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ARMY TAKES NEW APPROACH TO RETURNING COMBAT VETS
By KATE WILTROUT, The
Virginian-Pilot
© March 29, 2005
VIRGINIA BEACH — When the 368th Cargo Transfer Company
returned last month, thousands of well-wishers lined the road outside Fort
Story, cheering, clapping and waving flags. The gymnasium, packed with families,
exploded with noise and emotion as about 200 soldiers in desert camouflage filed
in and stood in formation.
Once, such tearful reunions would have unofficially marked the end of a
deployment. After a day or two turning in equipment and filling out paperwork,
troops usually went on leave. And when they resumed their duties, the focus
shifted to what lay ahead, not what experiences they left behind.
No longer.
Studies and tragedies have convinced the Army that it must do more to
prevent the possibly deadly consequences of combat stress. To help soldiers
cope, the service has revamped its routine for homecoming warriors, easing them
back into domestic life after the prolonged pressures of a war zone.
The new approach turns the image of the emotionally self-sufficient soldier
on its head.
“Soldiers are reluctant to admit a weakness,” said Col. Kenneth Musser , the
Army’s individual readiness policy division chief at the Pentagon . Now, he
said, returning troops are drilled with a different message: “You are encouraged
to ask for help.”
Outreach starts before soldiers reach home soil and continues with two weeks
of mandatory classes and a month of voluntary counseling for issues ranging from
stress and anger management to marriage enrichment. Three to four months after
their deployment, the Army formally surveys how troops are doing.
The first version of the program began in May 2003 ; it has been evolving
since, Musser said.
Soldiers aren’t the only ones being targeted. While family support groups
have long kept spouses and children informed and in touch during deployments,
now the Army teams those groups with chaplains and social workers to prepare for
the stresses of reconnecting with a soldier who’s been in harm’s way.
Experts hope the changes prevent the kind of bloodshed that haunted Fort
Bragg, N.C., in the summer of 2002 . Over five weeks, four soldiers – three of
whom had served in Afghanistan as special operations troops – killed their
wives. Two killed themselves alongside their spouses; another committed suicide
while awaiting trial; the fourth is serving life in prison.
Less spectacular, but potentially more troubling, is the psychological cost
of serving in combat. A report by military doctors and psychologists in July
found more than 15 percent of infantry troops surveyed showed signs of major
depression, generalized anxiety or post-traumatic stress disorder after
returning from Iraq. Published by the New England Journal of Medicine , the
study also concluded that less than 40 percent of those soldiers sought mental
health care.
The 368th works in transportation, not front-line combat. But with random
bombings and attacks almost daily, soldiers are in danger almost everywhere they
go.
“Anything can happen at any minute of the day,” said Capt. Erik Hilberg , the
company commander.
During their year long stint, the unit’s truck drivers, forklift operators
and mechanics were split into groups serving in Baghdad, Fallujah, Taji and
Tikrit . They came under mortar attacks, dodged sniper fire and encountered
roadside bombs. Eight soldiers received Purple Hearts for combat injuries; one –
Sgt. Carlos Camacho-Rivera – was killed in a rocket attack outside Fallujah in
October .
To ease the transition to life stateside, Hilberg and the men and women who
work for him spent their first two weeks back in half-day classes and briefings,
broken up by four-day weekends.
As they do after any overseas deployment, soldiers had blood drawn and eye
exams. They filled out health forms and updated life insurance policies. Classes
went further, though, to include suicide prevention, combat stress and anger
management.
“Most people like to focus on post-traumatic stress disorder, but there’s a
wide range of stress – we’re trying to mitigate all of that,” Musser said. He
compared the outreach to a patient getting a physical – the doctor doesn’t look
for one symptom, but screens for a range of potential problems.
Under the expanded effort, a chaplain who had met with their families
beforehand talked to the soldiers about their spouses’ expectations and needs.
“We had classes last time, but not as intensive,” said Spc. Ryan Nett , who
spent six months in Kuwait in 2003.
