Healing Combat Trauma

From the Canadian Side of the Street: A Military Author's Take on Veterans Suffering from War and PTSD

One of the many blessings of the new media -- social media like Facebook -- are the interesting, talented people one meets within that. One such person is Bonnie Toews, a Canadian former journalist and novelist with a longtime background in writing about the military. I forwarded her an article from the Montreal Gazette last week about social workers quitting because of burnout in Canada, meaning that fewer will be available to serve returning veterans with PTSD, and this is what she wrote on her website in response:

Outrageous failure of government assistance to returning Afghanistan vets

"It is wonderful that we celebrate the lives and courage of fallen soldiers when they are repatriated to CFB Trenton and paraded down the Highway of Heroes, but the question that is never answered: who looks out for the returning vets? Especially those whose minds, bodies and spirits have been shattered on a continual rotation of tours through the past eight years.

It is disgusting and absolutely unacceptable to hear that Canada's Veterans Affairs is cutting back on social workers because WWI and WWII vets are dying off. 

Excuse me, but Canada has a whole new generation of vets who have served in Afghanistan for eight years. By next year it will be nine years. The war in Afghanistan has lasted longer than either world war in the 20th Century and soldiers have been repeatedly rotated through three and four tours because our forces aren't large enough to handle a deployment this long and this demanding. These vets and their families need help to mend their lives back together. 

Kevin Dougherty in Montreal's newspaper, The Gazette, writes that soldiers suffering from Post Traumatic Stress Disorder can wait up to four months before seeing a social worker, a necessary step to integrate them back into society and return them to the labor market. 

Why? Because federal social workers each have a caseload of 40 clients to their provincial counterparts, who carry a caseload of 20 clients each. There are not enough social workers to contend with the need, and under such strained resources, these caregivers burn out, depleting veterans' social services even further. 

People forget that soldiers returning home are not the only victims of the wars they've fought. So are their loved ones, families and friends. They need as much social assistance as the soldiers themselves. Those coming home are forever changed. They have experienced things the rest of us can't imagine. They carry this psychological burden for the rest of their lives. 

In 1994, in Rwanda, I was briefly introduced to that world of theirs. I was one of the few North American journalists covering the massive humanitarian effort following the genocide against the Tutsis and moderate Hutus in Rwanda. One peacekeeper after another told me what they saw, incomprehensible mass slaughter with no human respect whatsoever and they were forced to observe because the UN didn't give them the mandate or size of force to quell the madness. Soldiers trained to fight and defend forced to stand down. Can you imagine the helpless rage they experienced? Yet, when I came home, I faced the same apathy from friends, co-workers and the public as they did. My husband proudly explained that I had been in Rwanda and time and time again I was asked, "Did you go there on holiday?" 

People didn't even know what was going on, and were indifferent when I chose to explain. I, like so many soldiers, learned not to talk about it because no one really cared to listen. 

This time the public must get behind their vets and demand the social services they deserve and need. This is the most important tribute we can give our returning vets for the sacrifices they've made on behalf of our country."

 -- Bonnie Toews. A longtime journalist reporting for logistics and private security magazines and now a novelist, speaks out for the victims of genocide and war, from the peacekeepers and coalition forces trying to save suppressed peoples to the children and innocent civilians caught in the crossfire of opposing powers, ideologies and cultures. Current writing "Trilogy in Treason." Member of Military Writers Society of America, American Authors Association and ACFW. Her website is linked here.

Editor's note: Find us on Facebook, here; follow us on Twitter @HealingPTSD.

"The Hell of War Comes Home" Almost Nets Reporter a Pulitzer Prize

The Pulitzer Prizes in journalism were announced today. A semi-finalist in the "local reporting" category was Dave Philipps of The (Colorado Springs) Gazette for" his stories on the spike in violence in a battered combat brigade returning to Fort Carson after bloody deployments to Iraq, leading to increased mental health care for soldiers."

Go here to read the series, "The Hell of War Comes Home." The link goes to the first installment in the series; other installments are linked to that initial article. There's also video.

43,000 Troops Found "Unfit to Serve": Non-Deployable but Sent Anyway?!

