Saturday, August 16, 2014

Comprehensive Treatment for Emotional Trauma


Turn on the nightly news; odds are you will hear a story about a veteran that is struggling with Post Traumatic Stress (PTSD). According to a recent Rand Corporation study, a substantial number of the more than two million military service men and women returning from deployment in Iraq and Afghanistan face behavioral health challenges. These “invisible wounds” show up as depression, anxiety, and Traumatic Brain Injury (TBI) and are being reported in staggering numbers. Veterans who suffer from this hidden damage face marital breakdown, job instability, substance abuse, domestic violence, anxiety and depression.

On a national level, both civilian and military mental health resources have insufficient capacity to provide the returning service men and women with the services that they need to treat their behavioral health challenges. In Sonoma County, health care for conditions such as TBI, PTSD and depression is limited primarily to medication. Many veterans frankly avoid these drug-centric regimens due to the undesirable side effects of dulled senses and weight gain.

Despite recent efforts to increase services provided by the Department of Defense (DoD) and the Veterans Health Administration (VHA), limited care is available at the community level. Community Based Organizations (CBO's) are where returning veterans, who are often averse to government bureaucracy and fear being stigmatized, look to receive services despite the fact that most CBO’s lack the specialized training for war-related trauma. Those services that are available are decentralized and there exists no process to systematically develop, track and evaluate individual program effectiveness.


The vision and passion of Sonoma Coast Trauma Treatment (SCTT) – a 501(c)(3) public charity – is to meet the urgent, critical need for comprehensive trauma treatment tailored to the needs of our veterans. We do this through a broad and unique spectrum of services and individually-customized treatment for veterans of the recent conflicts, as well as veterans of the Vietnam Era and Gulf War.

SCTT partners with both national and local organizations that currently provide services to veterans. Doing so allows SCTT to focus on trauma treatment – the strongest contribution we can make toward helping our nation’s veterans return to intimate family relationships and as productive members in our community.

SCTT’s protocols go beyond “one size fits all” trauma treatment model. Unlike the prevalent narrowly-focused emphasis on prescription medication and group therapy, the SCTT program quickly and confidentially evaluates and addresses the needs of the veteran and his or her family. Services are promptly delivered on a sliding payment schedule geared toward each veteran’s means supplemented by other funding, grants and donations.


Following is a partial list of  modalities included in SCTT’s integrative approach:

  • Trauma-Focused Psychotherapy
  • Reichian-Myofascial Release Therapy (RMFR)*
  • Eye Movement and Desensitization and Reprocessing (EMDR)
  • Cognitive-Behavioral Therapy (CBT)
  • Equine Therapy
  • Yoga Therapy
  • Group Counseling:
  • Addiction
  • Anger Management
  • Relationship
  • Parenting
  • Finances
  • Integrative Medicine:
  • Acupuncture
  • Nutritional Counseling
  • Drug Dependence Tapering
  • Reintegration Skills:
  • Training and Resources

SCTT’s core trauma-focused psychotherapeutic protocols combine counseling with bodywork. With more than forty years of experience in trauma treatment, we know that resolving PTSD and TBI begins with the body, where the traumatic memories are stored.
Our unique trauma work releases the trapped energy caused by the trauma, while providing valuable perspective and support through counseling. Through our treatment protocols individuals can “stand down” and unwind from the intense arousal that results from their traumatic experiences.

With the return of our nation’s forces from the recent wars, we see an opening window of opportunity to reach damaged veterans and help them heal. We also see a renewed hope for change awakening in local Vietnam Era and Gulf War veterans. Please help us take our place as agents for change and healing for these men and women who have sacrificed so much for us and who deserve our best, most effective treatment for their “invisible wounds.” SCTT is committed to this mission.

SCTT has the knowledge, experience, tools and passion to provide truly innovative and effective treatment for veterans’ combat-related trauma, and we ask for your support.

* RMFR is a trademarked protocol of the Bernstein Institute for Trauma Treatment. For more information on RMFR as well as a thorough background on emotional trauma and its physical manifestations, please read, Trauma: Healing the Hidden Epidemic by Peter M. Bernstein, PhD, available on Amazon.

