The War Within - Al Jazeera English, from April 2010

This has been going on for a while now. Diagnosing someone with a personality disorder means you can push someone out of the military with no benefits -- and more importantly in some cases, without the additional costs of treating them for PTSD, a very expensive diagnosis. This is only one of the reasons I am so very cynical about politicians who give moving speeches about "honoring our troops":

Capt. Susan Carlson was not a typical recruit when she volunteered for the Army in 2006 at the age of 50. But the Army desperately needed behavioral health professionals like her, so it signed her up.

Though she was, by her own account, “not a strong soldier,” she received excellent job reviews at Fort Leavenworth, Kan., where she counseled prisoners. But last year, Captain Carlson, a social worker, was deployed to Afghanistan with the Colorado National Guard and everything fell apart.

After a soldier complained that she had made sexually suggestive remarks, she was suspended from her counseling duties and sent to an Army psychiatrist for evaluation. His findings were shattering: She had, he said in a report, a personality disorder, a diagnosis that the military has used to discharge thousands of troops. She was sent home.

She disputed the diagnosis, but it was not until months later that she found what seemed powerful ammunition buried in her medical file, portions of which she provided to The New York Times. “Her command specifically asks for a diagnosis of a personality disorder,” a document signed by the psychiatrist said.

Veterans’ advocates say Captain Carlson stumbled upon evidence of something they had long suspected but had struggled to prove: that military commanders pressure clinicians to issue unwarranted psychiatric diagnoses to get rid of troops.

[...] Though it is impossible to know how many veterans are disputing their personality disorder discharges, Vietnam Veterans of America, an advocacy group, with help from the Yale veterans legal clinic, has sued the Defense Department seeking records they say will show that thousands of troops have been unfairly discharged for personality or adjustment disorder since 2001.

“We believe that many of the people who received personality disorder discharges were wrongly diagnosed and that in fact they were suffering from PTSD or traumatic brain injury,” said Thomas Berger, executive director of Vietnam Veterans of America’s health council.

Regardless of the reason, I can't be the only person who's tired of how our troops are used up and tossed away like used tissues:

For most of his 26 years in the military, Maj. Jeff Hackett was a standout Marine. Two tours in Iraq destroyed him.

Home from combat, he drank too much, suffered public breakdowns and was hospitalized for panic attacks. In June 2010, he killed himself.

Hackett’s suicide deeply troubled Gen. James Amos, the commandant of the Marine Corps. Hackett had been plucked from the enlisted ranks to lead Marines as an officer. He left behind a widow, four sons and more than $460,000 in debts. To Amos, Hackett was a casualty of war — surely the family deserved some compensation from the federal government.

Amos asked John Dowd, a prominent Washington lawyer who had represented Sen. John McCain, for help. “There is absolutely no doubt that he was suffering from Post Traumatic Stress,” Amos wrote to Dowd. “NONE WHAT SO EVER!”

“We will raise as much hell as we can,” Dowd, a former Marine, wrote back to Amos.

Almost two years later, the high-level intercession by the Marine commandant and the Washington lawyer has produced little from the federal government for Hackett’s widow. The inability of Dowd to wrest any money from the Department of Veterans Affairs shows the limits of what the federal government can do for families of service members who kill themselves as a result of mental trauma caused by war.

Dowd and a team of nine lawyers have fought unsuccessfully for the last 18 months to convince the VA and Prudential Financial Inc., which administers a life insurance program for veterans, to pay a $400,000 claim to Danelle Hackett. The life insurance premiums were automatically deducted from Hackett’s paycheck for 26 years when he was on active duty.

If Hackett had been killed in battle or committed suicide before he retired in 2008, his wife would have received the $400,000 from the policy. But Hackett left the military and, amid mounting personal crises, let the policy lapse.

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We talk about the trillions of dollars added to the deficit because of our occupations in Iraq and Afghanistan...but how can you monetize this very real and very painful cost?

