Healing Combat Trauma

Floyd "Shad" Meshad, MSW

After earning his Masters degree in Psychiatric Social Work from Florida State University in 1968, Shad went on active duty in 1969 as a Captain in the U.S. Army. In 1970, he served one tour as a Social Work/Psychology Officer for I and II Corps in the Republic of South Vietnam.

Upon his return to the states, Meshad continued his dedication to American veterans by starting the Vietnam Veterans Re-Socialization Unit at the Brentwood, CA VA Hospital in 1971. He spent eight years working with Vietnam veterans and their severe readjustment problems in the Los Angeles area. Shad was one of the pioneers in the study of the disorder known as Post-Traumatic Stress Disorder, or PTSD.

In the past 27 years, Shad has received many service awards and recognitions for his work. He authored a book about his year in Vietnam, Captain for Dark Mornings, which, highly acclaimed, is in its second printing. Meshad has made appearances on many major television networks and cable news talk shows, including 60 Minutes, 20/20, Dateline, Nightline, and CNN News. Shad continues to consult, train, and counsel nationally and internationally.

In 1986, Shad started a stress management and consulting service. In the early 90's he began focusing on treating compassion fatigue. This condition is identical to secondary traumatic stress disorder (STSD) and is the equivalent of PTSD. It is the stress resulting from helping or wanting to help a traumatized person. Through his associations, Shad introduced Charles Figley, Ph.D., a long-time friend and colleague to Dr. Roger Callahan who developed Thought Field Therapy. Dr. Callahan approached Meshad with the opportunity to study the effect of TFT therapy on veterans who suffered from PTSD. Impressed by the amazing results of this study, Shad has become a certified TFT diagnostician and practitioner, offering seminars on Levels I and II TFT nationwide.

In 2000 Shad founded Quantum Performance Institute with the goal of utilizing the amazing power of energy psychology techniques in the area of negative emotional states and attaining one's optimum performance level.

Army Ranger Writes Book about Fighting Two Wars - with Insurgents, and with PTSD

There's a new book out called Two Wars: One Hero's Fight on Two Fronts - Abroad and Within, by Army Ranger Nate Self (great name, on both counts).  It's already #3 on Amazon in books about PTSD - the rest are more typically clinically oriented texts about coping with combat trauma and PTSD, such as you'll see in the left hand column on this blog.  This one is written by a highly-decorated Army ranger (Purple Heart, Silver Star) and West Point grad about the two battles he's fought: one in Afghanistan and Iraq, with insurgents; the other on the home front, with PTSD.  I just learned about it today so haven't had a chance to look at it yet, but be forewarned - it appears to have a spiritual/religious angle to it, in terms of his recovery, and it's published by Tyndale House, which is typically known as a religious book and Bible publisher.  "Not that there's anything specifically wrong with that" - unless of course you'd rather know that in advance, which I certainly would.  Still, major kudos to Nate Self for a) recovering enough to tell his tale; and b) telling it in real time, when it can still help a lot of people, especially those who view life most through the prism of religion-based spirituality.  My guess is it must be pretty good to have already vaulted to #3 in its category on Amazon, although I'm sure the video helps, because that's a very wise marketing move indeed.  To the best of my knowledge, this is the first and only book written by an OIF/OEF veteran about his or her battle with PTSD, and subsequent -- what I'm assuming is -- recovery.  It will be great to take a look at this; and I'm hoping it helps a lot of people.

"Two Wars" by Army Ranger, Nate Self (book Trailer)

Army Broadens View of Possible PTSD Therapies, Includes Complementary and Alternative Medicine

A Military.com article published on May 29th reports on the U.S. Army's increasing openness to non-traditional therapies to treat PTSD.  The article by Bryant Jordan is called, "East Meets West in Army Mental Therapy," and it quotes Col. Elspeth Ritchie on the Army's increasing openness to options beyond traditional counseling and medication, to include items like yoga, acupuncture, meditation, and of course, virtual reality. The headline is positive, but in truth, the Army may be taking only baby steps towards including nontraditional therapies, often known as Complementary and Alternative Medicine (CAM).

(Some "definition of terms" is in order.  "Alternative medicine" means treatment choices other than conventional medicine, to be used instead of conventional medicine; "complementary medicine" means treatment choices to be used in addition to conventional medicine -- so the term "CAM," or "Complementary AND Alternative Medicine" is meant to be inclusive of both approaches.  This ends up being an important distinction, because responsible M.D.s are often more in favor of patients adding complementary therapies in to their treatment protocol, rather than replacing a conventional treatment protocol with fully alternative therapies. "Complementary" is misspelled in the Military.com article as "complimentary," which further confuses the terminology.) 

The article states that "Therapies that are "kind of tried and true" remain at the forefront of treating Soldiers with behavioral problems, [Col.] Ritchie said. These include behavioral therapy and exposure therapy -- where patients are "exposed" by degrees to scenarios that may be at the core of the problem -- and medication."  And it further quotes Col. Ritchie as saying that although CAM therapies "are interesting, we don't have the hard data to show which therapies are useful for what population. So we're really in the research phase of this for yoga, acupuncture and some other therapies."