Nett, a 23-year-old from Wisconsin , was one of 10 soldiers from the 368th
selected by unit officials to talk about the adjustment process soon after
coming home.
To them, some of the simplest lessons made the biggest difference.
Spc. David Smith , a 22 -year-old from Arizona , became a father for the
second time while he was gone. The mechanic returned to a 3-year-old son who was
wary of him and a 6-month-old daughter he barely knew. He appreciated
suggestions to take his time getting reacquainted – and a tip to get down on the
floor with his son, instead of towering over him.
That’s the kind of advice that works, said 11th Transportation Battalion
Chaplain C. Wayne Brittian , a Baptist minister and Army major who helped
families endure the deployment and led some of the soldiers’ readjustment
classes.
“It’s amazing what rolling around on the floor will do for building
relationships ” with children, Brittian said.
Further wisdom; don’t try to “recreate” moments missed during deployments.
“Go out and make new memories,” Brittian said.
Some of the 368th’s soldiers said they appreciated the expanded program, but
consider the best tool for coping to be a buddy in uniform.
Spc. Ashley Harris , 24, who also served in Afghanistan, said that when her
two-week R&R trip home ended, she was eager to reconnect with her fellow
soldiers in Iraq.
“You miss your friends,” she said. “They become family.”
Hilberg counts on that camaraderie to help him recognize who might need more
help readjusting. He and the chaplain said the company is small enough, and
close enough, they can ask around about how soldiers are doing.
There’s a more formal structure in place for that, too.
Unlike before, the Army now requires soldiers to fill out written surveys 90
to 120 days after returning.
“We just found that it makes sense to extend it out, to keep checking in with
people,” Hilberg said. “The majority, after the first three months, it won’t be
like they never left, but they’ve re-adapted.”
Soon, that practice will spread to other service branches as the Department
of Defense begins requiring all troops returning from Iraq to be screened
mentally and physically three months and six months after deployment.
“We learned from the Gulf War that health concerns emerge over time following
return from deployment,” Air Force Col. Joyce Adkins wrote in response to
questions about the pending change. Adkins works at the Department of Defense’s
Deployment Health Support Directorate , managing a mental health and deployment
stress program.
Research from the Persian Gulf War in 1991 – and more recently, the first
rounds of deployment to Afghanistan and Iraq – confirmed that one of the most
critical periods for service members is about four months after they return,
Adkins said.
The 368th won’t hit that milestone until June.
So far, members said, they’ve been glad for the extra emphasis on readjusting
, even if the classes kept them on base for two weeks before a long-awaited
month of leave.
Few think they’ve seen their last deployment. Even on the day they returned,
many said they expect to be deployed again within a year.
“We just enjoy the time that we have now,” said Spc. Lorenzo Pulliam , a
21-year-old from Kansas.
Harris said the transitions have gotten easier with each deployment. Like
Pulliam, she doesn’t bother worrying about if or when she’ll go through it
again.
“If you thought about it,” she said, “you’d go crazy.”
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Trauma of Iraq war haunting thousands returning
home
By William M. Welch, USA TODAY
MORGANTOWN, W.Va. — Jeremy Harrison sees the warning signs in the Iraq war
veterans who walk through his office door every day — flashbacks,
inability to relax or relate, restless nights and more.
He recognizes them as symptoms of combat stress
because he's trained to, as a counselor at the small storefront Vet Center
here run by the U.S. Department of Veterans Affairs. He recognizes them as
well because he, too, has faced readjustment in the year since he returned
from Iraq, where he served as a sergeant in an engineering company that
helped capture Baghdad in 2003.
"Sometimes these sessions are helpful to me,"
Harrison says, taking a break from counseling some of the nation's newest
combat veterans. "Because I deal with a lot of the same problems."
