Healing Combat Trauma

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)

When PTSD Sufferers Can't Sleep, Award-Winning "Pacific Light" DVD Brings Some Healing Peace

Hyperarousal or heightened anxiety.  Flashbacks, nightmares, intrusive memories.  Intense physiological stress symptoms: pounding heart, rapid breathing, nausea, muscle tension, sweating. Difficulty falling or staying asleep.  Irritability or outbursts of anger. Difficulty concentrating. Hypervigilance, or being constantly “on guard.” An exaggerated startle response, or jumpiness. Inability to relax. All these symptoms are very familiar to PTSD sufferers and their families.

Pacific Light, Wind and Waves Healing Music DVD for Stressed and Anxious Patients.

Into this mix comes the award-winning "Pacific Light" DVD, and the elusive promise of an interlude of healing peace, that might even involve a good night's sleep.

Time, Inc. awarded Pacific Light its first place award for health and medical media.  Alternative Medicine mgazine calls Pacific Light "a breathtakingly beautiful video."  And over 400 hospitals use "Pacific Light" to help provide an atmosphere of healing peace for distressed patients and their families.  Walter Reed, the Mayo Clinic, the U.S. Army, U.S. Navy and the U.S. Marine Corps at Twentynine Palms, plus hundreds of other institutions are becoming fans of this DVD, a combination of stunning cinematography of some of the West Coast's most beautiful locales, filmed at sunrise and sunset, with no cheesy voiceover instructing patients to relax -- instead, the Grammy-nominated, award-winning soundtrack of R. Carlos Nakai's cedar flute music, as arranged by Billy Williams.

Pacific Light is the second DVD in a series by Thomas Day Oates, Jr., an amazing person and personal friend, whose own bouts with serious illness changed his career path into cinematography.  Oates has a very strong conviction about the importance of distressed patients and their families being able to create a space for "healing peace" - he believes the words are almost synonymous -- and that without a sense of peace, people can't begin to heal.

Apparently, a number of hospitals, hospices, and patients agree -- the testimonials are pretty impressive; and even without them, watching a clip of the gorgeous scenery and its peace-inducing soundtrack make the point instantly accessible.  For hospitals and institutions, click here. For individuals and families, click here. Website linked here.  Ordering info: 1-877-835-0838. Special pricing for veterans and their families: $19.98, including shipping and handling (within the U.S./APO/FPO). Call to inquire.

Editor's Note: You know who/where else needs this DVD?  Balad Military Hospital in Iraq. Landstuhl Regional Medical Center in Germany. The Combat Stress Control Unit. Mologne House Hotel in DC. Military chaplains in Iraq, Afghanistan, and stateside.  PTSD residential programs at the VA. VA Medical Centers.  Wounded warrior units.  Wounded troops, wherever they are recovering, at home and abroad.  The possibilities are practically endless.  And not just for the troops themselves: for their caregivers as well, who often are also suffering from vicarious trauma.

Twiggs' Wife: "The PTSD Drove Him Crazy"

Wow...well, for a truly excellent experience, see this raw footage by Arizona TV reporter Suzanne Kennedy, interviewing SSgt. Travis Twiggs' wife, Kellee.  It's great stuff.  Kellee Twiggs speaks her mind, the reporter asks fairly good questions and leaves Kellee plenty of room to talk, and it's long -- which means you get quite an opportunity to hear from Kellee about what Travis Twiggs was going through recently, and how she felt about it.  Really excellent work.  It also clears up a lot of the mystery about what the last few months of Travis Twiggs' life was like, and reinforces the impression we probably already have, about how the Marines are still quite a bit better at fighting wars than they are at tending to the needs of their warriors, and how Twiggs' guilt over losing several men from his platoon weighed on him heavily, and didn't resolve.  Kellee comes across in a great way, and it's very sad at the end of the tape, when she breaks down talking about how much she misses him.  In the rest of the tape she's very composed, under the circumstances, and makes an impassioned advocate for better psychological care for the troops.  Here's the link to the excellent raw interview footage; if it becomes available as a video to embed, I'll add it here as well.  Great work.  Click here for the link.  (See also this later blog entry, linked here, which includes a transcript of the interview.)

Editor's Note: Elsewhere today we've learned that Kellee and her husband, Travis, go way back: they were childhood neighbors in Louisiana, and had been married for nine years, with two children.  That's another way of saying, she really knows the guy, and what's "normal" or "abnormal" in his behavior.