The Military.com article is linked here.  A previous article by Noah Shactman in Wired magazine on March 25 discussed similar material, and mentions a Department of Defense grant opportunity with a closing date of May 15, providing $4 million in funds to study therapies with possible benefits for PTSD and/or TBI, including but not limited to "music, animal-facilitated therapy, art, dance/movement, massage therapy, EMDR program evaluation, virtual reality, acupuncture, spiritual ministry, transcendental meditation, yoga and other novel approaches."  (The grant opportunity announcement is linked here.)  According to the Wired article, reading from the grant application, the Army is willing to contemplate as well the potential effectiveness of "biologically-based treatments, botanicals, and nutritional supplements for enhancing cognitive function and mood in patients with trauma spectrum disorders, including TBI and/or PTSD, depression, anxiety, and/or substance dependence/abuse," and adds, "Even proposals for wild-sounding "therapies using bioenergies such as Qi gong, Reiki, distant healing and acupuncture" would be accepted."  The Wired article is linked here.

I'm unclear whether the Army is leading the way of all the military branches in considering the potential of CAM for PTSD; but whether it is or isn't, kudos to it for being reasonably open-minded.  One of the problems that seems to keep coming up with PTSD is that no one obvious choice comes up in treating it, that works every time.  There are a variety of pharmaceutical drugs that are prescribed, but no one remedy in particular appears to be the wonder drug, or cure-all.  (You hear the frustration about this when you listen to the stories of combat veterans who are taking a handful of pills to combat PTSD, sometimes as many as 20 or 30 separate medications - a scary cocktail, indeed.)  Other approaches for PTSD, such as talk therapy, cognitive therapy, EMDR, etc., all have their place in the pantheon of treatments, and each has their adherents/proponents, but again, there doesn't seem to be a one-size-fits-all, cure-all for PTSD.  In the absence of the medicinal "silver bullet" that cures all PTSD, it's great that the Army is at least embracing the concept of possible adjunct therapies, while asking them to prove themselves clinically, as much as possible.

In the following weeks, we will report on complementary and alternative therapies that appear to have some benefit in treating PTSD; in addition to the more mainstream approaches that are already in use.  (Virtual reality is another type of treatment entirely: dependent on technology, it doesn't fit the typical rubric of CAM, nor should it.)

Army's PTSD Cases Double Over Last Year; Marines Close Behind

An article in yesterday's Washington Post, linked here, reports that diagnosed cases of PTSD in the U.S. Army have more or less doubled over last year, with the Marine Corps also increasing numbers significantly.  The Navy and the Air Force are reporting fewer cases; which either means that they're not seeing as much action or they're lagging in understanding how to report cases; or a combination of both.  It's no surprise to anyone who's been following veterans affairs that the Army, the Marine Corps, and the National Guard have been stretched to the maximum with overlong deployments, back-to-back deployments, and less than fully-adequate attention to the psychological wellbeing on the troops. Let's hope these and future statistics mean something to decision-makers who can make a difference to veterans who have given so much already.

The Army Says It's Aware of Its Rise in PTSD, Suicides

According to a conference call today with the Army's Col. Elspeth Cameron Ritchie, M.D., among others, the Army is allegedly aware of its rise in PTSD and suicides, and making some plans to address the needs for greater access to psychological help, at least according to one blogger involved in the call, John M. Grosol, Psy.D..  It sounds like the Army has roughly half the per capita psychology help available as the civilian world. Let's hope there are plans to increase that as soon as humanly possible.  Lives and wellbeing are both at stake.

Elspeth Cameron Ritchie, M.D.

Elspeth Cameron Ritchie, a colonel in the United States Army, holds a master's degree in public health and a medical degree. She trained at Harvard University, George Washington University, Walter Reed Army Medical Center, and the Uniformed Services University of the Health Sciences, where she is an associate professor of psychiatry. Her assignments and other missions have taken her to Iraq, Israel, Korea, Somalia, and Vietnam. She brings a unique public health approach to the management of disaster and combat mental health issues and is internationally renowned as an expert on the subject. She also has published numerous articles on forensic, disaster, and military operational psychiatry. She is the recipient of the William Porter and Bruno Lima awards. Ritchie is currently the psychiatry consultant to the US Army Surgeon General. She is also the author of "Interventions Following Mass Violence and Disasters: Strategies for Mental Health Practice."

Citizen Journalist Dad Uploads the Damning Ft. Bragg Barracks Video: "Ask Them to Fix This!"