For the second year in a row, more American soldiers—both enlisted men and women and veterans—committed suicide than were killed in the wars in Iraq and Afghanistan. Excluding accidents and illness, 462 soldiers died in combat, while 468 committed suicide. A difference of six isn't vast by any means, but the symbolism is significant and troubling. In 2009, there were 381 suicides by military personnel, a number that also exceeded the number of combat deaths.

Earlier this month, military authorities announced that suicides amongst active-duty soldiers had slowed in 2010, while suicides amongst reservists and people in the National Guard had increased. It was proof, they said, that the frequent psychological screenings active-duty personnel receive were working, and that reservists and guardsmen, who are more removed from the military's medical bureaucracy, simply need to begin undergoing more health checks. This new data, that American soldiers are now more dangerous to themselves than the insurgents, flies right in the face of any suggestion that things are "working." Even if something's working, the system is still very, very broken.

One of the problems hindering the military's attempt to address soldier suicides is that there's no real rhyme or reason to what kind of soldier is killing himself. While many suicide victims are indeed afflicted with Post Traumatic Stress Disorder after facing heavy combat in the Middle East, many more have never even been deployed. Of the 112 guardsmen who committed suicide last year, more than half had never even left American soil.

It sickens me. Every week as I do the In Memoriam post, I read so many of the service members official cause of death as "non-combat related" and my heart grieves, because I know that's likely a suicide. All those months of separation, the unrelenting stress of being under fire, the inability to adjust back to a non-combat life. It's all a vicious cycle. But there are people trying to be part of the solution

Today, Tucson shooting victim Eric Fuller apologized for his outburst and perceived threat against Tucson Tea Party leader Trent Humphries. CBS posted it as though it was somehow expected and necessary -- the right thing to do.

Fuller apologized for his "misplaced outrage."

Fuller was one of 19 people shot when a gunman opened fire Jan. 8 at a meet-and-greet for Rep. Gabrielle Giffords. The congresswoman was critically injured and six people were killed.

Fuller was shot in the knee and back, and drove himself to the hospital, where he spent two days.

Deruyter said Fuller has no family or children, and was coping with the shooting almost entirely on his own and lost his temper.

Notice how CBS made Humphries the victim:

Trent Humphries, co-founder of the Tucson Tea Party who was the focus of Fuller's outburst at a taping of ABC's "This Week" Saturday, told the Associated Press he is worried about threats he is receiving.

Humphries told the AP he was worried about Fuller's threat, and the dozens of other angry e-mails he has received from people blaming right-wing political rhetoric for contributing to the assassination attempt on Rep. Gabrielle Giffords.

As you might expect, I have an opinion on the whole fiasco. Let's start with this: How on earth did James Goldston, producer of This Week, think it would a really GREAT idea to bring a guy on who had just witnessed a horrific scene and been injured himself to talk about gun control with a Tea Party leader? That's idiotic, ignorant and opportunistic. Fuller hasn't even started to process everything he saw and heard that day. He has been injured for the mortal sin of being at the supermarket that day. He has seen and heard things that human brains are not wired to see and hear, and there is absolutely no way he was in any shape to tackle a debate with anyone, much less someone as opinionated and rigid as Humphries.

Emotional trauma after what Fuller has been through doesn't go away in a week. Or a month. Or a year. Fuller is still wired in survival mode and will be for some time. The only good that may come from this weekend's outburst is the mental health treatment he will now receive for the assault on his psyche, which may help to relieve inevitable PTSD later.

While it's too early for Fuller to be suffering from PTSD, the physical response (whether delayed or immediate) is something that doesn't really ever go away. The best one can do is learn, over time, to manage the physical and emotional response that comes with it. My youngest child was run over by a van when she was five, right outside our front door. While she survived with no lasting or permanent injury (a miracle in itself), I still have a visceral emotional and physical reaction to anyone driving fast past my front window. Neighbors have seen me chase speeding cars on foot, yelling at them to slow the hell down on a private street with a 5 mph speed limit. If I manage to control that reaction, I just shake and cringe, waiting for the inevitable thud I fully expect to hear.