Several weeks ago I watched a wonderful Bill Moyers interview on PBS with Oliver Stone, noted filmmaker and Vietnam veteran. The whole interview was great, but a figure Moyers used at the beginning was just stunning -- for the implications it has for soldiers with PTSD and their families.

Moyers said:

"...I read a report based on military records which revealed that from 2003 to 2008 some 43,000 troops had been sent to Iraq and Afghanistan despite having been classified as "non-deployable" for medical reasons. In plain English, they weren't healthy enough to go, but were sent, anyway."

Yowser. It's hard to imagine a circumstance in which being considered unfit to serve for medical reasons, and being deployed anyway, improves your situation. It sounds like all it would do is reinforce the difficulties you were already having, or pile more trauma on top of the pre-existing trauma.

Additionally, troops who have fought in Iraq, when they're deployed next to Afghanistan, find that to be a completely different experience. So Afghanistan for them isn't "more of the same," it's new and different, with all the challenges that implies.

(See news report from November 29, 2009, entitled "Afghanistan, Iraq: Different Wars -- U.S. Soldiers: Afghanistan War Dramatically More Difficult, Challenging Than Iraq," linked here.)

Editor's Note: For the link to Bill Moyer's Journal and his excellent interview with Oliver Stone, shown on December 4, 2009, click here.)

News from Hell before Breakfast: Journalists, War Trauma and PTSD

"I hate newspapermen. They come into camp and pick up their camp rumors and print them as facts. I regard them as spies, which, in truth, they are. If I killed them all there would be news from Hell before breakfast." -- attributed, perhaps erroneously, to Civil War General William Tecumseh Sherman.

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A different quote:

"On Thursday, June 26th, I witnessed the immediate aftermath of an Al-Qaeda suicide bomb attack.  Several dozen people lost their lives... children, old men, civilians, police, and military men.  The scene was horrific beyond words, even for someone like me who has a fairly high threshold for such things.

I found it nearly impossible to look through the viewfinder.  What I saw was abhorrently graphic, yet far too important for the world to ignore.  I present images that provide an uncensored view of a terrible event, and some small measure of dignity to those who lost their lives."

-- Zoriah, international humanitarian photographer, whose gripping images from that event were later censored by the U.S. military, and he was evicted from his embed assignment with the Marines. (The link to the post where he talks about those images, and shows them, is here.)

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PTSD from being a combat journalist of photographer, embedded or otherwise:  Not everyone who's exposed to combat trauma develops PTSD, as we know.  Recently, Kimberly Dozier, CBS correspondent and author of Breathing the Fire, says she didn't develop it from her horrific near-death incident in Iraq in May of 2006, though ironically -- according to Dozier -- almost everyone she interacts with believes thatshe must have.  (See article to that effect by Dozier, linked here.)  However...many do; and for others, the signs and symptoms take time to manifest themselves. 

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Journalists bear witness, both to some of the most savage atrocities of wartime, though without the training and the mindset of combatants, and also to the suffering of the survivors, military and civilian.  Says one photographer who served in Vietnam:

It has been very difficult for me [to recount some of his memories from the past] as it has brought back many of the horrible nightmares that I had thought that I had finally put away. It did get them out in the open and off my chest so to speak and now my family now knows why I sometimes have to take those walks out into the woods alone to just get away. Hard to explain. I do have severe survival guilt as I have lost far to many friends in combat in up close and personal confrontations. I have many photos of me smiling and yes there were many good times. However; there were enough bad times to more than compensate for the good ones. I have learned to cope with this new world that I came home to only because I still feel a great need to help my fellow veterans. We 'Nam veterans are all but forgotten in my eyes.

Two significant resources: Dr. Anthony Feinstein's work, and the Dart Center for Journalism and Trauma.

Two excellent books:

Dangerous Lives: War, and the Men and Women Who Report It, by Anthony Feinstein (2002); and Journalists under Fire: The Psychological Hazards of Covering War, by Anthony Feinstein. (2006).  (Recommended by Jonathan Shay, M.D., Ph.D., noted PTSD expert.)  Shay wrote: "the first and only book about the occupational [psychological] hazards of being a war correspondent.  Published in Canada, will come out in the US next year from Johns Hopkins UP with a new chapter on embeds."

