Wife of a Combat Veteran Seeks Guidance

I received this email from a reader which touches on a common situation facing spouses of combat veterans. I have an understanding between myself and my Higher Power that he will send people my way and my part is to point out that they have been chosen to advance the cause of their personal experiences with respect to the dilemmas they face.

We as humans will be surprised at the depths of suffering we can survive and the heights in which we can prevail. I am always telling people, "You will be surprised at what you can do when faced with hardship and how much you can handle when given the right tools to succeed."

Her email,

I have spent hours reading your blog and trying to understand. I am proud of my husband…for what he did for our country. I am not proud of the hateful man he is now. I love him and will forever stand beside him, but can you give me any idea of where I, as the wife, can go to gain assistance with dealing with the insanity that comes with being married to a man with PTSD. I am at my wits end and tired of crying and trying to be strong and support him.

My response,

I would suggest that you get involved with some organizations that advocate for the family of combat veterans with PTSD. I am certain that women in your area have similar situations to find the support that you need. You cannot go through this alone, it will destroy you and your relationship with your husband. Does he want to seek help, or has he been receiving help? Either way if you want to remain sane throughout the process then get active in your life, find support, advocate for better care for our veterans and support for families. If you have a lack of organizations or support groups in your area then start one.

Think of this as an opportunity to advance the standard of care for our veterans and the support of the families. Keep researching to better understand your husband and to better understand your self in this situation and reactions to his behavior.

I believe that my experiences in life will serve a higher purpose and that I have been chosen by God to prepare myself to become a combat trauma therapist. With my unique insights from both sides of the prism of PTSD, I will be able to empathize and help my clients in such a way as to guide them out of the fog of war and into productive lives. Maybe, you have been chosen to do similar work to advance the cause of increasing awareness and support for spouses and families of combat veterans.

Do not forget that this has completely changed your life, now it is up to you to turn your experiences into a force for change.

• Educate yourself to better understand your internal processes
  
• Review your internal values and belief systems
  
• Reevaluate your life's direction outside of work
  
• Get involved with women of combat veterans
  
• Find the inner warrior to combat the stigma, lack of care and understanding
  
• Evaluate skills you possess and translate them to your life outside work
• Begin to seek out your new path in life

If I left something out or you have more suggestions for our newfound friend, please post a comment.

Round and Round the VA Merrygoround

I am doing the, "Hey not in my backyard" thing with the VA again. I go to one therapist in an attempt to be admitted to the PTSD program and they tell me, no, that I am depressed to go see another therapist. It took me 2 months to see this one, then I get another appointment, and then, they tell me to move on down the road. Now at the VA getting in to see a new therapist. So, now I have to wait to see another therapist and guess what? Yep, you guessed it, another two months, add this up, 5 freaking months.

I know that I am depressed AND I know that my PTSD is kickin. Treat PTSD in one clinic, depression in another.....this is madness! No wonder veterans do not come back to another appointment.

Wait, did I just go into a tangent? I was trying to say that I want to go through EMDR therapy, it might take me another 5 months to receive it, but THEY will not get me to turn away!! Thats all folks a little help here please!!

What to do With a Drug and Alcohol Abuser

Mixed throughout some of my latest articles I have written about events centered around drug use and abuse. Over at A Soldier's Perspective I received a great question on a recent article, by a reader calling herself Susan.

Great story. A memorable milestone in your life. As a mom, I have to ask you how you went from a drug user to a soldier? Was there any defining moment in that change. I ask because I am a mother of a 20 year old young man. A young man I have found to my dismay is using drugs. I am lost as to how to help and live somewhat fearful for him.

Beyond taking a 2×4 across his head I am lost in this struggle. (Please note as a disclaimer that I would use the 2 x 4 with as much unconditional love that I could muster!)

any advice?

My reply to a well timed question,

Susan, I went from a soldier to a drug and alcohol user immediately upon returning home. Although I drank before I deployed, it did not get me into a spectrum of trouble until after combat. It took me 15 years of trouble at home, 2 marriages, alienating my children, problems with the law, violence, anger, 30 jobs, homelessness and landing in a long-term drug and treatment facility before I could come to terms with my addiction and mental illness (PTSD).