As the United States nears the two-year mark in its
military presence in Iraq still fighting a violent insurgency, it is also
coming to grips with one of the products of war at home: a new generation of
veterans, some of them scarred in ways seen and unseen. While military
hospitals mend the physical wounds, the VA is attempting to focus its
massive health and benefits bureaucracy on the long-term needs of combat
veterans after they leave military service. Some suffer from wounds of flesh
and bone, others of emotions and psyche.
These injured and disabled men and women represent
the most grievously wounded group of returning combat veterans since the
Vietnam War, which officially ended in 1975. Of more than 5 million veterans
treated at VA facilities last year, from counseling centers like this one to
big hospitals, 48,733 were from the fighting in Iraq and Afghanistan.
Many of the most common wounds aren't seen until
soldiers return home. Post-traumatic stress disorder, or PTSD, is an
often-debilitating mental condition that can produce a range of unwanted
emotional responses to the trauma of combat. It can emerge weeks, months or
years later. If left untreated, it can severely affect the lives not only of
veterans, but their families as well.
Of the 244,054 veterans of Iraq and Afghanistan
already discharged from service, 12,422 have been in VA counseling centers
for readjustment problems and symptoms associated with PTSD. Comparisons to
past wars are difficult because emotional problems were often ignored or
written off as "combat fatigue" or "shell shock." PTSD wasn't even an
official diagnosis, accepted by the medical profession, until after Vietnam.
There is greater recognition of the mental-health
consequences of combat now, and much research has been done in the past 25
years. The VA has a program that attempts to address them and supports
extensive research. Harrison is one of 50 veterans of the Iraq and
Afghanistan wars hired by the VA as counselors for their fellow veterans.
'It takes you back there'
Post-traumatic stress was defined in 1980, partly
based on the experiences of soldiers and victims of war. It produces a wide
range of symptoms in men and women who have experienced a traumatic event
that provoked intense fear, helplessness or horror.
The events are sometimes re-experienced later through
intrusive memories, nightmares, hallucinations or flashbacks, usually
triggered by anything that symbolizes or resembles the trauma. Troubled
sleep, irritability, anger, poor concentration, hypervigilance and
exaggerated responses are often symptoms.
Individuals may feel depression, detachment or
estrangement, guilt, intense anxiety and panic, and other negative emotions.
They often feel they have little in common with civilian peers; issues that
concern friends and family seem trivial after combat.
Harrison says they may even hit their partners during
nightmares and never know it.
Many Iraq veterans have returned home to find the
aftermath of combat presents them with new challenges:
• Jesus Bocanegra was an Army infantry scout for
units that pursued Saddam Hussein in his hometown of Tikrit. After he
returned home to McAllen, Texas, it took him six months to find a job.
He was diagnosed with PTSD and is waiting for the VA
to process his disability claim. He goes to the local Vet Center but is
unable to relate to the Vietnam-era counselors.
"I had real bad flashbacks. I couldn't control them,"
Bocanegra, 23, says. "I saw the murder of children, women. It was just
horrible for anyone to experience."
Bocanegra recalls calling in Apache helicopter
strikes on a house by the Tigris River where he had seen crates of enemy
ammunition carried in. When the gunfire ended, there was silence.
But then children's cries and screams drifted from
the destroyed home, he says. "I didn't know there were kids there," he says.
"Those screams are the most horrible thing you can hear."
At home in the Rio Grande Valley, on the Mexico
border, he says young people have no concept of what he's experienced. His
readjustment has been difficult: His friends threw a homecoming party for
him, and he got arrested for drunken driving on the way home.
"The Army is the gateway to get away from poverty
here," Bocanegra says. "You go to the Army and expect to be better off, but
the best job you can get (back home) is flipping burgers. ... What am I
supposed to do now? How are you going to live?"
• Lt. Julian Goodrum, an Army reservist from
Knoxville, Tenn., is being treated for PTSD with therapy and anti-anxiety
drugs at Walter Reed Army Medical Center in Washington. He checked himself
into a civilian psychiatric hospital after he was turned away from a
military clinic, where he had sought attention for his mental problems at
Fort Knox, Ky. He's facing a court-martial for being AWOL while in the
civilian facility.
