February 24, 2009

Mythical & Magical Components to Their Particular Pathology

I have to admit that upon reading the initial five pages of Saleebey's (1996) Power in the People, triggered in me the biases based within me. Having said that, I must plow forward to prevail upon my fellow students and faculty, my insights as they pertain to my having faced the same dilemmas detailed within.

To say that the "ascendancy of psychopathology" has harmed society, and results in the denunciation of traumatized persons, and the condemnation of persons living a life of recovery has in some way has protracted from their quality of life further convicts and restricts the pathological person. We have a deeper understanding of pathology and the root causes. Although we can become ridged interpreters of taxons and imprint our biases upon the client, we have need of the nomenclature and characterization of symptomology to better assess for possible treatments and remedies.

What we have to realize is that while some if not all of this information has merit, it only colors the tool of terminology. The delivery of such information has a more persuasive power than the mere words themselves. Our inflections and diction indicate to the client our personal biases, points of contention and stereotypical views.

The mentally ill, or truly pathological person feels "crazy" without an intuitive identifying and inclusive group. The experience of "craziness" makes the client feel outside of everything, themselves included. Not knowing what ails the individual gives a mythical almost magical component to their particular pathology. We who have a mental illness invent imaginary conceptions and without interventions sometimes we cannot know the difference between them and reality.

Educating the client to their condition places a categorical identification and particular brand of symptomology, thus dissipating the air of mystical and mythical proportions, whereby reducing the unseen and unknown into a manageable and treatable condition. Further, the person having a new understanding of their mental illness, now knows that they are not alone. They can identify with others who have similar thinking patterns and behavior, normalizing themselves and affording them an adoption of kinship as prescribed by a set of inclusive categorical criterion. A movement within the Internet and chat rooms prevail and assails the notion that we become less than when adopting a designation of mental illness, what we find is a world outside of ourselves where the inclination to alienate dominates.

When we assume our diction, as related to our usage of words carries the power to oppress, we ignore the more powerful point of contention within the elucidation of said word. The contrasts not only include the choice of words in speech or writing, but in the manor of pronouncing the inflections of language. Our attitudes, biases, and prejudices give the teeth to denounce, condemn through a wholly base rhetoric and appeals from the practitioner who has yet to come to terms with their personal stuck points within their lives.

Several veins of contention run through Saleebey (1996). Adopting a strictly focused and central theme without a wider eclectic enunciation, elicits our own dogma while dragging us down to the level of oppressor. "[M]utually crafted constructs....may have the power to transform....[have a] capacity to devise....on intuition, tacit knowing, hunches, and conceptual risk taking" (Saleebey, 1996, p. 7). Upon hitting the proverbial wall of self, when assigned the task of assessing another, we must be aware of the state of our self identifying conditions, as they can become the device of further harm to the client.

Without the deeper understanding of the "tools of the trade," or the "mutually crafted constructs" as it relates to their humanity considerations of the client we run the risk of becoming an unemphatic practitioner. Without identifying the client's strengths and values, our personal biases and stereotypes we will fail to see the clients as they truly present themselves. Without achieving a balance of client and personal self interest we may deem the individual deserving of their plight.

February 20, 2009

Just as No One Event Can be Attributed to a Suicide, Neither Can One Crisis be Excluded

To say that war does not have any influence on suicides would, in my opinion, be an ignorant statement and assumption.

When we see no other way out of a bad situation, we have exceeded our capacity to cope and manage our personal pain. I understand the consideration for taking ones life comes from an overwhelming sense of hopelessness. I comprehend this from a personal perspective and a deep realization to "know" the thought of "if I just pull the trigger, the relief I would feel" to ease my emotional agony.

Generally, no one factor precipitates the killing of ones self, to say otherwise would probably be foolish. To discount a soldiers or veterans taking of their own life because the last thing to happen to them was the death of their dog, would be to dishonor their service and sacrifice. Just as no one event can be attributed to a suicide, neither can one crisis be excluded.

February 19, 2009

Dear President Obama

I was reading the Army's StandTo! website as I often do and came across this blog post from a kick-ass blogger at Army of Dude.

Additionally, if you want to know what combat tastes, feels, smells, looks and sounds like check out Alex's intimate five part series where he uses the five senses in an attempt to describe the experince of combat to someone who has never been there.