Thursday, July 11, 2013

Veteran Trauma Support & Recovery Program


If you turn on the nightly news, odds are you will hear  a story about a veteran that is struggling. They may be struggling with mental health issues, or with hunger, homelessness, or even post-deployment  readjustment to family life.  According to military health policy research performed by the Rand Corporation a substantial number of the nearly two million military service men and women returning from the conflicts in Iraq and Afghanistan face mental health problems.  Approximately 35 percent of those back from deployment reported symptoms consistent with a diagnosis of post-traumatic stress disorder (PTSD) or depression.
There are identified gaps in the active-duty military and veteran’s health care systems that preclude returning service men and women from getting the type and quality of services that they need to address their mental health concerns.  Despite recent efforts to increase services available through the Department of Defense (DoD) and the Veterans Health Administration (VHA), there is still limited  care available at the community level and barriers to receiving services exist.  Currently, both civilian and military mental health resources  have insufficient capacity to treat all the returning veterans in need. In many parts of the country, including Sonoma County, specialized health care for conditions such as traumatic brain injury (TBI), PTSD and depression is not readily available.
     Most mental health specialists are concentrated in large counties and highly concentrated urban areas.  Even where specialty care is available, limited health plan coverage reduces access for veterans seeking care outside of the VHA.  The VHA expanded its mental health staff by 50% between 2005 and 2010, and yet they are still unable to keep pace with the increasing demand for services. Unfortunately, many community providers lack the therapeutic  skills needed to treat this specific population.  The VHA’s case-load crisis has been exacerbated by the phenomenon of older veterans who are already in the system filing for additional or increased benefits, as the diagnostic thresholds  for pre-existing medical conditions—often dating back to the Viet Nam war era—have been lowered.
     Technological advances in warfare and medical practices have resulted in service members  returning with wounds that would have produced fatalities in earlier conflicts,  but which now cause non-fatal but devastating effects in the psyches of these men and women. These wounds, called “invisible wounds”, exist in the form of PTSD, depression, anxiety, and TBI and are being reported in staggering numbers. Returning service members with these hidden wounds are likely to face marital breakdown, job instability, substance abuse, domestic violence, depression and child abuse. There has been a 300% increase in cases and severity of cases serving victims of violence associated with the military. Although the VHA, DoD and community organizations are doing the best they can, without thorough approaches to treatment our communities will be overwhelmed with veterans who cannot succeed in civilian life. Many lack the skills to be productive, stable citizens because of war-related trauma. While the DoD already funds more than 200 programs to address these issues, challenges to maximizing the effectiveness of these programs exist.
     There is a lack of knowledge of and/or specialized training  for war-related trauma among service providers, especially among CBO's where returning veterans often look to receive services. Additionally, most services are decentralized and lack a process to systematically develop, track and evaluate program effectiveness. Improved planning and coordination, the sharing of information, rigorous evaluation and offering services in nontraditional locations to expand access to care are key factors to expanding efforts to better support service members and their families.
     The Veteran Trauma Support & Recovery Program will provide CBO's with a tool-kit which includes specialized, evidence- and research-based practices to address the growing demand of this population. Petaluma People Services Center will be the first of many CBO's to be trained in the trauma treatment protocols of the Bernstein Institute for Trauma Treatment to help our service men and women return to healthy, productive functioning in our communities.  This program offers an expansion of what others have successfully done with peer-to-peer counseling, by purposefully incorporating into the treatment protocol the participation of a returning veteran who has a desire to follow a career path as a trained therapist or social worker.  Peer-to-peer trust is the basis of unit cohesion in all branches of the military, especially those with combat responsibilities. Numerous post-combat studies have shown that “fear of letting your buddy down” is far greater than “fear of injury of death” among combat soldiers and Marines. In short, peer-to-peer trust and loyalty is what keeps service members  in combat.  For fear of letting down their “foxhole buddy”, soldiers and Marines “gut it out and fight.”  A majority of veterans report that one of main challenges they face when attempting to re-integrate in civilian life is the loss of the close bonds with  their former comrades and others their small unit – usually a squad or platoon. By providing battlefield veterans as counselors and mentors, our peer concept will help the client form the initial, critical bond essential to keeping  client returning for subsequent phases of treatment.  We are specifically recruiting combat vets (i.e., Navy SEALS) to serve as clinically-supervised "peers" for veteran clients,  with the goal to create a safe environment.  This safe environment will retain the veteran in a program of therapy and counseling long enough to experience real healing.Longer-term retention of clients will also help us develop and perfect a training and dissemination program for the Veteran Trauma Support & Recovery Program protocols and also to create a sustainable, replicable program that can be utilized across our nation in years to come.   Participation in treatment also offers  service members who are looking for a new career an opportunity to obtain the required hours of internship training by teaming a peer counselor with a  supervising therapist.Our program will offer peer-to-peer treatment and career opportunities not normally obtainable for returning veterans. 