Goodrum, 34, was a transportation platoon leader in
Iraq, running convoys of supplies from Kuwait into Iraq during the invasion.
He returned to the USA in the summer of 2003 and experienced isolation,
depression, an inability to sleep and racing thoughts.
"It just accumulated until it overwhelmed me. I was
having a breakdown and trying to get assistance," he says. "The smell of
diesel would trigger things for me. Loud noises, crowds, heavy traffic give
me a hard time now. I have a lot of panic. ... You feel like you're
choking."
• Sean Huze, a Marine corporal awaiting discharge at
Camp Lejeune, N.C., doesn't have PTSD but says everyone who saw combat
suffers from at least some combat stress. He says the unrelenting insurgent
threat in Iraq gives no opportunity to relax, and combat numbs the senses
and emotions.
"There is no 'front,' " Huze says. "You go back to
the rear, at the Army base in Mosul, and you go in to get your chow, and the
chow hall blows up."
Huze, 30, says the horror often isn't felt until
later. "I saw a dead child, probably 3 or 4 years old, lying on the road in
Nasiriyah," he says. "It moved me less than if I saw a dead dog at the time.
I didn't care. Then you come back, if you are fortunate enough, and hold
your own child, and you think of the dead child you didn't care about. ...
You think about how little you cared at the time, and that hurts."
Smells bring back the horror. "A barbecue pit — throw
a steak on the grill, and it smells a lot like searing flesh," he says. "You
go to get your car worked on, and if anyone is welding, the smell of the
burning metal is no different than burning caused by rounds fired at it. It
takes you back there instantly."
• Allen Walsh, an Army reservist, came back to Tucson
45 pounds lighter and with an injured wrist. He was unable to get his old
job back teaching at a truck-driving school. He started his own business
instead, a mobile barbecue service. He's been waiting nearly a year on a
disability claim with the VA.
Walsh, 36, spent much of the war in Kuwait, attached
to a Marine unit providing force protection and chemical decontamination. He
says he has experienced PTSD, which he attributes to the constant threat of
attack and demand for instant life-or-death decisions.
"It seemed like every day you were always pointing
your weapon at somebody. It's something I have to live with," he says.
At home, he found he couldn't sleep more than three
or four hours a night. When the nightmares began, he started smoking
cigarettes. He'd find himself shaking and quick-tempered.
"Any little noise and I'd jump out of bed and run
around the house with a gun," he says. "I'd wake up at night with cold
sweats."
'A safe environment'
A recent Defense Department study of combat troops
returning from Iraq found that soldiers and Marines who need counseling the
most are least likely to seek it because of the stigma of mental health care
in the military.
One in six troops questioned in the study admitted to
symptoms of severe depression, PTSD or other problems. Of those, six in 10
felt their commanders would treat them differently and fellow troops would
lose confidence if they acknowledged their problems.
A report this month by the Government Accountability
Office said the VA "is a world leader in PTSD treatment." But it said the
department "does not have sufficient capacity to meet the needs of new
combat veterans while still providing for veterans of past wars." It said
the department hasn't met its own goals for PTSD clinical care and
education, even as it anticipates "greater numbers of veterans with PTSD
seeking VA services."
Harrison, who was a school counselor and Army
Reservist from Wheeling, W.Va., before being called to active duty in
January 2003, thinks cases of PTSD may be even more common than the
military's one-in-six estimate.
He is on the leading edge of the effort to help these
veterans back home. Harrison and other counselors invite Iraq and
Afghanistan veterans to stop in to talk. Often, that leads to counseling
sessions and regular weekly group therapy. If appropriate, they refer the
veterans to VA doctors for drug therapies such as antidepressants and
anti-anxiety medications.
"First of all, I let them talk. I want to find out
all their problems," he says. "Then I assure them they're not alone. It's
OK."
