The Modern Combat Veteran: Dissociative Posttraumatic Stress Disorder & Influences on Criminality

The following is a paper that I have completed for my Social Work Law class, parts of the paper I have been writing about in my blog. The paper ties together the evolution in my train of thought concerning the veteran or soldier consumed by the ravages of full blown PTSD.

The paper is long, but relevant to the plight of our returning combat soldiers and veterans. If you want to understand more about why a veteran or soldier runs afoul with law and society then you should read this.


Running Head: VETERANS, DISSOCIATIVE PTSD AND CRIMINALITY

Scott A. Lee
Kent School of Social Work, University of Louisville
November 3, 2008

The Modern Combat Veteran:
Dissociative Posttraumatic Stress Disorder and Influences on Criminality

Statistics
As of August 27, 2008, according to the Congressional Research Service (2008) 4,726 soldiers have lost their lives in combat and 32,977 troops were wounded in action, with 8,089 suffering from Traumatic Brain Injury (TBI). The USA Today (2008) reported that 68% of all soldiers have been deployed to a combat zone, 31% have been deployed more than once and 2,358 have had more than five tours of duty.

The United States Department of Justice (2004) reports that, “[t]he majority of veterans in State (54%) and Federal (64%) prison served during a wartime period….[that] Vietnam War-era veterans were the most common wartime veterans in both State (36%) and Federal (39%) prison.” The 57% majority of State prisoners were serving time for a violent crime compared to less than half of non-veterans who were serving less time for similar crimes. The report indicates the Iraq-Afghanistan era veterans comprise 4% of both prison populations (U. S. Department of Justice [USDJ], 2004).

Posttraumatic Stress Disorder: Dissociation and Other Considerations    PTSD is a life-long endeavor; there is no cure for it. The triggering traumatic event changes the landscape of the mind, it no longer works in the same fashion that it did before. The mind has been rewired; the neuropathways have been altered into a continuous loop. The PTSD triggering incident converts the fight or flight response in the primitive portion of our brain. Imagine having that scared feeling you get without the fear while keeping the bodily reactions; the tenseness, the adrenalin rush, the mind racing, heightened senses, and the hyper response reflex to react without thinking.

The incident that solidifies the mental wound of PTSD results in a mind numbing, or psychic shift. In response to the trauma of combat, the person needs to make a mental detachment to do what needs to be done. The survival mode of operation forgoes the higher levels of functioning and depends on the primitive reactionary portion of the brain. When this unconscious detachment has been activated to frequently or for extended amounts of time it becomes part of conscious processing and interferes with everyday interactions (Lee, 2006; and Cerone, 2006). According to Howell (2005), dissociation refers to,

the separation of mental and experiential contents that would normally be connected. The word dissociation is laden with multiple meanings and refers to many kinds of phenomena, processes, and conditions. Dissociation is both adaptive and maladaptive, both verb and noun, both cause and effect….Dissociation is often psychologically defensive, protecting against painful affects and memories, but can also be an organismic an automatic response to immediate danger….Dissociation can be understood as taxonic or, varying in degrees….It is both occurent and dispositional….It refers to such psychical events as spacing out, psychic numbing, and even experiencing oneself as floating above one’s body. Dissociation has been thought of in spatial metaphor, as acts of ‘keeping things apart’ as well as ‘vertical splitting’ (p. 18).

The mind can develop into split affective regions where multiple self-states dissociate incompatible values systems and set up residence along with establishing a unified substructure within matching internal guidance systems. The dissociated subsystems run parallel to other self-states and emerge when a particular skill set needs asserting pertaining to situational interactions. Here trauma based disorders may lead the symptomology to further entrenchment and compartmentalization that may lead to personality disorders. “A war veteran with PTSD might have more significant structural dissociation, involving the sequestration of more and larger portions of experience” (p. 22).

A defined preconditioned set of beliefs and values, the combat schema enables the warrior to navigate efficiently through the adversity of combat without a detailed consideration of consequences. I propose a unique set of beliefs, Combat Values Theory (CVT), based on the survival of self in relation to the context of war and the “combat-othering”, for we must wholly demonize our adversary and in the process dehumanize ourselves. The combat veterans primitive fight or flight defensive mechanism has been repressed through the training in the military, conditioning the troop to take up the fight portion leaving a proclivity for violence without a concern for personal safety. Too engage in a mortal fight with the enemy this schema spells out the actions in a given situation without becoming preoccupied with survivability in the moment which could get a soldier killed.

The warrior with PTSD has grown accustomed to the value and belief systems of war and feels threatened when they become faced with having to let go of this security in an attempt to reintegrate back into society. Howell describes animal defensive and posttraumatic biological states,

The human animal may have a repertoire of discrete behavioral states that are adaptive to conditions of predation….[t]hese animal defense states may underlie different dissociative parts of the personality….[t]his begins a neurophysiological alarm reaction…[and]…a tendency to over read cues as threatening, which can increase the probability for violence (p. 29).

The ambiguity inherent in social dynamics can lead to mixed feelings or even a lack of feelings depending on the degree of interpersonal relatedness to the returning combat veteran (RCV). We rely on our parental figures to shape healthy personality and values structures through attachments with significant others, the attachments become avenues of exchange, a distillation of proper interactions and expectations according to society norms. When this exchange becomes distorted to the point of the child becoming a repository of negative energy, instead a healthy exchange solidifying proper boundaries, then the nature of our attachments may become warped and disorganized further compounding the RCV’s reintegration.

The combat attachments born of blood do not leave us because we depart the battlefield; they become an empty feeling inside of us. The soldier develops a highly narrow functioning self-organization in conjunction with his or her other squad members. This organization, "troop-organism," becomes an extension of the combat-self, no different than an arm or leg. We do not will our arms or legs to move, we react from the expectations of intentional imagery based upon the combat values structure. It happens, such as the members of the "squad-herd" where each part of the troop-organism and acts in a homogeneous way, each troop becoming part of the others self-states.

These attachments to the other require a splitting within the interpersonal self-states where many such dissociated selves birth into existence, as each of the value system constructs do not match and out of necessity, develops into a complete compartmentalized persona while maintaining the "whole" sub-self organizations. Each of the self-states run parallel to one another and have the capacity of switching back and forth when the proper situation requires appropriate specialized skill sets. The interpersonal self of the civilian self becomes supplanted and filed away by the combat self due to the incompatibility of the value structures for survivability that requires a conforming from a civilian society to the norms of the combat environment.

Attachments can be considered the path to rigidity or vehicles of spontaneity; to become spontaneous the person must develop a mechanism for the free exchange of intimacy through beneficial interpersonal skill sets. Without a healthy development of attachments then disorganized attachments (d-attachments) form. The d-attachments become the mechanism to gauge interactions in the environment and in doing so they become rigid, an if this then that experiential existence. The d-attachment arraignment only allows for what can be controlled under a series of contingencies plans, or procedural knowledge, usually modeled after our parental attachments, an identification with the aggressor or other such negative role model. Becoming an identity of an exclusionary “personal culture” where the individual becomes estranged from regular society and defending their boundaries as they were national borders between two hostile countries (Howell, 2005; & Lee, 2006).

The cycle of procedural enactments play out in significant others that we allow in our lives, the reason why we keep having the same dramatizations and arguments while never finding a resolution. We enact our past roles and project them into our relationships cast from our childhood in an attempt to resolve the attachments constructively. Since we have not been shown healthy attachment enactments we reside in the cycle of d-attachments and further compound our disorders through retraumatization and or neglect, predisposing the person to develop trauma based disorders and or personality disorders (Howell, 2005).

Without a reintegration of the self and of attachments and d-attachments, a combat veteran can and will run afoul of friends, family and society. The returning combat veteran faces hurdles that they have not been trained to handle, the training and experiences they have navigated and survived will lead them to think a civilian life will be easy compared to the battle life. What they fail to realize is that they have replaced their civilian self with an operational combat value system and attachments, where in American society the individual has the utmost consideration further combining and compounding issues of integration. Little concentration on developing healthy attachment systems the untenable situation can lead the RCV with severely dysfunctional interpersonal skills and a mechanism of perpetual isolation.

Indoctrination 
Combat alters and modifies the value system, a preconditioned set of beliefs, entailing a value-orientated constitute of definitions of situation in terms of direction of solutions and action dilemmas, formulating a culture of killing, stripping the combat vet of the niceties that lubricate society’s interactions, which in combat would result in death. In combat the fluidity of boundaries becomes awash in the relational adaptation to an integral cohesion with their battle buddies, a devolution of survival mindset develops and provides a sense of safety; the germination of base natural selection process by successful integration of the combat value system. With a disproportionate 56% of Army veterans incarcerated, the Army culture seems to generate people more prone to violence (USDJ, 2004).

