I have done some reseach on fMRI and it is pretty amazing what this can do as far as allowing a person to see biological changes in the brain in response to stimuli. If you are in this area I would encourage you to check it out and help further the study of PTSD and its treatment.

Thursday, January 12th, 2012

Returning Veterans Needed for PTSD Study: New Medical Technique for PTSD

HOUSTON – Many Veterans return to civilian life having experienced traumatic events. Researchers recently discovered these experiences actually produce changes in the brain. A new medical study currently being conducted at the Michael E. DeBakey VA Medical Center (MEDVAMC) in cooperation with Baylor College of Medicine uses functional Magnetic Resonance Imaging (fMRI) to learn how deployment affects the brain and to improve treatment of Post Traumatic Stress Disorder (PSTD). FMRI is a technique for measuring brain activity.
It works by detecting changes in blood oxygenation and flow that occur in response to neural activity. When a brain is more active, it consumes more oxygen. To meet this increased demand, blood flow increases to the active area. FMRI can be used to produce activation maps showing which parts of the brain are involved in a particular mental process. This is a relatively new medical technique. “There is limited information regarding the brain-related changes during psychotherapy,” said Matthew Estey, a research coordinator for MEDVAMC.
“We are interested in learning how psychotherapy changes neural functioning in Veterans with PTSD and anxiety disorders.” “Ultimately, we hope what we learn in our study will assist future combat Veterans who may experience PSTD and anxiety symptoms due to combat trauma,” said Wright Williams, Ph.D., the principal investigator and a psychologist. The study is funded by a pilot merit review grant sponsored by the VA Rehabilitation Research and Development Program. As part of the research, eligible Veterans will use various computer applications while inside the fMRI machine.
Participating Veterans will also participate in interviews regarding their past and present difficulties. They will be compensated for their time at a rate of $10 per hour for interviews and $20 per hour for fMRI scans. Participants will also receive a free high-resolution image of their brain. For Veterans who decide to enroll in the study, the entire process takes approximately 14 weeks. “Week one includes an interview and fMRI scan,” said Estey. “Weeks two through 13 involve an hour and a half group treatment meeting. Week 14 is another interview and fMRI scan.
The study includes male and female treatment groups, and will potentially run through the beginning of 2013.” Eligible Veterans should be between 18 and 65 years old, free from current serious medical conditions, free of metal in their bodies, not claustrophobic, able to see a computer screen clearly with or without glasses, and diagnosed with PTSD. All participating Veterans receive on-going assessments by MEDVAMC mental health professionals. “Unlike most medical studies, this one involves treatment specifically for Veterans,” said Estey. “I think providing the best possible care for our nation’s Veterans is extremely important.” For more information about the study or how to enroll, call 713-794-7629.
Awarded re-designation for Magnet Recognition for Excellence in Nursing Services in 2008, the Michael E. DeBakey VA Medical Center serves as the primary health care provider for more than 130,000 veterans in southeast Texas. Veterans from around the country are referred to the MEDVAMC for specialized diagnostic care, radiation therapy, surgery, and medical treatment including cardiovascular surgery, gastrointestinal endoscopy, nuclear medicine, ophthalmology, and treatment of spinal cord injury and diseases.
The MEDVAMC is home to a Post Traumatic Stress Disorder Clinic; Network Polytrauma Center; an award-winning Cardiac and General Surgery Program; Liver Transplant Center; VA Epilepsy and Cancer Centers of Excellence; VA Substance Abuse Disorder Quality Enhancement Research Initiative; Health Services Research & Development Center of Excellence; VA Rehabilitation Research of Excellence focusing on mild to moderate traumatic brain injury; Mental Illness Research, Education and Clinical Center; and one of the VA’s six Parkinson’s Disease Research, Education, and Clinical Centers. Including the outpatient clinics in Beaumont, Conroe, Galveston, Houston, Lufkin, Richmond, and Texas City, MEDVAMC outpatient clinics logged almost 1.3 million outpatient visits in fiscal year 2011. For the latest news releases and information about the MEDVAMC, visit www.houston.va.gov.

