Healing Combat Trauma

Vietnam Veteran Turns to Acupuncture, Qi Gong and Yoga for Relief from PTSD

We've been discussing various forms of Complementary and Alternative Medicine, or "CAM" for short, which seem to have potential therapeutic usefulnessness for treating PTSD.  Here's a mention in a recent article in the Salt Lake Tribune of March 14, 2008, of other Eastern methods, including the energetic medicine, "Qi Gong," which appear to have brought some relief to one Vietnam war-era nurse.  From an article by Matthew D. LaPlante:

Mary Jane Shipley is a 62-year-old former trauma nurse who was stationed at a mobile Army hospital in Vung Tau, Vietnam. 

Shipley's "eyes well with tears," LaPlante writes, at the recollection of the young men she watched die there, burnt and broken and missing pieces of their bodies as they faded away." 

He continues, "Shipley says she knew almost immediately after returning home there was something wrong with her. In part, it was the helicopters. She could hear them, even smell them, ferrying patients to the Salt Lake City hospital where she worked - sometimes minutes before any of her associates could."

Her other symptoms are hallmarks of PTSD: "She had trouble relating to other people. She was restless. She was constantly afraid. Perhaps to the eyes of today's doctors and nurses, Shipley's illness would have been obvious. But back then, no one reached out."

In Shipley's case, according to LaPlante, "It took her 30 years to realize she wasn't alone. Now in treatment for post-traumatic stress disorder, the Western-trained nurse has found Eastern therapies to be most helpful. She practices yoga and qigong. And at least twice a week, she undergoes acupuncture. "It took me so long to figure out what works for me," Shipley laments, "and I still have so much trouble."

Writing Workshop Planned on "Trauma, Art & Writing" for June, 2009

Plan ahead for this writing workshop, June 15-26, 2009:

Sponsored by the William Joiner Center for the Study of War and Social Consequences and the Creative Writing Program of the University of Massachusetts Boston.

This workshop - open to writers of fiction and nonfiction, poetry, playwriting and translation - involves one or two weeks of working sessions and individual consultations with distinguished writers. The faculty includes Vietnam veterans and others whose lives have been altered by the experience of war, but applicants with diverse interests and backgrounds are encouraged to apply.

Visiting writers will join the teaching staff in a series of readings, seminars, and panel discussions. Special events held at UMass Boston and at other Boston locations will be open to both workshop students and the general public. This year's faculty reading series schedule will be posted.

Editor's note: Additional information about the writing workshop, including faculty bios, course schedule, accommodations, and application (as well as other materials) are linked here.

Why Soldiers Rape - Helen Benedict on Military Sexual Assault

If you've been following our recurring coverage on military sexual trauma (MST), here is an important addition to it: Helen Benedict, a professor at Columbia University's Graduate School of Journalism, currently on sabbatical, has a book coming out next year from Beacon Press called "The Lonely Soldier: The Private War of Women Serving in Iraq."  (You can pre-order the book at Benedict's own website, linked here.)

On Memorial Day weekend, she published an OpEd recently on the subject, in the New York Times. The piece, which was entitled "For Women Warriors, Deep Wounds, Little Care," is linked here.

A few months later, in August, she published another OpEd, called "Why Soldiers Rape," in a different outlet, which is linked here. Compared to the NYT piece, this one is more overtly politicized, both in thinking and in language.

While that strategy can have pros and cons, one positive is -- whether you agree with it or not -- that it's a useful stance to take to provoke thinking and/or discussion.  (Although I'd also like to compare the two essays side by side to see how Benedict treats the same material slightly differently, for different audiences.)

Decades ago, feminist authors and filmmakers were able to accomplish traction by taking on topics like rape (Against Our Will: Men, Women and Rape, by Susan Brownmiller) and pornography (Not a Love Story: A Film about Pornography, by Bonnie Klein, with Susan Griffin and others) as aspects of the culture that harm women substantially, yet are frequently overlooked.