The war zone recons the birthing of the “trooper organism,” where the firing squad becomes integrated with one other with a culture of survival. The individual boundary of the soldier submerges within the organismal boundaries of the trooper organism while shedding the individual identity. The troop organism allows for the diffusion of immense responsibility over all involved making the transition to an evolution of survival more manageable wherein the herd mentality brings forth the primitive instinctual remnants and the decentralization of obligation. Military culture portrays the combat arms military occupational specialty (MOS) as having more cultural capital and esteem. The infantry MOS with combat decorations increases the rate of promotion, rank and respectability while non-combat soldiers tend to be over looked (Lee, 2006; and Howell, 2005).

Situational Imprisonment    Military enculturalization subsumes CVT into an identification born of survival and dependent on the assimilation of the “firing squad mind set”, where one troops thoughts relates to an extension of his battle buddies. The fluidity of boundaries births the “troop organism” and forever impairs the RCV to return home without his “other selves.” Now the RCV has to try and interrelate without his relational attachments and attempts to reintegrate back into the civilian world where nothing makes sense anymore, where boundaries cross without attachments as a normative experience triggering perceived threat-states. This leads RCV to become his own “isolated island organism,” or an identity incomplete without the other part of the firing squad, that thinks, feels and acts as they do. The RCV becomes unable to interrelate with family and community in a meaningful way, impeded by the fluidity of boundaries.

As their safety has been compromised, a feeling of abject detachment has arisen from the conditioned reality of the combat organism that depended upon the battle buddy “having his back.” Therein leading to a sense of safety, the combat vet needed only to worry about their own personal “line of sight” in a battle field environment requiring a 360 degree threat radius. On his own in society this burden becomes an impossibly overwhelming sense of danger engulfing the RCV, leading to a susceptibility to triggers. A culture of 360 degree radius in the battlefield and shackled intimately with the culture of combat values, hereinto relying on the troop attachments and the evolution of survival, the RCV becomes stuck on the troop-organism functionality.

The troop-organism capacity becomes problematic to the integration of the “civilian-self” as it now has become supplanted by the “combat-self.” An attachment of the self to the self that is the identity of one whom sufficiently succeeds in suffering, completing the veteran and familial rift. The fluidity of boundaries in an intimate relationship with a loved one becomes a threat to the RCV due to the misidentification of signals between the two, one having adapted an independent perspective and the other a dysfunctional dependent state. The crossed-signals of the significant others has complicated the adaptation from independent relational skills verses over dependence and the perceived threatening self states with both parties expectations of returning to “the way it was.”

Compounding the issue, the RCV has now been conditioned to the “culture of killing” and the relational fluidity of boundaries between the two have become incompatible, further given rise to the RCV’s sense of threat as he where in combat. In combat a registering between non-compatible boundaries would be reconciled by a reflexive reactionary exercise of survival, triggering the culture of killing (Kirmayer, Rousseau, and Lashly, 2007). “Those supporting the use of culture as a defense argue that is it intrinsically unfair to judge someone exclusively by the rules and values of a society that he or she does not know” (p. 98). The above goes to the creation of a Veterans Court, where culture competency would require a special understanding of combat vets cultural “shaping.”

Criminal Behavior, Context and Responsibility    “[T]rauma exposure and symptoms of PTSD are prevalent among incarcerated veterans….[e]xposure to combat was the trauma most likely to lead to PTSD among males in a general population survey of 5, 877 individuals, [totaling] 19 percent” (Saxon, A. J., Davis, T. M., Sloan, K. L., McKnight, K. M., McFall, M. E. and Kivlahan, D. R., p. 962, 2001). Saxon et al. indicated a higher prevalence for PTSD in incarcerated veterans than the general population. Additionally veterans who screened positive for PTSD had significantly higher numbers of childhood trauma, indicating a possible correlation between peritraumas, military culture and past traumatization.

Taking culture into account means that the purposes of the criminal justice system—which include prevention and rehabilitation—can be achieved more effectively. Cultural awareness must be coupled with an equally astute political awareness that traces the consequences of clinical or forensic consultations out into the larger society (Kirmayer et al., 2001, p. 101).

Before the Insanity Defense Reform Act of 1984, questions of the “ultimate issue” when a defendant plead insanity in federal court was whether he lacked “the substantial capacity either to appreciate the wrongfulness of his conduct or to conform his conduct to the requirements of the law” (As cited in Buchanan, 2006, p. 14). After the bill was enacted, the question now goes to whether he “appreciated the nature and quality or the wrongfulness of his acts” (p. 14). “Case law and the Rules’ legislative history suggest also that in less clear cases an issue’s ‘ultimate’ status hinges on who has the authority to decide it…because it amounted to an ‘ultimate opinion’” (pp. 14-15). Psychiatric expertise falls under the Civil Procedure Rules (CPR), Part 35, whereby the duty of the assessor, in an expert capacity, is to help the court. A mental defense with the question of competency will rely on the weight of cognitive capacities.

With our modern soldiers averaging two to three tours of combat, we will begin to see an increasing epidemic of incarcerated veterans. In the next 10 to 15 years the American public will see a sharp rise in veterans suffering from Post-Traumatic-Stress-Disorder, to the point of epidemic proportions. You see, never before in war have our troops been subjected to such prolonged exposure to combat and life threatening situations. In World War II our troops were fighting a defined enemy while engaging real objectives with sufficient downtime in between engagements. Most of the troops to see combat were infantry soldiers fighting on a distinct front, not the ones "in the rear with the gear". With a real threat to our sovereignty and way of life soldiers of this era were less affected by the trauma of war.

The significant political interference of the Vietnam War generated little to no tangible objectives for our soldiers solidifying and branding their levels of anxiety and forever troubling their minds. Guerrilla warfare, an inherently cognitively damaging military action compounded the neuropathic damage experienced by our troops in Vietnam. Even with the troops having regular downtime in between engagements the cognitive fractures of these veterans were enhanced by more intense combat and the rejection of our returning soldiers.

The soldiers in the Iraqi war have been sent on multiple deployments with an average of two or three tours of duty with little time in between. While in Iraq, there are no friendly countries or areas to spend leave time to relieve stress while residing on constant alert and most, even non-combat soldiers, see combat or threats on a daily basis. Now combine this with the most intensive warfare possible, guerrilla warfare in an urban environment. We get troops that are overextended and overexposed to life threatening situations within unprecedented levels of combat. Our troops in Iraq have no respite from danger, further entrenching the effects of PTSD through the hyper levels of neurotransmitters (Lee, 2008).

Dissociated attachments reenact combat trauma somatically and between interstates within the RCV resulting in a “civil war” amongst oneself. A seemingly supra-intelligent guidance of the unconscious, this device of PTSD that engages in the survival defensive mechanisms that has sustained the combat veterans life on a persistent basis. Thus becoming the protector and a “conceptualization of hostile self-states in ‘personified narcissistic and sociopathic defenses’ that defend against dependency, vulnerability, and guilt…[and]…applies just as well to pathological narcissism” (Howell, 2005, p. 224). The ‘diminished capacity’ rule would apply when dissociative episodes result in a “psychotic” break, whereby a thought disorder could be ascribed.

Diminished capacity resulting in a thought disorder would be split between two categories; one being “disturbances in the content of thinking and perceiving (hallucinations and delusions), and… [the second would be]…disturbances in the form of thinking (formal thought disorder)” (Young, 2003, para. 7). Procedural memory becomes disengaged from experiential memories where reactionary encoding enables the maladaptive somatic response encoded reactions needed during survival in the moment situations. Multiple self-states dissociate and boundaries within boundaries abound.

I am just now starting to sift through the sea of case law and journal articles on the considerations of PTSD and criminality; unfortunately I think that there will be an ever increasing need for individuals well versed in the pitfalls of combat trauma and difficulties in reintegration. I feel as you do that something needs to be done to address this issue head on, such as a Veterans Court much like the one just established in Minnesota. Additionally, we have only begun to see the tide of returning veterans with psychological troubles facing criminal charges.

Never before in the history of American warfare have we seen such high numbers of soldiers who have been under unimaginable stress. In WWII 18% of our soldiers actually engaged in combat, with Vietnam it was 30-40%, today 68% have actually engaged in combat (Veterans for common Sense & Veterans United For Truth, Inc v. Veterans Administration, item 54, & National Center For PTSD Fact Sheet, Aftermath of Violence section, paragraph 2). Not only have more soldiers engaged in combat, they have been in combat longer with an average of 2 to 3 tours of duty. Many have been on 5 tours and some as much as 6. As high as 80-90% of soldiers (Hoge, C. W., Auchterlonie, J. L., and Charles S. M., 2008, results section, paragraph 5) have seen someone get killed, or been in a combat zone, we have reached "Combat Saturation."

Today 15% (300,000; Rand Corporation, 2008) of our soldiers and veterans have been diagnosed with PTSD and this seems like it may be a smaller number compared to other wars. 30% PTSD rates in Vietnam, 15% estimated in WWII and 15-20% of Gulf War I vets reported to have PTSD. It took Vietnam veterans up to 10-20 years before their symptoms reached the point of becoming debilitating. The implications for our modern veterans will have monumental deleterious effects in the next 10 years, it has been projected that PTSD rates in today's wars will reach 50-60%. We will be inundated with mentally ill veterans who have few options and nowhere to turn and they will run afoul with the law (Lee, 2006).