Refections on hating Christmas

This is a piece shared by my great friend Raub Nash whom I served with in "Deuce Four" 1st Battalion, 24th Infantry in Mosul, Iraq.
He makes a great point when he speaks about reflecting "I see it as a cathartic view into how people need, and should, reflect on everything that happens to them that they did not control." I encourage people to think back about some times when you served write it down and send it to me. Respond and tell us what you think;

Reflections on hating Christmas

By Raub Nash

Last year in Graduate School I was inundated with the idea of reflection and how it is the key to successful development. For 30 years I pretty much took every day for what it was worth and I rarely looked back on what I did or, more importantly, what events happened to me that I could not control. As I prepared to take over my new job as a leader developer at West Point, I felt as though I should at least try out what I would be preaching – it was scary.

A lot of things have happened in my short career, as I no doubt know is the same for all Soldiers in this time of a two-front war. What scared me was how little I knew how these events have changed me –both for good and bad.

As we come out of the traditional Christmas leave period, I was forced into a realization that, I hope, will make future Decembers better for me and those I spend the time with. For the longest time, or since about 2004, I have never really been in the uplifting mood that a father and husband should be in around this time. The old me would say that it was because I was raised on little extravagance, especially with respect to Christmas and gifts in general. After one evening of some rather disturbing and violent actions on my part – no one was hurt, just a sliding glass door, a scotch glass, cooler, and a shirt – I had to look in the mirror and try to understand why and where that person came from.

I was forced to think about several things on the journey to the realization of what caused my actions and what consistently causes my less than uplifting spirit over this time every year. The first event that came to mind was December 21^st, 2004. It was a pristine day in Mosul, Iraq. Clear skies and mild temperatures made it quite bearable. I was a young 2^ndLieutenant Platoon Leader in 1/24 IN. We had been in Mosul for only about 2 months. I finally had some sort of routine, without which I am a mess, and normalcy was setting in – normalcy does not mean complacency. Our platoon had already had our share of the“baptism-by-fire” incidents and we were operating as a cohesive unit for the first time. A routine patrol day started out with the usual events; drive up to our platoon area, search houses/garages/offices, chase some people that ran from our patrol and drive back.

By the time we returned to the FOB it was time for lunch. So, we dropped our gear and headed on the long walk to our chow hall. Before we headed out, our commander and a few other officers asked my Platoon Sergeant and me to go with them to get lunch. We declined so we could help close up our vehicles and let our Soldiers get to chow before us. The routine was almost always the same: clear your weapon and wash your hands outside, get a tray and choose main or short order line, get some salad and dessert in the middle of the chow hall, sit down to eat and talk about whatever, and finally clean up and leave. This day however would deviate drastically from the routine.

About the time I sat down, I noticed that I was the first one in our group of 4 that would sit together. I took a quick look around and quickly saw the other 3 heading over. I followed this with obligatory wave of the hand to let them see where I sat and for them to join me. No sooner did my Platoon Sergeant sit down in front of me than a flash of light and a loud boom shocked our world. I did what I think, especially regarding the fact that normalcy also included the occasional mortar attack, most everyone did – I jumped up, looked for those by me and we ran to a bunker just outside the door. I won’t write anymore about what happened next. It is an image and an event that I still want to keep buried somewhat. The result of the event was that I had my first experience with the loss of a comrade. My commander, CPT Bill Jacobsen, and our NBC NCO, SSG Robert Johnson, were killed while they ate lunch on the safety of their own FOB. They were not the only ones that died that day, but they were the ones I knew.