Aspen Institute Forum on PTSD and Iraq Veterans

Thanks to the miracle of the Internet, the full program from last fall's Aspen Institute's Health Forum on PTSD and Iraq War Veterans is available on the Web.  The program was entitled, "From the Front Lines: Post-Traumatic Stress Disorder and the Legacy of Iraq," and it featured panelists Charles Figley, Ph.D., combat veteran Georg-Andreas Pogany, Jennifer Vasterling, Ph.D., and Barbara Romberg, Ph.D..  Click here for the link to the video, or just watch it below.

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.

Showing Our Gratitude - How to Thank a Veteran

Ever wanted to thank an active duty military or veteran you see out and about, while you're running your errands, but not known how?  Want to avoid a potentially awkward moment with a total stranger, but still convey your appreciation?  (Thank the ones you know, in person -- please.)  Here's a wonderful little film about how you can.  One simple gesture that sums it up, in a gracious, heartfelt way.  Let's hope THIS becomes a trend that sweeps the nation...

As the flm clip memorably says: "It's not about politics.  It's about service.  And sacrifice.  And gratitude."

Way freakin' cool...

Watch the short film here.  Watch the slightly longer, full-length film here.  Learn about more about the Gratitude Campaign here.  BTW -- this is the short version, from YouTube, below:

What Does It Mean to Reach the Breaking Point?

What does it mean when an individual -- or a system, such as the VA -- reaches its breaking point?  Do they even know?   And what can we learn from what makes some, or even many or most, snap under the strain, when others (a few) manage to survive and find meaning, not crushing, in their suffering?

Viennese psychiatrist and Holocaust survivor -- concentration camp survivor might be more accurate -- Viktor Frankl wrote Man's Search for Meaning, considered one of a handful of hugely influential books in the 20th century. Like Elizabeth Kubler-Ross, who "systematized" the steps around death and dying, and postulated that everyone goes through them, Frankl took a look, as a psychiatrist, at the tremendous suffering he and other concentration camp inmates had experienced, and drew a few conclusions.  In his opinion, there were three main stages that everyone who suffered tremendously would undergo: shock, apathy, and either giving up, or choosing to find some sort of meaning in the suffering.

As the news we read is saturated more and more with ever more instances of veterans snapping under the pressure and the strain, and committing suicide, or going AWOL rather than return to Iraq, or lashing out at their loved ones in some extreme way; or the system itself snapping under the strain -- we are literally watching people and organizations hit their breaking points.  Some will survive, but many will not, and it's not a value judgment on the ones who do not.  Projects like the PTSD Timeline chronicle the incidences of individual combat veterans reaching their breaking points, sadly enough.  But the stressors on the system are also enormous -- the toll that combat doctors and nurses are under in treating massive injuries hour after hour in Balad, Landstuhl, Walter Reed, etc., and the various trauma hospitals where severely injured veterans are sent across the country -- the toll that the VA is under, which much greater demand for its services than can be safely delivered.  And we need to ask the question -- whether it's an individual veteran or a system supporting veterans -- what does the "breaking point" actually look like?  Will we know it when we arrive at it, or will we find out in retrospect that we just passed it, too late to do anything about it?  And is there anything constructive to be learned from those who reach the same crossroads -- either individuals or systems -- but bend, and do not break?  More questions than answers, to be sure, but questions that are both timely and need to be asked.

Rudy Reyes - Serious Veteran Eye Candy

Marine Sergeant (Retired) Rodolfo "Rudy" Reyes -- USMC 1st Recon Iraq war veteran, indisputable eye candy, soon-to-expire-cover pic from the 2007 "American Heroes" calendar from FreedomIsNotFree.org, frequent search term within this site -- we salute you.  It's a belated Veterans' day thing and/or an early birthday present to myself!  Mostly everyone who comes to this site, comes through a link or through a fairly heavy, intellectual, serious search about combat trauma, PTSD, signs and symptoms, treatment protocols that work, etc., etc.  But every once in a while, and not that infrequently, actually, somebody comes who is just looking for pics of Rudy Reyes.  I feel ya.  I can completely understand why.  So in the spirit of honoring yet another veteran who serves the cause, in his own special way, here's not just pics but actual VIDEO about Rudy Reyes, from the Freedom is Not Free website, and check this out -- there's actually some very good points being made about veterans aftercare and its affordability, or lack thereof.  Go, Rudy!

(If you've read Evan Wright's Generation Kill, or Nate Fick's One Bullet Away, both about the platoon in the 1st Reconnaissance battalion in which Fick and Reyes served in Iraq, you've been introduced to Rudy Reyes already.  Here's a pic of Nate Fick and Rudy Reyes from their tour in Iraq with 1st Recon that was on the web a while back, probably from Wright's book.  And here's the cover pic of Rudy Reyes from the current philanthropic calendar for Freedom is Not Free, before it got airbrushed a bit more.   Swoon, faint, thud...).