Many factors may contribute to your sons using and degree of using. He may be an occasional user, a frequent user or a chronic user. Even if his using is only occasional you could get friends, family and significant others together that love him and tell him of your concerns about his using drugs.

Does he have a mental health diagnosis, or do you suspect he may a mental illness? He could be self medicating, if this is the case then it will probably be harder to get him to quit because he may be seeking and receiving some relief in using.

If his using has caused him legal problems or difficulty holding a job, then he may need further interventions.

Some suggestions, If He Does Not Want Help:

• If he/she does not want help then he will need to reach his "bottom" (12-Step talk for abject demoralization), before they will seek help.
• Enabling an addict will only increase their use and dependence on you (causing you greater stress and safety issues).
• Do not let an addict borrow money.
• Do not trust an addict, they will use it against you.
• Call the police if you fear for your safety (you cannot help him if you are injured or dead).
• You may have to kick the addict out of the house, even if that means they will be homeless. (due to stealing, violence, or other situations that jeopardize the safety of the homes occupants).
• Throughout let him/her know that you are there for them if they want help and spell that help out for him/her.
• Before you help, they must sign into a drug treatment program.
• Unconditional love does not mean that you have to give them everything they "want", only what they "need". What they want will only become relevant to him/her or you if they are the one achieving it.

Live Honoring America's Fallen

By CJ Crisham


As you can tell, I haven't been writing a lot lately. To tell the truth, I haven't really felt like it. But, I've also been busy with a training week. We worked through the past two weekends and I'm REALLY looking forward to this Saturday for my first day off in a few weeks. I'm not complaining though. Guys in Iraq and Afghanistan go months without a day off.

Today, I had my second appointment with my psychologist. Originally, he was going to complete a command assessment, but I have to go to another post in Georgia for that. Not really sure why and neither is my doc. But, I'll do whatever it takes. The road time will be much needed.

What I don't want to turn this blog into is a constant repetition of PTSD issues. There's a lot going in the military and national security world that needs to be talked about – like the release of GITMO detainee Mohammed Jawad to Afghanistan. Jawad is accused of attacking two American soldiers and their Afghani translator in Afghanistan in 2002 by tossing a grenade at them. Instead of getting myself all wrapped up in that, I'll publish what Vets For Freedom Chairman, Pete Hegseth, said about the release since I agree with him on this:

The lives of our troops and the safety of our nation should be of paramount concern to the Obama Administration, not an afterthought. Today’s decision to release yet another trained terrorist shows a lack of consideration for the risks our war-fighters take to help bring insurgents and terrorists to justice.

Jawad’s treatment as a prisoner was unfortunate. However, his treatment does not exonerate him from throwing a grenade at American troops. America cannot afford to have terrorists released back to the battlefield and rejoining the fight to kill Soldiers and Marines, all for the purpose of appeasing a campaign promise.

Having served at Guantanamo Bay and in Iraq, I witnessed the cause of radical Islamists on two vital fronts. I saw how my fellow soldiers risked their lives in battle to capture these terrorists and the hard work and professionalism it took to hold them at Guantanamo Bay. Additional releases such as this will make the continuing mission of our troops far more dangerous and deadly.

Anyway, I've been officially diagnosed with PTSD, something I wasn't exactly happy about. Why? I just want to go on living my life. I've been pretending nothing is wrong with me for years and suddenly there's a name attached to it. I spoke with my doc today about anxiety, anger, stress, and depression. I won't go into all the details, but wanted to focus on something he told me just before we ended.

What is the leading cause of PTSD in civilians in America? It's an interesting question because most people don't think about PTSD as a civilian issue. Yet, it is. The difference is in how civilians deal with it. The number one cause of PTSD in civilians is a car crash. Yet, most people don't exhibit signs of PTSD. Why is that? When a civilian survives a catastrophic event like a violent car wreck, they still need to get places. They get a new or used car to replace the wrecked one and continue on with their lives. It's hard at first, especially when they see similar cars to the one they were driving in or the one with which they crashed. Or when they pass the location where the wreck took place.