Goals and Objectives

With funding we hope to train a core group of mental health providers in a specialized treatment modality, e.g., Veteran’s Trauma Support & Recovery Program, to address the mental health and reintegration issues faced by our returning service members and veterans. The program goal  is to restore veterans to full, productive, successful lives following their traumatic experiences in theatres of operations around the world.  Program protocols have been developed and utilized in treating veterans for the past 40  years by the Bernstein Institute for Trauma Treatment ( We believe that while learning and practicing skills for coping with trauma is essential as a first step, healing trauma requires therapy that goes beyond counseling and an often  lifelong dependence on medication. Truly effective therapy for service members suffering from PTSD, depression, and other co-occurring conditions must address the traumatic memories and emotions stored in the body.
     Our approaches encompass all aspects of trauma resolution – physical, emotional, mental, and spiritual. We will work with the services member and their families to restore the quality of life these warriors deserve for the sacrifices they made for us.
     PPSC will follow a strict treatment protocol from which we can track outcomes and treatment effectiveness  to  allow for replication for a large scale rollout in years to come. We have already discussed collaborating with larger organizations that have the capacity to help us take the necessary steps along the way with data collection and tracking. Relationships with the greater community will play a major role in the operation and sustenance of the program.  Additional support will be provided during  the treatment process by introducing a peer navigator or coach in the first phases of the treatment and continuing throughout the process.  This peer-to-peer counseling has proven successful in this population because the peer coach personally understands the effects of PTSD and TBI. We also know that this navigator must maintain on-going contact with the client and his or her loved ones while they work through the treatment of their war-related trauma and its impact on the client’s family.
     Groups which support our program and stand ready to refer veterans to us include: Veterans Administration’s trauma treatment facilities in Santa Rosa, San Francisco and Palo Alto; Vietnam Veterans of California; Northbay Veterans Center; Northbay Veterans Resource Center; the Coming Home Project; Swords to Plowshares; the Wounded Warrior Project; local reserve and National Guard units; Two Rock Coast Guard base; Sonoma State University, Santa Rosa Junior College, College of Marin and San Francisco State University; and the local chapter of Veterans of Foreign Wars. Addiction therapy will be provided in partnership with local community treatment centers or hospitals. We will be working concurrently with these agencies, managing overall treatment, placement, and training decisions. With  this design we can continue to offer the most thorough and long-lasting treatment and case management which is consistent historically with the Bernstein Institute’s approach for all clients. Partnerships with local community organizations will be used to surround the participants with professionals, para-professionals, peers and mentors. Community misconceptions about returning service members with PTSD, depression, and other trauma-related disorders can be corrected by positive interaction with our program.
     The outpatient trauma treatment program will be comprised of five phases: Assessment; Debriefing; Main Treatment; Reentry; and Aftercare. Each phase of the treatment will be conducted by trained professionals and a peer navigator, who will potentially  have daily contact with the client.  With an intial capacity to treat up to 25 participants per week, the Veteran Trauma Support & Recovery Program will grow to serve 50-100 patients per week within one year. Average program involvement will be 9 months to one (1) year with a maximum involvement of 3 years. Length of participation will vary for each veteran. Participants will gain access to appropriate program and community support services as they transition through the program phases.


In review, effective mental health services for our returning veterans and first responders are lacking in accessibility and many community-based providers lack the specialized knowledge and training to treat complex war-related traumas. Additionally, many veterans or active-duty service members often seek mental health services outside government programs due to perceived discrimination; they are often fearful that if diagnosed with a mental disorder their standing in the military will be affected. Often, the veteran or service member is not the only family member  who needs assistance, and mental distress is not the only issue affecting the veteran and their family members. When veterans seek assistance from CBO's, ALL members of their families can receive assistance. This can be in the form of rental assistance, housing support, job placement and additional mental health services for other family members and children. These wrap services help create a strong support network around the returning veteran to help ensure a smoother transition into civilian life.
     Not only do many CBO's lack the knowledge and training needed to treat war-related trauma,there is currently no specialized training program that provides the Community Based Providers with the necessary knowledge and tools to treat our returning vets. Furthermore, if there was such a specialized program many CBOs lack the funding to undergo the training.