In the mean time he writes a letter to President Obama,
Dear President Obama,

This letter comes to you from an unlikely supporter: a young Iraq War vet from the blood-red state of Texas. As an Army recruit in basic training, I cast my vote for George W. Bush in 2004 because I felt he was the best choice for a responsible prosecution of the wars in Iraq and Afghanistan. Five years and a combat tour later, I have come to understand the consequences of that decision. Last November I pulled the lever for you after hearing about the refreshing notion of a new era of government accountability that never existed in my adult life. I was sold when you promised to end the practice of involuntary mobilization, a program that reactivates veterans out of the service and sends them back to war. Given the new era of responsibility ushered in by your administration, it is imperative that you keep a promise made to the tens of thousands of veterans across the country.

I am writing to you on behalf of Steve Lewey, one of Illinois' bravest sons. Steve grew up in a working class family not too far from your old stomping grounds of Chicago. He did well in high school and went on to college to study architectural design. After realizing he and his parents could not afford to continue his education, Steve enlisted in the United States Army at the age of nineteen. He did so not only for education benefits but to satisfy the intense need to serve his country in a time of war. As an infantryman, Steve completed a fifteen month tour in 2007, distinguishing himself in the Battle of Baqubah, the deadliest battle of the surge. In one instance, after an insurgent attack claimed the life of our comrade, Steve completely exposed himself to enemy fighters by climbing on top of a Stryker vehicle and firing at three insurgents, killing them instantly. On a dirty and blood-soaked street in Iraq, no one seemed to notice the kid from Chicago in an act of remarkable gallantry. Many of my fellow soldiers are walking examples of his bravery - without his incredibly selfless act, more American soldiers would have surely fallen in that battle.

With his GI Bill in hand, Steve left the service after an extended combat deployment and headed back home to Chicago in the winter of 2007. Filled with the fire of discipline and motivation he found in the Army, he settled into a job and waited patiently for the new GI Bill to become law. He wanted to finish the schooling he started so many years ago. That dream came to an abrupt end late last month when he came home to find a thick brown envelope on his doorstep. Inside were instructions on where to report for medical screening for a deployment back to Iraq.

The IRR has been used in the past as an emergency pool of trained soldiers to augment forces overseas, but recently history has shown it has been badly abused following 9/11. The link between Iraq and the Global War on Terror is tenuous at best, yet the Presidential Reserve Call Up Authority still exists to mobilize and deploy inactive soldiers even in cases of non-emergencies, Iraq being a clear example. Though repeated and lengthy deployments are causing a terrible strain on active duty soldiers, there was no concern on the part of your colleagues to expand the size of the military to meet the rigorous demand of two wars. Instead, the Department of Defense has overindulged on inactive soldiers meant to fix temporary problems, not become long term solutions. Though you seek to draw down forces in Iraq, Mr. President, the recalls continue in the twilight of a six year war.

For combat veterans, the task of integrating back into society has been a difficult journey as old as war itself. From Odysseus to eighteen year old soldiers coming from the battlefields of Iraq and Afghanistan, the path to normalcy is wrought with post traumatic stress and a disconnect between soldiers and their civilian counterparts. The added weight of a potential involuntary recall is more undue pressure on the fragile mind of combat veterans. Army career counselors exacerbate the duress with threatening phone calls and ominous visits to the homes of veterans, suggesting recall is a certainty if they don't join the Guard or Reserves. For Steve and over 20,000 inactive soldiers across the country, their worst fears have been realized in the form of mobilization orders. For them it's another crushing defeat in an already burdensome mission to find peace after war.

For years, you have spoken extensively about the need for a more robust civil service program in the country. I cannot think of a greater civil service than serving in the military, especially in a time of war. For eight years, soldiers have sacrificed their bodies, minds, and in the most tragic of cases, their lives, to complete the mission. We have stared into the black abyss of war to see an inner reflection of triumph and tragedy. There are pieces of us, physical and otherwise, that are left on the battlefield forever. That is what we gave up for this nation. Now that the war in Iraq is coming to a close, it's time to end the recalls immediately. Every soldier in the military stands ready to report, mobilize and deploy in any corner of the world in 96 hours or less. The abrupt cancellation of the Presidential Reserve Call Up Authority and subsequent orders would seem effortless in comparison to what soldiers stand ready for each and every day.

"Keeping faith with those who serve must always be a core American value and a cornerstone of American patriotism. Because America's commitment to its servicemen and women begins at enlistment, and it must never end."