However they do it, the fact that they continue to face their fears of driving out of necessity helps them to overcome the root causes of PTSD. Eventually, they learn not to be afraid of driving because they are doing it so much without incident and their symptoms slowly disappear. So, I told him, the answer is simple. I just need to go back to Iraq, right? No. I need to confront those events (or spikes) that have contributed to my PTSD. How can I do that? The same way I did it when I started this blog five years ago – by writing.

I've published an edited version of my journal before, but I've never written about those events in detail and some I didn't publish at all. I'm not sure how I'm going to do that publicly or if I even want to, but I've decided to write my experiences down privately. One day, like my journal, I hope to publish it for others to read and identify or find solace with.

So, CJ, what's with the title? I have a LOT of survivor's guilt that I've lived with for years. I ask that question often about why did I come home? If there is a purpose behind it, have I served that purpose already? If so, then what? That's a lot of pressure I've put on myself. All I can do is follow the advice of the magnet I keep on back of my van: "Live Honoring America's Fallen."

Illuminating our Covenant Selves

I am thankful that God chose to reveal intimacy on a deeper level of meaning and understanding upon me. By honoring and conveying our intimate attachments throughout our day we strengthen this communion between ourselves, significant others and our spirituality. Carrying with us our intimate self and the connections with significant others we become an extension of said selves which allows us to illuminate this covenant.

Seeking Help is Not a Weakness

By CJ Grisham


I guess I could call this part III of my recovery. Earlier, I wrote about how I've been wrestling with inner turmoil for quite some time. I think I've largely been winning, but wrestling nonetheless (I was a wrestler in high school, so that may be helping). Throughout the years, I've learned how to cope with the hardest parts and other parts were no big deal.

Last week, I went to my first appointment with a local psychologist. My intent isn't to necessarily bare my soul here. It was hard enough to do in that office. My intent is to be an example to others that may be dealing with issues related to their combat experiences that they may be hiding.

The Army DOD has made it clear that they are trying to remove the stigma related to PTSD. It's a fundamental shift in attitude and mentality that must occur from the top down in order for it to be effective. A few weeks ago, I spoke with one of the assistants to General Chiarelli who is a LTC. She told me her experiences with PTSD which are encouraging considering that she is a Field Grade officer. She was likewise nervous about "coming out" about her PTSD issues.

I also don't want to get into this stupid debate about "you were only a signal guy or an MI guy, what are you so screwed up about?" Getting shot at, mortared, or having an IED blow up beside your truck doesn't care what MOS you hold. It affects us all differently. And, yes, there are some people simply looking for sympathy or a handout with claims of PTSD, but those will get flushed out in due time. PTSD is not an easy thing to fake, I would think. Maybe I'm wrong.

The bottom line is that I'm a senior NCO in the Army who takes an active role in his Soldiers' and civilians' lives. I impress upon them the importance of taking care of themselves. I've discussed suicide prevention and PTSD with them till I was blue in the face. But, all of that means nothing if I can't lead by example. How can I convince these troops to seek help and not worry about their clearances or jobs while inside I'm ignoring my own advice.

For over six years, my wife has endured uncomfortable nights of sleep while the man next her jerks, flails, tosses, and turns all night long while feeling powerless to help. I've woken up too many nights to an empty bed because it's easier for her to sleep on the couch instead of waking me up from the little sleep I'm able to scrounge up at night.

For over six years, Emily has learned to recognize when my inner temper is flaring up; to pull me aside before I absolutely explode or lash out. I'm not a physically abusive father, but I lose my temper too easily with my kids. The little things that are just the dumbest excuses in the world will set me off. Later, I just feel like the biggest ass because something so small as not closing a door or leaving something on the stairs sets me off.

I struggle with a deep sense of failure that my kids don't feel like they can come to me with their problems because my response is usually "suck it up and deal with it. What doesn't kill you makes you stronger." What a weak response and utter lack of love and compassion for a father to have towards kids who are learning to cope with life! It pierces my very soul when my kids are calling for mom and when she isn't around I ask what they need. Instead of telling me what is bothering them, they say they don't want to tell me because I'll "just get mad at them."