Most of the time, I don't remember what I said when it happens. It just hits you right in the gut and your mind goes to the place where you were when the first event happened and you lash out with rising dread that there will be yet another bleeding child left on the street. You relive it, one second at a time, while hoping this time is different. It's irrational, it's draining, and it's real. In those seconds, you realize you have no ability to prevent or avoid a disaster. These physical and emotional responses still happen, nearly 12 years later.

Had someone taken a moment to ask the question "Is it perhaps too soon to try to put these two together?", they might have taken a pass on the entire segment. Humphries wasn't going to change his mind about gun control. Fuller is still in the early stages of trying to sort all of this out and manage this horrible thing that had happened to him. It was irresponsible of that producer to even attempt such a thing, but not surprising, given the constant hunt for controversy and ratings.

Given that it was attempted, however, the only one who should be apologized to is Mr. Fuller, who will now suffer humiliation and scorn for a reaction he could not control.

For CBS to turn Humphries into a victim while reporting that Fuller has apologized just ignores the responsibility we all should share for this. Exploiting victims for 24/7 media cycles is as harmful to them as it is to the conversation.

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Michael Ware reporting from Afghanistan, Sept. 2009

All things CNN:

We won't be seeing any more of Michael on CNN...

In addition to having taken a break recently in order to work on his book, it is no secret that he has been grappling with PTSD, brought on from the hellish years he worked in Baghdad. I was told that, unfortunately, when he needed more time off in order to deal with things, his request was denied. So he will not be returning.

While it is a huge loss for us (and for CNN) I am extremely relieved that he chose to take care of his own needs first. And while I sincerely hope that he will return to US television someday on another network, it is far more important that he gets the care he needs.

His work for CNN over the past four years has been an astonishing and brutally honest look at the causes and results of war. Not easy subject matter to watch… but he made us care. His urgency and passion burst through our television sets and made us pay attention, made us want to understand.[..]

And exactly how does a news organization justify (to themselves, even!) not giving their war correspondents whatever they need in order to deal with their wounds, whether they are visible ones or not? If ABC had treated Bob Woodruff so callously, there would have been hell to pay. I don’t doubt they wanted him back in the field ASAP — doubly so after losing Christiane Amanpour — but don’t force him to make a choice between getting better and getting paid. That just sucks. Surely it would be better to have him off the air but still yours once he is ready to come back than to have him off the air and someone else’s upon his return? So not only has CNN made a callous move here, they have made a stupid one, as well.

What a tremendous asset he has been to CNN. And how foolish they are to lose him.

Michael War was a breath of fresh air with his reporting in the Gulf. Look at how he blew past the empty rhetoric of Bush and generals,Petraeus, Condi Rice, Lieberman and McCain with brutal and unflinching honesty about the conditions there. I can only imagine the nightmares he still endures. And CNN's response to his pain (which Men's Journal covered in Dec. 2008 in a powerful interview with Ware) was to tell him he wasn't allowed any more time to come to terms with the death and destruction he saw daily for years for their benefit. Instead, they hire one of the great armchair soldiers, Erick Erickson.

Smear a doctor for reporting that veterans are being badly treated for PTSD? Unbelievable:

Internal documents and e-mails show that Navy officials unfavorably doctored a psychiatrist’s performance record after he blew the whistle on what he said was dangerously inept management of care for Marines suffering combat stress at Camp Lejeune, N.C. The internal correspondence, obtained by Salon, also includes an order to delete earlier records praising the work of the psychiatrist, Dr. Kernan Manion, who was fired last September after lodging his complaints.

Now top Navy officials are tangled up in the blackball campaign. Soon after Manion was fired, Rep. Walter Jones, R-N.C., asked the Pentagon about Manion’s concerns about healthcare at Camp Lejeune. In a Dec. 17 letter to Jones, Navy Secretary Ray Mabus panned Manion’s ethics and professionalism, presumably based on information Mabus received about Manion from Camp Lejeune.