(Benedict's website indicates that a previous article published in Salon last year, "The Private War of Women Soldiers," was awarded the James Aronson Award for Social Justice Journalism in 2008. That article is linked here.)

Some of the terms Benedict uses, like "misogyny" (literally, hatred of women) are very strong indeed.  How big a problem is this really? My hunch is less so than what Benedict suggests.  But by using such volatile language to communicate similarly incendiary thinking, Benedict succeeds in drawing greater attention to the problem.  Doubtless what she portrays, however, is not "everywoman" servicemember's experience in the military.  (The comments to the NYT piece make that abundantly clear.) But for those who are harmed by military sexual trauma, no doubt she makes some very good, and thought-provoking points -- even if you don't end up agreeing with everything she says, or how she says it. 

Another difficulty is the topic is so polarizing, based on individuals' own experiences -- that those who have suffered from it tend to see the pervasive nature of it; whereas those who haven't personally experienced also tend to believe their experience is the norm, and shut out the other point of view.  (See the comments section in the NYT piece for examples of this "all or nothing" thinking.) In this way, both sides run their own risk of illustrating the cliche that "when all you have is a hammer, you tend to see everything as a nail."

The following is an excerpt from that piece:

"Rape in civilian life is already unacceptably common. One in six women is raped or sexually assaulted in her lifetime, according to the National Institute of Justice, a number so high it should be considered an epidemic.

In the military, however, the situation is even worse. Rape is almost twice as frequent as it is among civilians, especially in wartime. Soldiers are taught to regard one another as family, so military rape resembles incest. And most of the soldiers who rape are older and of higher rank than their victims, so are taking advantage of their authority to attack the very people they are supposed to protect.

Department of Defense reports show that nearly 90 percent of rape victims in the Army are junior-ranking women, whose average age is 21, while most of the assailants are non-commissioned officers or junior men, whose average age is 28. . . "

Benedict ties rape to misogyny -- literally, hatred of women -- and what she suggests is the systematic, institutionalized degradation of women in the military:

"Two seminal studies have examined military culture and its attitudes toward women: one by Duke University Law Professor Madeline Morris in 1996. . . and the other by University of California professor and folklorist Carol Burke in 2004 . . . Both authors found that military culture is more misogynistic than even many critics of the military would suspect. Sometimes this misogyny stems from competition and sometimes from resentment, but it lies at the root of why soldiers rape. . .

Morris and Burke both show that military language reveals this "unabashed hatred of women" all the time. Even with a force that is now 14 percent female, and with rules that prohibit drill instructors from using racial epithets and curses, those same instructors still routinely denigrate recruits by calling them "pussy," "girl," "bitch," "lady" and "dyke." The everyday speech of soldiers is still riddled with sexist insults. . .

The view of women as sexual prey has always been present in military culture. Indeed, civilian women have been seen as sexual booty for conquering soldiers since the beginning of human history. So, it should come as no surprise that the sexual persecution of female soldiers has been going on in the armed forces for decades. . ."

Benedict then goes on to suggest why rape is under-reported in the military:

"Having the courage to report a rape is hard enough for civilians, where unsympathetic police, victim-blaming myths, and the fear of reprisal prevent some 60 percent of rapes from being brought to light, according to a 2005 Department of Justice study.

But within the military, reporting is much riskier. Platoons are enclosed, hierarchical societies, riddled with gossip, so any woman who reports a sexual assault has little chance of remaining anonymous. She will probably have to face her assailant day after day and put up with resentment and blame from other soldiers who see her as a snitch. She risks being persecuted by her assailant if he is her superior, and punished by any commanders who consider her a troublemaker. And because military culture demands that all soldiers keep their pain and distress to themselves, reporting an assault will make her look weak and cowardly.

For all these reasons, some 80 percent of military rapes are never reported, as the Pentagon itself acknowledges. . . ."

