Sebastian Junger Pushing Faker Theory of PTSD Veterans

Wounded Times
Kathie Costos
May 16, 2015

This one is going to take up most of my morning because of how very wrong it is to push the faker theory. Good Lord! When will this ever end? When will folks claiming to be serious about research they are pushing actually admit they are pushing their agenda and shared only the research they found to support whatever message they want known?

Right from the start I need to publically admit once I figured out what the real agenda was, I stopped reading a very lengthy article. The message had already been delivered.

Vanity Fair has a story by Sebastian Junger "How PTSD Became a Problem Far Beyond the Battlefield" about combat and PTSD. The problem with it is that Junger must have decided to push the faker theory and apparently grabbed whatever research he wanted to share to support his thoughts like this,

Though only 10 percent of American forces see combat, the U.S. military now has the highest rate of post-traumatic stress disorder in its history.

Hmm, gee wonder where he got that idea since the Army already studied the effects of redeployments into combat.

Repeat Iraq Tours Raise Risk of PTSD, Army Finds
Washington Post
By Ann Scott Tyson
Washington Post Staff Writer
Wednesday, December 20, 2006

U.S. soldiers serving repeated Iraq deployments are 50 percent more likely than those with one tour to suffer from acute combat stress, raising their risk of post-traumatic stress disorder, according to the Army's first survey exploring how today's multiple war-zone rotations affect soldiers' mental health.
read more here

Guess it must have much easier for Junger to just put out a blanket statement like that than to a do some real hard research into facts like before this generation, we didn't have the internet or social media. It wasn't that older veterans didn't have PTSD. It was more about no one knew about them and a majority of those veterans were following their Dads guidance of "Get over it like I did" when clearly, they didn't.

In the 90's when we were fighting have have my husband's claim approved so his treatment would be covered, there was a backlog of claims as well as waiting lists for in patient care. But let's not talk about that. Why should we bring any of that up when it comes to what older veterans went through before most of them had a clue what happened to them or why they were suffering?

Before the internet it was hard to find out what was happening beyond our own area of the country. Somehow veterans managed to find each other and gained support, understanding and shared their own experiences so that by the time the internet was in more homes, websites were already loaded with facts obtained by decades of research.

In 2007 enough information had reached 148,000 Vietnam veterans who sought help for the first time.

In the past 18 months, 148,000 Vietnam veterans have gone to VA centers reporting symptoms of PTSD "30 years after the war," said Brig. Gen. Michael S. Tucker, deputy commanding general of the North Atlantic Regional Medical Command and Walter Reed Army Medical Center. He recently visited El Paso.

That came out of the El Paso Times report about the VA pushing older veterans to the back of the line to fit in the OEF and OIF veterans no one thought to prepare for ahead of time.

VA memo orders top priority given to terror-war vets
El Paso Times
by Chris Roberts
10/07/2007

An internal directive from a high-ranking Veterans Affairs official creates a two-tiered system of veterans health care, putting veterans of the global war on terror at the top and making every one else -- from World War I to the first Gulf War -- "second-class veterans," according to some veterans advocates.

"I think they're ever pushing us to the side," said former Marine Ron Holmes, an El Paso resident who founded Veterans Advocates. "We are still in need. We still have our problems, and our cases are being handled more slowly."

Vice Adm. Daniel L. Cooper, undersecretary for benefits in the Department of Veterans Affairs -- in a memo obtained by the El Paso Times -- instructs the department's employees to put Operation Enduring Freedom and Operation Iraqi Freedom veterans at the head of the line when processing claims for medical treatment, vocational rehabilitation, employment and education benefits...

Veterans Affairs officials say prioritizing war-on-terror veterans is necessary because many of them face serious health challenges. But they don't agree that other veterans will suffer, saying that they are hiring thousands of new employees, finding ways to train them more quickly and streamlining the process of moving troops from active duty to veteran status.

"We are concerned about it, and it's something we are watching carefully," said Jerry Manar, deputy director national veterans service for Veterans of Foreign Wars in Washington, D.C. "We'll learn quickly enough from talking with our veterans service officers whether they're seeing a dramatic slowdown in the processing of claims."

Average processing time now is about 183 days, according to VA officials, and the goal is 145 days.

Earlier this year, Cooper told members of the Senate Committee on Veterans Affairs that the disability claims workload was growing and becoming increasingly complex.

He said the number of first-time disability claims has grown from 578,773 in fiscal year 2000 to 806,382 in fiscal 2006, a 38 percent increase. Already, he said, 685,000 of the more than 1.45 million troops who deployed for the Bush administration's global war on terror have been discharged.