Today we have become faced with a growing trend of soldiers and veterans becoming enmeshed in the court systems. In direct conflict with the perception in the media I propose the theory that our veterans and soldiers face an insufficient mental health care which has a major impact to their lives, families and communities. The problem is not individualistic but systemic requiring major changes in how we view and treat PTSD. The care of our soldiers and veterans is not being met and we have just begun to see the aftereffects of the mind shattering results of combat trauma. Untreated PTSD can destroy the lives of many, not only the soldier and veteran. We send our soldiers to war for our freedom and then lock them up when they are broken and of no use anymore (Lee, 2008).

Suggested Guide to Help Your Veteran or Soldier Diagnosed with PTSD
and Charged With a Crime
To whom it may concern,

I would suggest that you start researching about PTSD right away. The mind-body connection and interactions, the psychology of PTSD, defensive mechanisms, how the mind responds to trauma, the symptoms of PTSD, how extended combat (such as multiple tours served) effects soldiers and veterans, legal ramifications of criminal behavior and PTSD, the processes of the psychic split from reality and past combat experiences, how anxiety plays an everyday part of our lives, how ordinary stress can lead to higher levels of stress and extreme responses and flashbacks, the nature of flashbacks, the nature of triggers and how they apply to PTSD, and the mental compartmentalization that happens to a PTSD survivor. This is by no means a comprehensive list, but should give you some kind of idea of where you might want to start.

Like it or not, this has consumed your life by no choice of your own, instead of letting that energy overwhelm you and feeling helpless, turn that energy into a useful endeavor and focus it toward finding out as much as possible about PTSD and the effects of combat. You have more passion about this subject than anyone, use this as an opportunity to help your loved one get a fair trial and to force the courts to consider his/her mental illness as a contributing factor in their actions.

Do not take no for an answer from his/her lawyer as to your wanting to get involved in your significant others case, jump into his/her pocket and become the "paralegal" and find them the information that needed for fair consideration of the case. Most lawyers will resist this from you, again do not take no for an answer. I am guessing that the lawyer will probably be a public defender; they are overloaded with cases and cannot really give the appropriate attention that their caseload needs. So, you need to assume that role of "defender" and information detective, this can greatly impact the outcome of the trial.

Consider trying to find a high profile lawyer who will take the case on pro bono; this type of case has become a hot topic in the news and media. A lawyer might take a case for this reason and could benefit the outcome. Go to the clerk’s office and get a copy of the court case file, this will help you by becoming familiar with the states perspective on the case and what exactly is being done. Educate yourself in Miranda rights (If they violated his rights here, this could have a considerable impact on the outcome), federal constitutional law concerning 1st, 4th (emphasis here), 5th, 6th and 8th amendments, along with state constitutional law. Educate yourself on how the court works, the proceedings, when and where evidence can be brought, the questioning of witnesses and how that process is different in every aspect of the trial.

Educate yourself on case law concerning PTSD and other mental illnesses where a consideration or precedent has been set, this can be used in your case and can greatly influence what happens. Look into your state laws first as they will have the most sway, because state law guides state cases first, then look to federal law to find precedents and findings where PTSD was considered in the sentencing phase. Concentrate on first on the main trial part where the evidence and witnesses will be displayed then on the sentencing. Both of these parts of the overall court proceedings will be the most important part, your soldier or veteran’s fate will be decided between these two proceedings.

Educate yourself on and things to do:

• Do not talk with the police or anyone else until you have talked with your lawyer, what you say will be used against you
• learn your rights and assert them, you do not have any rights if you do not know your rights
• get a copy of court case file
• get a copy of VA file and military file
• jump in your lawyers pocket
• try to find a pro bono lawyer
• individual rights, Miranda and if they were violated
• legal proceedings, structure of court formalities and rules of law
• psychology of PTSD
• case law, state and federal, concentrating on the main trial and sentencing process
• constitutional law
• legal responsibilities of the judge, your lawyer and the prosecutor
• find a support group
• contact your senator, congressperson
• contact your local VFW, AMVETS, or veterans associations

I know that this seems like too much, just figure out what is coming next and then concentrate your efforts into that. Take one court proceeding at a time and concentrate on the legalities of that part of the process and use it as a guide to where you need to research and what you should do. The structure of the next proceedings will be your sign post for the direction you need to concentrate on. You can do this, if you accept that you have been put on this earth for this.

You were born to do this; this may be your purpose in life, to be the freedom fighter for all veterans and soldiers who will face similar tribulations. You have more vested in this than anyone else, you have more to lose, do not stand by and be a spectator. Get involved and later you will not have the guilt of "I wish I had done something". A most important issue to face would be finding a support group that you feel safe with and trust. You cannot do this alone, enlist the help of as many people that you can. Contact your congressperson, senator and your local VFW, AMVETS, DAV or American Legion. This is only a suggestion for what to do. I have compiled this list and information as a suggested guide for personal empowerment.

Thank you for listening and God bless,

Scott Lee

References    Appelbaum, P. S., Jick, R. Z., Grisso, T., Givelber, D., Silver, E., and Steadman, H. J. (1993). Use of posttraumatic stress disorder to support an insanity defense [Electronic version]. American Journal of Psychiatry, 150(2), 229-234.

Brook, T. V. (2008, August 12). Report: 57% of troops sent on combat tours. USA Today. Retrieved October 12, 2008, from http://www.navytimes.com/news/2008/08/gns_deployments_081108/

Bourget, D., and Whitehurst, L. (2007). Amnesia and crime [Electronic version]. Journal of the American Academy of Psychiatry and the Law, 35(4), 469-480.

Buchanan, A. B. (2006). Psychiatric evidence on the ultimate issue [Electronic version]. Journal of the American Academy of Psychiatry and the Law, 34(1), 14-21.

Cercone, K. (2006). Brain based learning. In E. K. Sorensen (Ed.), Enhancing learning through technology (pp. 293-322). Hershey, PA: Information Science Publishing.

Congressional Research Services (2008). United States military casualty statistics: Operation Iraqi Freedom and Operation Enduring Freedom. CRS Report RS22452. Retrieved on October 29, 2008, from http://assets.opencrs.com/rpts/RS22452_20080909.pdf

Hoge, C. W., Auchterlonie, J. L., and Charles S. M. (2006). Mental health problems, Use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan [Electronic version]. Journal of the American Medical Association, 295, 1023-1032.

Howell, E. F. (2005). The dissociative mind. Hillsdale, NJ: The Analytic Press.

Kimayer, L. J., Rousseau, C. and Lasley M. (2007). The place of culture in forensic psychiatry [Electronic version]. Journal of the American Academy of Psychiatry and the Law, 35(1), 98-101.

Lee, S. A. (2006). Effects of combat on returning veterans. Unpublished manuscript, Jefferson Community and Technical College at Louisville Kentucky.

Lee, S. A. (2008). Combat veterans and institutions: A systems analysis. Unpublished manuscript, Kent School of Social Work at the University of Louisville.

National Center for PTSD. (n. d.). The unique circumstances and mental health impact of the wars in Afghanistan and Iraq. Retrieved December 23, 2008, from http://www.ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_iraqafghanistan_wars.html

Mezey, G. (2006). Post-traumatic stress disorder and the law [Electronic version]. Psychiatry, 5(7), 243-247.

Poortinga, E., and Guyer, M. (2007). Criminal responsibility and intent [Electronic version]. Journal of the American Academy of Psychiatry and the Law, 35(1), 124-125.

Powers, R. (2005). Deployment rates, United States military. About.com. Retrieved on December 26, 2008, from http://usmilitary.about.com/od/terrorism/a/deploymentrates.htm

Rand Corporation (2008). Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery. Retrieved December 23, 2008, from http://www.rand.org/pubs/monographs/2008/RAND_MG720.pdf

Robinson, C. L. (1999). Observations on cognition and insanity [Electronic version]. American Journal of Forensic Psychology, 17(4) 63-75.

Saxon, A. J., Davis, T. M., Sloan, K. L., McKnight, K. M., McFall, M. E. and Kivlahan, D. R. (2001). Trauma, symptoms of posttraumatic stress disorder, and associated problems among incarcerated veterans [Electronic version]. Psychiatric Services, 52(7), 959-964.

Young, D. W. (2003). Varieties of thought disorder in the criminal context. Washington State Bar Association. Retrieved October 29, 2008, from http://www.wsba.org.media/publications/barnews/2003/mar-03-young.htm

United States Department of Justice. (2004). Veterans in state and federal prison system, 2004. Retrieved November 20, 2008, from http://www.ojp.usdoj.gov/bjs/pub/pdf/vsfp04.pdf

Veterans for America (n. d.). Talking points: The consequences of churning and weekend warriors to frontline soldiers. Retrieved October 29, 2008, from http://www.veteransforamerica.org/wp-content/uploads/2008/04/talking_points.pdf

Veterans for Common Sense and Veterans United For Truth, Inc v. Veterans Administration, C-07-3758-SC, 2007 U.S. Dist.