And then Benedict suggests two reasons, not exactly complimentary to recruiting, about how violence is perpetuated in and by the system.  Hmmmn.

"Misogyny has always been at the root of sexual violence in the military, but two other factors contribute to it, as well: the type of man who chooses to enter the all-volunteer force and the nature of the Iraq War.

The economic reasons behind enlistment are well understood. The military is the primary path out of poverty and dead-end jobs for many of the poor in America. What is less discussed is that many soldiers enlist as teenagers to escape troubled or violent homes.

Two studies of Army and Marine recruits, one conducted in 1996 by psychologists L.N. Rosen and L. Martin, and the other in 2005 by Jessica Wolfe and her colleagues of the Boston Veterans Affairs Health Center, both of which were published in the journal Military Medicine, found that half the male enlistees had been physically abused in childhood, one-sixth had been sexually abused, and 11 percent had experienced both. This is significant because, as psychologists have long known, childhood abuse often turns men into abusers. . .

Worse, according to the Defense Department's own reports, the military has been exacerbating the problem by granting an increasing number of "moral waivers" to its recruits since 9/11, which means enlisting men with records of domestic and sexual violence.

Furthermore, the military has an abysmal record when it comes to catching, prosecuting and punishing its rapists. The Pentagon's 2007 Annual Report on Sexual Assault in the Military found that 47 percent of the reported sexual assaults in 2007 were dismissed as unworthy of investigation, and only about 8 percent of the cases went to court-martial, reflecting the difficulty female soldiers have in making themselves heard or believed when they report sexual assault within the military. . ."

(Those last statistics are perhaps most troubling of all...)

Benedict also has an essay on her website that's worth reading, called "For Women Warriors, Deep Wounds, Little Care," which is linked here. (Same title as NYT piece, slightly different content.)  Watch for her book to come out in the Spring of 2009, from Beacon Press.

Go to War, Do Art - Afghanistan and Iraq Combat Art Show Opens in DC

You are invited to visit the new show opening on "Afghanistan and Iraq: Combat Art," from the United States Navy and United States Marine Corps Combat Art Programs.  

Pictured here is USMC Warrant Officer and Combat Artist Michael Fay, with his unfinished canvas for "Between Sunset and Moonrise, Wazir Pass, Afghanistan" (oil paint on gessoed watercolor paper). 

Fay is one of the combat artists featured in the exhibit, and we've written about his powerful work before on this blog: here,  here, and here, among others.  Marine Sgt. Kristopher Battles is another U.S. Marine Combat Artist whose work will be featured in the exhibit.  Both come from a long tradition of those told to "Go to War, Make Art" -- both in the Marine Corps and in the other branches of the military.

See the superb PBS series, "They Drew Fire," for more on combat artists.  Abbott Laboratories has its own magnificent collection of war art.  For more on the Marine Corps combat art program, and its permanent inclusion in the new Marine Corps Museum, click here.  For a look at Mike Fay's personal blog, Fire and Ice, click here.

We're going to assume that the combat art show is going to be in the same place the opening for it is: in other words, the (irony) Cold War Gallery, Building 70, at the Navy Museum, in the Washington Navy Yard.  My guess is it's moving later to the permanent digs at the new Marine Corps Museum. If this information later on turns out to be different, I'll update it when I know for sure.  In the meantime, here's a link to the Cold War Gallery: there does not seem to be a page up yet for the show itself (bummer).

In the meantime, at right is a look at Fay's finished work for "Between Sunset and Moonrise, Wazir Pass, Afghanistan."  His artwork, which the BBC and the Wall Street Journal have both profiled, contains any number of extremely moving images, particularly his sketchwork, and recently his bronzes.  Amazing stuff.  If you're in the DC area, do yourself the favor of catching this show, and acquainting yourself with the rich tradition of combatants who clarify through art what it's really like to be a veteran of war: the bad, the good and the ugly.