But Salon has obtained internal Navy documents and correspondence that suggest officials at Camp Lejeune altered Manion’s favorable personnel records after he went public with his concerns, adding new, derogatory remarks similar to some of the information in Mabus’ letter to Jones.

[...] O'Byrne, head of mental health at the Camp Lejeune Naval Hospital, of "immediate concerns of physical safety" due to mistreated Marines teetering on the edge of violence. “There was -- and continues to be -- no means of discussion of high-intensity/dangerous cases,” he wrote. Later that month, Manion quoted to O’Byrne some Marine superiors who were calling troubled Marines “worthless pieces of shit” if they sought help.

I mentioned before that they were looking at this "positive thinking" program for vets with PTSD - something that seems like a way to cut costs rather than treat vets' trauma.

Now psychologist Bryant Welch says the program has no scientific validity:

Johnny had been with his platoon when they were attacked by enemy fire and pinned down for the better part of two days. Much of his face was blown off. His two closest buddies died gruesome and agonizing deaths while lying on top of him.

As a psychologist, my work with him was not medical. It was to address the psychological trauma, then newly labeled as Posttraumatic Stress Disorder [PTSD], that haunted him and to help him "grieve" that much of his life had been blown away along with his face.

The pain of his surgeries was nothing compared to the night terrors that undercut his every attempt at sleep. The flashbacks that occurred daily put him back in the jungles of Viet Nam and the noises in the hallways became the sounds of advancing Viet Cong. Nurses and doctors could suddenly become menacing figures who he believed had captured him and were about to torture him. He was terrified to take his medications and unexpected noises could leave him shaken for hours.

Emotionally, on the best of days Johnny fluctuated between agitated depression and complete numbness in which he was unable to feel at all. He felt cut off from his family and felt enraged and misunderstood when they tried to "cheer him up." Johnny was not actively homicidal, like some of the PTSD vets on his psychiatry ward, but he was consumed with thoughts of suicide.

Johnny showed me a picture of himself before the accident on a motorcycle with an attractive girlfriend. He said, "This was a guy who had everything." After four months on the psychiatric ward, I was transferred to a new rotation and Johnny remained.

With the President's announcement last Tuesday night, over one hundred thousand American troops will soon be in harm's way in Afghanistan. Estimates are that thirty thousand of them will come home with Post Traumatic Stress Disorder, the same psychological condition that plagued Johnny.

This makes returning veterans a ticking time bomb for serious mental illness with a very real danger of violence to themselves, their loved ones, and the general public.

As a psychologist who has treated many serious cases of Posttraumatic Stress Disorder, it was a jaw dropping experience to learn that under a new $119 million military program these young men and women who have sacrificed so much will have their PTSD addressed with a superficial, psychological treatment based loosely on Norman Vincent Peale's Power of Positive Thinking, known in this generation's iteration as "positive psychology" or the "psychology of optimism.

There is no evidence that the techniques of positive psychology can prevent or ameliorate the effects of PTSD. When its adherents' attempt to extrapolate simplistic studies done on normal junior high students to military combat troops struggling with military traumas they are misleading the military, the public, and, most importantly, the troops.

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Dear 24 Hour Cable News Channels:

I understand your dilemma, I really do. You have 44 minutes on the hour to fill with content. And it has to be compelling stuff, so that the viewer isn't tempted to channel surf to your rivals. In the situation like the Fort Hood shootings, where news is coming scattershot and conflicting, it's even more difficult.

See? I get it.

But having said that--and I say this with love and respect--PLEASE, SHUT. THE. F#@K. UP. Don't spend time guessing on motivations when there is so little information available. Don't surmise terrorist intent when you can't possibly know. And for the love of everything holy, don't go to criminal profiler Cliff "A Hammer Sees Everything As A Nail" Van Zandt (a crime of which Keith Olbermann is also guilty) to make up utter bovine excrement.