     PPSC is seeking funding to work in partnership with the Bernstein Institute for Trauma Treatment to develop and perfect a training model that will help train CBOs across the nation to meet the unmet needs of returning veterans and first responders. This funding is needed to help get  our program off the ground and become a model program.  Please help us provide for those men and women of our military who have sacrificially served our country over the past decade, and beyond.

Sunday, April 22, 2012

For Veterans with PTSD, Building Relationships is No Easy Task

As men and women return from military tours in Iraq and Afghanistan, they go through a significant adjustment as they rejoin civilian life. Part of that adjustment is figuring how to communicate their experience at war. This can be especially challenging for veterans with post-traumatic stress disorder (PTSD) who are trying to build new, romantic relationships.
Rob’s six-pound Chihuahua Diablo is making his way sideways down a flight of stairs at Rob’s uncle’s house in Natrona Heights. Rob, who didn’t want his last name used because, in his words, “it’s a hard enough getting a date,” takes care of his uncle during the week. Rob is single.
I’ve got my dog, and that’s kind of like my relationship basically. He’ll always have that unconditional love for me,” he explained.
Rob is 36 years old and an Iraq war veteran. He was discharged during his second tour in 2006 after sustaining a traumatic brain injury, but these days it’s the post-traumatic stress disorder, more commonly refered to as PTSD, that has the greater impact. He was diagnosed in 2010.
I was always having nightmares at night, and certain things trigger it: just, loud noises, or, I don’t like people behind me a lot of the time, or stuff like that. I don’t like malls with a lot of people in it. I hate it. I can’t stand a lot of people around me, because there I was, able to carry a gun and get people the heck out of my way,” said Rob.
But Rob views those residual effects as natural, and Dr. Wendy Troxel agrees. She works with veterans with PTSD at the University of  Pittsburgh’s Western Psychiatric Institute and Clinic. “Recalling the event, having nightmares, avoiding difficult feelings, hyper-vigilance, being kind of alert, all of these things are actually normal stress reactions in the acute phase. PTSD is when these symptom clusters persist over time and they interfere with one’s functioning,” Troxel said.
These symptoms can also stand in the way of initiating and sustaining deep, quality relationships. Rob seems ambivalent about finding a girlfriend. On the one hand he said he doesn’t really care if he meets someone; on the other hand, he said, “I want to find somebody who’s there for me and supports me, and I want to have that white picket fence and house. That’s all I want to do.”
Troxel said deeper relationships are crucial. According to the National Institute of Health, a growing body of research suggests that involving partners and close family members in treatment for PTSD is beneficial and can lead to improvements in symptoms.
Having a stable relationship is one of the most protective factors for veterans in terms of diminishing so many negative impacts of the adjustment difficulties, including PTSD,” she explained.
Ben Keen said when he began experiencing the signs that accompany PTSD, he tried to keep it to himself, both because he didn’t understand what was happening to him,  “and the other half of it was that I tucked it away because I didn’t want people to find out, and I didn’t want to be tagged as a crazy soldier, or people think that all of my accolades mean nothing now because I can’t hack it.”
These days Keen accepts that PTSD is a permanent part of his life. Keen, 31, runs a veterans outreach group called Steel City Vets. He served four tours in Iraq, and was diagnosed withPTSD in 2004. He’s in the process of getting a divorce and says while he’s got a strong grasp on how PTSD impacts his life and how to cope with it, he’s not exactly sure how to go about broaching the topic in the singles scene.
I’m not going to walk up to somebody — ‘Hi, my name is Ben, I have post-traumatic stress syndrome, let me tell you all about it!’” he said. “You know, day one, ‘Let’s buy a beer!’ No, it’s not going to happen.”
Beyond the manifestations of PTSD, it can be complicated for a veteran to talk about time in combat. Dr. Anne Germain works with vets at Western Psych and she said when they return home from the battlefield, they’re still trying to digest the experience, “and a lot of people coming back have a period where they have to integrate what they’ve been through with the person they were before and with the person they are now and come up with a new sense of self.”
And trying to translate the war experience to an outsider? It might seem like a better idea not to bring it up at all, but omitting major, life changing years isn’t exactly good for a relationship.
I think that one of the comments they will get is that they’re not completely honest, so it’s setting constraints right from the beginning,” said Germain.
But Germain explained that there is another path, one where instead of disclosing specific, difficult memories, a veteran can share the emotional consequences that resulted from spending time at war, because it’s the emotional response where veterans and non-veterans can find common ground.