The words above should look familiar. You said them on the presidential campaign trail as my unit conducted combat patrols in the fifteenth month of our tour in Iraq. It must be realized that above all else, the American soldier is the most valuable thing this country has to offer. The bodies, minds and lives of our fighting men and women cannot be taken for granted. There is too much at stake. Ending the involuntary recalls is a step in the right direction to repair the ties that bind the military to the citizens they stand to protect. You were Steve Lewey's senator in the great state of Illinois, and you are now his President. You must keep the faith with him and the many thousands of veterans that hold recall orders in their hand and uncertainty in their hearts. For more than two hundred years, soldiers have fought to protect this land. Now it is time to ask you, Mr. President, to fulfill your commitment to end recalls and put veterans back onto their long journey to peace and prosperity.

Very Respectfully,

Alex Horton


I have never expected any politician to keep their word, but this issue is too important to remain pessimistic about. Lives and futures literally hang in the balance as we wait for the president to pick up his red pen and cancel the Executive Order allowing the involuntary mobilizations to continue. Please take a moment to send a message to the White House comment page. There is a 500 character limit, so please include the link to this post ( http://armyofdude.blogspot.com/2009/02/keeping-faith-letter-to-president-obama.html ). You can also contact your House representative and let them know about the issue. Anyone that can get the gears turning - newspapers, magazines, local and state politicians - let them know. This is not something to remain quiet about. Spread the word, help some veterans. Now it is your turn to protect them this time.

February 18, 2009

God, The Things Our Minds Omit When We Thought We Could Never Forget

When I was in basic training we had a soldier kill himself while on bivouac training, two weeks away from graduation. He put his M-16 to his forehead and blew out the whole side of his skull.

We woke that morning to what I thought it was another blissful dawn where Drill Sergeants would detonate flash-bang grenades or fire M-16 rounds off because they forgot their alarm clocks. We all started looking around at each other when we heard all the commotion that would have gotten us in huge trouble otherwise, and knew something was wrong.

The news spread fast through the encampment, I went to go look and saw his brains all over the place. God, the things our minds omit when we thought we could never forget.

February 17, 2009

Signed Sealed and Delivered Packages of Quotable Quotes

Digressions diluted diligently. This to you can Quote me on. I kind of feel a bit like, somewhere in me, I am well. Narcissistic? I have been told that this may be part of the traumatic responses and defenses. Did you buy that?
Long after the war ends, the battle still rages (Veterans and Problems With Attachments to Significant Others).

We live in a world society that dissects everything into an dichotomous orgy of categorical righteous indignation (To Ignore Our Humanity is Deal in Death and Destruction).

I am here to tell you, the guy who stabbed me in the throat was trying to kill me (More about me and other digressions).

In the mix, blood pounds through the veins and I received a powerful sense of completeness that I still chase today (We Cannot Make it Through the Confines of Our Minds Without the Help of Others).

In loosing my attachment to the troop-organism, I unconsciously reformed that attachment on the one thing that I could take home with me, my guilt (I Was The Driver, On Point For The Division, So I Saw It All).

Thinking patterns and processes underlying our everyday activities and greatly influence our beliefs and emotional states. If we cannot examine them we will be led by them (Dedicated Soldiers, Combat Values and the Shattering of a Mind).

…read further into my blog you just might find some understanding and compassion for the broken spirited warriors who were not lost in battle but destroyed in mind (Leave Judgment at the Door Upon Entering).

February 15, 2009

Hey, You Can Quote Me On That

More teasers and words that pour out of my twisted mind, enjoy.
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 (A Prisoner of My Beliefs).

My older brother was on the 33rd floor of the towers….We watched the TV frozen, numb and praying against all odds (9-11, A Day I Will Never Forget).

In combat this defensive mechanism, or "tool of death", works well and allows a device within the person to eradicate the enemy who has been assigned a wholly less than human label of demon, enabling denial of the "killer" in us and identifying the burden of blame on its adversary as due adjudication (Soldier's Heart, the Swiss Army Knife of Death).

The concentric circles of influence radiate outward while becoming increasingly formal and incrementally lacking of freely given trust….while out of necessity the body becomes separated and fixated to the immediate arena of kill or be killed. The mind resets the linkage of attachments from the ruble of comfort, contentedness and connectedness to the raging fight for life (Personal Attachments, Before and After Combat).

For me it was more of a forward frontal facade that forcefully identified me more so than conversely while surrendering my personal power (Shadow Persona).

