December 16, 2009

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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