And while you're at it, be sure to check out our extensive collection here of links to art and war, and also art therapy -- a modality that doesn't work for everyone, but for those whom it helps, including combat veterans, a true blessing as a way to process the images lodged in the subconscious through a means that releases them therapeutically (i.e., catharsis).

The Other Purple Heart: For Wives, Husbands and Partners of Those with PTSD

The Bible, in the section known as Proverbs (from the Wisdom Literature tradition), has a stunning description of a woman known as the "Proverbs 31 Woman," or the "wife of noble character."  Here's just one sampling of what she's said to be like: "A wife of noble character who can find? She is worth far more than rubies. Her husband has full confidence in her and lacks nothing of value. She brings him good, not harm, all the days of her life."

From the spiritual to the secular, we have another example of the same in the praise that well-known philanderer Ben Franklin (and yes, that's a man who collects paramours, not stamps -- in his case, on two sides of the Atlantic) heaped on his wife, Deborah, for being the highly-cliched but apparently in their case, true, "wind beneath his wings."  While Franklin became famous for, among other things, his witticisms about wealth in "Poor Richard's Almanac," he often credited his wife and her good habits with being the reason they saved any money at all. (I'll find the reference later, but it's true.)

Well, if you scratch the surface of PTSD and veterans, you quickly find how many of the perhaps less famous (guys get famous) , nonetheless vitally key players, heroes and and true angels, are women.  There's Sarah Haley, who we read about the other day; Kathie Costos; Patience Mason; Aphrodite Matsakis; the list goes on and on.  (We fully expect that Kellee Twiggs was that kind of woman, too; as is Bet Ison; as is the highly-impressive Jennifer Briest, though that's TBI not PTSD.) And now, there's Pat Kemm Mann who we can add to the list.  (Not the same "Pat," whose wonderful insights and recollections into his time at war we've been reading about in the "Eyewitness to Combat" series.)  This lady is one impressive person, in her tremendous caring for her husband who she met and married when he had PTSD, as well as her remarkable smarts and strength of character in being the support he and their subsequent family needed.  Just an amazing woman. 

Not saying she's likely to be the only one out there -- actually, she reminds me very much of Kathie Costos, through whose blog I learned about her story, and secured permission to reprint it here -- but she IS very much worthy of our admiration, and she is also articulate and organized enough to tell her story in a compelling way: a story she's willing to share in the hopes that it helps younger wives and women learn what it takes to "love someone with PTSD" and be a real support to them in the life they build together.  As we read about yesterday in the Tao of Caring for Others, sometimes caring for someone else can be just an expression of who you are.  In Pat's case, that's the story.  Here it is, in her own words, about "loving someone with PTSD":

"At the age of 32, I met a man who wasn’t intimidated by my independence or education. A man who made me laugh, introduced spontaneity into my life and who cherished me. He was a 30 year old Nam vet...and twice divorced. But we shared the same family values and dreams for the future. When he proposed, I told him that I was not going to be his third wife; I would be his LAST wife. I only intended to get married once.

He told me that he had a dark side. I had no idea what he meant. I was to find out within months of our marriage. He was driven at work. Always put in more than was required. Naively, I just assumed he had a strong work ethic. I didn’t realize he was trying to escape demons. He had warned me about nightmares; told me how to wake him so he wouldn’t inadvertently hurt me. As a GI Brat growing up in a family with a strong, military tradition, I didn’t think it that unusual since I had several uncles with the same problem.

3 months after we married, however, his behavior began to change noticeably. He began “self-medicating” with alcohol. And he began seeing things that weren’t there. Hearing people calling him for help. Sometimes hearing a child cry would make him jumpy. The smell of urine would bring flashbacks. He had to sit with his back to the walls in restaurants. Anxiety attacks in crowded places. Sudden noises, like party balloons popping or a car back-firing would make him jump or even “hit the deck”. He would be embarassed and apologetic, telling me it sounded like small arms fire.