Sunday, February 26, 2012

Surprising Findings on Postwar PTSD

A recent op-ed piece in the New York Times by Anthony D. Mancini reported surprising and disturbing preliminary findings from a military PTSD study soon to be published in the British Journal of Psychiatry.  Mancini, an assistant professor of psychology at Pace University, and his colleagues set out to examine the stress responses of over 7000 United States service members, pre- and post-deployment to Iraq and Afghanistan.  The verdict?  “Fewer than 7 percent showed signs of PTSD following deployment”, and “among those with multiple deployments . . . only 4 to 5 percent” suffered from PTSD.

I don’t buy it.  Those numbers are way too low.

While we must wait for the full study to be published before drawing firm conclusions, Mancini’s contention that “the prevalence of PTSD among veterans” is “substantially lower than is commonly believed” should be a cause for concern. 

I want to see how the researchers set up the study, look at the guidelines and approach they used, and examine how they interpreted their data.  Researchers always go into a study with a goal, something they hope to prove, and possibly even additional agendas they are not fully conscious of.  These agendas can color the findings they report.  The study results quoted in Mancini’s piece on the low prevalence of PTSD among returning service members are so counter to what I’ve seen in my work that I suspect some bias crept in.
Mancini states that “many assume that humans are inherently vulnerable to trauma”, but that “a growing body of scientific research is telling another story”.  Only the first part of that statement is true.  Our nature as human beings, our biology and psychology, program us to respond to traumatic events in patterns that ensure our survival.  Almost everyone has heard of the “fight, flight, or freeze” responses, arising from our sympathetic and parasympathetic nervous systems.  These responses to danger make it possible for us to survive and then learn from threatening experiences.

Trauma, short-lived or lasting, arises when we fail to complete our natural trauma response.  Because we can bury and refuse to deal with the painful and overwhelming events of our lives, the intense emotions aroused by trauma (leading to that fight-flight-freeze) may never be released.  This happens all the time.  We can go back and resolve past trauma, but we are always “inherently vulnerable” to it, and our vulnerability to trauma increases the more we bury our previous “invisible wounds”.

The authors of the British Journal of Psychiatry study defend their results by characterizing their respondents as “not seeking treatment” and “representative of the military as a whole”.  They add that “[the participants’] reports were confidential and had no bearing on their military careers”.

I want to make a couple of points here.  First, and most importantly, why didn’t the study include service members who were seeking treatment?  How could the researchers’ study be “representative” without them?

Secondly, confidentiality is certainly an essential factor in getting accurate disclosure, but did the researchers take into account the lingering mindset of stigma within the ranks attached to a diagnosis of PTSD?  Most service branches have campaigns in place to de-stigmatize the invisible wounds of combat, but that message hasn’t yet been fully embraced by the military culture as a whole.

Mancini reports that “about 83 percent of respondents showed a pattern of resilience: they exhibited a normal-range ability to cope with stress both before and after deployment”.  What I want to know is, how did the study’s researchers define “normal-range ability”?  I have first-hand experience with government agencies who work with veterans, and I can absolutely state that their baseline definitions of good coping function are set appallingly low.  Their “good enough” is far from what I consider healthy, as a professional in the psychotherapy field for over 40 years.  I believe the average person would agree with me, and wouldn’t want to see the men and women who have served our country limited to life on such unsatisfactory and unfulfilling terms.

I am particularly suspicious – convinced, even – that the study’s parameters or methods were flawed due to their finding that service member resilience went up with multiple deployments.  This is absolutely counter to everything I’ve witnessed in my work and what many other professionals in my field have seen as well.

