Showing posts with label ptsd. Show all posts
Showing posts with label ptsd. Show all posts

Saturday, May 17, 2008

Supporting the troops?


I've written in passing about the uncounted costs for the United States and its allies, including Canada, that are fighting in Afghanistan and Iraq. Much has been made of the number of soldiers killed in action and there has been some coverage of the tens of thousands of seriously wounded. Earlier this year, I linked to the stories being told at the Winter Soldier conference about the U.S. Veterans Administration hospitals failure to diagnose and treat Post Traumatic Stress Disorder.
It would seem there is a reason for this failure. Depending on the study you look at - and there are several - it is estimated at anywhere from 12% to 20% of vets returning from Iraq suffer from PTSD to some degree. Add to that the uncounted number of "military contractors" working as everything from truck drivers to mercenaries security consultants and that is a lot of potential for very bad things to happen.
But not to worry. In war, we all must make sacrifices. After all the President is working hard and has given up golf for the duration, what more can we ask?

crossposted from the Woodshed

Sunday, January 27, 2008

Opening the ugly box


Not since Viet Nam have defendants in murders committed in the United States used the post traumatic stress disorder defence. Now, a US judge has included combat stress as a mitigating factor when passing sentence on a convicted murderer in South Dakota.
When it came time to sentence James Allen Gregg for his conviction on murder charges, the judge in South Dakota took a moment to reflect on the defendant as an Iraq combat veteran who suffered from severe post-traumatic stress disorder. “This is a terrible case, as all here have observed,” said Judge Charles B. Kornmann of United States District Court. “Obviously not all the casualties coming home from Iraq or Afghanistan come home in body bags.”

Judge Kornmann noted that Mr. Gregg, a fresh-faced young man who grew up on a cattle ranch, led “an exemplary life until that day, that terrible morning.” With no criminal record or psychiatric history, Mr. Gregg had started unraveling in Iraq, growing disillusioned with the war and volunteering for dangerous missions in the hope of getting killed, he testified.

This was supposed to have been long past. It was to have died with the veterans of the Viet Nam war. Remember, Iraq was only supposed to last a few weeks.

Born during the Vietnam War era, the combat version of what became known as the PTSD defense is being dusted off for a new generation of war veterans.

“I’m seeing it all the time now,” said David P. Sheldon, a civilian lawyer in Washington who represents military personnel. “And I will not be surprised to see this resonate as a consistent theme over the next few decades when people will be committing crimes after suffering repeated traumas in Iraq.”

California has updated a law, written five years after the end of US involvement in Viet Nam, which permits judges to divert offenders with Iraq or Afghanistan service to treatment instead of jail. Although only for lesser offences, it is an acknowledgment that combat stress is real and has a lasting effect on many individuals.

“I see these stickers that people have on their vehicles saying, ‘Support the troops,’ ” Judge Kornmann said. “I don’t see much support for the troops as years go on when these people come back injured and maimed.”
A millenniums old problem. Douglas MacArthur did no favours to returning combatants when he said, "Old soldiers fade away."

Maybe they do, but there is likely to be a horribly disturbed life between the date of discharge and the final fading away.

Sunday, January 06, 2008

The more things change, the more they remain the same


Back in the day there was no such thing as a military ombudsman. We had to state a complaint, "at the table", as a Captain's Requestman. (The procedure for the Royal Navy and Canadian Navy are identical).

When the military ombudsman became a fact of life there were two things we all hoped:

1. That the pressure of complaints and the means to provide redress would be somewhat relieved; and,

2. That some of the ongoing irritants which so regularly and consistently pissed-off sailors, soldiers and air-force personnel would be addressed.

It would appear, however, that such is not the case. In fact, given that we now have fairly regular casualties occurring in Afghanistan, "things" may have gotten worse.
The outgoing military ombudsman is criticizing Ottawa for failing to provide adequate support to families of fallen and injured soldiers, especially those with post-traumatic stress disorder.

In an exclusive interview with CBC News, Yves Côté said his office has dealt with many families who complain of too few answers after a death in Afghanistan or little help after loved ones return home with mental health problems.

Here's the point: PTSD is still treated as something embarrassing by the Canadian Forces and there is still a stigma attached to those who visit the "shrink".

The ombudsman was supposed to have provided a fast-track in the resolution of problems. From all accounts, that has occurred, but there are great gaping holes, one of them being the difficulties encountered by families and the ability of families to speak directly to the CF bureaucracy in the absence of the military member.

The article continues with something even more revealing than most people think. Do you know how difficult it is to get a special forces member to speak about anything?

A former member of Canada's elite special operations force told CBC News that while he was serving in Afghanistan, his wife haggled with the military in a dispute over $30,000 in moving expenses.

Brian, who did not want to give his last name, said he returned from his mission and witnessed the toll it took on his wife.

"She had lost a bunch of weight; her skin was grey. She looked sick," he said. "I was making my wife sick because of my job and their lack of support."