Dr. Anthony Feinstein is a professor of psychiatry at the University of Toronto and a neuropsychiatrist at Sunnybrook and Women's College Health Sciences Centre in Toronto. He is an expert on Post-Traumatic Stress Disorder in war journalists. Feinstein received a 2001 Guggenheim Fellowship to pursue his research. Dr. Anthony Feinstein's bio is linked here.  Much better bio, linked here.

For reporters: War, Journalism and Stress: The Self-Assessment Test, linked here. (General description of the test, linked here.)

What Feinstein has to say:

More than anything, says Feinstein, he’s learned that, “War is not good for journalists. They suffer from it.”

Specifically, they suffer post-traumatic stress disorder, substance abuse and anxiety disorders. One in five journalists, over the course of a long (15-plus-year) career, endures significant PTSD, says Feinstein. That means, among other things, bad dreams, flashbacks, numbness, an overly sensitive startle response and an inability to get close to others emotionally. One in four experiences depression. “And a number drink very heavily as well,” says Feinstein, “but I don’t know how many, because I never know for sure what they’re telling me.”

The most surprising revelation of the research for Feinstein? “I didn’t realize that the journalists were in such great danger. You see them when they report the news: cool, collected, with everything seemingly going on behind them. But these people are really right in the middle of it all.”

He is particularly sympathetic to still photographers. More than anyone, he says, these professionals have no choice but to get into the thick of things to do their jobs well.

The Dart Center for Journalism and Trauma, located on the campus of the University of Washington in Seattle, is a particularly good, targeted resource for journalists about reporting and trauma: both externally reporting, and internally experiencing trauma from reporting in war zones.  Click here to look through their extensive offerings, which are really superb.

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Who's the handsome young man in the photo? 

That's Robert W. "Grif" Griffin.  Griffin says, "I was a combat photographer with the 1st Cavalry Division Airmobile from 1966 to 1968 and 1970. I was in country [in Vietnam] as a photographer from 1966 to 1968, and back again in 1970."  (He was shot down near Quan Loi in 1970.)  He adds that he "spent 20 years in the Army mostly as a photojournalist/motion picture and still photographer."

According to Griffin, "the photographer who took the photo is Jere L. Smith, a fellow combat photographer and a Specialist E5 at the time. We were both assigned to the 13th Signal Battalion, which was part of the 1st Cavalry Division Airmobile."  At the time the photo was taken, Griffin was duplicating some slides for his Command for a Division briefing that was to take place in several locations at the same time: hence, the dupes.

Books Fall Open, We Fall In: Reading to Better Understand the Vietnam War and Its Veterans

The kindly and indulgent boyfriend, GuvBoy, left for the local library book sale with instructions to purchase anything that looked good about the Vietnam war and several other blog-related topics. As a former journalist and all-around smart person, he knows how to figure that out, so I knew I was in good hands.  As it turns out, he returned with some good ones, that seem to have been lost to history.  So I thought I would point them out here, in case they help anyone else who's interested in digging deeper into what went on and what the combatants experienced. 

(In case it's never been clear what orientation the categories of books in the various columns flanking this blog have, here's the breakdown:

The column to the right here on this blog lists various books of poetry about war, any war; followed by a section of all sorts of excellent first-person narratives about various wars, the better to give us an understanding of what veterans went through.  Those first-person narratives are organized by war, to make it more self-explanatory.  The column to the left here lists therapeutic resources for dealing with combat trauma up on top; and various miscellaneous things that get mentioned on the blog further down).

For Vietnam-era veterans who want their families (i.e., children and grandchildren) to better understand what the war was like, I'm still recommending "Home to War: A History of the Vietnam Veterans Movement," by Gerald Nicosia, because while he's talking about the veterans movement, in 700 pages, he's capturing all sorts of history of the era and feelings for and against.  The book is actually pretty neutrally, historically written, and it's a very good resource.  I've blogged about it earlier, here.  Except for its oversight of the extremely impressive (to me, anyway) Lawrence Kolb, M.D., I can't say enough good things about Nicosia's book.  There's a fascinating wealth of information about the legitimization of the PTSD diagnosis in the book as well.

Here are a few others:

Stanley Karnow's Vietnam: A History, is also good.  The cover calls it "The first complete account of Vietnam at war" -- maybe it should actually say, the first complete account of Americans at war in Vietnam -- so it has its place.  It was written as the companion to the long-ago PBS series of the same name.