I also “do not want to stigmatize those with the disorder” of PTSD, as Mancini cautions.  But I also don’t want to minimize or mislead the military or the public about the true dimensions of what I and many of my colleagues believe will be a hidden epidemic.  I give Mancini credit for stressing that “even an estimate of 1 in 10 represents a public health issue of the first magnitude, requiring our full attention and resources”.  How much more, then, will be required if the real prevalence of PTSD is closer to 30 percent, which is my opinion?

Mancini closes his piece with a truly alarming statement.  He starts well by saying that “PTSD is a treatable condition and a realistic and informed understanding of our inherent coping abilities can only assist treatment”.  But he goes on to propose that “perhaps one day, even prevention of this debilitating disorder” will be possible.  That Mancini could make such a proposal betrays a profound misunderstanding of the nature of human beings and our innate, invaluable trauma response.

To prevent PTSD we would have to rid the world of cruelty, abuse, violence, and evil.  Or we would have to develop into one of two kinds of people: impervious automatons, able to turn off our feelings at will; or psychological super-humans, able to easily experience and quickly and completely resolve every shock, crisis, and horror, from the cradle to the grave.

My take on this?  Won’t happen anytime soon.

Saturday, February 18, 2012

We've Got a Bad Connection

This week I want to return to a disturbing statistic, taken from a recent Pew Research Center survey [Link #1 below] of veterans and the American public, which I quoted in my last post.  Only about half of our civilian population feels that our armed forces’ sacrifices have been greater than their own, post-9/11.  I want to repeat that, as I repeated it last week – only about half.  I think this reveals a bad connection, an enormous disconnect between our veterans and our communities.  Of those civilians who do believe the military and their families shouldered greater burdens with their combat service, about 26% believe it to be unfair, while 70% consider it “just being part of the military”.  I find that attitude very disturbing as well, and I will get back to it later in this post.

First, some good news.  The survey results indicated that 96% of veterans are proud of their service, 93% say the military helped them mature, and 74% say their military experience has helped them get ahead in life.  Over 80% would recommend a military career to a young person close to them.  Also on the positive side, as reported by [Link #2 below] Tom Bowman of National Public Radio, the general public holds the military in “highest regard.  It towers above organized religion, big business, and Congress”.  The negative?  Only 40% of civilians surveyed would advise a loved one, friend, or acquaintance to join the armed forces and bear the heavy burdens of military service.

Now, some bad news.  Of the veterans surveyed, 44% experienced a difficult adjustment back to civilian life, 50% reported signs of post-traumatic stress, and 75% live with nightmares and flashbacks from their combat experiences.  And, of the general public, only 25% say they follow the progress of our wars in Afghanistan and Iraq closely, down from about 50% just a couple of years ago.  Marine Sergeant Jon Moulder, interviewed in Afghanistan by NPR’s Bowman, didn’t need the Pew survey to tell him that people back home are losing interest.  “We’re starting to fall by the wayside,” he feels.  “This has been going on for so long.  It’s America’s longest conflict running to date.  Kind of like the bastard children of our generation.”

What’s happening?  Why don’t these wars feel like a national experience?  Paul Taylor, editor of the Pew study, observed, “We’ve never had sustained combat for a full decade, and we’ve never fought a war in which such a small share of the population has carried the fight.”  According to Taylor, just one-half of 1% of the population has served on active duty in the past decade, while 9% of Americans were in uniform during World War II.

Having such a small fraction of the public in uniform this time, according to Martin Cook, a civilian professor of military ethics at the Naval War College, makes it “much more easy to deploy U.S. forces in tough environments for long periods of time because the vast majority of Americans don’t feel they have any skin in the game.”  “I’ve often speculated,” Cook continues, “could we have fought wars for 10 years if this was a draftee army and I doubt it.”

These Pew Research Center survey statistics leave me with a lot more questions than answers.

Are the sacrifices of our veterans – and their families – really “just being part of the military”?  Have recruits been fully able to anticipate the potential physical and psychological health risks of combat?  Did they know just how bad warfare conditions would be in Afghanistan and Iraq?  Did they expect multiple deployments?  Did they realize how menacing it would be to police terrorists embedded within a civilian population?  And, if their “job-related” stress has become debilitating, can service members “quit” – like civilians can – without long-term consequences, such as a less-than-honorable discharge?