"It is expected that this high level of claims activity will continue over the next five years," Cooper said.
read more here

There is a section on Shell Shock where Junger writes,

It was not until after the Vietnam War that the American Psychiatric Association listed combat trauma as an official diagnosis. Tens of thousands of vets were struggling with “Post-Vietnam Syndrome”—nightmares, insomnia, addiction, paranoia—and their struggle could no longer be written off to weakness or personal failings. Obviously, these problems could also affect war reporters, cops, firefighters, or anyone else subjected to trauma. In 1980, the A.P.A. finally included post-traumatic stress disorder in the third edition of the Diagnostic and Statistical Manual of Mental Disorders.

Junger must have not thought about actually researching the history of it especially when the Department of Veterans Affairs has a whole section on it.

History of PTSD in Veterans: Civil War to DSM-5

Shell Shock
In 1919, President Wilson proclaimed November 11th as the first observance of Armistice Day, the day World War I ended. At that time, some symptoms of present-day PTSD were known as "shell shock" because they were seen as a reaction to the explosion of artillery shells. Symptoms included panic and sleep problems, among others. Shell shock was first thought to be the result of hidden damage to the brain caused by the impact of the big guns. Thinking changed when more soldiers who had not been near explosions had similar symptoms. "War neuroses" was also a name given to the condition during this time.

During World War I, treatment was varied. Soldiers often received only a few days' rest before returning to the war zone. For those with severe or chronic symptoms, treatments focused on daily activity to increase functioning, in hopes of returning them to productive civilian lives. In European hospitals, "hydrotherapy" (water) or "electrotherapy" (shock) were used along with hypnosis. Battle Fatigue or Combat Stress Reaction (CSR)

In World War II, the shell shock diagnosis was replaced by Combat Stress Reaction (CSR), also known as "battle fatigue." With long surges common in World War II, soldiers became battle weary and exhausted. Some American military leaders, such as Lieutenant Gen. George S. Patton, did not believe "battle fatigue" was real. A good account of CSR can be found in Stephen Crane's Red Badge of Courage, which describes the acute reaction of a new Union Army recruit when faced with the first barrage of Confederate artillery.

Up to half of World War II military discharges were said to be the result of combat exhaustion. CSR was treated using "PIE" (Proximity, Immediacy, Expectancy) principles. PIE required treating casualties without delay and making sure sufferers expected complete recovery so that they could return to combat after rest. The benefits of military unit relationships and support became a focus of both preventing stress and promoting recovery.

and then there is this from Junger

"Today’s vets claim three times the number of disabilities that Vietnam vets did despite a generally warm reception back home and a casualty rate that, thank God, is roughly one-third what it was in Vietnam. Today, most disability claims are for hearing loss, tinnitus, and PTSD—the latter two of which can be exaggerated or faked. Even the first Gulf War—which lasted only a hundred hours—produced nearly twice the disability rates of World War II. Clearly, there is a feedback loop of disability claims, compensation, and more disability claims that cannot go on forever."

Oddly, one of the most traumatic events for soldiers is witnessing harm to other people—even to the enemy. In a survey done after the first Gulf War by David Marlowe, an expert in stress-related disorders working with the Department of Defense, combat veterans reported that killing an enemy soldier—or even witnessing one getting killed—was more distressing than being wounded oneself. But the very worst experience, by a significant margin, was having a friend die. In war after war, army after army, losing a buddy is considered to be the most distressing thing that can possibly happen.

It serves as a trigger for psychological breakdown on the battlefield and re-adjustment difficulties after the soldier has returned home.

Oddly? Seriously? Does Junger understand the differences between the shock setting off PTSD and the moral injury type hitting the soul as well as the rest of the mind? In 1995 Dr. Jonathan Shay wrote Achilles in Vietnam: Combat Trauma and the Undoing of Character after working with Vietnam veterans for decades and doing the research.

From Junger

The much-discussed estimated figure of 22 vets a day committing suicide is deceptive: it was only in 2008, for the first time in decades, that the U.S. Army veteran suicide rate, though enormously tragic, surpassed the civilian rate in America. And even so, the majority of veterans who kill themselves are over the age of 50. Generally speaking, the more time that passes after a trauma, the less likely a suicide is to have anything to do with it, according to many studies. Among younger vets, deployment to Iraq or Afghanistan lowers the incidence of suicide because soldiers with obvious mental-health issues are less likely to be deployed with their units, according to an analysis published in Annals of Epidemiology in 2015. The most accurate predictor of post-deployment suicide, as it turns out, isn’t combat or repeated deployments or losing a buddy but suicide attempts before deployment. The single most effective action the U.S. military could take to reduce veteran suicide would be to screen for pre-existing mental disorders.

Junger just argued with himself. Either they are less likely to commit suicide after combat or they are more likely as he pointed out when the fact that most of the suicides are committed by older veterans? Which one does he agree with? Plus the much omitted part of most reporting done is the simple fact that these deadly results came after the DOD instituted the FUBAR Resilience Training to prevent PTSD and suicides. That started full force in 2009.

