PTSD is a huge trust test that we have failed

PTSD is a huge trust test that we have failed
by
Chaplain Kathie

There are many things being done to address PTSD that were not being done when other veterans came home from combat. What it took to accomplish this is someone had to care about doing something about it instead of watching them suffer. PTSD is not new. It's what happens to one out of three humans after traumatic events. It has been around as long as man has walked this planet and will be around until the end of our existence here. We cannot control other people. We cannot control nature. We cannot stop all wars any more than we can stop all criminals from deciding they are of more value than anyone else. We cannot prevent all fires, car accidents, plane crashes, drowning deaths or anything else that has been proven to induce PTSD. What we can do is prevent what comes after. For what we cannot prevent, we can alleviate the hell after the trauma.

First look at the different types of trauma. Some are caused by nature and survivors have a little easier time making peace with it because there is no one to blame for it. They thank God they survived as they mourn the loss of those who did not. Some will walk away thinking God did it to them as some sort of punishment and they will have a harder time healing from it. It also gets harder to heal if what came after trauma was more suffering. As with Katrina, they survived the hurricane but then saw help delayed, bodies in the streets, families separated into different states and the list goes on. Much of what is happening in Haiti since the earthquake is worse for them than the earthquake itself. It will take much longer time to heal and a lot more effort to help them heal because of the aftermath.

A survivor of fires caused by nature will recover more easily than one caused by the acts of a person. The list goes on. What is harder to recover from is when someone else caused the traumatic event or made it worse.

This is why combat takes such a heavy toll on the men and women we send. Wars are all caused by man and they witness what man is capable of doing to man. The goal of war is to defeat and destroy what cannot be defeated. The terrorists actions we've seen have been done in order to cause as much suffering as possible because they know the survivors will suffer after constantly looking over their shoulder wondering when the next act of violence will strike. They have no control over what other people do. They operate under no rules. Civilians are their favorite target, men, women and children. The military has rules and while they train to take out "bad guys" they do not intend to take out civilians. With Iraq and Afghanistan, much like Vietnam, there were no clear targets to take out. Someone can appear to be just minding their own business only to turn around and blow themselves up. These unbelievable actions take hold. The soldiers know they cannot trust what they see and are forever changed by their experiences.

When they come home, if there is more suffering inflicted because there is only judgment against them, belittling when try to open up about what is going on inside of them or they are handed pills instead of help, it adds to their loss of trust. When their families, the people they are supposed to be able to trust, turn against them because they don't understand why they act the way they do, it adds to their loss of trust. When they turn to the government, the DOD or the VA, for help, are responded with delayed claims being processed or a series of denials and appeals, this adds to the loss of trust. When they do end up going to a mental health provider with no idea what PTSD is, this makes PTSD worse and they lose trust yet again.

PTSD is a huge trust test that we have failed.

There is also the spiritual aspect involved when some will survive traumatic events, especially in combat, then believe God has abandoned them, judged them and have left them on their own to suffer. With little ability to trust another human, the loss of ability to trust God removes hope. If a soldier turns to a military Chaplain with no understanding of what PTSD is, then it makes it all worse, yet if they have a full knowledge, there is great healing possible, restoring faith in God's compassion and also restoring faith in man knowing someone cares enough to help.

Friday I attended a conference, Clinical Issues for Clinicians Working With OEF and OIF Veterans and their Families. The people attending were from all walks, psychiatrists, psychologist, social workers, veterans and me. All of us trying to make lives better for our veterans. Some of the questions came from psychologists addressing the issue of patients saying they do not believe in God. When people survive combat, or any other traumatic event, most of the time it is not a matter of they never believed in God, but lost the ability to believe. Mental health providers need to ask if the patient believe in God before or never had reason to believe and then take it from there instead of just assuming they never did. The spiritual aspect is vital to healing PTSD especially if the patient had faith before because they are now dealing with the loss of the faith they always had before.

There are conferences all over the country trying to get ahead of what combat is doing to our veterans so that finally the suicide rate will go down instead of up because we know it will take buddies, the chain of command, chaplains and the mental health workers while they are still enlisted, but it will also take the VA, doctors, social workers, nurses, claims processors, communities, clergy and especially families to help these veterans heal. The knowledge gained by all will help restore trust in the combat veteran and thus, help them heal.

This is what the Montana National Guard is doing with their Yellow Ribbon Program. They are putting together an army of people to help these veterans heal. They understand it is not just a matter of welcoming them back home and then assume they are finally safe. We lose more after combat than during it. The Montana National Guard managed to think outside the box and it appears to be working.

Coming home is the moment that troops deployed abroad dream about, but it's also a traumatic moment because soldiers are changed by combat. The Montana National Guard's Yellow Ribbon program is designed in part to help soldiers reintegrate into their families, their jobs and their communities. (PHOTO COURTESY OF MONTANA ARMY NATIONAL GUARD)

Montana model for PTSD detection to face first major test
By ERIC NEWHOUSE • Tribune Projects Editor • January 24, 2010
One of the largest troop deployments in the state since World War II will test the Montana model for combat stress assessment and treatment over the next couple of years.

It is a particularly important test because Montana's model of preparing families for deployment, assessing soldiers for post-traumatic stress disorder and mobilizing crisis response teams to help traumatized soldiers has become the nation's model.

"This would have been great stuff to have had on my first deployment," said Lt. Col. Ryck Cayer, commander of the 219th RED HORSE, who is facing his fourth tour of duty abroad. "I wish I'd had this kind of knowledge going in the first time."

The National Guard's determination to take better care of its soldiers who deploy was a result of the suicide of a former infantryman, Chris Dana from Helena, in March 2007.

Dana was one of approximately 700 soldiers from the 163rd Infantry who served in Iraq in 2004-05. Once he returned home, he began isolating himself. When he could no longer handle Guard drills, he received a less-than-honorable discharge and shot himself a few days later.

In a state with one of the nation's highest percentages of veterans per capita, Dana's death spurred calls for reform, which the Guard responded to immediately.

Among the Yellow Ribbon briefings are several on PTSD, alerting soldiers and their families of the danger signs such as hyper-vigilance, irritability, nightmares, flashbacks and excessive reliance on alcohol or drugs, as well as how to seek help if a service member displays those signs.

To make sure service members don't drop through the cracks, the Montana National Guard set up a system under which all service members returning from combat receive a mental health assessment — not just a self-report questionnaire — every six months for the first two years after their return.

"We've had problems with suicide and depression previously," Reiman said. "Combat is a new thing for many of these soldiers, and there's a lot of stress. It's a great benefit for returning airmen to provide an avenue to get them help.

"We can't judge them," he added. "We just have to give them help."

"Of the hundreds of guys that I talked with, every one of them had symptoms, things like hypersensitivity and irritability," he said. "And we had policemen and firemen and EMTs (emergency medical technicians) whose previous experiences may have contributed to their PTSD."
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Montana model for PTSD detection to face first major test

So far with the suicides of veterans as well as active duty, we have failed this test of trust. The good news is, at least many are trying to change what has been done wrong with knowledge and a true understanding of how to help.