Plus three new finds, though, thanks to the pleasantly-disposed boyfriend and his handful of small bills:

"Long Time Passing: Vietnam and the Haunted Generation," by Myra McPherson; "Healing from the War: Trauma and Transformation after Vietnam," by Arthur Egendorf; and "Vietnam: the Valor and the Sorrow" (from the home front to the front lines in words and pictures), by Thomas D. Boettcher.

Each of these books has a particular reason why it's good and worth perusing.  McPherson was a Washington Post and New York Times reporter who carried on 500 interviews with veterans and others to get her material; Egendorf, who Nicosia writes about in his history, was a Harvard graduate, Vietnam vet and psychologist who became one of the founders of the first rap groups to help veterans deal with the personal fallout from the war; and Boettcher was a graduate of the U.S. Air Force Academy who served in Vietnam in the press corps.  His book has more than 500 photographers, many never before published, which adds greatly to its interest (it's also very well-written and well-paced, not deadly.) 

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Additionally, we've already blogged about Lori Sekala's great bibliography on PTSD and war in the blog post entitled, "A Good Librarian is a Wonderful Resource," linked here.  (Sekala is the collection management librarian at the U.S. Army War College library).  But here's something we haven't talked about yet -- possibly THE definitive bibliography on books about the Vietnam war, to better understand the experience.  It's linked here.  Enjoy :-)

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.

Military Sexual Trauma: A Sexual Violence That Injures the Soul

The other day a reader wrote to comment on her own experience of military sexual trauma:

"From my sorry experience, military sexual assault is a predatory crime of opportunity. ...  Victims are quite disposable... few perps are ever tried in court.  Yet the victim gets quickly processed out as a defective nuisance.  You suddenly become jobless & homeless for daring to report, no matter how good your daily job performance. The victim is subhuman and utterly alone and reviled, while the predator gets a promotion.  This is probably why military rape creates more PTSD cases percentage-wise than does combat.  In combat at least you are scooped up into the bosom of your band of brothers." 

"A couple of military stats," she continues: "Sexual assault is more likely in a command that encourages/allows harassing/misogynist behavior," and "Fifty percent of perps have a prior history of violence upon entering the military -again OPPORTUNITY to observe and select their prey in close confines."  Yikes.  True? Not true?  Either way, it's a hideous experience for the unwilling victim.

That brought to mind some healing words of Britta Reque-Dragicevic, but first, the bracing truth: "Military sexual trauma is a crime, not a misfortune of war," writes Reque-Dragicevic in her book, Close to Home: A Soldier's Guide to Returning from War.  The e-book is available here for the very affordable price of $10.  Buy it :-)  Because it's a download, you can have it within minutes.The following is Reque-Dragicevic's thoughts on sexual trauma in war. 

As with the rest of her very worthwhile book, they are soothing, sane and reasonable, and will comfort the afflicted.  This book should be a must for veterans and their families; and at its very reasonable price would also make a thoughtful "Welcome Home, Veteran!" gift for veterans in your life or in your community.  She writes:

An increasingly common trauma far less talked [than PTSD] about is military sexual trauma—which is experiencing sexual assault or harassment while you are in the military. This is not just a women’s problem. In fact, the VA reports that fifty-five percent of women and thirty-eight percent of men in the military have experienced military sexual harassment. While military sexual trauma is more common in women, over half of all veterans with military sexual trauma are men.

War has historically seen an increase in sexual assault and rape incidents for both military and war-zone populations. It’s become more publicly recognized in war-zone civilian populations (mass gang rapes were widely reported during the Bosnian war and rape has traditionally been a way to violate an enemy population), but rarely do we hear about sexual assault among our own soldiers.

If you have experienced a sexual violation during war that has left you ‘just not feeling the same’ since, please know that you are not alone. Most victims of military sexual trauma will never report it. Whether or not you call it rape doesn’t matter. What happened to you wasn’t right and it wasn’t your fault; and no, you couldn’t have prevented or stopped it. Rape is always an issue of power, not sex. Unfortunately, rape in war happens too often as people deal with overwhelming feelings of god-like power, lowered inhibitions, excessive anger, lack of usual sexual release and the devaluation of human life—sexual force is often used with little outward consequence to the perpetrator. But the consequences to the victim are life-changing.

