among troops returning from America's two wars. "I have dealt with it. I'm dealing with it now," said Blackledge, who came home with post-traumatic stress. "We need to be able to talk about it."

The article focuses on the perceived "stigma" in the military culture about admitting there is a problem, seeking help and getting treated -- as well as indications that some positive change is afoot in this area.  Blackledge, who served in Civil Affairs in Iraq, and now works at the Pentagon, is clearly leading by example.  He was involved in several traumatic incidents in Iraq -- his convoy was ambushed, his driver was killed, and he was in a hotel that was bombed by suicide bombers -- and he's successfully sought help dealing with the incidents, help which he believes has strengthened him.

Given that we all pretty much know the statistics of how few people seek treatment vs. the ones who should, as well as how pervasive the culture of silence and fear of retribution is, it's GREAT to see Maj. Gen. Blackledge's openness -- and on this Veterans' Day, we can only hope it encourages many other servicemembers to go for help. The article is linked here. (Thanks to veteran John M. for the heads up!)

Editor's note: That's Maj. Gen. Blackledge 2nd from left in the photo, standing just to the right of Bob Dole, in this picture from a charity fundraiser for the Jericho Project.

In the News: Two Articles Worth Reading Recently

Two articles worth reading that have been in the news recently:

"How the VA Abandons Our Vets," by Joshua Kors, in The Nation, linked here; and the poorly-headlined but otherwise worthwhile"Military Town Newspaper Challenges U.S. Military on Murder of Military Women," by Ann Wright, in TruthOut.org on the Web, linked here. 

Kors' article talks about the recent veterans' class-action lawsuit against the VA, fought in Federal court, and WHY it was necessary -- and there are some interesting and unexpected points, which didn't show up elsewhere in enough detail.  The biggest one is about the "fuzzy math" the VA employs to calculate claim times, and how this uniformly works against veterans (no pun intended on the "uniformly" thing.) It also confirms a longheld impression on my part that a veteran who struggles intensely with the mammoth difficulty of being his or her own advocate in the process, and ends up committing suicide, is actually counted as a "victory" for the VA, who calls their claim "resolved" in the time it took them to kill themselves.  In other words, fellow veterans killing themselves while waiting for their claims to be resolved actually makes the VA look "better and faster" at resolving claims, if you can believe that.  Yikes.  Talk about a system that needs to be overhauled and addressed...

Another great point Kors makes is that "someone" already attempted -- but was fired for her efforts.  That "someone" is Frances Murphy, M.D., who in 2004, according to Kors, "helped draft the Mental Health Strategic Plan, a blueprint for overhauling the VA.  The plan called for 256 changes to the organization, among them: installing a tracking system to stay in touch with suicidal veterans, creating rehabilitation programs that involved veterans' families, and streamlining the benefits process to resolve wounded veterans' immediate needs."  However, after expressing her frustration in public (to mental health providers) about the barriers the VA erects to veterans' speedy care, and how this causes veterans to suffer additionally and unnecessarily -- she was summarily fired.

Read the Kors piece to understand what wounded veterans have to go through, and how unfair it is; and to get a better picture on the fuzzy math that's employed to make things seem much better than they are.

The Ann Wright piece talks about military wives and women servicemembers murdered recently by other servicemembers, and mainly serves to remind us of how this is a problem that isn't going away.  The "news peg" for her article is a recent editorial in the Fayetteville, NC Observer -- Fayetteville is close to huge Army and Marine bases -- called "Our View: Military Domestic Violence Needs More Aggressive Prevention" (speaking of odd word choices).  That editorial is linked here.  The editorial references a recent vigil to memorialize the murdered women locally.

In conjunction with the Helen Benedict material and the other writings on Military Sexual Trauma, blogged about recently, here -- this is a topic worth keeping in the forefront of our minds.  Collateral damage from combat trauma? Or just crimes committed by otherwise sick individuals who happen to be in the military?  Either way, "more" needs to be done about this terrible problem.  (A similar and related topic is the "non-combat deaths" one we discuss from time to time, which can sadly be what's used to describe what more actually is a victim's suicide or a "domestic violence" type murder, of one servicemember by another.) We're just about to add a series of blog posts about domestic violence, and why it's important to leave when you're at risk, but ideally how to do so in a way that preserves your life.  Look for that shortly.

About the authors:

Joshua Kors is an investigative reporter for The Nation, where he covers military and veterans' issues. He is the winner of the National Magazine Award, George Polk Award, IRE Award, National Headliner Award, Casey Medal, Mental Health Media Award, and the Military Reporters and Editors Award.  He was also a finalist for the Michael Kelly Award, Tom Renner Award, Harvard's Goldsmith Prize for Investigative Reporting, and the American Bar Association's Silver Gavel Award.

Ann Wright is a retired US Army Reserves colonel with 29 years of military service. She also was a US diplomat who served in Nicaragua, Grenada, Somalia, Uzbekistan, Kyrgyzstan, Sierra Leone, Micronesia and Mongolia. She is the co-author of "Dissent: Voices of Conscience," profiles of government insiders who have spoken and acted on their concerns of their governments' policies.