On Point

Over at A Soldiers Perspective (ASP), CJ had recommended a post for one of Paulette's Ramblings. She writes about greeting the soldiers coming home as they get off the airplane. This is of utmost importance for our soldiers morale and memories of stepping onto that tarmac and feeling welcomed home.

Paulette gives soldiers pennies with an angel punched out in the middle. She tells them to bring it back home, when she really means for the angel to bring them back. A token of remembrance of things back home which brings a sense of calm and serenity. When I came home there was no fanfare or gentle angels, such as Paulette, to welcome me home. I was actually let down quite a bit over that, but my situation was different in that I came home by myself due to my sons birth. So I had contradictory emotions associated with my journey home.

I was stationed in Germany and came home before the rest of my company. My youngest son, who will be 18 in February, was born right before we left the demarcation zone (DMZ) to go into combat. I received a Red Cross telegraph out in the middle of the desert, hand delivered. I could have went home then...WOW... I had never even thought about that until now. In 18 years this never crossed my mind. I could not have left before, I knew that my experience driving a Bradly Fighting Vehicle (BFV) was in need, I was responsible for 9 lives, 6 squad members, Track Commander (TC), my squad leader who was the Gunner and of course mine.

My TC, squad leader and I hated each other, we argued and nearly came to blows several times. This went on the whole time we were in Garrison (on the military base). But, when we went into the field, we kicked ass. In war games we were usually some of the last to be knocked out of commission. So, when we went to war, none of us wanted anyone else to to be in any positions within our squad. We trusted and respected each other and knew that everyone on us had each others back.

This trust in your squad members is paramount in the successful survivalship in combat situations. We were one organism, complete and whole. Numerous contingencies have to be considered before the squad has a green light for combat readiness, comprehension and functioning. I knew without a doubt that when the time came, everyone of my immediate leaders and squad would be ready for whatever we faced. So, all I had to concentrate on was my job.

My job as a driver was of course to maintain the BFV, which was more than a full time job. I had over 150 checks and maintenance tasks that I had to perform three time a day. When we were on the move I had to watch for unexploded ordinance and keep an eye on. Then there was the actual driving, my vehicle was on point for the 1st AD, 1st brigade. I had to keep an eye two other divisions one to two miles away.

OH YEAH, did I mention that I had drove for 172 hours straight? Yeah, I drove for 172 hours without sleep, unless if you call the 5 to 10 minutes that I fell asleep at the wheel and lost the other divisions at night. It took us two hours to find them again. My TC told me the only way he wanted our reserve driver to drive was if I was killed, I took it as a compliment. The first 72 hours was extremely hard to stay awake. The 100 hours of sustained combat, now that was extremely easy to stay awake for that. After combat, I slept for two days and only woke up after sleeping 24 hours to go urinate and then went back to sleep for another 24.

Advocate for Soldiers and Veterans

My Prescription to Address Soldiers and Veterans Issues

• Revamp screening process for returning soldiers, the system as it stands detracts and dissuades soldiers from reporting traumatic stress and depression, thus impeding effective assessment. After a negative report of mental illness, the soldier will have a difficult time in receiving treatment after the fact. The question of "Do you have any psychological problems?", in contrast to the internal question of "Do you want to answer yes, or do you want to go home and see your family and friends?", does not fully appreciate and record the numbers of mentally wounded soldiers.
• Implement rigorous psychological training throughout the military from basic training and integrate into regular training at the company, squad and regimental levels on a continual basis. This will be the only way to break the stigma of psychological wounds. Additionally, it will increase the soldiers capability to recognize internal reactions and external signals from their battle buddies.
• Include a Clinical Social Worker in every Battalion to address psychological needs and counseling as they arise
• Double the Veterans Administration funding
• Replace every bureaucrat that has impeded veterans receiving benefits
• Hire thousands of clinical psych-workers
• Implement effective national treatment and reintegration programs, such as the Minnesota veterans program
• Develop initiatives to fund university programs to teach Combat Trauma Therapy (to aid hiring quotas)
• Significantly increase research monies for combat trauma based disorders, attach funding to universities that have Combat Trauma Therapy programs
• Adopt Substance Abuse and Mental Illness (SAMI) treatment modalities, treating both disorders as primary illnesses, across all VA treatment facilities and contract facilities
• Open long term treatment centers specializing in PTSD, if possible, one in every state
• Fix the VA disability process, in 2005 after 7 tries and 15 years I finally received a diagnosis, treatment and compensation, for which I should have been receiving continuously for 15 years. My mental illness was too severe to navigate the process. Only after spending 20 months in a treatment center was I able to complete the process. The bureaucracy is to complex and overwhelming for someone suffering from PTSD or other psychological injuries.
• Increase Concentration in area of Veteran Criminality research concentrating on connections and implications for individual, family and societal impacts
• Federally mandate Veterans Courts for every major municipal entity, such as Rochester and Buffalo NY, and Tulsa OK. Mandate to direct veterans in rural areas to such courts

PTSD Rates: Part One

Image by The U.S. Army via Flickr

Combat Saturation
 
I am just now starting to sift through the sea of case law and journal articles on the considerations of PTSD and criminality, unfortunately I think that there will be an ever increasing need for individuals well versed in the pitfalls of combat trauma and difficulties in reintegration. I feel as you do that something needs to be done to address this issue head on, such as a Veterans Court much like the one just established in Minnesota. Additionally, we have only begun to see the tide of returning veterans with psychological troubles facing criminal charges.

Never before in the history of American warfare have we seen such high numbers of soldiers who have been under unimaginable stress. In WWII 18% (Flashback, 2006, p. 73, War Psychiatry, n.d., p. 15; Grossman, 2007) of our soldiers actually engaged in combat, with Vietnam it was 30-40%, today 68% to 86% have actually engaged in combat (Veterans for common Sense and Veterans United For Truth, Inc, 2007, item 54, National Center For PTSD Fact Sheet, n.d., paragraph 2, and Hoge, 2004). Not only have more soldiers engaged in combat, they have been in combat longer with an average of 2 to 3 tours of duty (Boston.com, 2005, Veterans for America, 2008). Many have been on 5 tours and some as much as 6. As high as 80-90% (Journal of the American Medical Association, 2006, paragraph 5) have seen someone get killed, or been in a combat zone, we have reached "Combat Saturation."

Today 15% (300,000; Rand, 2008) of our soldiers and veterans have been diagnosed with PTSD and this seems like it may be a smaller number compared to other wars. 30% PTSD rates in Vietnam, 15% to 25% of combat soldiers "...nonfatal battle casualties...[were] neuropsychiatric" as reported in WWII by the Surgeon Generals report (as cited in War Chronicle, 1944) and 15-20% of Gulf War I vets reported to have PTSD.

It took Vietnam veterans up to 10-20 years before their symptoms reached the point of becoming debilitating. The implications for our modern veterans will have monumental deleterious effects in the next 10 years, it has been projected that PTSD rates in today's wars will reach 50-60%. We will be inundated with mentally ill veterans who have few options and no where to turn and they will run afoul with the law.

Causes of Gulf War Syndrome

On November 17, 2008, after 17 years, Gulf War Syndrome Really Does Exist. These guys have been through a rough time of acceptance with the Gulf War Syndrome. Which by the way have you heard that after 17 years the government finally has admitted that the Gulf War Syndrome exists? But what about the 23% of Gulf War Veterans getting Multiple Sclerosis (MS)? My girlfriends nephew, is getting out of the Army due to PTSD and MS. How many of our modern day veterans will receive a crippling and debilitating diagnosis?

Even though this has only become a reality for the government, this reality has been a denied one for my Gulf War I brothers and I for 17 years. Finally, we have been told that the physical pain, Chronic Fatigue Syndrome (CFS), Severe Headaches, Joint Pain, Muscle Pain, Nerve Damage, Neurological Damage, Auto-Immune Deficiencies, Unusual Fevers & Night Sweats, Sleep Disturbances, Gastrointestinal signs or symptoms, Confusion, Memory Loss, Blood In Stools & Urine, Fybromyligia, Epstein Barr Syndrome, Micoplasma Fermentans Incognitis Infections, Chemical Sensitivities--(These are just the symptoms that I have--YES there is more).