A stunning video, shot by a returning combat veteran's dad, and uploaded to YouTube by him, shows the deplorable conditions awaiting his son in the barracks at Fort Bragg, North Carolina, after 15 long months in Afghanistan.  The screen capture to the left is a soldier plunging a clogged bathroom drain, on a bathroom floored filled with inches of standing water and raw sewage.  Ft. Bragg's living conditions, at least as shown in this video by a suitably outraged father, bring to mind those at Walter Reed, profiled by the reporting team at the Washington Post last year.  The Fayetteville Observer has weighed in with an article on the conditions at Fort Bragg, prompted by the release of this video, and they're asking for answers, too.  Do yourself a favor and watch what one citizen journalist did to document the conditions facing some returning military.  We are not remotely giving them the care that they deserve.  And it's shameful that public pressure has to be brought to bear, by videos like this, before conditions are improved for returning servicemembers. When you think of all the challenges they've been through, which are more than enough to process and decompress from, the last thing they need it to be "greeted" with hospitality like this.  If this is how we treat our returning soldiers, what hope can they have that we as a country really care about their welfare -- mental, emotional, physical and spiritual.  These pictures speak louder than words.  Watch the video, below.  The article in the Fayetteville Observer is linked here; with follow-up linked here, and three full days later (cough, cough) on CNN, linked here.  (It's great to scoop CNN on a blog ;-).  (Military.com has not covered it yet, but ideally they will, and soon.)  Over time, of course, we can expect to see follow-up, and damage control, and spin -- and eventually, one hopes, actual change.

Editor's Note: the video was uploaded by Edward Frawley, the father of a sergeant who served with the Army in Afghanistan, as part of Charlie CO 2/508 82n Airborne.  His son returned to the U.S. on April 13, 2008, and is living in the dilapidated barracks on base.

"All I Want Is What I Deserve" -- a Soldier's Own Story of Service, Injury and Neglect

Tony Neff is a 22 year old Army veteran, now disabled, who served in South Korea, Kuwait and Iraq.  This Frederick, Maryland native, from a military family, was trained as an arc welder, but is also an excellent, clear writer.  Recently he took the time to write out the story of what happened to him since his injury, and it offers a very compelling, straightforward look at the life of a disabled veteran.

Tony's original injury, while service-related, may not reek of the glory of combat, but his story nevertheless shows how completely life up-ending a disability is in one so young.  It also shows how not getting the care you need in the field, or even afterwards, can result in a progressively worsening condition.  Tony's original back injury, never properly diagnosed or treated, has reduced this big, strapping, and need I re-emphasize, young guy to first a cane, now a wheelchair.  Now back in the U.S., but still being treated by the V.A. system, this weekend he went to the Emergency Room, because he'd lost feeling in his leg.  Perhaps almost as hard, this hard-core truck enthusiast had to give up his beloved Dodge Ram SR10 truck because he couldn't afford the payments.  Really, who could afford anything on the miserly $212 a month Tony currently gets for what seems like fairly complete disability?  Reading his story, you're struck by how, in the civilian world, Tony would have a great case for medical negligence, with the possibility of a jury payout that would far exceed his being able to get his truck back.  In the military, though, no such luck.  Tony now suffers from PTSD, as a result of his combat experience, in addition to his injury, so he's currently undergoing a new round of evaluations for his PTSD disabilty as well.

Take the time to read Tony's story, written in his own words, and see if you don't agree with him that what this soldier wants is only what he deserves.  And with an umpteen billion dollar budget for warfare, can't we find more than a measly $212 a month for this injured soldier?  It's just plain wrong and un-American to separate a man and his truck!  Download tony_neff.pdf

Editor's Note: Tony's pic is up on the Frederick News-Post online, as a hometown hero.  Follow this link to go there.  Tony is also an ardent supporter of the National Fallen Heroes Memorial, and would appreciate your support for that good work.  Click here to follow that link.

Army Admits Troop Suicides "On the Rise"

An article on Yahoo! today reported that the Army admits that troop suicides have been on the rise.  While the numbers and the increase may not be staggering, there's also some sense (outside the scope of the article) that suicides are actually being under-reported, for various reasons.  Some would also argue, any suicides are too many.  But life is hard, and combat can make it even harder.  Then the various "tools" people employ to handle the pain and the stress may make matters worse as well.  In any case, this is going to be a topic to watch over the coming years.  There was some argument about sucides among troops in Vietnam: that more Vietnam veterans died from suicide than died in the war itself; although this conclusion was often disputed, it was equally often contended to be true.  There's also been some statistic floated about that suicides among the children of Vietnam veterans are three times as high as would be characteristic of the same age group in the general public.  If this story is true, what about the situation is making it so difficult, and what, if anything, can be done to "combat" it (no pun intended).  It's hard to conscience that life is so difficult for returning combat veterans; it would be nice to think the price they'd already paid would be price enough.  Apparently not, though.  Keep this topic in mind over the coming months and years -- see how it develops.

Soldier Describes the Emotional Burden of War

A decorated Army Iraq veteran, with a master's degree, shares the pain he feels:

“I am a man who carries the emotional scars of tragedies that have befallen me.  From my initial activation for the World Trade Center disaster, to my deployment to Iraq in 2003.  Seeing so much destruction and death, and having lost friends in both catastrophes changes a person.

I don’t go out and have wishes of committing violent acts, nor do I see apparitions.  I just have developed very little tolerance for ignorance and unsophisticated thinkers – who believe that all soldiers are trained just for killing, and that there is no compassion for human life.  If you know someone who’s been over to Iraq, please remember one thing: he or she is not the same, and it’s a burden in their lives that they were there, and what the saw.  Show your love and support, and never turn your backs on them.”