Regardless of whether or not I wanted to set an example for those Soldiers out there reading this that are going through the same thing, I NEED to find my family again. My issues have caused them to adjust their lives as much as mine. They have had to alter how they speak to me or behave around me. The families are just as much affected by PTSD as the Soldier who is afflicted with it. They cannot be forgotten.

Probably one of the factors that helped me cope these past few years is patience and love. The patience and love provided by wife and kids has been met with constant apathy. But, I've made the decision to finally allow that patience to pay off. My family is more important to me than anything in this life except my God. Even if the Army weren't serious about legitimately helping troops and wanted to use this to ruin my career, I simply don't care.

The good news is that the Army IS serious about this. Secretary Gates has put in black and white in no uncertain terms that seeking mental help will NOT affect your clearance. Seeking help with mental issues is NOT a weakness. Walking into that building last week and being surrounded by junior troops was a LOT harder than simply continuing through life hoping I live to see my grandchildren. Baring my soul to a complete stranger wasn't exactly on my list of the funnest things to do in life. But, it had to be done.

So far, I think I've had good command support. I am being given the time I need to navigate this road to recovery and normalcy. They have shown me that they understand the Army's intent. To be honest, I wasn't so sure at first. And only time will tell, but I'm convinced so far that I didn't make the wrong decision, as least as far as my career goes. And I honestly believe the Army wants to help us get through this the best way possible.

One Step at a Time

By CJ Grisham


For those that listen to our You Served Radio Show each Thursday evening, you probably missed an announcement I made at the end. Our interview with General Chiarelli went long so those listening live probably didn't catch it unless they went back and listened to the archives.

I've been noticeably missing the past week or so for a number of reasons. Not the least of which is Army business, but I can't blame it all on work. At the end of the show, I publicly admitted that I'm having issues dealing with life. Not in the sense of ending it, but just coping and interpersonal issues. I consider admitting that I have a problem phase I of my new recovery.

Last week, my company completed Phase II of the Army's Suicide Prevention program. We watched the video, "Shoulder To Shoulder: No Soldier Stands Alone" (I'll have it uploaded later) and then discussed some scenarios afterwords. When the training was complete, I sat down with my Soldiers to talk them face to face about what we had just trained on. I explained to them that NOTHING in this life – nothing in this Army – is worth taking your own life for. Life sucks…a LOT. But, it's never so bad that you should end your life.

I explained that in my experience there is a common thread to people who want to commit suicide. Almost without fail, the inner thought of suicidal people is that "life [for others] would be better without me." Or, "I'm inconsequential." A common goal of suicide is to easy the burden of one's life on other people. What they don't realize is that suicide only compounds the burden's on other people. The only thing it ends is that individual's problems while placing those problems in the hands of someone else. I looked my Soldiers in the eye and told them from the heart that I and the commander are there for them if they EVER feel like life is too burdensome to continue. We will not chastise them, mock them, make light of their situation, or try to convince them that their problems aren't real. We will do everything within our power to help them overcome whatever in their life is causing them pain and anguish.

I then explained that seeking that help, either from us or real professionals, is not a sign of weakness. I talked about my conversation with General Chiarelli and the Army's commitment to ending the stigma that has historically been attached to seeking mental health counseling. To lend credibility to what I had just told them, I entered phase II of my recovery – telling my Soldiers that I am seeking counseling. For far too long since returning from Iraq, people both inside and outside of the military have sort of hinted to me that I should seek help. My lovely wife has mentioned it a few times, sometimes joking for fear of offending me. Even my Command Sergeant Major suggested I seek professional help when he spoke to me about my IG complaint. I met each suggestion with either humor, disinterest, ambivalence, or anger depending on whom was telling me. There's nothing wrong with me. I'm fine. You're crazy for even suggesting such a thing. Haha, that's funny.

As most of you know, I started this blog as self-medication. It worked for a few years, but I'm not sure what's happened in recent months and years. Perhaps it's the physical pain I've been in for more than six years now. Maybe it's the accumulated lack of sleep that is catching up to me. Maybe there really is nothing wrong and I'm just really tired! Whatever it is, my behavior has changed and it sort of scares me.