Fifty counselors from the latest war is a small
number, considering the VA operates 206 counseling centers across the
country. Their strategy is to talk with veterans about readjustment before
they have problems, or before small problems become big ones. The VA also
has staff at 136 U.S. military bases now, including five people at Walter
Reed, where many of the most grievously injured are sent.
The toughest part of helping veterans, Harrison says,
is getting them to overcome fears of being stigmatized and to step into a
Vet Center. "They think they can handle the situation themselves," he says.
Vet Centers provide help for broader issues of
readjustment back to civilian life, including finding a job, alcohol and
drug abuse counseling, sexual trauma counseling, spouse and family
counseling, and mental or emotional problems that fall short of PTSD.
More than 80% of the staff are veterans, and 60%
served in combat zones, says Al Batres, head of the VA's readjustment
counseling service. "We're oriented toward peer counseling, and we provide a
safe environment for soldiers who have been traumatized," he says.
"A Vietnam veteran myself, it would have been so
great if we'd had this kind of outreach," says Johnny Bragg, director of the
Vet Center where Harrison works. "If you can get with the guys who come back
fresh ... and actually work with their trauma and issues, hopefully over the
years you won't see the long-term PTSD."
In all cases, the veteran has to be the one who wants
to talk before counselors can help. "Once they come through the door, they
usually come back," Harrison says. "For them, this is the only chance to
talk to somebody, because their families don't understand, their friends
don't understand. That's the big thing. They can't talk to anyone. They
can't relate to anyone." |
PTSD &
Spirituality
We encourage you to visit the
North American Association of Christians in Social Work website. Below is a
sample of the types of instructions offered by them.
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Description
This audio conference,
presented by Hope Haslam Straughan, Ph.D., will first present a
bio-psycho-social-spiritual approach to social work practice. Various ways
of thinking about development theories in general & spiritual development in
specific will be reviewed, including a segment in which the participants
will consider his/her own spiritual journey, development, and identity.
Finally, spiritual assessment tools will be presented and discussed in order
to further one possible application of inclusion of spirituality within
social work practice. Overall, the focus will be on the integration of
openness to acknowledging the possible strengths, concerns, and impacts of a
persons’ spirituality within the helping relationship. |
Learning Objectives
The participant will be able to describe an integrated
bio-psycho-social-spiritual understanding of a social work client system.
The participant will be able to define spiritual development, utilizing
at least two definitions.
The participant will identify some sort of connection to their own
spiritual development and identity, and consider the implications for this
in their social work practice.
The participant will recognize a variety of spiritual assessment tools,
and have a beginning knowledge on how to implement these within his/her
practice.
The participant will identify at least one way in which his/her
understanding of spiritual development will impact his/her practice.
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We also encourage you to visit some of the links posted
below:
Department of
Veterans Affairs on PTSD & Spirituality
Spirituality & Trauma Treatment by the National Center for PTSD
Spirituality &
PTSD - The Vietnam Veterans of America
PTSD
& Spirituality by Vietnam Veteran Ministers
The Spiritual Costs of
Being In Combat
Questions
& Answers on Health and Spirituality
Spirituality &
Faith in Anxiety Disorders
Spiritual Alienation: Life
After the Vietnam War
Science & Theology: What Ministers Need to Know about PTSD
Spirituality &
Psychology
The Role of Religion & Spirituality in Understanding and Promoting Mental Health
THIS PAGE IS STILL UNDER CONSTRUCTION
WE APPRECIATE YOUR SUGGESTIONS AND FEEDBACK
Matt 8:8-10
I know, because I am under the authority of my superior officers and I have
authority over my soldiers, and I say to one, 'Go,' and he goes, and to another,
'Come,' and he comes, and to my slave boy, 'Do this or that,' and he does it.
And I know you have authority to tell his sickness to go-and it will go!" 10
Jesus stood there amazed! Turning to the crowd he said, "I haven't seen faith
like this in all the land of Israel!
TLB
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