Here you will find the "probable causes" of GWS,

• Pyridostigmine Bromide (PB) - I was forced to take this experimental drug - it has been reported that this was an optional participation experiment - bullshit, my squad leader watched me three times a day when I took this drug of death, I had to open my mouth and lift my tongue after ingestion as he inspected
  
• Pesticides - yes I slathered this shit on (the old Vietnam pesticide worked the best, yes it had DEET in it) the fucking flies where thick you could look up at the top of the tent and see black patches of flies as big as 6 feet in diameter.
• Oil Well Fires - uh check, it was night for a week before I was shipped out to go home
  
• Psychological Stressors - if you call watching over 20,000 enemy soldiers dying that did not stand a chance to our superior weaponry and technology then yes I, may, could have possibly, received some psychological damage
• Depleted Uranium - Well the report does say that this one here was not a contributing factor, I say bullshit - up until the first Gulf War the government has had strict handling procedures in the storage of depleted uranium (think of the storage facilities that every state in the US does not want Nuclear Waste stored in their backyard - YES, HELLO Depleted Uranium is that exact same Nuclear Waste - except now the US has a place to 'safely' put this waste), I was talking about storage handling - the factory that makes DP rounds for the military have the employees dress in radiation suits all day during manufacturing, then when we get them in the field, sitting right on top of the rounds, YES on top, it somehow is 'OK' to handle them without any safety precautions (except point your weapon down range of course), the government is more worried about LEAD then this toxic metal, LEAD is bad - DU is good - how long were we feed that Lead did not fry our kids brains when they ate that paint?
  

An excerpt from the Gulf War Illness and the Health of Gulf War Veterans report quoting Special Assistant to the Secretary of Defense for Gulf War illnesses, LTG Dale Vesser, [he] remarked that although Saddam Hussein didn’t use nuclear, biological, or chemical agents against coalition forces during the war, 'it never dawned on us … that we may have done it to ourselves' (emphasis added) (Gulf War Illness and the Health of Gulf War Veterans: Scientific Findings and Recommendations, p. 128).

I think that even though this war was so short, that the experience of killing literally thousands upon thousands of people in 100 hours cannot be imagined and has had a profound effect on the Gulf War I veterans which has been overlooked. The movie Jarhead does a disservice to the experience that I had. My experience, 100 hours of sustained combat and carnage, watching many thousands of people die, and I contributed to many sons losing their fathers. A crippling guilt that I still face today.

Anyway, my point is that we, Gulf War I veterans have been through quite a bit of shit from the government and would be an asset to the guys coming home now. The reason that I have been extending my hand to those that need help and recognition of the walking wounded and the fight against the stigma of asking for help.

Decades of denial, starting from the Vietnam War, that our military service has had a lasting impact, mentally and medically on our lives--Agent Orange and PTSD with our Vietnam Vets, Gulf War Syndrome with Gulf War I vets and now a psychological band-aid for our modern vets.

When will our nation learn that we cannot keep ignoring our veterans, that to do so, we do to our nations peril?

Predisposition to Develop Trauma Based Disorders or Personality Disorders

The ambiguity of family dynamics can lead to mixed feelings or even a lack of feelings depending on the degree of possible neglect or abuse. We rely on our parental figures to shape our personality and values structures, through attachments with significant others, the attachments become avenues of exchange. If this exchange becomes distorted to the point of the child becoming a repository instead a healthy exchange of proper boundaries, then the nature of our attachments may become warped.

Attachments can be considered the vehicles of spontaneity, to become spontaneous the person must develop a mechanism for the free exchange of intimacy and interpersonal skill sets. Without a healthy development of attachments then disorganized attachments form. The d-attachments become the mechanism to gauge interactions in the environment and in doing so they become rigid, an if this then that kind of existence.

The d-attachment arraignment only allows for what can be controlled under a series of contingencies plans, or procedural knowledge, usually modeled after our parental attachments, an identification with the aggressor or other such negative role model.

The mind can develop into split affective regions where multiple self-states dissociate the incompatible values systems and set up residence along with establishing a unified substructure within matching internal guidance systems. The dissociated subsystems run parallel to other self-states and emerge when a particular skill set needs to asserted pertaining to situational interactions. Here the trauma based disorders may lead the symptomology into further entrenching of compartmentalization, and neglectful family structures may lead to personality disorders.

The cycle of procedural enactments play out in significant others that we allow in our lives, the reason why we keep having the same argument and never finding a resolution. We enact our past roles and project them into our relationships acting out the roles of our prior childhood to attempt to resolve the attachments constructively. Since we have not been shown healthy attachment enactments then we reside in the cycle of d-attachments and further compound our disorders through retraumatization and or neglect, predisposing the person to develop trauma based disorders or personality disorders.

The Combat Veteran and Police Assisted Suicide

The Blood Runs Thick as The Bonds of Brotherhood 
On November 8, 2008, I wrote an article about identity and dissociation and the relationship between the two. Since then I have struggled with writing more, actually I have been having difficulties writing in the last month as I have only composed 7 articles this month so far. Granted some of the issue has to do with my having to write butt loads of papers for school about crap I do not want to write about. Uhh, professor(s) (they say that they have been here), if you happen to read this then I did get something out of the writing assignments, but I still did not want to.

So, anyway. Identity, dissociation and a connection to some kind of topic. Yeah, ok. Here it goes.

I was just reading about Sgt. Travis Triggs again, for those that do not know who I am talking about he was the soldier who had 5, yes FIVE tours of combat, that shot himself and his brother in the head after a police car chase. He went to Iraq 4 times and Afghanistan once. He had never been in trouble before that day even though the media had portrayed them both as having violent criminal histories. Sgt. Triggs volunteered for the extra deployments,

My symptoms went away. After all, I was going back to the fight, back to shared adversity, where the tempo is high and our adrenaline pulses through our veins like hot blood (as cited in Times Online, November 23, 2008).

The article gives an account of a lost soul that had left everything over in a far away land where the blood runs thick as the bonds of brotherhood. He had assumed a culture of killing and the persona of a "combat self," a subsumption of the "Soldier's Heart," shedding all of the remnants of his civilian identity and connections to self and home. He had become the perfect soldier, much to perfect.

There is disconnection between everything that is human and the necessities of killing and what has to be done in combat. Imagine being in an unimaginable situation and having to do the unthinkable. How can this be done? A disconnection between everything human and having to do the unimaginable resounds in combat. For we must wholly demonize our adversary and in the process we dehumanize ourselves, whereas the monster must die. A neurological reprogramming engaging dissociative states and a compartmentalization splitting. In doing so some veterans and soldiers lose their way, not only on the inside of our mind but now they become outsiders in society. Everything at home had become foreign to him, he had become lost within a once comfortable environment.

The parallel contrasts to my article on identity and dissociation and Sgt. Triggs? On the night where I had lost myself into psychosis, if the police had shown up, or if someone had confronted me on my abnormal behavior, it would had became real and the psychotic break would have been complete. I was convinced that everyone was out to get me and I would have responded with violence to "protect" myself due to a warped conception of a perceived threat.

I ran out of that house and jumped into my car and drove away; drunk, high and out of my mind. Easily I could have been in an incident that probably would have resulted in a similar outcome. My death, an innocent bystander and possibly the police.

To survive war is not a relief, it is a sentence of guilt and shame from killing and surviving.

IAVA

The IAVA in conjunction with the Ad Council have started an initiative to get the word out to veterans of the Iraq and Afghanistan wars to join a community support group restricted to veterans. You will need to submit proof of your service and deployment to a combat zone. The social networking site, Community of Veterans will concentrate on veterans helping one another with support, advice and the sharing of resources. Here is a video from the television campaign.






Later this month a second website, Support Your Vet, will be launched to address concerns of friends and family, here they can learn how to discuss the difficult readjustment issues that face the veterans and their loved ones, in addition to resources available.

Join us in supporting one another and bringing the reintegration of veterans closer to a reality.

The Combat Veteran and the Birthing of Dissociation

Combat Attachments Born of Blood
I think that the world needs to know what a combat veteran goes through on a daily basis. If PTSD goes untreated, more than likely it will become a permanent and chronically debilitating mental wound. The combat attachments born of blood do not leave us because we depart the battlefield, they become an empty feeling inside of us. The soldier develops a highly narrow functioning self-organization in conjunction with his or her other squad members. This organization, a "troop-organism," becomes an extension of the combat-self, no different than an arm or leg. We do not will our arms or legs to move, we react from the expectations of intentional imagery based upon the combat values structure. It happens, such as the members of the "squad-herd" where each part of the troop-organism acts in a homogeneous way, each troop becoming part of the others self-states.

These attachments to the other, require a splitting within the interpersonal self-states where many such dissociated selves birth into existence, as each of the value system constructs do not match and out of necessity, develops into a complete compartmentalized self while maintaining the "whole" sub-self organizations. Each running parallel to one another and capable of switching back and forth when the proper situation requires appropriate specialized skill sets. The interpersonal self of the civilian life becomes supplanted and filed away by the combat self, due to the incompatibility of the value structures for survivability that requires a conforming from a civilian society to the norms of the combat environment.