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 is not their fault, this to is a judgment…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… (What To Say To Your Soldier or Veterans Who Confesses Their Sins of War).

We consider ourselves to be the lucky ones who have somehow learned to suppress that part of the night, where the unlucky of us find the terrors of the dark as they can no longer fight these enemies who have no feel or flight (PTSD, boundaries and a Welcome Home).

February 14, 2009

Janurary 2009, Not The Month of the KIA-The Month of Killed at Your Hand

In light of the most recent shocking statistics on military suicides, we have had more suicides in January than killed in combat. When will we begin to do something about our soldiers and veterans killing themselves?

They fought hard to keep themselves and their battle buddies alive. Should we not do the same for them?

As a nation we should be ashamed of our inaction to prevent this self administered massacre. Do we go on and keep letting down the people who gave us the right to ignore them?

How many of our modern warriors will become one of these statistics before you act?

February 13, 2009

Quotes From Within

Welcome home. This blog is a collection of military soldiers, veterans and caregivers stories. Our contributors write about living with Military PTSD, MST and TBI in the context of Post-traumatic Growth and trauma telling. It started with the founder Scott Lee, a Gulf War veteran, blogger, freelance writer and advocate for Military PTSD awareness. He battled his feelings of helplessness and started writing to reach out to connect with others.

The passages below are from some of his past articles rich in metaphors and descriptive language to attempt to bridge the gap in understanding.

"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" Would You Like to Forget The Biggest Most Influential Part of Your Life?

"There is disconnection between everything human and what has to be done in combat. Imagine being in an unimaginable situation and having to do the unthinkable." Honor The Soldier, Betray The Veteran

"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."

"Seemingly my senses and body would hijack my mind and I could only be a witness looking out as I reflexively reacted to apparent hostility." A Suggested Guide to PTSD Management, comment section

"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."

"I was flippant, arrogant and unable to quantify your sarcastic attempts to inform me of your slighted facade." Facades do clash

"A small combat squad that has experienced several fire fights develops a sense of oneness with each other, they have become one organism through the forging process of fight or flight." Soldiers in Combat Develop Powerful Attachments to One Another

"Bonding through blood and battle takes the soldier to a whole new level of raw humanism forged through survival and fight or flight defensive mechanisms. The psychology of killing alters the terrain of the mind disabling the rational machinery and enabling the ancient reflexive responsive unconscious." Lower Recruitment Standards Contributing to Military Suicide Rates

"We send our soldiers to war for our freedom and then lock them up when they are broken and of no use anymore." Suggested Guide to Help Your Veteran or Soldier Diagnosed With PTSD and Charged With a Crime

"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." Self Care Contingencies For The Loved Ones of Incarcerated Veterans and Soldiers

February 12, 2009

Why Are Our Soldiers and Veterans Killing Themselves?

I received this comment today on an older article that I wrote back on April 17, 2008. This comment compliments a recent post from February 8 on the VA Mental Health System,
Its not only the VA - but the lack of support from the military. When soldiers try to go to the military to get help for PTSD and other war combat related injuries - they are brushed aside... and told that they need to suck it up.

Regardless of what the Army says to try to cover this up - its obvious by the amount of suicides that are still going on today... if the proper help was given to those coming back to war, suicides would not be on the rise.

My husband is a combat wounded soldier at Fort Bragg. The Warrior Transition Unit is ran by National Guard - by many who have not even been to war. There are less than 100 combat wounded soldiers in the Warrior Transition Unit with almost 600 soldiers total. Guys who have broken legs from training are put in with combat injured soldiers - the mix is not working.

The Warrior Transition Unit needs to separate the combat wounded from other soldiers and treat them with 1. RESPECT 2. DIGNITY 3. COMPASSION.

It does not take a rocket scientist to figure this out. Why all of the red tape?
 My original post,

Who is Killing our Veterans?...in the coming years we are going to see a growing trend in veterans suicide. On Nov. 13, 2007 CBS reported:
Veterans aged 20 through 24, those who have served during the war on terror. They had the highest suicide rate among all veterans, estimated between two and four times higher than civilians the same age. (The suicide rate for non-veterans is 8.3 per 100,000, while the rate for veterans was found to be between 22.9 and 31.9 per 100,000.)
This is just the beginning, the Iraqi veterans have been exposed to unprecedented levels of sustained combat. Never before in the American history of War have our soldiers seen three and four tours of combat as a common experience.