I was to learn that he had entered a 6 month period of “anniversary dates”. Not pleasant anniversaries. Anniversaries of the Tet Offensive, of being left for dead under a pile of bodies, of being a VC POW (until he managed to escape), of ambushes, being overrun, of being shot down, wounded and crawling and hiding for 7 days until he reached a friendly LZ. All of them crashing down on him like an avalanche of horror.

One day he came home from work and instead of coming into the kitchen where I was washing baby bottles, he went downstairs to the basement. That was unusual but I didn’t think too much about it. Then suddenly I felt an overwhelming sense of panic. I dropped the baby bottle and ran down the stairs. He was standing under them, in the dark, with a pistol in his hand. He was exhausted and terrified of going to sleep because at least when he was awake, he could see what was happening around him as well as the “film” his mind was playing. But he couldn’t make himself blow his brains out because he didn’t want me to have to live with that image forever burned in my brain.

The term PTSD wasn’t known then, or at least not known by many. But I knew my husband was suffering from “Combat Fatigue”. He didn’t want to believe that. Hell, he was a Hillbilly. A rough, tough coal miner. A combat hardened Marine. A third generation Marine... But one who’d been on Valium (through a civilian doctor) since he finished his second tour of duty.

He ended up starting therapy before our first anniversary. The man I had fallen in love with was slowly disappearing, being overshadowed by an often cold, uncommunicative loner. Sometimes I felt like a Life Guard, hanging on to a drowning man, refusing to let him go under.

But I had an advantage that many of the younger wives of combat vets didn’t have. Growing up on military bases. A brother and friends who’d gone to Vietnam while I was in college. I was 33 years old. And I had enough psych courses under my belt that I was able to "deal" with the nightmares, hallucinations, rages, and suicidal ideations as well as monitor and administer the massive quantities of anti-psychotic medications the VA was doling out... (and to eventually question the efficacy of most). Even so, the pain of seeing him look at me, with total confusion in his eyes - knowing he doesn’t know who I am but thinks he should... the pain and sorrow was indescribable.

His cup of stress was full to the brim from memories alone. Anything at all, no matter how minor, was like that one extra drop that causes the cup to overflow. Every car “accident” - always single car accidents, one near fatal - happened immediately following his 6 months of anniversary dates, when he had reached the limits of his endurance.

At one point, we lived on the Texas coast. Driving to the Houston VA was a challenge. It’s a nice, straight highway but for long stretches, it has rice paddies on both sides. He drove hunched over the steering wheel , knuckles white. Eyes darting constantly left and right. Muttering about damn rice paddies. I knew what he was doing and finally told him “I’ll drive. You watch for Gooks.” After that, I always drove that stretch.

I found myself “interpreting” other people’s actions and comments to my husband so he wouldn’t deck someone who had merely glanced our way but whom he thought was challenging him. He was quick to anger and quick to fight. But he was mostly able to keep his promise not to get in fights after I told him I knew he could take care of himself but no matter how the other guy looked, it hurt me to see him with scraped and swollen knuckles.

It wasn’t easy. And it wasn’t fun. But the man I loved was still in there and I was determined to beat back the demons that were dragging him down. We lost some friends who just saw him as crazy or irrational or scary. I remember once asking “Who are we not friends with this week?” His head kind of jerked, he looked at me for a moment and then he laughed. It stopped another rampage over an imagined insult or slight.

He had no patience at all. If we decided to go somewhere, the girls and I had to be ready to go the second he was. I’d remind him that no one’s life was in jeopardy if we were slower than he wanted. The thing that did the trick, though, was the time I finally took the car keys from him, handed over our two small daughters and told him that this time, HE could get them ready to go. I’D sit in the car and honk the horn.

He started group therapy and we found friends who understood because they were going through the same thing with minor variations. Almost all had done the “geographic