8 days later, our Platoon responded to an event that would also change me. A suicide car bomber drove a dump truck full of explosives precariously close to an outpost and detonated the device. PFC Oscar Sanchez was killed in the blast, but what most people don’t know is that he probably saved his entire platoon mates lives. If that truck made it another 100 feet or so, the entire building would have most certainly collapsed. This event I recall not because of the incident in itself, but of my actions during this. I was forced several times to place my Platoon Sergeant and the squad with him in danger. When I say forced, I really mean it. I did not like the orders I was getting, but a leader understands that sometimes orders must be followed and that people can get hurt following them. What scares me about this incident is how happy it made me to see things get destroyed while in this firefight. It was eerie how I could feel great joy as we engaged suspected – yes, suspected – targets with heavy machine guns and strafes from F-16s and, the now retired, F-14. I don’t know why I felt as though I did, but I suspect it was because I was in the young stages of burying my emotional destruction that came from the chow hall bombing.

Fast forward to December 20^th, 2007. I am a young Company Commander in the 101^st and we were finishing up an operation that my Soldiers dubbed “Operation Shitty Christmas”. This was one of those times that, much like the outpost bombing, I really did not agree or understand the intent of what we were trying to accomplish. But, the orders were legal, ethical, and moral and I was given ample time to object and add my spin on the operation – so, we executed it. After about 5 days in the middle of nowhere during an unusual cold spell, we trudged away at the invisible goal trying to find a non-existent enemy. This day was just like the others – except that we had finished our mission and were moving back to our base. One of my platoons was tasked with following a route clearance team on an untraveled route to open it for further use by our sister company. I chose to move with my main effort, getting all of our equipment safely back to our company patrol base, and I chose not go with my boss’ main effort. Well, these choices never end up good.

When I first showed up to Fort Campbell and found out which company I would be afforded the opportunity to command, I was given the green light to go and start poking around. The first person I met was SPC Leon. He was youthful looking but had an air of experience that just emanated from him. I was immediately drawn to Wesley. I can remember always looking for him at formations, during PT, and while out at training. As I got to know the Soldiers in the company, I quickly found out that Wesley was a consummate warrior. I knew I liked this kid and I knew that I could always count on him. He was in the patrol that went with the route clearance team, probably located in the order of march where my vehicle should have been, when his vehicle was hit with an IED. This event took both of his legs and cut me to the core. I was already not very good with empathy, and this event made me separate myself from my feelings more than ever which resulted in the desire to never get close to another Soldier. Terrible decision on my part. Even though Wesley hasn’t slowed down accomplishing more than most people, it doesn’t take away the deep feeling that it should have been my vehicle, an MRAP and not a HMMWV, that got hit.

Three pretty major events in my life that happened close to Christmas. No wonder I am a scrooge. This story is much more to me than a revelation of why I hate the Christmas season. I see it as a cathartic view into how people need, and should, reflect on everything that happens to them that they did not control. I wish that more people would partake in this venture and critically look at their actions and reactions to these types of events. I know now why I feel the way I do and this fact will allow me to accomplish my ultimate goal – being a great dad. There is no greater joy for me than to see my sons smile and see them do new things. It would be shame if my failure to change my attitude based on events I had no control over affected my children in a way that would have them dread the Christmas season as I do. I will let you know how I do next year.

Response to "A deeply troubled base" Post

I recived some very intereting responses from a couple of my friends I served with at Fort Lewis and in Korea who are no longer in the service but non the less had some very intersting things to say. Andy was an Infantry Company Commander with a few combat tours under his belt I served with him in 1st BN, 503rd INF in Korea and John was an Infatry Soldier who served with me in Iraq with "Deuce Four" 1st BN, 24th INF SBCT.

John: "Embarrassing. 4th Styker brigade was pretty messed up when I left lewis in the beginning of 2008."

Me: "I agree it is a little embarrassing that a base this big can't "police" itself up. But the Army is changing and so are the Soldiers. They do what they see their leaders do and sometimes they are just as bad!!"

John: "Unfotunately this guys rambo actions reinforce stereotypes veterans battle everyday. Leadership failure for sure."

Andy:"Leadership starts at home. Even the best NCO can't undo 18 years of bad parenthood overnight."