He quit the military last July, citing family stress.

"It was the greatest job I've ever had," he said. "It was fantastic, but I love my wife more, and I'm not going to let them treat her like that."

Cote gave it a good shot, but he was fighting a system that provides a lot of lip service to problems involving families. The bureaucracy would rather not hear from families or spouses at all, much less acknowledge their existence.

Côté said Ottawa should make sure families are not ignored or lost in the system, as they are "paying a huge price as a result of their dear ones having served Canada in Afghanistan."

He said he is presenting recommendations on how to address such issues in two reports his office is preparing, to be released this spring.

No one from the department of national defence was available for comment.

Taken in order, Cote is absolutely correct, the two reports will find themselves a place on the famous "shelf of dust" and, I'm not surprized.

Supporting the troops has nothing to do with being a cheer leader for a dubious mission.

H/T CC.

Sunday, August 05, 2007

Iraq veterans suffer stress and alcoholism


The British have started to figure it out.
Thousands of frontline veterans of the wars in Iraq and Afghanistan are facing escalating mental health problems, alcoholism and family breakdown, an extensive examination of the British military has found.

Prolonged periods in conflict are linked to higher levels of post-traumatic stress disorder, psychological distress and problems at home, researchers report in the British Medical Journal online.

The Ministry of Defence said it would study the findings to try to better understand mental health problems in the military, but last night there was pressure on the government to address accusations that the military is currently overstretched, forcing personnel into longer tours of duty. Opposition MPs said the burden on the military was another reason to begin phased withdrawal from Iraq.

The Royal Navy has, for well over a decade, maintained "Harmony" guidelines, intended to provide an opportunity for individual sailors to spend time with families. It can get complicated because it depends completely on ship deployments, commitments and available refit locations for ships. These were extended across the whole of the British forces with the conflicts in Afghanistan and Iraq become the focal point of individual rotations on long deployments.

The problem is, "Harmony" guidelines were regularly breached. In 1996 the Royal Navy had been able to report that very few breaches of "Harmony" guidelines had occurred and in some of those cases they had actually been able to leave one watch ashore while the ship sailed on fisheries protection duties.

That's all well and good, but Afghanistan and Iraq suddenly put the army, in particular, into long and recurring rotations. Harmony guidelines took a second place to the need to maintain strength on the ground in theatre.

It's the price of going into a protracted engagement with a peacetime armed forces.

An MoD spokesman said: "We will of course study the research and work with the researchers to improve our understanding of the effect of operations on personnel.

"Before their deployment every member of the armed forces will know the length of their operational tour. But there will always be occasions where unforeseen circumstances will impact on their return. The MoD works hard to minimise the effects and will not keep personnel in operations unnecessarily."

He said that the latest figures showed that of all personnel less than 1% of the Royal Navy, 12% of army and 6% of RAF personnel were exceeding the harmony guidelines.

The concern here is actually the extending of tours. While the study talked about tours extended to 13 months or more, that only constitutes 20 percent of the total British force deployed. The usual length of tour is between six and seven months. And the British are concerned about the effects on troops extending longer than that.

The Americans have extended tours to 15 months and many troops have done multiple rotations.

Wait until that has to be sorted out.

h/t Cat

Sunday, April 15, 2007

The Abyss

I was going to link to a whole pile of studies to do this post, and decided not to. It’s not that there isn’t a lot, it’s that there’s almost too much. It’s that they don’t prove anything to you or, in this case with some importance, to me.

I was going to link to various stories about servicemen and servicewomen returning from some of the worlds worst places and events, having more than a little difficulty getting their minds to calm down and their consciences to absolve them of the moral dilemma. There are lots of those stories out there, and they’re not hard to find. Find them if that helps.

My grandfathers both fought in the Great War, 1914 – 1918. They both survived and shortly afterwards, emigrated from Great Britain to Canada. They had always described that move as a means to escape the rigidity of the British class structure. One of them eventually told me it was also to escape the memories of what he had been through during the war.

One became a policeman and the other a radio technician. Both spent their lives as troubled men, unable to escape the memories of the horror of the battle known as The Somme. They spoke very little of their experiences. In their homes there was always a stiffness around them. One of them loved to play with children – for a while. Then he would sink into his chair in silence, an unread book in his lap and stare at the floor until called for the next meal. Sometimes that was hours. My Grandmother would tell me, “It’s the war,” and never offered any further explanation.

The truth is, both of my grandfathers were troubled men and, while one of them seemed to adapt to life thousands of miles away from the muddied fields of Belgium and the sooty streets of Manchester, the other could never escape the horror of his experiences so long ago.

It probably didn’t help them that just over twenty years after their participation in the “war to end all wars”, they sent five of their six sons off to do it all over again. They too survived the second great war having fought in the Battle of the Atlantic, the Dieppe Raid, Ortona, The Scheldt and, as an added infliction, the disaster at Ostend which saw the destruction of the Canadian-manned 29th Motor Torpedo Boat Flotilla.