Editor's Note: Apparently Generation Kill is going to become a 7-part miniseries on HBO, and Rudy Reyes is tapped to play himself.  Hre's the link to the news on HBO (see item from June 1, 2007).

Nate Fick's Inspirational Stance on Veterans Care

Last year around this time I had the pleasure of meeting Nathaniel Fick, author of the stupendous One Bullet Away: the Making of a Marine Officer.  (Here he is at the Marine Ball at the Harvard Business School, where he is an MBA candidate, signing a few copies of his book.)  Whenever I think of combat trauma, I think of how inspirational Fick's own words on the subject were.  Writing in an article in the Boston Globe from August 28, 2005, entitled, "Coming Home...to What?" Fick wrote about the need to take veterans' psychological health seriously on their return from combat, possibly even mandating screening for combat trauma/PTSD.  Said Fick at the time:

The screenings are only one step in the long process of reintegrating combat veterans, but mandating them would correct a dangerous oversight and better serve both veterans and the communities where they live. To have value, though, the screenings must be done right.  Members of the active-duty forces are already subject to post-deployment mental evaluation, as are the National Guards of several states. These screenings often involve little more than filling out forms.

I remember slogging through my own mental health questionnaire after leaving Iraq, answering questions such as ''Did you ever feel that your life was in imminent danger?" Yes.  Or ''Check all that apply: I saw the dead bodies of a) enemy combatants; b) American forces; c) civilians; d) all of the above." D.

Answers like mine should have prompted some sort of follow-up, but none came.

Psychological screenings in a vacuum are worse than a waste of time because they give a false sense that someone has been ''cleared." The main lesson of my experience is that the recovery process takes time, and healing only happens in community. Screenings can be gateways to those communities, both formal ones such as therapy groups and counseling sessions, and the informal networks of friends, neighbors, and colleagues with whom we live.

In a war whose burden is borne almost exclusively by the tiny minority in uniform and their families, veterans' care is one place we can all make a difference."

Nate Fick's book, One Bullet Away: the Making of a Marine Officer, is well worth reading, as is the rest of his writing.  But most of all, I appreciate his inspirational stance on veterans issues -- that taking care of veterans really is the second half of the social contract, if the first half is sending them off to war on our behalf.

"Must Have Been a Real Mean Bottle" - Veterans, PTSD and Substance Abuse

The relationship between trauma and substance abuse, or in our case, PSTD and self-medication through drugs and alcohol, is well-known. Some "sobering statistics" about substance abuse and veterans -- pun quite intentional -- follow here:

• Substance abuse rates are higher among veterans than their non-veterans counterparts.
• 76% of all homeless veterans suffer from drug, alcohol, or mental health problems (National Survey of Homeless Assistance Providers and Clients, 1999).
• According to an Army Post-Deployment Reassessment Study completed in July of 2005, alcohol misuse among soldiers rose from 13% among soldiers to 21% one year after returning from Afghanistan and Iraq.

(These statistics from the excellent fact sheet at the National Veterans Foundation - "The Lifeline for America's Veterans" -- called "Facts about Veterans: Needs and Solutions." Click here for the link to the fact sheet; click here for the link to the organization.)

There's even at least one scholarly book written on the subject, Trauma and Substance Abuse: Causes, Consequences, and Treatment of Comorbid Disorders, edited by Paige Ouimette, Ph.D., and Pamela J. Brown, Ph.D. Washington, D.C.: American Psychological Association (2003).  [Editor's note: "comorbid" means "appearing together."]

In a review of it by psychiatrist Edward J. Khantzian, M.D., of Haverhill, Massachusetts, he writes that his experience, "spanning four decades of clinical work involving patients with substance use disorders," has led him to conclude that "suffering is at the heart of addictions.  Nowhere is this more evident than with individuals who have developed posttraumatic stress disorder (PTSD) and resorted to addictive drugs to medicate the distress and pain associated with PTSD."

In future blog posts, we'll cover this topic in greater depth, but for the present, it's important to note how closely intertwined the two concepts are: if combat trauma or PTSD is a "normal reaction to abnormal events," it's no surprise that so many veterans of combat attempt to medicate the most troubling and painful experiences away through misuse or overuse of drugs and alcohol.

(The blog post's title comes from the country song, originally written by Vince Gill, and performed by Bob Seger and Kid Rock on Seger's latest album, Face the Promise.  To see a video of Seger and Rock singing this in concert recently on YouTube, click here.)

The toll free number for the National Veterans Foundation is 1-888-777-4443.