Penny Coleman, author of Flashback: Posttraumatic Stress Disorder, Suicide, and the Lessons of War testified before the House Committee on Veterans’ Affairs on December 12, 2007,
My name is Penny Coleman. I am the widow of Daniel O’Donnell, a Vietnam veteran who came home from his war with what is now known as PTSD and subsequently took his own life. I use the term PTSD grudgingly—it is the official term, but it is deeply problematic. My husband did not have a disorder. He had an injury that was a direct result of his combat experience in Vietnam. Calling it a disorder is dangerous; it reinforces the idea that a traumatically injured soldier is defective, and that idea is precisely the stigma that keeps soldiers from asking for help when they need it.
She goes on to report that more than 6256 veterans commit suicide each year.

Over 30 years have passed since the Vietnam War ended, since then more than 180,000 veteran deaths have been attributed to suicide. 300,000 Iraq and Afghanistan veterans suffer from mental illness. 58,000 names emblazon the black granite in Washington D.C. at the Vietnam Memorial Wall, one third of the amount of veteran's deaths attributed to suicide.

The VA system is poorly underfunded and not ready to take on such a high level of veterans needing mental health care...as we will see in the next 10-20 years.

February 11, 2009

More Quotes You Can Quote Me On

The deep fractured fissures of the traumatic subjugated mind lay unrest. A coiled wrath waiting seemingly without care to unleash on what may not be there. Reacting without interacting racing and straining the rigors of rationalities foregoing the fulcrum of lucidity and stupidity. Reacting without reason the reflexive trigger rigorously ripping tripping and stripping the underneath (Father Has Passed as Has the Past).

Survival depends on a reactionary responsive reflex, a instantaneous engagement of life threatening situations (No Offense to Our Veterans?).

With the unprecedented levels of sustained combat and extended multiple tours our veterans will be facing the crippling effects of PTSD with their families as well as the public with generational consequences (Mental Health Field Unprepared for Epidemic of PTSD).

It was surreal, beautiful, terrifying, the most intense fireworks I had ever seen filling the entire sky illuminating the battlefield, I was in awe. It felt like I was one with the universe, out among the everything, feeling all and knowing all. I heard over the distance of what seemed like eternity, "Move out" (Dissociative Fugues).

Now that being said, I know a guy that did 5 tours in Vietnam which was uncommon, most soldiers did their two years and the ones that survived went home (Iraqi War Mental Health Epidemic).

I kept thinking of killing myself for 15 years or so, driving off the road, instigating fights, fingering my gun and imaging the relief I would feel if I just pulled the trigger (Never Give in to the Enemy).

A fight, it didn't matter who, what, when or where, just give me that respite despite the spite. I kept plunging deeper dredging in demoralization stumbling into madness seeing only with my corrupted sight (Vision of Unrest).

So, I go forward because my balance depends on foiling the fall backwards. OK, OK stop it!…My mind goes into these circles of creativity circulating the circumference of creation (Responsibilities, Relationships, Compulsions and Convictions).

In his last speech Dr. King talked of the threats against his life, without saying the words he found forgiveness for his fellow brother who snuffed his life (Dr. King’s Light and My Emergence).

In a battle with no solid enemy and no apparent battleground the warrior having been trained to combat the physical comes in contact with a foe that can over shadow the imagination (PTSD, Combat and the Guilt of a Nation Mediated by the Media’s Lip Service).

February 10, 2009

Treatment Resistance, A Misconceived Attribution Attached to Combat PTSD

To say that combat veterans have a resistance to treatment is a misconceived attribution attached to combat PTSD. A chronically mentally wounded combat veteran has many issues that must be continually and thoroughly assessed throughout the treatment process. Many treatments modalities stop at symptom reduction, while veterans have significant relief they still have symptomology that intrudes into daily life.

After I was in the treatment center for homeless veterans for 20 months I stopped all therapy as I felt I was in the best place in my life I had ever been. Gradually over the last two years the dissociative responses have become the major symptoms that I face. It interferes with my relationships, studying, and my sociability. My level of structural dissociation of the personality I would consider at the secondary level and complex PTSD as a diagnosis. I have tertiary dissociation features, with periods of psychosis and hallucinations during extremely high levels of stress.