I am always tired. No matter how long I "sleep," I NEVER wake up rested. I toss and turn throughout the night. I lie awake for hours enjoying the company of the beautiful woman beside, soundly sleeping. Sometimes, I get up and walk around the house or surf the internet. I'm not willing to get specific about the things keeping me awake at night publicly, but it's a combination of bad dreams, everyday stresses, and physical discomfort. I have a prescription to Vicodin for nights that I can't sleep through the pain that I rarely take. I'm afraid to get addicted to the pills if I take them every time I need them. A bottle typically lasts me about six to eight months. But, when I take them I keep Emily awake. Sometimes, they even keep me awake. I'm not in pain, but they make me itch.

I'm not comfortable being around people. I'm not the social butterfly I pretend to be anymore. This year's Milblog Conference was the most uncomfortable I've been in years. I used to love being the center of attention of making an ass out of myself. I don't like doing anything anymore. I hate leaving the house and when I do, I make sure I'm always armed. There's a sense of impending doom just walking out my front door. To at least get me out and about, I've turned to geocaching. It's something I can alone or with my family. It keeps me moving, but I don't have pay for anything or worry about large crowds.  Even when I went to the Tea Parties, I tried to keep mostly to myself and not draw attention.
That is what is so great about the internet. I can have all these friends and be in the company of hundreds of people and I feel perfectly fine. The problem is that I've made a lot of GREAT friends online that I truly love, respect and admire. Yet, I dread the eventuality of being social except with certain people. That tends to push people away or cause them to think that they've somehow done something wrong or that they aren't important to me which is completely untrue. I don't even like hanging out with my own family! My sister just finished a visit and I felt so distant the whole time.

One of the things that keeps me up at night is the fact that I expend a LOT of energy trying to keep my life in order. For many years I've had memory issues and it's gotten much worse lately. I have to write EVERYTHING down or I forget it. I'm not talking about complicated things or detailed things, I'm talking about virtually everything. I forget meetings, appointments, names, faces, promises made, places I've been, things I've done or not done, etc. The list literally goes on and on. It's frustrating because I used to be a virtual encyclopedia of information. Now I have to strain to remember anything.
There's nothing more frustrating than when my commander asks me a question about a Soldier's issue that I know about, but need to check my notes to brief. Hell, I even forget which Soldiers are at which field offices and I've been doing this for nearly two years!! Every day I come into my office, I open up my "go book" that I recently created and read through the list of offices and the troops located there so I don't forget. I used to be able to spout out with ease when someone was ETSing, in their promotion window, having a birthday, etc. I knew their family members' names and had them committed to memory. Now I'm lucky if I can get my own nieces and nephews' names right. I don't know if this is a result of stress or all the wonderful, cool explosions I had the pleasure of sitting through, but it's the one thing that I probably spend the most time trying to combat!

There is a bright side to all this. In my quest to deflect the attention I receive, I work hard to draw attention to other, more worthy, individuals. Instead of worrying about myself, I can put all my energy into worrying about my troops and making sure that their achievements are recognized. I try to focus on those injured or killed in combat. They deserve to be recognized for what they've sacrificed for their country.

Why am I writing all of this? Well, for the same reason I started this blog – to get it off my chest. To "tell someone without having to tell anyone." It makes me feel better – a little. The last thing I want/need is sympathy or people feeling sorry for me. I'm no victim here! I don't want special attention, help, or pawing. I don't need pats on the back and I don't want to be a poster child. I don't want money, congressional testimony, or the support of VoteVets or IVAW who want to politicize these issues. I want other Soldiers to realize that the Army is serious about removing the stigma. I have a problem! And I'm still "Army Strong" in spite of it! Don't believe me? Screw up and I'll still nail your arse to the wall and start shooting darts. I'll still put you in the front leaning rest for a decade or "until I get tired." I can still pass my PT test, qualify expert on my weapon, and meet my daily suspenses (thanks to Outlook's "tasks" function).

