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.