Paula J. Caplan's Blog, page 2

Curing Loneliness Takes a Village

True Community Galvanizes for Heartfelt Change

First published on November 8, 2013 by Paula J. Caplan, Ph.D. in Science Isn't Golden at http://www.psychologytoday.com/blog/s...


"..the most daring thing is to create stable communities in which the terrible disease of loneliness can be cured." -- Kurt Vonnegut

It's interesting what images come to mind when something major and moving happens. For me this week, the image has been of those massive, powerful horses called Clydesdales. Let me explain.

Tony Smith (vsacoaching.com/about-vsa/our-people/...) is an expert on how to make real change, and as I have worked for the past two years to help reduce the chasms between military veterans and nonveterans in this country, he has given me sage advice. Tony urged me to think of the aim of my Welcome Johnny and Jane Home Project (WJJHP listen2veterans.org) as already existing somewhere in the future and, sharing my view that many more people need to learn how harmful the chasms are and how healing it is to bridge of them, he described the Project as requiring us to drag people into that better future, a future, he says, that few even think of.

There are obstacles to making that happen, including the rarity of Americans who are willing even to think about veterans at all. When I wrote about this rarity in my 2011 book, When Johnny and Jane Come Marching Home: How All of Us Can Help Veterans, I fervently hoped to be proven wrong. But blogging for Psychology Today has only proven me right. With only one exception, every time I post an essay that has anything to do with veterans, it receives between 30% and only 3% (no, that is not a typo -- three percent!) the number of readers of any other subject I write about. Recently, when about to post yet another essay about veterans, I tried an experiment: I took care to keep the headline free of any mention of veterans. The result was that within a couple of days, as many people had clicked on that essay as click on any of my essays that are not about veterans.

Many people say they want to help veterans but do little or nothing, as though simply stating their wish to help is sufficient. And given the huge number of groups and organizations that either do help veterans or give the mistaken impression that they do -- and there are some of each kind -- it is easy for most nonveterans to assume that all is being looked after. But the rising rates of veterans' suicides, homelessness, substance abuse, and family breakdown make it clear that far more is needed. And although it is very important to provide veterans education, employment, and healthcare, if they are not genuinely and deeply embraced and integrated into their communities, their intense isolation and suffering continue.

Often, people talk about bringing together disparate groups and individuals to meet community members' needs, but few actually make it happen. The first two days of this week, I was immersed in a phenomenal community from in and around Mansfield, Ohio, where eight separate but intertwined events galvanized the Welcome Johnny and Jane Home Project there. Funny how things happen, and you never know what will lead to what. Activist Pat Risser had introduced me at a conference last year to Steve Stone. Steve heads the area's Mental Health and Recovery Board of Ashland County, and when he heard about The Welcome Johnny and Jane Home Project, he said he wanted to bring it to his area and would be in touch. I said I would look forward to hearing from him. You know how, when someone says that, and you don't hear from them, you don't know if they were just being polite but really are not interested, and you don't know whether to pursue the matter or spend the time some other way? Many months went by, and I wrote to Pat that I guessed Steve was not after all interested in the WJJHP. He wrote back that I was wrong, and soon afterward, I heard from Steve directly.

During those months when I had been thinking that Steve had dropped the idea of working together, he had been busy. He is one of those rare people who combines a great heart with tireless energy and an astonishing capacity to think strategically, to seek out and make connections, to find ways to make common cause between and among people and groups that others might not have thought would come together. He had been laying extensive groundwork for the WJJHP in his area. In fact, he had been creating a model of community partnerships that I would have thought impossible but that he has achieved and that ought to be cloned far and wide. Furthermore, he had made the important choice not to base the work in his community mental health system but rather in his capacity as a Board member of North Central State College (NCSC) in Mansfield. Why did he do this? To make clear that (1) the WJJHP is based not on the mistaken and damaging assumption that being upset by war or sexual trauma or other troubling features of military life is a mental illness but instead is based on the assumption that most responses to these events are deeply human reactions; (2) that these events cause suffering; (3) that enduring that suffering in isolation is soul-destroying for veterans and their loved ones and ultimately therefore is damaging to the wider community; and (4) that the community needs to bear witness to that suffering and, by listening, help make healing possible.