Here are some more uncomfortable questions: Do we all agree that the 9/11 attacks – which killed thousands of innocent Americans, and targeted not only our nation but our way of life – required an armed response?  Do we all believe that without our Homeland Security and foreign military commitments post-9/11 more innocent lives would have been lost on American soil?  Haven’t these battles been deemed necessary by politicians on both sides of the aisle?  Hasn’t our involvement in Afghanistan and Iraq in fact benefitted all Americans?

Does the military serve our government, or do they serve us?  Aren’t they fighting on our behalf, for our sake?  Isn’t whatever happens to them in country more than “just being part of the military”, more than just their tough luck?  One of our greatest presidents, Abraham Lincoln, declared in his Gettysburg Address that ours was a government created “of the people, by the people, and for the people”.  Are we willing to uphold this long tradition, sharing in the decisions, commitments, and obligations of our elected representatives?

I believe, as “the people”, that the government’s promise and obligation to restore veterans’ physical and psychological health post-service is our promise and obligation as well.

I know my calling: to provide health and healing for veterans and their families.  To restore them to full participation in life and in their communities.  To say, “Thank you for your service”, in the most practical, effective way I can. And I‘m asking, can we – can you - make a commitment to be better aware of the pressing needs of our returning veterans?  Can we all make a commitment to care?  A commitment to stop the disconnect?

Sunday, February 12, 2012

Your Neighbor, Your Co-Worker, Your Friend

Two of the top sources of stress in our lives today are “wealth”, or our lingering financial downturn, and “health”, the toll that downturn is taking on our physical and emotional well-being.  A third major source of stress exists, and I’m going to call it “stealth”.
Why “stealth”?  Because too few of us recognize it exists, or, when encountering it, prefer not to acknowledge it.  So what am I talking about?

I’m talking about, possibly, your neighbor or your neighbor’s son or daughter.  I’m talking about your classmate, your co-worker, the person you used to see at Starbuck’s, the movie theater, or church.  The one who’s been away for several months now.  The one who’s coming home sometime soon.  In uniform.

I’m talking about our country’s servicemen and women, and veterans.

The wars in Iraq and Afghanistan have been going on now for almost a decade.  Hundreds of thousands of Americans have served in some of the most physically and psychologically intense battlefields in our history, served repeatedly over multiple deployments, and none of them will come out of their stressful combat experiences without deep and lasting personal changes.  Those changes will be both positive and negative.

Along with the combat stress our returning service members and veterans have endured, they’re experiencing health and financial stress in disproportionately greater numbers than our general population.  Technological advances in personal and vehicle armor have increased the ability of service members to survive attacks both in battle and from improvised explosive devices.  The downside to this is that more veterans come home with significant wounds and physical health limitations that will follow them the rest of their lives.  Whether it’s the challenge of losing an arm or leg (or both), loss of sight or hearing, or loss of mental clarity and memory from repeated concussions, the stress from physical health restrictions is and will continue to be a very real part of many lives.

Studies of post-traumatic stress (PTS) rates in returning veterans vary, but I’d estimate maybe half will suffer some kind of emotional and psychological stress as a result of their service.  Symptoms can run from mild – sleep disturbances, short tempers – to extreme – drug and alcohol addiction, paranoia, and suicide attempts and completions.

Financial stress for veterans runs extremely high, as well.  Statistics show that the unemployment rate for former servicemen and women is well over 20%, more than double the rates for the rest of the country.  Individuals who have prided themselves on their abilities and contributions to society are finding themselves without purpose or value in our stagnated job market.

I’ve also seen a kind of spiritual stress in the returning veterans I’ve treated: a crippling self-loathing because of the acts they committed in country, some necessary and some beyond the stipulated rules of engagement.  Men and women, who left the States with a strong set of ethics for their thoughts and behavior, return having violated their innate personal code.  Along with the bullets and IEDs, they find their personal honor and worth have exploded as well.  In some ways, I feel that this loss is the most tragic.

About that word, “stealth”.  I believe that the combat stress of returning American service members and veterans, and their families, can be characterized as stealth because of my own experience and because of a recent survey by Pew Research.  In an article in USA Today, “Veterans Proud but Struggling in Civilian Life [LINK]”, reporter Gregg Zoroya summarizes some of the survey results from about 1800 veterans and about 2000 members of the public.  One question throws an extremely disturbing light on the different ways the public and service members see the sacrifices our military has made on the battlefields of Iraq and Afghanistan.