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.)

Lisa Chedekel, Veteran Reporter on Veterans Issues, Allegedly to Take Courant Buyout

In the "Another One Bites the Dust " Dept., it's discouraging to learn that Lisa Chedekel, one of only a handful of truly great reporters on veterans issues – and by handful I really do mean, five or fewer -- is apparently taking a buyout offer from The Hartford Courant, the newspaper where she has reported for years, at least according on media-watcher blog, linked here.  (Sorry, Lisa, about the dismal, DMV-ish photo -- it's all I could find to identify you with to readers. )

 

This is particularly sad news for veterans, their families, and anyone else who wants to learn about the perils of their frequently inadequate mental health and treatments, because Chedekel, who specializes in what she calls "in-depth, old-fashioned shoe-leather reporting," has provided wonderful coverage of these topics over the years.  It’s disappointing to learn that Chedekel will be leaving the Courant, because it means one fewer voice covering this subject well; and perhaps no one to replace her who can do it nearly so well.

 

(There are others, of course, who do a great job covering veterans and mental health issues, but they are few and far between: The Washington Post's reporting duo of Anne Priest and Dana Hull, who did the seminal Walter Reed series; independent journalist Aaron Glantz, who's a new Rosalynn Carter fellow in mental health reporting this year; Mark Benjamin, who wrote about this topic in Salon and elsewhere well before it was popular on any level to do so; and Kathy Dobie, who seems to have a trauma survivor's insider's take on why this topic is so important.)

 

A 1982 grad of Wesleyan University, Chedekel's work has frequently been nominated for the Pulitzer Prize.  Her fantastic investigative piece, Mentally Unfit, Forced to Fight, is fortunately still available on the Web, as is her recent article, "Mental Health Providers Too Few for Troops," linked here, and another titled, "Army Sees Record Number of Suicides in Iraq," linked here. 

 

Mentally Unfit, Forced to Fight, is one of the best articles to date that covers the murky ground where mental illness and military readiness co-exist, and specifically covered the U.S. military's cavernous gaps in mental health care for its soldiers.  Calling Chedekel's "Mentally Unfit, Forced to Fight," an "impressive investigation," a reporter at the renowned British paper, The Guardian, summarized its impact when he wrote:

 

The Hartford Courant found that, despite an order by Congress that the US military should assess the mental health of all deploying troops, fewer than one in 300 US personnel saw a mental health professional before deployment.

 

The paper says there is evidence of the US military "recycling" troops with mental health problems, redeploying them even if they develop PTSD. It also notes that the number of troop suicides in Iraq reached a high of 22 last year. The Courant says at least 11 of the soldiers who killed themselves were kept on duty "despite showing signs of significant psychological distress".

 

(This was news at the time, and we owe Chedekel’s reporting, and the  Hartford Courant’s resources, for contributing to growing public awareness of the problem. In the mostly misplaced anger that particularly military bloggers direct at the alleged "main stream media" -- sorry, that's two words, not three -- reporters come in for a lot of flak, as though inferior coverage starts and ends with them, as opposed to also the commercial concerns of running a newspaper, often one allied with business interests.  Since many of these disgruntled types seem reasonably unaware of the part that good journalism can play in helping move society forward -- by spotlighting a problem that needs to be solved, and writing persuasively about it so that people start to care -- I sometimes feel the urge to spell that out.  That's what Chedekel's work did for veterans, and we're thankful that at least some important changes came about, because of it.  Here's what that effort took.)

 

According to the Courant's website:

 

To report this series, The Courant obtained records under the federal Freedom of Information Act, including never-before-released pre-deployment screening data for nearly a million troops and investigative reports into dozens of service members' deaths.

The Courant also interviewed more than 100 mental health experts, service members, family members and friends. The military does not publicly identify suicide cases. But The Courant was able to identify -- in most cases for the first time -- the service members who killed themselves in Iraq through records and interviews. Details of their deaths came from investigative reports and interviews with family, friends and fellow troops.

(The series was first published in May 2006.)

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Here are some articles from Lisa Chedekel and the  Hartford Courant's coverage of PSTD and the military, hyperlinked so you can go right to them:

 

Mentally Unfit Soldiers

The military is focused on retaining troops in combat, even when they exhibit clear signs of psychological distress, a Courant investigation uncovered in 2006.

Army Sees Record Number Of Suicides In Iraq

The Army is losing its battle to stem suicides among troops serving in Iraq, with a new report showing that 32 soldiers killed themselves in the war zone last year — a record high since the war began five years ago.

Special Report: Mentally Unfit, Forced To Fight

The U.S. military is sending troops with serious psychological problems into Iraq and is keeping soldiers in combat even after superiors have been alerted to suicide warnings and other signs of mental illness, a Courant investigation has found.