At the time that Van Zandt was waxing rhapsodic over possible terrorist inclinations, remember, the news was that there were two or three shooters, one of whom was dead (Hasan, the single shooter, was alive and being treated at the time). That Maj. Nadil Hasan was of Jordanian, Arab, or Palestinian birth (he was born in Virginia of Palestinian immigrant parents), that he was a recent Muslim convert (he had been a practicing Muslim his whole life), that he was suffering from PTSD, or secondary PTSD from his work with returning vets in Virginia, that he was sympathetic with suicide bombers, angry at bad evaluations, upset at being deployed to Iraq, frustrated by the Army's dismissal of the harassment he got at Ft. Hood about his faith and/or desperate to get out of his upcoming deployment.

Bottom line: we didn't know enough. It was irresponsible of you to try to make suppositions when the information (including the fact that he was alive) was so sketchy.

And to focus on the one known of his name and then presuming his faith (A lot of 2nd and 3rd generation immigrants don't necessarily practice the religions of their grandparents, yet still have Middle Eastern names, and I will reiterate, in those early hours, WE DIDN'T KNOW) to then suggest jihadist and/or terrorist sympathies was to give legitimacy to all those hate-mongers like Michelle Malkin and Fox & Friends anchors Doocy and not-Doocy to once again, call into question ALL Muslims.

Don't you get it? "Terrorism" is not defined as "any violence by any Muslim anywhere at any time for any reason." If it's true that Hasan had been the victim of harassment because of his religion and that contributed to his state of mind, then those who create and foster an environment that makes it acceptable to demonize and dehumanize Muslims were right there with him, pulling the trigger. To focus on Hasan's faith as you did in those early hours was the lazy approach and avoids the deeper reasons:

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One of the reasons I thought this war (in addition to being immoral) was so very stupid is that I remember the veterans from the Vietnam era - how many of them were a mess when they came home, and how many stayed that way. The power to send soldiers to war is a sacred trust, and it should not be used for anything less than the most compelling reasons.

As bad as it is for soldiers, recruiters have a uniquely stressful job in which they're expected to somehow turn their own war experiences into happy talk for potential converts:

Morning Edition, January 2, 2009 · The Army is investigating a cluster of suicides in the Houston Recruiting Battalion, where five soldiers have taken their own lives since 2001. Nationally, 17 recruiters have committed suicide during the same period.

Back in March of 2007, Aron Andersson locked himself in the cab of his Ford 150 pickup, called home to say he was going to kill himself, shot up the dashboard radio, and then put a bullet in his head. He had threatened suicide five months earlier, and back then his father, Bob Andersson, reported him to the military.

"I don't know if that was the right thing to do, but I called a major and told him his girlfriend had said he threatened to commit suicide, and she told me he was going through night terrors and a bunch of other things. And he'd get up to go to work in the morning and tell his girlfriend he was exhausted, and she'd say, 'Yeah you've been jumpin' over the couch, hidin' behind the chairs and stuff, like you're in battle,' and he wouldn't even realize it in the morning," Andersson says.

Aron Andersson served two tours in Iraq, and he was furious with his father for reporting him, saying his Army career would be ended.

"And I just simply told him, 'Well, Aron, if you don't talk to me ever again, I can live with that. But if I didn't turn you in and something happened, I don't think I could live with that,' " Bob Andersson says.

Andersson says his son had trouble delivering the required two recruits a month, especially after his experience in Iraq.

"How could you be over there and see some of the things he saw and dealt with, and try to hire people to go over there and do that?" he says.

NOW on PBS:

Of the thousands of U.S. troops getting discharged from the Army each year, many who are suffering from post traumatic stress disorder and brain injuries aren't getting the vital care they need. The Army claims these soldiers have pre-existing mental illnesses or are guilty of misconduct. But advocates say this is a way for the Army to get rid of "problem" soldiers quickly, without giving them the treatment and benefits to which they're entitled.

This week, NOW travels to Fort Hood in Texas to meet traumatized soldiers fighting a new battle, this one against the army they served. Are soldiers being wrongfully discharged for honorable service?

The entire episode is available for streaming on the NOW website, as well as web-exclusive interviews with Jonathan Norrell and David Chavarria (above) about their heart-breaking experiences.