Andy: "I got found it ironic that one of police officers interviewed about crime around JBLM tried to blame the military for causing most of the violence. Yeah, right. Lakewood, WA has plenty of its own problems, (http://www.komonews.com/news/local/78088192.html)." This link takes you too the unfortunate story of the four Lakewood Police Officers who were killed. 

Andy: " I hope the Soldiers and Airmen around JBLM take heed. Police officers read the news, too. You can be damn sure that this recent series of unfortunate events will bias them against the local military much the same way that a platoon will treat locals from a town differently after an IED strike against one of their own. Don't expect to get a break on that speeding ticket or be cut any slack for that DUI. The word is out on the street and in the national newspapers: JBLM is a hot bed for military misbehavior."

Me: "Totally agree Andy it's just poor business when that 10% pit the military community against the surrounding communities. There is already a pretty exclusivness by military families that live on post against the "civilians" but I believe this widens that rift."

Andy: "Gene - a former squad leader shared this article with me. It clearly articulates that the Rainier gunman wasn't a crazed military killer devoid of positive Army leadership. Instead, he was just a nutjob who had no place in the Army to begin with. It's too bad that the "Rambo with PTSD" storyline sells more newspapers than the truth."

Here is that article:

The Mt. Rainier Shooting and PTSD: How the Media Got It Wrong
January 6, 2012 by Alex Horton