Without an reintegration of the self, a combat veteran can and will run afoul of friends, family and society. The returning combat veteran face hurdles that they have not been trained to handle, the training and experiences they have navigated and survived leads them to think that civilian life will be easy compared to the battle life. What they do not realize is that they are still operating from the combat value system and attachments, where in American society the individual is the central concern.

Military enculturalization subsumes the civilian self with the combat self, what I term "combat values theory" into an identification with a culture of survival, born of blood and dependent on the assimilation of the “firing squad” mind set, where a troops thoughts and actions relate to an extension of his battle buddies. Fluidity of boundaries births and envelopes the “troop organism” and forever impairs the returning combat veteran by returning home without his “other selves.”

What to Say to Your Soldier or Veteran Who Confess to You Their Sins of War

By listening without judgment and negativity you are giving your soldier something extremely valuable. It may seem insignificant, they are pouring out their soul to you and in doing so you can have a unique opportunity to help them reclaim what they lost on the battlefield.

Living through combat changes who we were. We may choose to remain in denial because if we can pretend to be who we were then we might not have to face who we have become.

Your soldier has chosen to look into their soul and share with you. When they delve into this abyss they experience it for the first time as well as you. In combat we have to compartmentalize all of the horrors of war due to our inability to process it, to do otherwise would get us killed.

By listening and giving them comfort they can begin to regain that part of the mind that has been ravaged by war. They are not proud of the things they will share with you. Do not tell them that you are proud of them in these moments for this is a judgment. Deep down they know it's not their fault, this to is a judgment.

They may blame themselves, guilt of surviving and leaving your battle buddy behind is a crippling cycle of incrimination and damnation.

Tell them soothing things that a mother would tell her son or daughter when he or she comes running home and crying. There, there. It's ok, it's ok. I am here for you. I love you. I am glad you made it home, etc. Also encouraging words or phrases; Uh huh, yeah, ok, go on, I'm listening, etc. can help encourage the veteran to go on. Silence can be an effective communicator of interest in listening.

Remember, this is more about the veteran. Let them lead the way and do not push them into talking when they would not be comfortable.

I hope this helped, if you want to understand why they do the things they do or what may be going on in their mind; browse my blog, I have poured my heart out in it and think that it closely resembles what many combat veterans think and feel.

Complex-PTSD, Should it be Included in the Forth Coming DSM-V?

I was just discussing the argument on the case for Complex-PTSD, or C-PTSD. The argument goes to how far should this "new" classification should go or if it should be included at all. Some of the leading theorists say that personality disorders, PTSD, and dissociation belong on the same continuum and should be treated as such. I agree with this leading thesis and definition of, and yet lest agreed upon, nomenclature for trauma based disorders (TBD). I base this on scant research and mostly from my personal experiences, one of my recent articles describes this event as it pertains to PTSD and extreme dissociative states. I have this on my list of things to further research and write about.

C-PTSD does not necessarily need to be of multiple traumatic experiences (MTE), it depends on the degree to which the person was impacted. Many rape victims suffer from symptoms that could be classified as C-PTSD. The need for a broader PTSD spectrum of diagnosis comes from the fact that dissociation has a high prevalence in persons diagnosed with PTSD, most having experienced MTE. I see a compromise in not including persons with single experiences in a C-PTSD diagnosis in the DSM-V, which would be tragic as I suspect that this would exclude many rape victims.

Where do psychosis, dissociation, personality disorders, Acute Stress Disorder, Post-Traumatic Stress Disorders relate and how?

You are still thinking in linear terms concerning TBD. Take away all of the differing classifications,...now,...throw every TBD together, all of them. Somewhere along the way one leads to another and could possibly vacillate back and forth, which would explain why all TBD have the same symptoms but different clusters of symptomology for a definitive diagnosis (a wholly ineffective attempt to categorize).

Psychosis would be a temporary result of an extreme overload of anxiety or stressors triggered by some mitigating factor, a defense mechanism overload where a blending of fantasy and reality merge and explode into the conscious from the unconscious.

In my post "Relationship Between Dissociation and Identity," the triggering factor was the drugs (drug induced psychosis), the mitigating circumstances where feeling disowned or disemboweled in a place that once was my comfort zone (dissociation) and the blending of fantasy and reality was I had always wanted to be the center of attention hence my starring on a TV show (narcissistic personality disorder). All in one night, a smorgasbord of anxiety inducing defensive mechanisms relegated by past trauma, yeah!

Welcome Home My Combat Brothers and Sisters

Today we celebrate those who came home and remember the ones who did not. This day of remembrance holds more of a special place in my heart as the years go by and I find comfort here on this day today.

After 1991, upon coning home and many years after I could not stand alone very well on this day, due to my insulation and isolation. Today I realize that it was my insistence upon doing it all on my own that was the making of my downfall.

I lost a friend yesterday, his life was taken from him. I can remember his laugh, his good natured personality, he would help anyone who asked and he died by himself.

Today I am going to go to school wearing my veterans hat and later go to dinner with some friends and remember the ones who have fallen and will never again stand alone.

From Freudian Superself to Maslowian Self-Actualization and Buddhist Transcendence

Freud set us on the right track with his engineering of the Superself, a higher mediating construct of the ego verses Id conflict based mind. This system has its limitations, due to the fact that it still rests in the manifestations of the Ego driven by the primitive instinctual desires of the Id in a systematical, if this than that theorems of delineated thought.

The problems with a person who has been stricken with PTSD, their minds have become deeply entrenched and compartmentalized. Wherein the psychic energy becomes channeled through the rails of the heavily imprinted synapses feeding the body with responsive synergy for explosive reactions needed for survival. These encoded processes have subsumed the rationale of analytical considerations to forge a frontier of force.

To disallow the primitive mind to reign supreme one needs to form a more than Freudian superself to a Maslowian self-actualization, akin to the Buddhist transcendence of self.

In my post on Dissociative Spectrum, I spoke of a feeling that "...I was more alive than I had ever been, except that there was no conscious processing of information and a total lack of emotion, absolute detachment. Time had suspended itself for me, I was eternal, I had accessed a part of me that was omnipresent."

This feeling of becoming one with the universe I have only been able to achieve briefly and never as completely as I did for 100 hours of the ground war in the first Gulf War.

Combat PTSD: Relationship Between Dissociation and Identity

Lately I have been thinking about how identity issues have an integral part of becoming whole in PTSD survivors. During my research I found an article on dissociative identity possibly being a major part of combat trauma. I have experienced this phenomenon many times and once in particular I was at a party and found myself convinced that my life was a sitcom where I was the star of the show (yes, a bit narcissistic) and having just realized this I began to seriously question the interactions I was having and wondering what my lines were supposed to be.

Of course the incident was triggered through a drug induced psychosis (alcohol and marijuana), again a commonality in the deeper spectrum of PTSD and identity crisis; a further distancing with the loss of self. I kept going from room to room trying to get away from the "cameras" that I could not see, but was convinced that were there. I was having homicidal thoughts along with the delusions, I kept hearing voices that was telling me to kill everybody and was convinced that I could hear the "in studio audience" laughter. I was convinced that they were laughing at me, which I told myself, "of course they are you are on a TV show." This moment could have been the breaking point and I was extremely close to totally separating from my consciousness.

In the last quote you will notice that I was not using first person conjugation, but second person. This was a conversation with myself, but I was convinced otherwise. My self dissolution was teetering on a complete psychotic break from reality, where anything was possible concerning my behavior.

In a moment of clarity I realized this thinking pattern was quantitatively deficient and possibly a precursor to violence. I was scared to death when I had this brief awakening and ran out of the house without saying anything to anyone and I believe that this was the last time I had any significant social interactions in my second wives life, we where separated at this point and had entertained the possibility of getting back together.

Thinking back on that now, I remember blaming her for us not getting back together, when in reexamining this part of my life just now I must have been operating more from my shadow self, a shallow self that can dip down into the murky pool of delirium and insanity. It was my fear from the resulting brief moment of lucidity that made me flee, subconsciously I could feel the submerging actualities skimming the opacity of the break waters. Somewhere inside me I felt that I could not do the work I needed to regain my complete sanity by staying, so I left never to return.

Yes I agree that finding an identity would be important in recovery and discovery of self. I had not made this connection until lately, but it seems that a higher power knew of this and governed my arrival to this without me formulating the thought of this brick within the foundation of my life. Thank you for your part in guiding me to this realization.

PTSD Can Evoke a Sense of Safety

My blog is about what I deal with on any given day, the continuing battle wrought by one man attempting to overcome PTSD again, and again, each day. Sometimes I achieve just that and others I succumb to its ravages; the chronic struggle that most combat PTSD sufferers deal with on a continuing basis.

Identity issues prevail throughout the mind of a PTSD host, so to speak. When I think of a cure my mind almost reels in horror, because of my survival instincts having defeated death as a result of having PTSD, and its shaping of my life. I would not be who I am today without it, this device of PTSD that engages in the survival defensive mechanisms that has sustained my life on a persistent basis.