I always say that all that's needed to do the WJJHP is for one nonveteran to connect with one veteran who would like to have the nonvet simply listen silently, with respect, without judgment, and in confidence to whatever the veteran wants to say. The beauty of this healing work is in its simplicity. Steve Stone agrees but wanted to implement this simple project widely. He teamed with Iraq War veteran Adam Boyce, who had attended NCSC and now is a Veterans' Service Officer at Richland County Veterans Service Commission, to involve a remarkable number of individuals and organizations. So I want to give you a feel for the terrific variety of people who came together on Monday and Tuesday of this week on the campus of NCSC and its neighbor, Ohio State University at Mansfield (OSU-M). They included NCSC President, Dr. Dorey Diab; OSU-M Dean and Director, Dr. Stephen Gavazzi; nearby Ashland University's Director of Adult Studies and Veterans' Services, Dr. John Sikula; Col. Gary McCue, Commander of the 179th Airlift Wing, Air National Guard, and NCSC Trustee; OSU-M Special Assistant to Vice President for Student Life, Dr. Louise Douce; NCSC media maven Kevin Stoner; Jason Dominguez, an Iraq War veteran who is now Deputy Director of the Ohio Department of Veterans Services; Lisa Sheehan from Hospice (many veterans, tragically, do not speak to anyone about their experiences until they know they are dying); a host of representatives from the offices of local, state, and Congressional officials; at least 50 veterans from eras spanning the past 65 years; undergraduate students; faculty and administrators; and members of the wider community who were there just because they cared.

The working committee included Betty Preston, Chief Public Affairs Officer, NCSC and OSU-M; Dr. Donna Hight, Chief Student Life and Retention Office, OSU-M; retired therapist and school psychologist Mary Wedell; and Richland County Veterans Services Director Tony DeLong, who with his wife and a corps of volunteers provided a hearty luncheon feast.

The eight events included a major kick-off, where veterans Adam Boyce and Jason Dominguez told their stories publicly; an orientation session I conducted for the "coaches" who will orient new listeners; and an orientation session where to a group of 40 volunteer listeners, I described the need for the WJJHP, gave them the simple guidelines for serving as listeners, and told them about the wealth of research showing that listening has the power to heal, and explained why the fact that the listeners are not trained therapists but are members of the veterans' wider community is a significant plus. I also described the surprise of many WJJHP listeners, who volunteer for the Project as acts of charity, wanting to help veterans but who find that doing even one listening session transforms them in powerfully positive ways.

Another session included brainstorming with faculty about their possible roles, including but not limited to offering extra credit for any veteran or nonveteran student who does a listening session; working with students to do surveys of the needs of the student veterans on their campuses; and conducting studies of stereotypic beliefs that veterans and nonveterans may have about each other.

A wrap-up session was focused on how the two days of events had gone -- "inspirational," "energizing," and "welcoming" -- and brainstorming about a wonderful variety of ways to continue the work.

At one of the meetings, coming on board to join Steve Stone and Adam Boyce as the third ongoing coordinator for the WJJHP in the area was Julie White, a veteran who is currently NCSC Site Facilitator for Success Unlimited, a program offering specialized supports for students with disabilities or other challenges.

The collective energies, ideas, and commitment to making real change were so powerful that they brought the image of Clydesdale horses to mind. Thinking of Tony Smith's vision, these Clydesdales are pulling us forward into a better future. As Margaret Wheatley has said:

"Most cultural traditions have a story to explain...why there is so much suffering on earth. The story is always the same... we forgot that we were all connected.... These stories always teach that healing will only be found when we remember our initial unity and reconnect the fragments."

©Copyright 2013 by Paula J. Caplan                                                                                        All rights reserved

The Art of Healing Through the Arts

Amid the brown, barren-looking, high desert landscape of Joshua Tree, California, which is not far from the huge Marine base at Twenty-nine Palms, great vibrancy comes from Mil-Tree, a collective aimed to help veterans through connection and the arts. Last night, I had the deeply moving experience of attending an event called "The Art of War" at Radio Free Joshua Tree Listening Lounge at 61597 Twenty-nine Palms Highway.

Mil-Tree's founder, the phenomenon named Cheryl Montelle, emceed with warmth and great sincerity the program, which was co-sponsored by the local Arts Council, Hiway 62 Art Tours, and Arts Connection. The shape of the program was this: A number of musicians and poets each had a lyric or poem displayed on the walls next to one or two works of visual art that were connected to or had in many cases been created in response to that lyric or poem, which were sung or performed.

Last night, musician Walt Cronin opened with a beautiful song, from which one phrase especially grabbed me and has not let go: "Healing comes from looking closely." In listening for many years to veterans from all eras, I have each time been struck by how healing happens when a veteran who has been suffering in isolation -- or at least in isolation from anyone other than close family and friends and other veterans -- begins to heal in important ways when given the chance to speak, telling their story or even talking in fragments, to a nonveteran who gives them the gift of the time and space to do that, bearing witness and listening with respect, without judgment, and in confidence. What the veteran says is a way of looking closely and thus of healing, and it also transforms the listeners. listen2veterans.org

After Walt's song, many wonderful poems were read -- and in one case excerpts from letters to servicewoman Jodi Callahan when she was in Desert Storm were read -- and the related visual art works were pointed out.

I cannot here do justice to the depth and variety and quality of both the spoken and visual art, but at http://www.rfjt.org/Archived_Broadcasts.html at the bottom of the page, you can hear many of the verbal ones.