The massacre at Ft. Hood two years ago stunned the nation in its cold-blooded calculation. The high body count was just as shocking as the fact soldiers were killed not in combat, but on the grounds of a military installation. Before the slain soldiers were buried, many in the media speculated on a link between combat stress and the shooting, the correlation being that war trauma had driven a soldier to commit those crimes.
When news reports finally explained that Nidal Hasan hadn’t deployed during his Army career, the narrative shifted to secondary PTSD. The thought was that his work as a psychiatrist could have caused it. The reality, however, was that Hasan’s personal beliefs about the United States and the military were among the chief motivations behind the killings. Taken together, the prevailing narrative from those early reports—intentional or not—was this: Post-traumatic stress is a strong factor in violent crimes, and anyone who has deployed to a combat zone is capable of the same.
That narrative—fairly common since John Rambo hit movie screens in 1982—bubbled to the surface once again with the killing of Park Ranger Margaret Anderson on January 1st by Benjamin Colton Barnes, a 24 year-old Iraq Veteran. Within hours of the Rainier shooting, journalists and writers clamored to mention Barnes’ war record, combat stress, and even his duty station in a dizzying effort to find a connection:
The problem? It wasn’t true.
As more information became available on Barnes, it grew clear that his troubles had little to do with his service in Iraq or his assignment at Joint Base Lewis-McChord. According to The Seattle Times, Barnes was apparently disturbed before he entered the Army—having been expelled from school as a teenager. Additionally, military records show Barnes served in a headquarters communications job in Iraq. A spokesman at Lewis-McChord told the Times there was no record of Barnes having received a Combat Action Badge, indicating he probably never came under fire in Iraq.
While violence is undoubtedly a potential consequence of war-related trauma, highly publicized crimes by active duty members and Veterans cast the overwhelming majority of law abiding Vets in a horrifying—and typically unfair—light. As one Army officer pointed out recently, sensational stories devoid of context (like those about Barnes) inhibit the ability for people to assess likelihood and frequency in a given population. He cites the availability heuristic, which says people “predict the frequency of an event, or a proportion within a population, based on how easily an example can be brought to mind.”
When I asked her today, VA clinical psychologist Dr. Sonja Batten said that “despite this image in pop culture of the dangerous, unstable Veteran, there is no direct, causal link between combat-related PTSD and the type of violence shown at Mt. Rainier. Although PTSD is associated with increased anger and irritability in some individuals—whether civilians or Veterans—this sort of negative portrayal of Veterans is unfair and does a disservice to those individuals who have served our country. We work every day in VA to dispel these negative and inaccurate stereotypes.”
In other words, the misguided and incorrect correlation between military service and violent crimes like murder can lead to damaging stereotypes that can inhibit the success of Vets once they leave the military. The Texas Veterans Commission says some employers have reservations about hiring Veterans because they may show signs of post-traumatic signs in the workplace. Hiring managers may think they’re getting a Travis Bickle instead of a “Sully” Sullenberger.
In an MSNBC article about the Mt. Rainier shooting, reporter Alex Johnson connected Barnes to the “deeply troubled base” of Joint Base Lewis-McChord. While he later walked the piece back, his original reporting joined the media-constructed narrative that JBLM is in crisis without offering a valid explanation why. There were no mentions of inadequate mental health services or of a distinct culture of the base that would indicate a trend of violence—only some data showing that violent incidents happen there and in the surrounding communities.
But Johnson made no mention that those who murder are overwhelmingly men between 15-30 years old, and that men make up 92 percent of the U.S. Veteran population. If you accept that folks in the military represent a cross section of society, it will always attract the best and the worst our nation has to offer, from Sal Giunta to Benjamin Barnes.
That simple reality didn’t jive with Johnson, whose angle wasn’t helped by the fact that, despite problems with violence around the base, Veterans in general are incarcerated at half the rate. of non-Vets.
I’m a former infantryman who saw combat in Iraq. I was based at JBLM my entire Army enlistment. And I know dozens of those just like me—representing a larger sample than that from which Johnson and his cohorts seemed to draw. All of us are men and most of us are between 25 and 35 years old, like Barnes. And many of us dealt with the residual effects of combat trauma, like hyper-vigilance, an inconveniently short temper, and substance abuse. As far as I know, none are guilty of murder or any violent crimes. Unless evil spirits inhabit the base, I see no connection between that facility and the murderous tendency of one of its former dwellers.
To his credit, Johnson published an update with a warning from Brandon Friedman, my boss and fellow combat Veteran. Friedman cautioned against linking post-traumatic stress to Barnes’ behavior before facts were established, adding that “having PTSD doesn’t signify a propensity to murder Americans.”
We must confront the serious issues of mental health that affect those who served. Post-traumatic stress is one of the most common subjects on this blog—and one of the most vital aspects of VA’s presence online has been connecting Veterans in crisis with support services. At the same time, Veterans, the public, and the media must do two things.
First, we must step out of the feedback loop that both feeds and informs the stereotype of the broken, mentally unstable Vet. The damaging caricature proved to be difficult for Vietnam Vets to overcome. And with a new generation coming home from Iraq and Afghanistan, history will repeat itself until we take a moment and realize that faulty assumptions are dangerous and that anecdotal, sensationalist conclusions are designed to help sell newspapers and generate hits rather than responsibly inform.
Second, we must overcome the availability heuristic by keeping perspective on the prevalence of post-traumatic stress and, more importantly, violence committed by those who experience it. A 2008 RAND study estimated that 18.5 percent of Iraq and Afghanistan Veterans have symptoms of post-traumatic stress or major depression. But the vast majority of folks with post-traumatic stress recover successfully with support from family, friends, community, and effective treatment. PTSD and other mental health issues don’t just lead to challenges, but also to post-traumatic growth for many people. And that’s a story that needs to be told more often.
The rush to connect Barnes’ wartime service to his horrific crime makes for good drama but bad journalism. There are serious mental health consequences that stem from serving in the line of fire, but we do a disservice to those who suffer from those problems—as well as those who do not. Our communities need the experience and skills Veterans bring now more than ever before. But before that happens, we must chase away the lurid cloud of stereotypes and conjecture that hang over Veterans as they try to find their way after war.
If you feel you might be struggling with post-traumatic stress, visit our PTSD resource directory for information on symptoms, treatments, issues specific to female Veterans, and more. For immediate help, call the Veterans Crisis Line at 1-800-273-8255. It’s open day and night, along with our online chat. If you prefer text messaging, send a message to 838255.
What do think? Thank you Andy for providing this link. I want to say more but I will take the time put it all in order before I post it.