What would I do to replace the safe feeling I receive when I am vigilant in my personal protection? How would I deal with life when I am used to coping from minute to minute and occupying myself with this endless game of self absorption? An attachment of the self to the self that is the identity of one who sufficiently succeeds in suffering.

PTSD is not only about personal protection or self preservation but in its essence a mechanism of such endeavors, thus becoming a self-perpetual entity in of itself. Almost as if it has become self-aware and not only will it steer me away from danger, but also away from its own demise; a seemingly serendipitous supra-intelligent guidance of the subconscious (I do love word play for sure).

Tis no wonder that we who suffer from combat or complex PTSD have existential identity issues intertwined with the usual symptoms, and at times, exhibit this as a personality crisis while occasionally leading to psychosis and neurosis.

Combat PTSD and Memory

Would You Want to Forget the Biggest Most Influential Part of Your Life?

Sometimes you have no choice but to do so, or go insane. I do not think that every soldier who contracts PTSD from combat in the defense of our country wants to use this as an excuse to commit crimes. Maybe some will claim so, less than 1% and I doubt that they actually have PTSD. The rest of us live in fear of what may happen, we feel the snap of reality going and when we come to we fear what may of happened and what we did.

How many times have you heard about the wife waking up in the middle of the night with the Vietnam Vet choking her, he has that 1000 yard stare and a look of death on his face. He comes to and cannot believe that he was back in combat trying to kill charlie when in fact he had his hands around her throat. This is not a warm up to go kill, rob or steal because we think what a great idea it would be to become a criminal now that we even have the "perfect" excuse. Tell me, where do you see soldiers and veterans getting away with anything?

If anything we have attention drawn to us and have placed upon us a higher demand for a show of integrity and character. We exemplify the pride and honor of our country and its people. Not that soldiers or veterans with PTSD need any more stress than we already live with, but there it is.

Sometimes I need to share with someone who will listen and validate what happened to me was real. If I do not do this I might convince myself, again, that I made it all up, that it just did not happen. I do not need solutions, I do not need answers. I just need to be heard to know what I am feeling matters, that it is real.

Imagine knowing something about yourself more than you know anything, and at the same time knowing how unreal it is. This part of you has such a hold on you, that you cannot for the life of yourself feel its grasp until it is too late, then it has you and you are no longer yourself. Imagine a watery consciousness slipping away and thinking who was that? And, you already know the answer, as it dissipates like smoke on the wind. In that moment of realization comes the instantaneous realization of your being, slipping away.

The sad truth is that the American Public has become blinded to the plight of our vets and this has become evident of the ease to condemn those that commit crimes, and vilify them rather than to actually solve the dilemmas we face. We have become accustomed to ignoring our veterans who have defended our nation, since after WWII we have become your person you love to hate. This is who we are, we who do what you do not want to do and wear the emotional scars and bear your shame.

Let me ask you again. Would you want to forget the biggest most influential part of your life?

I Would Like to Introduce 'Family of a Vet'

I read a comment on my article “A Prisoner of My Beliefs” over at A Soldier's Perspective, and went to check out the web site that was referenced. I was dually impressed with the informative articles on how to deal with a combat veteran and the life that entails. An honest and engaging snapshot of what the veteran and family faces, I think the relevance of this site extends to educating the families of soldiers, veterans and to the general public.

A much needed straight forward educational experience for struggling families, that were not informed of what they probably will face to some kind of degree from full blown PTSD and its effects or the adjustments and changes in our solders and veterans. I wept and laughed as I read the shared antidotes delivered with as much humor and obvious emotion splashed throughout with advice and stories.

The central message seems to ring true with mine as well, to inform our veterans and families that they do not have to share this burden alone. We have been through it and want to help others see their way through to the strength that can emerge and wish others to share in our triumphs and tribulations so that we all can rise above and prevail, and along the way hopefully someone who does not understand or comprehend the combat veterans plight that they too will begin to grasp what PTSD can do to a person, family and their community.

I invite all to check out Family of a Vet, a wonderful web site with true to life information for families that share their lives with a combat veteran.

For Family of Incarcerated Veterans and Soldiers

In the last post I wrote some suggestions to help with a veteran or soldier diagnosed with PTSD and charged with a crime, today I want to touch on some additional suggestions to those persons involved and separated from their loved ones. This information could apply to anyone in a position of adversity and great change.

During times of great turmoil and adversity such as a loved one struggling and succumbing to the ravishing effects of PTSD, this will release devastating effects on the person and sometimes can reap outrageous and deleterious consequences to others. During times such as the later, we may have our loved one incarcerated due to their actions under extreme duress due to triggered stressors leading to abominable repercussions to all involved.

This tragedy will lead to a host of emotional states, starting a whole cycle of sensations you will be going through, similar to the grief cycle that goes with a loss of a loved one as if they had passed away. Realize this and begin your passage through it, without doing this you will not be able to weather the oncoming issues.

The first issue needing attention more than anything; take care of yourself first. This will be a long journey that you find yourself in, it has just begun. I'm sure your loved one wants you to be happy and to do that, you need not put your life on hold during this ordeal.

I went through a long custody battle for my children and put everything on hold for 8 years and as this court battle went on, to the detriment of my mental and physical health. I won custody of my children in my state, but she moved them to the next state that did not recognize my states proceedings or my court order for custody. Long story short, I DID NOT THINK OF MY SELF FIRST and lost everything, my kids, house, my second marriage and eventually my sanity. I let the whole ordeal define me; I was the case and the case was me, there was nothing else, and I was consumed by the whole process.

Self-care is not being selfish, since I have learned that by thinking about myself and meeting my needs first I was able to take resume my responsibilities. I learned the concepts of personal boundaries where boundary concepts and identification gives you the ability to not let life and situations overwhelm and control you; your feelings of discomfort will alert you of boundary intrusions.

Self-care is loving yourself so you can love others, helping yourself so you may help others as long as no harm has come to you. When I figured this out I was able to function at a level I had never before achieved. By not taking care of self we begin to loath self and think only in terms of failure, a development of self-loathing and negative perspectives will warp our reality and doom us to fail; a self fulling prophecy. Extremely important to my peace of mind, praying and meditating.

It seems counterproductive to issues of great importance to you today, this process will be a long and drawn out trial and ordeal for all concerned. You have to accept that, it is of utmost important that you accept this, right now. It will alleviate quite a bit of anxiety and stress just by accepting that you have been committed to a long process that may take years to resolve.

It may feel as if you will be betraying your soldier or veteran by trying to let go of some of the feelings that you have been clinging to. It only feels like this, you have to let go of these feelings to get through it. By holding on to the emotions and not letting go we stay stuck in the moment and cannot grow. The ability to grow in personal development during times of extreme adversity will be the ONE thing we need to begin toward a forward momentum, without it we will fail.

Now, with our acceptance of personal self and our life situation our load will lighten, as we now have the ability to spontaneously interact with our environment instead of only reacting. We can begin to trust our own judgments in the moment without having to try and think of every possibility and contingency in exchanges between individuals. By doing this we loose sight of the subtler interactions in life and miss out on important exchanges that effective interpersonal communication requires.

List of Self-Care Contingencies:

• Self-care, by taking care of self we can navigate life successfully
  
• Personal boundaries, with self defined boundaries we can assert ourselves effectively
  
• Grief-cycle, by accepting our situations and self we can grow as our life situations require
  
• Acceptance, self validation and self examination allows change and forward momentum
• Interpersonal communication, allows for effective exchanges; a give and take interaction necessary for negotiations that dominate most social situations, business networking and judicial settings
  

I wish you well on your journey, it will be difficult and can be an opportunity to advance and advocate the cause by shedding light on the plight our veteran and soldiers face due to the consequences of inadequate funding and lack of mental health services.

Suggested Guide to Help Your Veteran or Soldier Diagnosed With PTSD and Charged With a Crime

Today we have become faced with a growing trend of soldiers and veterans becoming enmeshed in the court systems. In direct conflict with the perception in the media I propose the theory that our veterans and soldiers face an insufficient mental health care which has a major impact to their lives, families and communities.

The problem is not individualistic but systemic requiring major changes in how we view and treat PTSD. The care of our soldiers and veterans is not being meet and we have just begun to see the aftereffects of the mind shattering results of combat trauma. Untreated PTSD can destroy the lives of many, not only the soldier and veteran. We send our soldiers to war for our freedom and then lock them up when they are broken and of no use anymore.

Below is a suggested guide on how to help your soldier or veteran with PTSD that has been charged with committing a violent crime:

To whom it may concern,

I would suggest that you start researching about PTSD right away. The mind-body connection and interactions, the psychology of PTSD, defensive mechanisms, how the mind responds to trauma, the symptoms of PTSD, how extended combat (such as multiple tours served) effects soldiers and veterans, legal ramifications of criminal behavior and PTSD, the processes of the psychic split from reality and past combat experiences, how anxiety plays an everyday part of our lives, how ordinary stress can lead to higher levels of stress and extreme responses and flashbacks, the nature of flashbacks, the nature of triggers and how they apply to PTSD, and the mental compartmentalization that happens to a PTSD survivor. This is by no means a comprehensive list, but should give you some kind of idea of where you might want to start.