I must mention briefly three of the spoken pieces, not because the others were not also wonderful but because for various reasons, these affected me so powerfully. Ralph S. Carlson's "Perimeter Guard: Another Quiet Night" ends the description of a harrowing incident in combat with the words that one gentle soul "names his every breath thereafter a gift." I caught my breath upon hearing those words, because my late father, Jerome A. Caplan, a gentle, gracious soul who was drafted and fought at the Battle of the Bulge, often said with gratitude that since that battle, he had been living on borrowed time. And I thought of how my late, dear friend, Tom McDonald, a Vietnam veteran, used to say with quiet reverence, "Life is a gift."

Katherine Barta, whose late husband was a veteran and who has been a caretaker, read her beautiful poem, "In Enemy Territory," about someone matching their own humanity to that of a wounded "enemy" soldier, saving the life of the latter and welcoming her or him to their own home.

Then Ted Haler, a Vietnam veteran, read "First Tour," which is profoundly affecting all the way through and ends with an unexpected twist that packs a wallop that moved me to tears. I won't tell you what it is about, because I hope it is on the Radio Free Joshua Tree broadcast referred to above. If it isn't, I will see if I can find out if it is available somewhere and will post that here.

James Loomis, a more recent veteran, read his poem, "We Mighty Warriors," about his excruciating attempts to come home. I have always thought that, while on the one hand it is important to have Veterans Day as an official day, it is tragic that so many nonveterans ignore veterans the rest of the year. James Loomis expresses this in a deeply personal and stunning way that every American ought to have to read. I hope that this one, too, is on the Radio Free broadcast, and if it is not, I will see if I can direct you to a place where you can read it.

The program ended with Ted Quinn's performance, singing and on guitar, accompanied by the wonderful cellist Jennifer Irvine, of his "The Ballad of Kythe Yund" about an anguished veteran Ted knew who took his own life.

I do not have a listing of the wonderful and varied works of visual art, but I can mention specifically the one by Marsha Straubing, who told me last night, when I said, "I never knew you were an artist," "I didn't know I was." I mention it not just because she is the one artist I happened to know but also because it was among the most imaginative and moving of an array of stirring creations.

Every community should have an event like this, bringing together veterans and nonveterans in their area, using spoken words, music, and visual arts to connect and thus to heal. Let me amend that: Every community should have many such events.

©Copyright 2013 by Paula J. Caplan                                     All rights reserved
 

On Syria and Related Concerns

These are complex matters, and there are no easy answers.

 I've been on the phone and email with friends and colleagues in tormented discussions about whether or not the United States should take action against the Syrian government's killing of many of its citizens with chemical weapons. The torment comes, among other things, from what we know, what we do not know, and what we guess at. Images of terrified Syrians being gassed haunt us, and we want that terrorizing stopped. But we want the horrors of Darfur ended, and we want the killings of millions in the Congo ended, and we know there are dictators and terrorists and oppressors in more countries than most of us can keep track of, and we want all that to end. We ask who can end it all...and how we choose when our own country should be the one -- whether alone or with others -- to try to end it. We wonder why we did not attack Iraq and indeed why we helped through giving it intelligence back when it used chemical weapons against Iran. And since no one country can do it all, why doesn't the United Nations take on what it was created to do?  

How can we guess at the motives of the President and the Congress and the lobbyists in pushing for our country to attack one place and not another, based on one principle -- or publicly-alleged principle -- or another? How can we attack Syria for using chemical weapons, when we used chemical weapons like Agent Orange in Vietnam and have used depleted uranium in our current wars and white phosphorus last year in Fallujah? Was it all right that Assad killed far more people before now, just now with chemical weapons? And if the United States takes some action now, what will be the fallout for the innocent in the country we attack and who are inevitably killed in war, as well as from the blowback against the U.S. that will inevitably follow? After all, we know that weapons of war often kill more civilians than soldiers. Due to our country's use of drones, more than 200 children have been killed in Yemen, Pakistan, Afghanistan & Somalia as "collateral damage" -- that horrible term used to try to mask the killing of totally innocent people --  in drone attacks. Do we want to kill more Syrian civilians with our weapons to punish Assad for killing Syrian civilians? As activist and artist Robert Shetterly said in our recent discussion, "It's a bit like saying we're intent on punishing the bad boy in class by blowing up the classroom." 

Most of all, what I cannot get out of my mind are the faces and the words of the countless veterans -- from World War II through every American war including the present ones -- to whom I have listened over the past decade.