Only about half of the general public surveyed believed that American troops and their families made more sacrifices than all other citizens, post-9/11.  Only about half.  Eighty-four percent of service members, however, say that “the public has no idea of the problems incurred as a result of wars demanding multiple deployments”.

I’ve seen this myself, even in my own, much-loved hometown of Petaluma, California.  There seems to be some kind of irrational disconnect between the community and our veterans who are coming back devastated from the wars, having faced atrocities we can’t even begin to imagine.  There doesn’t seem to be real recognition by enough of us that we’ve been at war, and there’s a lot of good people – service members, their extended families, and neighbors – who are truly traumatized and suffering.  I’m a veteran of the Vietnam War era, and still I’ve never seen such a complete disconnect between the community and our military and the wars that are being fought.  This hits very close to home for me; it almost breaks my heart.

The Pew Research survey included many other significant findings, some encouraging and some disturbing.  I’ll return in another post to share more of those results.

Saturday, February 4, 2012

I Am a Veteran

In 1968, during the Viet Nam era, I enlisted in the United States Army.  I reported for duty at Fort Ord, California, where I went through boot camp and then was trained in advanced infantry.  Most of the men I trained with went on to serve in Viet Nam, but I didn’t go with them.  My father suffered a massive heart attack while I was at Fort Ord.  I was transferred to an infantry training Army Reserve Unit so that I could return home to help my family through our crisis.

I lost friends in Nam that I cared for deeply.  I carry a great deal of guilt and remorse - survivor’s guilt - about it to this day.

My time in the army changed my life.  It brought out the best and worst in me.  It showed me a lot about myself that I didn’t want to have to look at.  Today I have regrets about that time, because when I look back on it I know that I could have done a better job, have been a better soldier.  I lacked maturity and had an enormously negative view of authority.  I didn’t know better at the time, but I still have regrets.

Viet Nam was a different era, and a different war than Iraq and Afghanistan.  Our country was much more conflicted then about our military involvement, and public awareness and consciousness about our role in Southeast Asia was very high.

Frankly, and in contrast, until I enlisted I was in many ways unconscious to myself and to the larger world outside of New Jersey.  I was consumed with pain and anger over my abusive childhood.  I couldn’t or didn’t want to see any other life beyond proving myself on the tough streets of Newark and its nearby neighborhoods.

Then I started losing friends in combat.  And my infantry training was so vigorous and brutal (necessarily so, to try to ensure my survival on the battlefield) that my eyes began to be opened.  I started to consider things about life I had never thought about before - the really “big picture” questions for which I had no answers.

My time in the service was a life-changing experience.  The changes didn’t come from having a wonderful time, for sure.  They came about, like so many other changes in my life, from pain, struggle, and sacrifice.

I was traumatized by my time in the service.  I had many trauma-related reactions after returning home, but because of the rough life I was living I attributed them to my ongoing struggle for survival in New Jersey.  I didn’t realize how bad the whole experience had been until it was over and further events took me out of New Jersey and back to California, this time as a civilian.  Then I really started to feel the painful effects of my time in the service.  But that’s another story, one I may share another time.

A number of my fellow soldiers at Fort Ord were pretty confused.  The trauma from our intense training and from public animosity to the war took its toll.  I remember one guy who tried to use a hand grenade to blow himself up rather than go overseas to kill other people.  If I hadn’t stopped him, he would have taken me with him.  Like I said, it was a very confusing time.

Not like today.  Soldiers today are much more committed and well trained.  They are passionately patriotic.  They deserve our support.  They especially deserve to hear something they’ve told me means everything to them - to hear from us, after they come home, “Thank You”.

This Veteran’s Day, if you know a vet, tell him or her, “Thank You”.  Don’t let feeling awkward stop you.  Don’t let not being able to fathom what they’ve been through stop you.
Viet Nam, Iraq, Afghanistan, the Gulf, World War II - one thing remains the same.  Soldiers experience trauma.  Repeatedly.  Beyond our thanks, they also deserve to receive the help they need to heal and to return to the lives they left in order to serve us.  I want to use what I know to be a part of their healing.  This is what our Veterans Program at the institute is all about, and why I am so deeply committed to it.

It’s just that the need is great, and what our veterans can afford is relatively small.  So, I have a dilemma.  I need your help.  Stay tuned . . . .