If this has happened to you, you may develop PTSD from this alone, but be too embarrassed or humiliated to tell anyone why. This may be the hardest part of your war experience to deal with and one that strangles you in secrecy, shame, and embarrassment. After all, with fellow survivors coming back with missing limbs and mental shock, how can having been sexually violated compare to that? No one would believe you, would they? What would loved ones think? Soldiers are supposed to be tough; how could you ever admit that you weren’t strong enough to keep someone from forcing sex on you? Yet, for you, what happened has become your war. A war that no one will ever know anything about.

Please stop. Stop and take a deep breath. Forget the fact that it was a war environment for a moment and realize that no matter where it happens, when, or to whom, being sexually violated always leaves a person feeling powerless, doubtful of themselves, uncertain, unable to believe it really happened, and feeling very, very small inside. Why? Because sexual assault is about taking away your power. Sex is our most intimate and most powerful interaction with another human being. And when someone overpowers us physically and enters our bodies without our consent, we are deeply ashamed and shocked at how powerless we were.

Sexual violence injures the soul. The shame, humiliation, loss of control, and shaken self-esteem affect both men and women even though each gender experiences them differently because of what we are conditioned to believe about our masculine or feminine roles in life.

Sexual violation impacts our self-image, sexuality, and our future, safe sexual experiences. The overwhelming sense of vulnerability and shame can lead to suicidal thoughts and actions.

For war survivors who have been violated by one of their own, the confusion and uncertainty, not to mention potential repercussions to your military career or even survival, lead most victims to never tell anyone. Keeping your mouth shut may be the only way to survive and get back home. But once you are home, please realize that if this has happened to you, you have been affected and it’s not just going to go away. It takes feeling safe to get yourself to the point where you can admit to someone that it happened. And for a lot of people, finding someone safe seems almost impossible.

Even if you tell no one else in your life, please call the National Sexual Assault Hotline at 1-800-656-4673 or visit them online for an anonymous chat at www.rainn.org. You can remain anonymous, and at least you will be able to talk with someone who deals with this trauma every day and can start to give you the resources you need to find healing. The VA also reports that it has counselors at every hospital trained to assist veterans with this issue. You can also visit www.ncptsd.va.gov, search for “military sexual trauma”—and a number of fact sheets will come up where you can learn additional information.

Remember, what happened to you was a crime, not just a misfortune of war. The person who assaulted you did not have the right to do this to you under any circumstances.

One of the hardest parts about having been sexually traumatized can be sharing that information with a spouse or partner. It’s normal to worry about how they will accept you once they know what has happened and to wonder how it will impact your intimate life together. Even though this trauma may loom large before your eyes, your partner loves you for who you are—not just your ability to have sex. You may find far more love and acceptance than you imagine. You are still attractive, beautiful, desirable, virile, and your partner still longs to experience sexual intimacy with you. You may struggle with feeling that you are not worth loving which is one of the ways sexual violation diminishes your own sense of power. But feelings are not facts. You are a human being worth being loved, enjoyed, and you deserve to experience sexual intimacy in a safe and caring relationship.

Partners of sexual assault survivors may feel a sense of rage, powerlessness, guilt for not having been able to protect your loved one, and a natural reaction to want to get even with the person who has hurt the person you love. Counseling individually and as a couple can be a safe place to express what you are feeling. You can also call the Sexual Assault Hotline—it’s not just for survivors; they can assist family and friends.

Remember, as long as you don’t tell your partner what happened, he or she will have no way of knowing what you are feeling, worried about, remembering, or associating with your current sex life. You may have no desire to have sex because of the trauma, but how will your partner know that? If you don’t share, he or she may assume that they are no longer desirable and that you’ve lost interest. They may easily blame themselves or you. Don’t lose your relationship because you are too ashamed to share what happened. Seek a counselor who can help you decide how to share this information. Don’t shut out what may be the only true source of love and support in your life. Loving partners can be incredibly patient when it comes to sex and trauma, but you have to give them the chance to understand what you are going through.