The combat flavor of PTSD has serious implications with identity crisis and integration of the personality. To adjust to killing, a psychic shift must prevail and in doing so splinters the personality, shattering the attachments with significant others and reforming them into the troop-organism, an identification with the combat squad. Separate action systems whereby the individual reformulates their value system in congruence with the combat environment mediate the internal operating system. They have completely replaced their civilian self with a warrior self.

The warrior identity (WI) has a separate sense of self from the other aspects of the personality and will assert itself when faced with the possibility of its demise. The crux of this juxtaposition lies in the survivability of the person in relation to threats perceived or otherwise. To survive, evolution has provided us with a mechanism to do the deed. In doing so the Darwinian switch triggers the animalistic defensive operating system from the higher functioning administrative capacity to the lower level of reflexive WI.

To carry out its function of survival the WI has adapted a code of moral imperatives relative to the act of killing and survival. To understand this matrix as it relates to the spectrum of structural dissociation of the personality and the fracturing into differing selves relative to the combat soldier or veteran, one needs to ascertain the connections of attachment systems, identity, developmental cognitions, evolutionary defensive systems, the nature of memories, emotional blocks and how all of these form the schemas of the person. To do this one should educate themselves on the Theory of Structural Dissociation of the Personality.

The Theory of Structural Dissociation of the Personality has given me incredible insights into myself and a greater understanding of the dynamics of action systems and defensive systems that drive thinking, behavior, emotions and actions (Structural Dissociation of the Personality, Lee, 2009, Steele, van der Hart, and Nijenhuis, n.d., para. 8, Steele, van der Hart, and Nijenhuis, 2005).

February 9, 2009

Some Quotes and Passages From Previous Postings

I have compiled some clips from past articles to expose you to some of my writings with links in the highlighted text. I will be posting more snippets over the next week or so. I hope you will find some inspiration and more insights into he mind of a combat veteran.

Their formative associations have been left back in the field of combat and killing, where they have left part of themselves with the ones not going home and take with them the guilt of leaving (Warrior Archetype).

As we looked upon each other in anticipation, with our trigger fingers itching, we knew that this would be a heavy fought battle with many casualties. Both sides in a bid for life within a surreal cloud of apprehension, waiting for the order to fire (A Soldiers Conviction).

Later in the next day we received an account of the engagement. A brigade of foot soldiers had been trying to surrender and we killed them (Are You Saying That You Killed People in Cold Blood?).

My self discussion dribbles on about we, our, them and I as it were a fight for me (Searing Images Sheaving Surreally).

PTSD is a life-long endeavor…The triggering traumatic….The mind has been rewired….converts the fight or flight response in the primitive portion of our brain. Imagine having that scared feeling…the adrenalin rush, the mind racing, heightened senses, and the hyper response reflex to react without thinking (Experiencing PTSD).

This cognitive binding can be triggered by situations that require emotional response, trusting issues, and really just about anything that requires thinking (Zoning Out).

…the heavily imprinted traumatic axonal entrenchment supersedes conscious thinking processes and the mind seeks behavior reminiscent of the initial trauma. The hyper states of PTSD once engaged result in the continuation of the dominate neurological processes (Battling PTSD).

Dissociation is a tightly woven boundary around the Id, keeping out emotions and people by placing concentric circles within reach and without access (Feeling Dissociative?).

Today, the only thing you can change is your behavior, by changing your behavior over time you can change your thoughts and your feelings (Thoughts, Feelings & Behavior).

We spread our light into their darkness to evoke that which envelops the tormented spirit with sparks that spread like wildfire (One Small Candle).

February 8, 2009

Our Veterans Mental Health System is Broke

The government system (DoD and VA) have become inundated with an ever increasing caseload of mentally ill combat soldiers and veterans. Compounding this problem, approximately 80% of military psychology positions have been filled, along with 80% of the VA positions. This does not reflect other mental health service practitioners.
I have an ongoing dialog with a therapist who just now received Tricare approval (after some much needed advice from a blogger that you might know...Yep, you guessed it, me), and she has taken a crash course in the combat flavor of PTSD. I gave her some direction and research when she was feeling overwhelmed in the beginning, as you can imagine one can when facing the horrors of killing and the pain this brings.
In Kentucky we have two major military bases with many soldiers who I know need help but cannot or will not seek help. Further widening the barriers to care, private practitioners do not have adequate integrative therapeutic skill sets based on the latest up to date research to engage this population, who in the past have been labeled as "treatment resistant." A misconceived attribution attached to combat PTSD (to be addressed in a follow up article).
Not only do we have this gap in services between the government and private sector, we do not have a treatment modality based on the most up to date research, and as if this was not enough of a hill to climb, we have unfilled mental health positions in the military and at the Veterans Administration.