From Junger

Conversely, American airborne and other highly trained units in World War II had some of the lowest rates of psychiatric casualties of the entire military, relative to their number of wounded. A sense of helplessness is deeply traumatic to people, but high levels of training seem to counteract that so effectively that elite soldiers are psychologically insulated from even extreme risk. Part of the reason, it has been found, is that elite soldiers have higher-than-average levels of an amino acid called neuropeptide-Y, which acts as a chemical buffer against hormones that are secreted by the endocrine system during times of high stress. In one 1968 study, published in the Archive of General Psychiatry, Special Forces soldiers in Vietnam had levels of the stress hormone cortisol go down before an anticipated attack, while less experienced combatants saw their levels go up.

Wonder what Junger has to say about Special Forces not only being put through pre-enlistment screenings but psychological testing before becoming Special Forces or the simple fact that among them there are more committing suicide? Associated Press reported on October 12, 2005 Special Forces Suicides Raise Questions but since not much happened on the prevention side by 2014 this was the outcome.

Rising suicide in Special Operations Forces prompts call for review
TBO
By Howard Altma
Tribune Staff
Published: April 29, 2014
Concerned with the increase in commandos taking their own lives, a subcommittee of the House Armed Services Committee is calling for the Pentagon to review Department of Defense efforts regarding suicide prevention among members of the Special Operations Forces and their dependents.

The call for a review is included in proposals by the Military Personnel Subcommittee as part of the half-trillion dollar-plus military budget request for the fiscal year beginning in October. If the measure passes, Defense Secretary Chuck Hagel would have three months after passage of the budget to report the findings to the House and Senate Armed Services committees.

“If the final bill calls for a report, we will work with the Department of Defense to ensure they have all the information they need to report to Congress,” said U.S. Special Operations Command spokesman Ken McGraw.

The subcommittee is also calling for a look at the overall issue of troop suicides, as well as how the military is handling sexual assaults, military health care costs and other health and well-being issues.

Earlier this month, Socom commander Adm. William McRaven told a Tampa intelligence symposium that commandos are committing suicide at a record pace this year. Though he offered no figures, he was repeating a concern he first raised in February at a Congressional hearing on his budget.

“The last two years have been the highest rate of suicides we have had in the special operations community and this year I am afraid we are on the path to break that,” McRaven, whose headquarters is at MacDill Air Force Base, said at the GEOINT 2013* Symposium in Tampa earlier this month.
read more here

Then again, this doesn't fit in with the claims Junger made either.

Donnelly Looking To Curb Military Suicides
Indianapolis Public Media
By BRANDON SMITH
Posted March 6, 2013

Last year, more combat troops took their own life than died in combat in Afghanistan. And Senator Joe Donnelly says 43 percent of service members who committed suicide never sought help. He says trying to combat the problem of military and veteran suicide needs to involve erasing the stigma of seeking help.
read more here

From Junger

Thirty-five years after acknowledging the problem in its current form, the American military now has the highest PTSD rate in its history—and probably in the world. Horrific experiences are unfortunately universal, but long-term impairment from them is not, and despite billions of dollars spent on treatment, half of our Iraq and Afghanistan veterans have applied for permanent disability. Of those veterans treated, roughly a third have been diagnosed with PTSD. Since only about 10 percent of our armed forces actually see combat, the majority of vets claiming to suffer from PTSD seem to have been affected by something other than direct exposure to danger.

The acknowledge rate of PTSD has been one out of three exposed to a traumatic event including military contractors. But again, why point that out?

Why point out that in Crisis Intervention training we were taught that there is a difference between traumatic shock and PTSD. Traumatic shock is right after the event itself. Civilians get hit by PTSD but so do responders. I focused on the responders while others focused on the survivors.

If the symptoms do not subside within 30 days after the event there is a clear indication the person needs professional mental health help. That is, after the event and they were back to their normal routines. With combat, their normal routine is more exposures to more events causing more trauma and when they were not happening, there was the constant, never ending threat of more to come.

Huge difference but mostly underreported. Guess that doesn't fit in with most of the reporting done.


Almost half of the veterans committing suicide never filed a claim or sought help from them.

CNN repoted the error in the "22 a day" claim in Why suicide rate among veterans may be more than 22 a day in 2013.

A recent analysis by News21, an investigative multimedia program for journalism students, found that the annual suicide rate among veterans is about 30 for every 100,000 of the population, compared with the civilian rate of 14 per 100,000. The analysis of records from 48 states found that the suicide rate for veterans increased an average of 2.6% a year from 2005 to 2011 -- more than double the rate of increase for civilian suicide. Nearly one in five suicides nationally is a veteran, even though veterans make up about 10% of the U.S. population, the News21 analysis found.

In 2009 the Congressional Budget Office put out "The Veterans Health Administration's Treatment of PTSD and Traumatic Brain Injury Among Recent Combat Veterans that is also a great thing to read. Just wish that Junger bothered to read most of what we pay attention to.

Our agenda in the Veterans' Community is trying to help veterans survive being home after surviving combat in the first place.