'Jeffrey Was Really Messed Up'

There is not enough guilt to go around here, so intent is each woman in Jeffrey Henthorn's life on owning a piece of the blame.

Slipping Through The System

In the 17 months after their son, Eddie, announced he was heading off to fight the war on terror, Margaret and Edward Brabazon of Bensalem, Pa., had held their breath.

Potent Mixture: Zoloft & A Rifle

When Army Sgt. 1st Class Mark C. Warren was diagnosed with depression soon after his deployment to Iraq, a military doctor handed him a supply of the mood-altering drug Effexor.

Amid Patriotism, Anger And Questions

Just off the two-lane main street of this southern Maryland town, a couple doors shy of the big lumber mill that rumbles all day like thunder, Ann and Jim Guy's modest dwelling is the picture of a patriotic American home.

Still Suffering, But Redeployed

Eight months ago, Staff Sgt. Bryce Syverson was damaged goods, so unsteady that doctors at Walter Reed Army Medical Center wouldn't let him wear socks or a belt.

Use Of Unfit Troops Blasted

U.S. Sen. Joseph I. Lieberman called Wednesday for a federal investigation of mental health screening for troops deploying to Iraq, after The Courant reported in a series that mentally ill service members are being sent to war and kept there, sometimes with tragic consequences.

Moving Violations, or the Needle in the Red Zone - Combat Veterans and Adrenaline Addiction

Adrenaline in combat helps the servicemember stay alive, and execute the plan.  Being addicted to the same adrenaline rushes after combat, though -- back on the home front -- can go from being an asset to a liability -- especially behind the wheel or on the motorcycle, and contributes to the sad phenomenon known as "non-combat deaths" from various origins.

Enough returning combat veterans kill themselves through reckless driving that different steps are being taken to warn participants of the semi-obvious dangers:

The Guardian (UK) newspaper has a story in today's paper, previously published yesterday in the Observer (UK), about the the British military's current advertising campaign to warn returned servicemembers about the dangers of amped-up, reckless driving.  The article, "Ads warn soldiers back from war zones against reckless driving," is linked here.

Says the article, "British soldiers are twice as likely as civilians to die as a result of reckless driving, because they have difficulty adjusting to normal life after returning home from active duty, according to official statistics."  The ads feature catchy slogans, such as "Drive Carefully.  You're Tough, but Not Invincible," and one directed to motorcyclists, "You're An Accident Waiting to Happen."  Hmmmn.  Those ads are likely to catch people's attention -- in fact, almost 60% of troops surveyed said they would think about slowing down, said the article, after considering them.

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Rick Roger's article in the May 23 issue of the San Diego Union-Tribune talked about the rash of non-combat fatalities among Marines at Camp Pendleton, many of whom had died in motorcycle fatalities.  Five Marines had died in the past eight days, where the "confirmed or probable causes" were homicide, suicide and traffic accidents. The article described Marine commanders and commands "backtracking to see if we need to do anything different to avoid these things happening again.”

It also clarified:

“Two of these deaths were caused by apparent motorcycle accidents, an area of deep concern for our Corps as motorcycle fatalities continue to rise at an alarming rate,” the statement said. “In a recently released All-Marine Message, the commandant outlines guidance and directives designed to curb motorcycle injuries and fatalities.”

Motorcycle-related deaths in the Marine Corps have risen every year since 2004, when there were seven. Last year, there were 19, according to the Naval Safety Center.

As for efforts to minimize combat stress and substance abuse, Camp Pendleton officials said the base has programs, policies and officers devoted to outreach and education. They also said each unit conducts monthly random drug tests on a mandated percentage of its Marines."

(Since that article was published, even more Marines have died as a result of motorcycle accidents.  See the article by Trista Talton in Friday's Marine Corps Times, linked here.  She writes, "Twenty Marines have died in motorcycle wrecks since Oct. 1, making this fiscal year the deadliest on record despite the Corps’ efforts to reduce two-wheel fatalities."  YIKES.

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From an article in the May 13, 2008 edition of the Marine Corps Times:

The new order, a work in progress for about six months, was initiated because of the number of motorcycle fatalities and injuries occurring within II MEF. From October 2007 to January 2008, more II MEF Marines died in motorcycle wrecks than in combat.

According to the order, released April 29, most of those deaths involved junior Marines and included things such as reckless behavior, blatant disregard of orders and policies, lack of proper training, little driving experience, alcohol and willfully disobeying state and federal traffic laws.

Information about the order is linked here.

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"Adrenaline addiction" is a familiar concept but by no means an official diagnosis (there are, however, informal support groups for it, on the Web, although I wonder if they're not just catchy names for invitations to drag racing and hang gliding events :-).

Sgt. Chad T. Jones wrote about it, back in April of 2004, in an article called "Flipping Off the Switch Can Save Your Life," linked here, first published in a Fort Bliss military publication, called the NCO Journal.  He introduced the article by saying:

A Soldier who has re