February 7, 2009

More on PTSD Rates in the War On Terror

Most existing studies define cases of PTSD and depression using criteria that have not been validated, that are not commonly used in population-based studies of civilians, and that are likely to exclude a significant number of servicemembers who have these conditions (italics added for emphasis, Rand, 2008, p. 94).
Read that last part again, “…likely to exclude a significant number of servicemembers who have these conditions (p. 94). Which will increase the percentage of veterans and soldiers who will or have developed severe mental illnesses.
Stringent screening criteria will miss not only actual cases of PTSD and depression but also subthreshold cases, individuals with symptoms of PTSD or depression who do not meet the established case definition yet (italics added) who experience significant impairment. Identifying subthreshold cases of PTSD and depression is important, since interventions and treatment aimed at these cases can reduce symptomatology and prevent progression to full diagnoses (p. 95).
Subthreshold cases of PTSD and depression left untreated will in all probability develop into full blown cognitive pathology and severe maladaptive symptomatology, warranting a diagnosis of a severe mental illness. Soldiers and veterans who do not receive treatment run a high risk of the mental wound to become entrenched into their psyche, further exacerbating their problems in living full productive lives.
Regardless of the sample, measurement tool, or time of assessment, combat duty and being wounded were consistently associated with positive screens for PTSD (p. 97).
Our servicemembers survive wounds that would have killed them in earlier wars. Coupled with the trauma of combat and killing, the trauma of surviving such devastation weighs heavily on the individuals mind.
…research conducted many years after previous conflicts, such as Vietnam…and the first Gulf War…have produced prevalence estimates equal to if not higher than those presented here, which may be due to the emergence of symptoms over time (i.e., a “delayed onset” PTSD) or increases in treatment seeking behaviors. We hypothesize that, regardless of its cause, the need for mental health services for servicemembers deployed to Afghanistan and Iraq will increase over time, given the prevalence of information available to date and prior experience with Vietnam. Policymakers may therefore consider the figures presented in these studies to underestimate the burden that PTSD, depression, and TBI will have on the agencies that will be called upon to care for these servicemembers now and in the near future (p. 105).
Heed the warnings, the research shows that as of right now PTSD rates are equal if not higher than previous wars and that the estimations “…underestimate the burden…” (p. 105). Given this information, I again, lay claim to the oncoming mental health epidemic that our soldiers, veterans and nation face.

February 1, 2009

To The Soldier or Veteran Who Has Lost Their Way

I can understand and appreciate the precarious position you find yourself in. It can be a horrendous feeling to loose a powerful position such as being a soldier. Professions that hold a high public trust have plenty of prestige and respect as part of the package. The loss of identity tied to a vocation that commands an elevated sense of purpose due to a psychological malady can impinge upon the individual. The public can deny forever the stigma, we who live this know the doubt and disappointment in the eyes of former colleges and even strangers upon learning of the wounds received.

You deserve to be a complete person, to enjoy life, to find your true self, to be who you are. Your past life is a part of you, not who you are, just who you used to be. Mourn this loss, doing so can help you let go of your past personage. Look deep into self and find who you were meant to be, this can become an opportunity to explore and discover your destined path. When we take the journey God has laid for us, he will provide the opportunities to expand our composure and place those who comprise our spiritual communion of endeavor to assist us so.

Accept what has happened to you, take responsibility for your feelings, it is OK to feel the way you feel, you are not your feelings. You do not have to act upon your emotions, they are what they are, they are not you, but only a part of you.

Our illnesses and pain, physical or otherwise, seeks to hold us up inside of ourselves and our homes. This will only increase our grief. You will have your pain wherever you go, so go, do something for yourself. You have served and done your part, let others do the sacrificing, now you have your journey to begin.

I have found my former anguish to be a strength today, people who go through the fires of hell develop a unique set of skills. Beware for they can become a burden if we succumb and enmesh them within without transcending.

Find people that have had similar experiences, they have been waiting for you, they are there, look for them.

Integration of all our skill sets, beliefs, values and potentials entails a lifetime journey, the sooner we accept this the sooner we can embark. Reject nothing of yourself, for without all that you are, you cannot move forward and begin to find hope.

I am here for you, come back when you can.