The dog of war: Sgt. 1st Class Zeke helps Fairbanks-based soldiers deal with stress

Therapy dogs are a great service to Soldiers suffering from some of the associated symptoms of PTSD. We have these dogs at my work and they are so great and lovable. They also have more credentials than some of the counselors, haha.  If you know anybody that suffers from PTSD and would like a companion visit your local Vet Center they can guide you in the right path.

The dog of war: Sgt. 1st Class Zeke helps Fairbanks-based soldiers deal with stress

 By Cheryl Hatch/For the News-Miner

FORWARD OPERATING BASE MASUM GHAR, Afghanistan — Soldiers from the 3rd Infantry 21st Battalion of Task Force Arctic Wolves hang around talking and smoking cigarettes at the entrance to the dusty brigade headquarters of Forward Operating Base Masum Ghar in Kandahar province in Afghanistan.

Sgt. 1st Class Zeke approaches, and the soldiers flock to him, dropping to their knees.

They want to pet Sgt. Zeke.

Zeke is a black Labrador and therapy dog, part of the 113th Medical Detachment Combat Stress Control, an Army Reserve unit mobilized to support the 1st Stryker Brigade Combat Team, 25th Infantry Division’s “Arctic Wolves” in southern Afghanistan.

“Whenever you see a dog, it makes your day a bit better,” said Spc. James Sroka, 22, from Pinckneyville, Ill., as he ran his hands over Zeke’s back again and again. He misses his dog.

It’s a common reaction, said Sgt. Paul McCollough, 28, Zeke’s primary handler, from Santa Fe, N.M. “Everything stops. The guys come out of nowhere.”

Zeke serves as an icebreaker for the members of Combat Stress Control. He’s approachable when social workers and therapists may not be.

“We’ve had more contacts today than we’ve ever had,” said Maj. Renee Reagan, 45, of Charleston, S.C., a clinical social worker who works at the Veterans Affairs office in Charleston when she’s not on orders with the Army.

There’s no problem visiting with a dog.

“There’s still that stigma — talking with a therapist, behavior health,” McCollough said. “There’s no stigma associated with coming up to talk to a dog. A dog’s non-judgmental.”

The Combat Stress Control team is designed to be both proactive and reactive. Its members visit combat outposts, with or without Zeke, and meet with soldiers to discuss relationship and home-front issues, operational stress and combat stress.

“We treat the wounds that don’t bleed,” McCollough said.

And they’re called in when soldiers are injured or killed. Twenty soldiers from the Fairbanks-based Stryker brigade have been killed since the deployment began in April.

“When there is a traumatic event, we’re out there for one to three days,” Reagan said. “We meet the soldiers typically by squad. We get them to talk about it, the event and their feelings. We try to identify any at-risk soldiers and can meet with them individually. Our role is basically to help the soldiers where they’re at.

“The leadership is very supportive of us,” Reagan said.

And of Zeke.

Zeke has been in the Army five and half years and, like many Fort Wainwright soldiers, is a veteran of multiple deployments.

“This is his third deployment,” McCollough said. “Been there. Done that.”

“It’s pretty bad when a dog outranks you,” said Staff Sgt. Adam Dye, 30, from Chattanoga, Tenn., laughing as he bent to pet Zeke. “I love dogs. He’s the mellowest dog ever.”

“I think dogs raise the morale for everyone around,” said Pfc. Tanner Neal, 21, from Sweet Home, Ore. “I’ve got five sitting at home waiting on me.”

Like other soldiers, Pfc. Christopher Sauber, 24, misses his dogs. He has five at home in Athens, Ohio. He said he appreciated Zeke’s visit.

“It helps you get away from this place,” Sauber said. “It’s relaxing, like a piece of home.”

Cheryl Hatch was a recent Snedden chair in the University of Alaska Fairbanks journalism department. She and photographer JR Ancheta, a UAF student, are embedded with a Stryker brigade unit in Afghanistan.