If you have been sexually traumatized, it may seem that that experience now defines who you are. Shame, guilt, self-blame, denial, rage, depression, lack of self-worth, fear of being intimate again, aversion to being touched or approached without warning, doubts about whether or not you are still desirable, or if having been raped effects your sexual orientation (it doesn’t) are all normal reactions. Just remember the trauma is real and intimate, but you are not defined by what has happened to you. You are a whole person who has experienced vulnerability and powerlessness; but that experience did not change who you really are: still strong, still powerful, still in control and still able to move toward healing. Deciding to move toward healing may be the only justice you ever get for what happened. You owe it to yourself, your partner, and your children to make sure that this trauma does not take you away from them any more than it already has.

Talk to a counselor. Sexual trauma is humiliating, but counselors deal with it everyday. Nothing bad will happen to you by just talking. It doesn’t mean you have to take legal action or that everyone will find out. You are not alone. Don’t let the one who took your power from you keep it.

You deserve a lifetime of being sexually loved and enjoyed.

Reprinted with permission from Close to Home: A Soldier's Guide to Returning from War, by Britta Reque-Dragicevic.  The e-book is available here for the very affordable price of $10.  Buy it :-) 

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.

An Unprecedented Aesthetic Triumph: A War Poet (Jarrell) on a Combat Journalist (Pyle)

Randall Jarrell is famous to many (okay, I'll say it, so you won't have to) ex-English literature majors, and other fans of poetry, including war poetry.  His poem, "The Death of the Ball Turret Gunner," is one of the more famous war poems around.  What I didn't realize until I read more about Ernie Pyle was that Randall Jarrell made one of the more profound quotes about why Ernie Pyle's contribution as a journalist in wartime was so important.  He wrote:

"We felt most the moral qualities of [Ernie Pyle's] work and life; but we could not help realizing that his work was, in our time, an unprecedented aesthetic triumph: because of it most of the people of a country felt, in the fullest moral and emotional sense, something that had never happened to them, that they could never have imagined without it -- a war."

Never read Jarrell's famous poem?  Here's your chance, then: It's pretty short and to the point in its ability to communicate, elliptically, the experience of war on the individual:

From my mother's sleep I fell into the State,
And I hunched in its belly till my wet fur froze.
Six miles from earth, loosed from the dream of life,
I woke to black flak and the nightmare fighters.
When I died they washed me out of the turret with a hose.

The two men -- one a poet, who had served briefly in the military, the other a journalist who had embedded at length with the troops, and considered himself one of them -- both served to "amplify" the experience of serving in combat for those to those who stayed at home.  Interestingly, for our purposes on this blog, no one is clear whether Jarrell's "accidental" death at 51 (he was hit by a car while walking) was actually accidental, or in fact a successful suicide attempt.  He had struggled with mental illness (depression) before his untimely death. 

As for Pyle, he died in combat, with the troops he loved and whose individual experience he communicated so successfully to the folks at home.  According to Pyle's obituary in the New York Times, Eleanor Roosevelt herself wrote of Pyle, "I have read everything he has sent from overseas," and, further, the obituary states, "recommended his writings to all Americans."

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Just because I can't get enough lately of this journalist with the compassion for those he encountered in combat, I have to add one more quote from his (excellent) obituary.  How I wish we had someone like this today.  See how very much his point of view is needed among veterans today:

Said General Mark W. Clark, from Fifteenth Army General HQ in Europe:

"A great soldier correspondent is dead, perhaps the greatest of this war. I refer to Ernie Pyle, who marched with my troops through Italy, took their part and championed their cause both here and at home.

"His reporting was always constructive. He was "Ernie" to privates and generals alike. He spoke the GI's language and made it a part of the everlasting lore of our country. He was a humble man and in his humility lay his greatness.

"He will be missed by all of us fighting with the Fifteenth Army Group. There could have been only one Ernie Pyle. May God bless his memory. He helped our soldiers to victory."

Shaking Off the Blues: Two New Books Help Veterans and Others Get "Unstuck"

A well-regarded psychiatrist who thinks there are other-than-pharmaceutical antidotes to biochemical depression?  Rank heresy!  Oops, actually we meant -- how very refreshing indeed. 