There's nothing weak about me because I'm having these issues. I can still lead by example, accomplish the mission, and take care of my Soldiers. And if my Soldiers feel like they can't trust me or serve under me, tough! Suck it up until your ETS or call your branch manager and get the hell out of here. Thankfully, I have good Soldiers who embody the Warrior Ethos and Army Values. They see that I'm still very much in control as "Top."

The stigma is hereby dead. I challenge all leaders to understand this and apply it where they can. Our troops need to understand that there is nothing weak about seeking help. I know because it has been much harder to acknowledge these issues than to hide them. It's been a lot harder knowing I may very well be ending my career by admitting that I'm not all there mentally. Talking about this now after 15+ years – and prior to being eligible for retirement benefits – is probably the hardest thing I've ever done. I'd be lying if I said I wasn't worried. I am, but I trust the Army on its word and I'm challenging that mentality. And as I do so, I will be documenting most of my progress here. There are still a great many issues I will probably never feel comfortable talking about, but I owe to others out there that may be trying to hide their problems for fear of losing their jobs or risking their reputation. I need to lead by example. And if I can do it, so can you!

Now, I'm gonna go get some sleep and enjoy the rest of my vacation. I'll be leaving my cell phone in the room tomorrow so I can really relax!

Hey, By the Way I Ran into the Dope Man Today

Yesterday I was running some errands to get ready to spend the weekend with my girlfriend. After I had picked up a prescription from Wal-Mart I was sitting in my car when a guy walks up to me pointing like he had always done. I looked thinking what and was immediately thinking defensively. When I looked up I saw my old dope dealer and was surprised, so to be polite I got out of the car and talked with him for a minute.

We talked about people we used to hang with and if we had seen any of them, I replied no but had actually had seen some of them. I felt guarded with this guy, not wanting to give him to much information about me. He asked where I lived and responded with a general area. He asked me what I was doing today and I was proud to tell him I am in my senior year of college. He seemed surprised, but changed the subject quickly. He did mention that the college campus would be a great money maker, with all the partying going on. I asked him was he working and his reply was "Oh yeah, 7 days a week." He asked me if I still was hustling, code for do you want any drugs to sell and/or use. I was also proud to tell him that, no I do not. But, their was conflicting emotions and the lure of getting high again. The wheels where turning in my head, a voice was seductively saying,

You know he has some weed in his car, all you have to do was ask for it.

Another voice was reminding me of how far I had come, to get high was to give up the esteem that I have earned. I was reminded of the cirlce of frineds I have and how they play a part in my descion making skills today. That my friends today lift me up and inspire me to new heights; they encourage and challenge me. The conflicts I have today with my friends comes from love, not petty resentments from unmet needs and expectations. In that moment I realized a deeper appreciation and understanding of what friendship entails and how it impacts my life. The foundation I have built steadied my course and enabled me to tell myself no, to shut off the negative voices and drive away feeling blessed.

If You Need Help Ask For It

By CJ Grisham


I then explained that seeking that help, either from us or real professionals, is not a sign of weakness. I talked about my conversation with General Chiarelli and the Army's commitment to ending the stigma that has historically been attached to seeking mental health counseling. To lend credibility to what I had just told them, I entered phase II of my recovery – telling my Soldiers that I am seeking counseling. For far too long since returning from Iraq, people both inside and outside of the military have sort of hinted to me that I should seek help. My lovely wife has mentioned it a few times, sometimes joking for fear of offending me. Even my Command Sergeant Major suggested I seek professional help when he spoke to me about my IG complaint. I met each suggestion with either humor, disinterest, ambivalence, or anger depending on whom was telling me. There's nothing wrong with me. I'm fine. You're crazy for even suggesting such a thing. Haha, that's funny.

As most of you know, I started this blog as self-medication. It worked for a few years, but I'm not sure what's happened in recent months and years. Perhaps it's the physical pain I've been in for more than six years now. Maybe it's the accumulated lack of sleep that is catching up to me. Maybe there really is nothing wrong and I'm just really tired! Whatever it is, my behavior has changed and it sort of scares me.