Like it or not, this has consumed your life by no choice of your own, instead of letting that energy overwhelm you and feeling helpless, turn that energy into a useful endeavor and focus it toward finding out as much as possible about PTSD and the effects of combat. You have more passion about this subject than anyone, use this as an opportunity to help your loved one get a fair trial and to force the courts to consider his/her mental illness as a contributing factor in their actions.

Do not take no for an answer from his/her lawyer as to your wanting to get involved in your significant others case, jump into his/her pocket and become the "paralegal" and find them the information that needed for fair consideration of the case. Most lawyers will resist this from you, again do not take no for an answer. I am guessing that the lawyer will probably be a public defender, they are overloaded with cases and cannot really give the appropriate attention that their caseload needs. So, you need to assume that role of "defender" and information detective, this can greatly impact the outcome of the trial.

Consider trying to find a high profile lawyer who will take the case on pro bono, this type of case has become a hot topic in the news and media. A lawyer might take a case for this reason and could benefit the outcome.

Go to the clerks office and get a copy of the court case file, this will help you by becoming familiar with the states perspective on the case and what exactly is being done.

Educate yourself in Miranda rights (If they violated his rights here, this could have a considerable impact on the outcome), federal constitutional law concerning 1st, 4th (emphasis here), 5th, 6th and 8th amendments, along with state constitutional law.

Educate yourself on how the court works, the proceedings, when and where evidence can be brought, the questioning of witnesses and how that process is different in every aspect of the trial.

Educate yourself on case law concerning PTSD and other mental illnesses where a consideration or precedent has been set, this can be used in your case and can greatly influence what happens. Look into your state laws first as they will have the most sway, because state law guides state cases first, then look to federal law to find precedents and findings where PTSD was considered in the sentencing phase. Concentrate on first on the main trial part where the evidence and witnesses will be displayed then on the sentencing. Both of these parts of the overall court proceedings will be the most important part, your soldier or veterans fate will be decided between these two proceedings.

Educate yourself on and things to do:

• Do not talk with the police or anyone else until you have talked with your lawyer, what you say will be used against you
  
• Learn your rights and assert them, you do not have any rights if you do not know your rights
  
• get a copy of court case file
• get a copy of VA file and military file
  
• jump in your lawyers pocket
• try to find a pro bono lawyer
• individual rights, Miranda and if they were violated
• legal proceedings, structure of court formalities and rules of law
• psychology of PTSD
• case law, state and federal, concentrating on the main trial and sentencing process
• constitutional law
• legal responsibilities of the judge, your lawyer and the prosecutor
• find a support group
• contact your senator, congressperson
  
• contact your local VFW, AMVETS, or veterans associations

I know that this seems like to much, just figure out what is coming next and then concentrate your efforts into that. Take one court proceeding at a time and concentrate on the legalities of that part of the process and use it as a guide to where you need to research and what you should do. The structure of the next proceedings will be your sign post for the direction you need to concentrate on.

You can do this, if you accept that you have been put on this earth for this. You were born to do this, this may be your purpose in life, to be the freedom fighter for all veterans and soldiers who will face this tribulation. You have more vested in this than anyone else, you have more to loose, do not stand by and be a spectator. Get involved and later you will not have the guilt of "I wish I had done something".

A most important issue to face would be finding a support group that you feel safe with and trust. You cannot do this alone, enlist the help of as many people that you can. Contact your congressperson, senator and your local VFW, AMVETS, DAV or American Legion.

This is only a suggestion for what to do. I have compiled this list and information as a suggested guide for personal empowerment.

How a Soldier Prepares to Kill

To Do the Deed, the Dance of Death
To understand what a person with PTSD goes through "in the moment" we have to think beyond our belief of how we would handle ourselves in a high stress life or death situation. Put self away, go to that place that enables you to kill or be killed.

Forget the theoretical self analyzing the process, but concentrate on the dominating, primeval alpha self that goes beyond rationalizing why or why not, realize that part of you that goes without thinking. This part operates from the law of the wild, the component that keeps you alive when your life becomes threatened to be snatched away. Your will to survive is an entity of its own and will separate from your rationale to preserve itself, self preservation.

We have a filtering mechanism inside of the mind that strains experience looking for the pertinent information needed to navigate stimuli in the environment. The subconscious screens the information through our emotive center which guides us on appropriate actions. When this controller becomes overloaded, the trigger is pulled and the irrational takes over. The flood gate becomes inundated and can no longer hold the storm wind and rain, the dam breaks releasing the rainwater's natural propensity to flow and overwhelm everything in its path.

Once this part of us has been released due to a death threat, it places itself on point and plows the way to safety. That part of us summoned by the heat of anger and the fire of rage and shuts down all thinking and rationalizing to do the deed, the dance of death.

Soldiers Who Kill Can Become Imprisoned by Their Experiences

A Prisoner of My Beliefs
Soldiers and veterans with full blown PTSD usually have low personal self-esteem, a self-constructed foundation of self-affirmations grounded in positive thought, word and deeds, reinforced through values and principles. Esteem manifests in an outward appearance of honor and moral mastery, integrity and humility as others would know a consistency of character established through words, deed and actions. Where all of these principles were meet and mastered in the field of battle they no longer apply to a civilian life or civil society.

The combat schema, a defined preconditioned set of beliefs and values enabling the warrior to navigate efficiently through the adversity of combat without a detailed consideration of consequences. To engage in a mortal fight with the enemy this schema spells out our actions in a given situation as being preoccupied with survivability of the moment can get you killed. The warrior with PTSD has grown accustomed to the value and belief systems of war and feels threatened when they become faced with having to let go of this security to reintegrate back into society.

Without a proper identification of values and a conceptualization of a solid schema we can become lost to the reality of a situation and possibly lose out on our interactions necessary for relationship building. Combat critically changes our value systems, mostly to the detriment of constructing and maintaining significant relationships with family and friends. A disconnect happens between the soldier or veteran that leaves everyone feeling as though an insurmountable wall has been erected.

By an identification of values, along with acknowledging and deconstructing the combat schema one could find the ability to critically analyze in the moment, the validity of said beliefs as required by situational reflection enabling readjustments and disallowing an inflexibility of position. An underpinning of empowering schema and a reevaluation of ethical morality allows one to find plasticity in the moment producing a positive self-efficacy; a confident and self-assured person.

When PTSD is an Excuse and Ignorance Not

I was tooling around the internet and checking for some inspiration to write a post, oh boy did I ever find one. This piece I found was on a blog that I never would have thought would allow such lowbrow lack of insight and wholly judgmental holier than thou attitude perpetuated against our soldiers and veterans who have PTSD.

Just because we have a shortage of mental health workers to help our returning soldiers and veterans does not mean we should let just anybody in the doors to help. More damage can be done than good, even if they mean well. Especially if they have the kind of mental prowess and short sightedness such as this "counselor" who wrote this piece that I read.

I try not to wail on people because of who I used to be, but this guy goes on and on...well I will let you read his treatise of ignorance if you want to, but first here are some of his astounding mental feats of "I know I'm right because I said so"

I see the effects of PTSD on a regular basis and have dealt with it’s effects on people suffering from it for quite a few years. I strongly advocate for, is better health care for our returning Soldiers, whether they have physical injuries that can change their lives, or whether they’re suffering from TBI or PTSD.

No, nothing out of order here, even looks as though he might be on a roll to advocate actually, but keep going on,

Something that I’ve been seeing lately that really alarms me however, is Soldiers suffering from PTSD, committing crimes and then using their mental disorder as an excuse to not be held accountable for the crimes they commit. Unfortunately, that’s occurring more and more and it frightens me that they would be allowed to do so.

Ouch, believe it or not this is his next sentence. I do not see where we "let" or "allow" these crimes be done. Seems to me that the lack of mental health care might be contributing to this, but I doubt that's what he meant. Read on

The one thing that I want to stress here, is that just because someone is suffering from PTSD, doesn’t mean that they don’t know the difference between right and wrong and it doesn’t mean that they don’t have control over their behavior. If we allow them to use that as a crutch and an excuse their behavior, then honestly, I don’t see them bettering themselves. Instead, we’re inviting them to stay stuck in that behavior and never taking personal responsibility for their actions. We’re telling them that it’s okay for them to break the law or do bad things, because they have a mental disorder. That’s just not acceptable. When we allow it to become acceptable, then we’re opening the door for thousands of Americans from Soldiers to a crime victim, to do whatever they please and to use the excuse that they’re suffering from PTSD.

Well, I cannot read this anymore, so if you want to see what this guy who calls himself a counselor says, the link is here.

If you would rather skip his bull shit and get straight to my comment to his article then go to the first comment here, it is kind of long just letting you know, but it goes by real fast.