A soulful journalist who's lived and worked in war-torn countries, and knows what it's like to be a survivor -- who then turns her attention to helping veterans and their families come home from war and rebuild the pieces of their often-shattered psyches? Again, a wonderful suggestion.

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NPR the other day published a great interview with none other than James S. Gordon, M.D., author of the new book called "Unstuck: Your Guide to the Seven-Stage Journey Out of Depression." Depression is an important topic, because many people who are risk for suicide have depression as an underlying state.  According to one psychiatry textbook for medical students, "A majority (60% to 80%) of people who commit suicide carry a diagnosis of depression."   

If you remember, we've talked about Dr. Gordon on this blog before.  He has an impressive, very talented background academically (Harvard College, Harvard Medical School), and is the founder of the Center for Mind-Body Medicine in Washington, D.C., as well as a frequent lecturer at the Smithsonian, and the former chairman of the White House Commission on Complementary and Alternative Medicine, also known as "CAM."  (We've blogged about CAM, also known somewhat misinformedly as natural medicine, and its opportunities for treating PTSD here on the blog, at length here; and also about the varieties of mind-body medicinethat might show some promise for treating combat trauma and PTSD, here.)

To listen to the NPR interview, or to read the accompany material on getting unstuck -- in Dr. Gordon's words -- click here.  To read Dr. Gordon's bio -- click here.  To read our previous posts about his work on "Healing the Wounds of War," click here; on "Healing the Troops," click here; and on his and the Center for Mind-Body Medicine's annual conference, planned for October 25-29th in Minneapolis, Minnesota this year, click here.  The topic of this year's conference is the highly-appropriate "Integrating Mind-Body Medicine into Clinical Practice, Medical Education & Trauma Healing."  As Dr. Gordon's website says, "We're teaching thousands to heal the world's millions." Indeed -- and what a noble task that is; and how very, very vital.

If I had ONE RECOMMENDATIONfor the Pentagon, the DOD, the VA, the various branches of the military (Army, Air Force, Navy, Marines, National Guard) that frequently comb this site, looking for answers to the questions they have -- it's that they would get to know Dr. Gordon's work, and send representatives to this conference in late October, 2008.  Check into mind-body medicine, with a credible expert, and somehow who's already worked with, and proven his work with, the war-torn and traumatized (troops and civilians) here and abroad.  Broaden the outlook on how to treat PTSD and combat trauma, by returning people to themselves, and helping them to learn to manage their own stress in creative and supportive ways.

Dr. Gordon says his book, Unstuck, goes into many of the same principles that his trauma work does. I can't wait to start reading my copy, which his office promises to send.

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In the meantime, I hope Dr. Gordon gets to cross paths professionally with Minnesotan Britta Reque-Dragicevic. I have read her book-- devoured it in one sitting is the more accurate description -- and think it has lots of potential to comfort, support and nurture returning veterans and their families in putting the pieces of the puzzle back together.  (One thing I love about both Dr. Gordon and Britta Reque-Dragicevic -- they both "get" it.  They've had a personal experience with what they're talking about; it's not just academic.  And they're both driven to help others heal from their suffering -- the not exactly unspoken single purpose of this blog: there's synchronicity.)

Reque-Dragicevic has written a completely soulful manual on getting unstuck herself, and with her profound understanding of the needs of trauma survivors, as a longtime journalist in post-war Saravejo and Bosnia, I sense a little (**magical?!**) professional matchmaking going on that would only serve to increase the amount of healing and overcoming in the world, especially among trauma survivors and veterans with PTSD.  If you want to read more about Reque-Dragicevic's marvelous book, Close to Home: A Soldier's Guide to Returning from War, click here.  Her book is endorsed and recommended by Dr. Edward Tick, among others.  At a mere $10 as a download on the Web, you really can't go wrong.  (We'll be quoting from Reque-Dragicevic's book on this blog in the future, with her permission, because it's wonderful stuff and she really "gets" it. Veterans and their families need to experience this.)

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If you have $10 to spare, or as a gift for someone else, buy Britta Reque-Dragecivic's book.  It's a download, and you can have it in your hands within minutes, from anywhere in the world, and start the healing process today.  If you have about $18 and shipping, buy Dr. Gordon's book, and start the healing process when it arrives in the mail -- or at your local bookstore.  If you have about $40, buy them both :-)