I am always tired. No matter how long I "sleep," I NEVER wake up rested. I toss and turn throughout the night. I lie awake for hours enjoying the company of the beautiful woman beside, soundly sleeping. Sometimes, I get up and walk around the house or surf the internet. I'm not willing to get specific about the things keeping me awake at night publicly, but it's a combination of bad dreams, everyday stresses, and physical discomfort. I have a prescription to Vicodin for nights that I can't sleep through the pain that I rarely take. I'm afraid to get addicted to the pills if I take them every time I need them. A bottle typically lasts me about six to eight months. But, when I take them I keep Emily awake. Sometimes, they even keep me awake. I'm not in pain, but they make me itch.

I'm not comfortable being around people. I'm not the social butterfly I pretend to be anymore. This year's Milblog Conference was the most uncomfortable I've been in years. I used to love being the center of attention of making an ass out of myself. I don't like doing anything anymore. I hate leaving the house and when I do, I make sure I'm always armed. There's a sense of impending doom just walking out my front door. To at least get me out and about, I've turned to geocaching. It's something I can alone or with my family. It keeps me moving, but I don't have pay for anything or worry about large crowds. Even when I went to the Tea Parties, I tried to keep mostly to myself and not draw attention.

Review of Treatment of Tinnitus with a Customized Acoustic neural Stimulus: A Controlled Clinical Study

This study describes a new treatment, the Nueromonics Tinnitus Treatment (NTT), combining the use of acoustic stimulus augmented by a clinician providing a structured counseling program for tinnitus management. The abstract does not go into details as to how the treatment works; it describes the successful testing of this system. An overall success rate of 73% gives ample reason to suspect replications of the studies and possibly providing a new treatment modality and assessments, affecting several clinical care settings, such as primary care, mental health, emergency rooms, and psychiatric wards.

The audience target would be clinicians looking to improve the assessment of veterans with auditory disorders with mental health comorbidity. The abstract is solution oriented and would translate well to the social worker devising a systemic change to patient care from the veteran in the hospital bed to the veteran in the emergency room who may be misdiagnosed due to the fact that she cannot communicate due an auditory disorder. This study would facilitate sound structural changes within the VA system ensuring that our veterans have better care. With this information becoming more prevalent, practitioners could become more aware of the culture of the deaf and hard of hearing veterans and could better accommodate their needs and better round out the person-in-environment approach.

Davis, P. B., Wilde, R. A., Steed, L. G., and Hanley, P. J. (2008). Treatment of tinnitus with a customized acoustic neural stimulus: A controlled clinical study [Abstract]. ENT-Ear, Nose & Throat Journal, 87(6), 330-339.Journal, 87(6), 330-339.

Review of Progressive Audiologic Tinnitus Management

This brochure provides the fundamental principles found in Progressive Audiologic Tinnitus Management (PATM) modality to raise awareness to the practitioner and veteran clients. Only about 20% of veterans suffering from tinnitus require a clinical intervention which necessitates a progressive management approach, providing triage guidelines to facilitate appropriate care for the veteran with tinnitus and other presenting problems such as physical trauma, mental health problems, ear pain or drainage and depending on a categorical fit they would be referred to Ear, Nose and Throat (ENT), the audiology department, mental health or other specialist.

The brochure clearly delineates which level of care the veteran would need based on a few short surveys and gives direction on the next steps, interventions and treatments. The brochure has a concise and efficient overview of the helping process for the clinician in a generic way that could easily bring highlighted points to reinforce educational seminars and lectures within the Veterans Administration (VA) medical and mental health centers. The target audience would be the VA system enabling a more balanced and cultured response to an ever increasing diverse veteran population.

The article could translate well for the social worker as they would benefit the discipline of practitioners ranging from clinical to social services within the VA. The brochure expounds on a solution that pervades the VA system today, veterans with audiologic disorders that have exponentially increased within the last five years.

Myers, P. J., Henry, J. A., Zaugg, T. L., & Schechter, M. A. (n. d.). Progressive audiologic tinnitus management for veterans [Brochure]. Portland, Oregon, and Tampa, Florida: Veterans Administration (VA) National Center for Rehabilitative Auditory Research, VA Medical Center, Department of Otolaryngology/Head and Neck Surgery, and James A. Haley VA Medical Center.