The biggest problem the Army and service members face is the stigma that is associated with a PTSD diagnosis. If we can beat this we will get those who need help the help they need. In being true to my preaching I have decided to speak with a counselor even if it just for a wellness check and to ensure that there is something I am not seeing. Do the same.....
"A study published in the Archives of General Psychiatry in October found that soldiers were two to four times more willing to report PTSD, depression, and suicidal thoughts if they were allowed to answer a survey anonymously, rather than put their names on a routine post-deployment screening form."

Idea to take the 'D' out of PTSD being studied

By Lindsay Wise

Houston Chronicle

Published: January 16, 2012

 

The president of the American Psychiatric Association says he is "very open" to a request from the Army to come up with an alternative name for post-traumatic stress disorder so that troops returning from combat will feel less stigmatized and more encouraged to seek treatment.
Dr. John Oldham, who serves as senior vice president and chief of staff at the Houston-based Menninger Clinic, said he is looking into the possibility of updating the association's diagnostic manual with a new subcategory for PTSD. The subcategory could be "combat post-traumatic stress injury," or a similar term, he said.
"It would link it clearly to the impact and the injury of the combat situation and the deployment experience, rather than what people somewhat inaccurately but often assume, which is that you got it because you weren't strong enough," Oldham said.
The potential change was prompted by a request from Gen. Peter Chiarelli, the Army's vice chief of staff, who wrote to Oldham last year, suggesting APA drop the world "disorder" from PTSD.
"Calling it a disorder contributes to the stigma and makes it so some folks -- not all, but some folks -- don't get the help they need," Chiarelli said.
The general doesn't like to use the word disorder. "It's not a dirty word, but I think it's misused here," he said. "I don't think that the post-traumatic stress that soldiers experience is a disorder. It's not something that happens just to weak people or people that are somehow inclined to be affected by horrible things that they see or are required to do. I think it causes an actual injury to the brain and how the brain works."
Early discussions
After receiving Chiarelli's letter, Oldham wrote back to say he appreciated his concern, but dropping the word disorder might not be the best way to go. He said he was eager to work with Chiarelli to see what APA could do.
The general invited Oldham to the Pentagon to discuss the situation. They met for about an hour and a half on Dec. 9. Oldham agreed to bring the general's suggestion to the APA work group tasked with reviewing PTSD for the next version of the association's Diagnostic and Statistical Manual of Mental Disorders, the classification book used by psychiatrists in America. APA is finalizing the fifth edition of the manual, due in May 2013.
Oldham cautioned the discussion is very preliminary but speculated that a new subcategory like "combat post-traumatic stress injury" might work.
Although Chiarelli still would prefer to lose "disorder" entirely, he said a new subcategory would be a start. "I'm frustrated with how long this is taking to be honest," he said.
The general pointed out that PTSD has had many names over the years, from shell shock to battle fatigue. "It's been called all kinds of different things and somehow we decided to go with PTSD and I think that's just wrong," he said.
Chiarelli's campaign to change the name of PTSD is part of the Army's effort to reduce alarming suicide rates among soldiers. Statistics released last month identified 260 potential suicides in 2011. Of that total, 154 were active-duty soldiers, 73 were National Guard troops and 33 were reservists.
Silence over stigma
Stigma is a major problem. A study published in the Archives of General Psychiatry in October found that soldiers were two to four times more willing to report PTSD, depression, and suicidal thoughts if they were allowed to answer a survey anonymously, rather than put their names on a routine post-deployment screening form.
Of the soldiers who screened positive for PTSD or depression, 20 percent said they weren't comfortable answering honestly on the routine form. The study concluded that the Army's screening process misses most soldiers with significant mental health problems.
Dr. Harry Croft, a psychiatrist in San Antonio, said the findings jibe with what he hears from veterans he treats for PTSD.
"Even though the rules, as I understand them, say you don't get kicked out if you get diagnosed with PTSD, depression or any other issues, a lot of veterans say, 'I knew damn well if I answered the questions right my chance to get promoted was gone,' " Croft said.
Croft has mixed feelings about changing the name of PTSD. He understands the concern about stigmatizing troops but thinks whether the condition is called PTSD or something else will have little effect on the suicide rate.
"Rather than concentrate on what we call it, we need to concentrate more on how to help warriors coming back from the combat zone, because I don't think the name we give it will have much of an impact on the 18 suicides a day and all the other problems that we see," Croft said. "That's putting a Band-Aid on a much bigger wound."
Chiarelli says his main concern is getting soldiers into treatment, so if calling post-traumatic stress a disorder keeps them from seeking help, then the wording needs to change, the sooner the better.
"You can have the very, very best treatments in the world, but if you can't get people take advantage of them, they don't do any good," he said.

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.