My father and one uncle, stayed in the service. They would go on to fight in Korea. In the years as I was growing up I would ask them about their particular experiences and receive no answer. I was told I was too young to know. I watched my uncle slide into acute alcohol abuse and spend a lifetime recovering; a short lifetime. Before he died the only thing he said about his experiences in war was that he hoped we had, as a people and a species, found a way to stop destroying the consciences of young people by sending them to do unnatural things.

I never understood that until much later.

I was just short of thirty-years old when my own call came. I had been in the services, both British and Canadian, for over ten years. If there had ever been a sense that with war came glory and with combat came the test of one’s character, it ended that day. A sense of fear replaced everything. Oh, there was a sense of duty and some excitement, but this was the real thing and the real thing was extremely dangerous.

In the months that followed the fury of unrestrained combat was unleashed. Ships were destroyed, comrades were killed, aircraft were shot down and I killed the enemy, at close quarters. I didn’t think much about it then. I emerged, glad to have survived, a little the worse for wear and satisfied that the incessant fear was over.

In subsequent years I would be called to one more war which, thankfully, was extraordinarily short. In the years that preceded and followed it however, there were missions to places which had been engaged in the worst horrors humans can wreak upon each other.

We had arrived to protect people and in every case, we had arrived far too late. From Cambodia to Haiti, the earth was strewn with the remains of those who sought the solution to their problems in the killing of others. And nothing was solved. The poverty, starvation, disease and corruption remained as firmly entrenched as when the killing had started, only by the time we had arrived the hatred was on display in the rotting corpses and over-filled morgues.

Had we arrived early enough to prevent it, it would have started after we left. And we would have been involved to such a degree that we too would have had to deal with the aftermath of the personal effects.

That’s what this is. It’s about what happens after. It’s about holes: holes in the psyche. There are plenty of names for it. Today’s flavourful term is Post Traumatic Stress Disorder. It is described as a “condition”. No one wants to call it a combat wound.

In the decades that have passed since my first shooting war, I have thought little about what happened to me. I used to think about the people I served with and those who did not find their way home. I used to think about the good times and the loss of them when a friend fell. I used to think how they would never know what I know because their life ended too early. That was always painful enough.

Recently, however, something ignited in my mind. I don’t know what it is but it’s unpleasant at the least and terrifying at worst. The nightmares of past events come more often and with more clarity. And, in the middle of a conversation with people who know nothing of my history, I suddenly recall an event which sends my mind flying in a thousand different directions.

Back then, I used my weapon precisely as I was trained to do: automatically, surgically and as an extension of my arms. Often, I did not feel it kick into my shoulder or hear the metallic working of the action. Now, I can feel the trigger and the pressure against my index finger as I release the round that will kill the human in front of me. I can see the faces of mere boys who were given no choice but to die by my actions. In a particular instance, I replay an event which at the time I could not afford to second-guess. And I now wonder if the wounded young conscript laying in a fire-pit ahead of me was not reaching for his weapon but crossing himself in the style prescribed by his Catholic faith. I put two rounds into his chest before he could finish his act and I will never know whether he intended to kill me or whether he was simply asking for help from his God.

My mind randomly and with no warning suddenly erupts with one thought: “You are a killer.” It is something I have to fight back because when it happens I can see the edge of an abyss. It is a debilitating feeling that no matter what I have done in my life or what good I do, I will always be a killer; someone whose conscience was able to repress remorse for over two decades.

Those are the worst times. They come and they go. And now I understand the troubled times experienced by my antecedents: The unwillingness to tell others what they had experienced. There is a feeling of despair, moments of shame, and a fear that by verbalizing it, it will only promote something worse.

It might. Or, it might not.

The one feeling that nags at me is that no one will truly understand what is happening unless they were there. Can anyone truly know the sound of bullets whizzing by unless they have experienced it? Can they understand the shock of killing another human at close range? And can they understand that somehow, it should have all ended with me.

I understand my elder relatives’ misgivings in relating the stories of their wartime experience. It is a hugely difficult thing to do. But had they done it, more of us would have known the truth. From the first time a comrade drops like a sack of potatoes and never gets up, to the first time you watch a bullet from your rifle tear into the body of another, spreading flesh and bone over a narrow arc, any glory that might have been associated with being a warrior vanishes.

There is no glory. There is only a lifelong regret and a wish that things had been different.

I know now that those who preceded me wished that they were the last generation to ever have to go to war. Their hope was that the human condition could change and war could be made obsolete. That was my hope too.

It was not to be. We have sent yet another generation of young men and women off to become permanently scarred with first-hand knowledge of war. In time they will return and those who have had to experience the worst war has to offer will pay heavily. They will experience the dismissal of their difficulty to deal with the turmoil in their minds and the humiliation of having to try to beat back depression, anxiety and a simmering anger.

They will look into the abyss and, as a so-called enlightened society looks on knowing nothing of what agony exists in their minds, wonder what lies at the bottom.