World War II was my father's war. Miraculously, he came through it and retained his gentleness, graciousness, and capacity to love. But so many from that war did not. As I learned while writing When Johnny and Jane Come Marching Home: How All of Us Can Help Veterans, it's not unusual for Americans to make the dead-wrong assumption that World War II veterans were emotionally unscathed by their war, because it was "a good war." But a great many World War II veterans dealt with -- and today deal with -- their pain through substance abuse or horrible emotional isolation. I cannot tell you how many daughters and sons of deceased veterans of that war have said to me that their fathers or mothers either spoke about the war only on their deathbeds or never to their dying days.

Korean War veterans often speak of their war as invisible, forgotten...feeling that the risks they took and their suffering are unremembered.

The Vietnam War was my generation's war, and the suffering caused by that one has been more visible but unabated. It has been exacerbated by the rush since then to call war-caused suffering a mental illness and to treat it with usually multiple psychiatric drugs that do not lessen their moral anguish or intense grief and that cause more problems than they solve. One man in particular embodies all of this for me, because I know him so well. His adult son tells me that his father sleeps most of the day, and when he tries to move around the house, the son has to stay nearby to catch him when he often starts to fall because of the drugs.

The veterans of wars since Vietnam suffer from any and all of the above, and the brave women and men who have recently spoken out about the epidemic of sexual assaults in the military -- while what has barely been addressed is the epidemic of misogyny in forms other than assault -- has brought out of the woodwork the stories of such suffering both current and long-buried from veterans of all wars.

Advocates of a strike against Assad in Syria, including President Barack Obama, make the plan sound so simple, so clean. They speak of "surgical strikes," though it is well-known that such missile strikes often kill civilians, even more civilians than soldiers. They say there will be "no boots on the ground," using "boots" to mean "living, breathing, human beings."  Do they think that will make us forget that our war in Iraq was supposed to be one of "shock and awe," get in, strike surgically, and get out fast, with few or no people dying? How do the loved ones of those who were killed there feel when they hear such talk? And can we forget the many places where we were told we were sending only "advisors," when that turned out to be a cover for fighting forces who killed and some of whom were killed?

Those who led this country knew about the Nazi death camps but failed to bomb the railway tracks that took victims to those camps, and the U.S. and many countries turned away boatloads of people desperate to escape the Nazis. Knowing and having listened to people who escaped those camps or lost loved ones there makes it impossible to ignore what is happening in Syria and also in many other countries.

Shortly before the Iraq War began, I heard the thoughtful, perceptive journalist James Fallows speak about a cover story he had just prepared for The Atlantic. Going way beyond the then-usual question, "Should we go to war in Iraq or not?" he had thoroughly explored what would happen after that initial decision was made: What would probably happen on the first day of the war? In the first week? The first month? The first year? And after that. Pointing out the huge numbers of military people we still had stationed in Germany, Japan, and Italy all those decades after World War II ended (even today, we have more than 115,000 in those three countries and South Korea combined), he addressed the fact that war is never as simple or as brief as we think it might be from the start. Will President Obama and Secretary Kerry address these questions? Will they let us in or their plans beyond whether or not to order those initial surgical strikes?

In light of that, don't we need to ask, as Robert Shetterly did in our recent conversation, what is the reason our government would order missile attacks on Syria? Of course chemical weapons are outlawed by international treaty, and Obama and Kerry seem to propose we attack to punish the Syrian government for using them. But we have not punished other countries for using them, nor have we been punished for our use of them. Do we have any aim -- or plan -- in mind once we inflict that initial punishment? And who will establish the guidelines for our country to decide when and how to punish the overwhelming array of crimes against humanity that are being committed across the globe?

As I wrote at the beginning: These are complex matters, and there are no easy answers. This essay is a plea for two things. It is a plea for honesty -- which I realize is asking for more than we will get from most politicians and from the many who profit financially from wars -- but I issue that plea nonetheless. And it is a plea to keep clearly in our sight that there are always human costs of attack -- loss of life and increases of many kinds of suffering.
 
  ©copyright by Paula J. Caplan                           All rights reserved

The Welcome Johnny and Jane Home Project's Progress: National Resolution, FAQs Video, Community Education and Action

 I've been so moved by some people's willingness to help with The Welcome Johnny and Jane Home Project (WJJHP), which is aimed to help veterans and their families as well as the rest of the country and consists of the simple act of having one nonveteran sit in a room with one veteran from any war and just listen to what the veteran wishes to say. This is one of a series of periodic updates I will be posting about the WJJHP. This time I will describe a wonderful national resolution that was recently passed, the new video posted on the website for the project, some recent events, and a list of very specific tasks for the Project with which I would love to have some help.

As readers here may recall, perplexed by the question people often asked -- "Can listening really help?" -- I wrote an essay called "The Astonishing Power of Listening"[i] and did a pilot study of the effectiveness of the listening project at Harvard Kennedy School. The results revealed that veterans from every war since World War II found it helpful and healing, and the nonveteran listeners found it transformative for them in very positive ways.[ii]

When I spoke in the Rhode Island Statehouse in May, as the guest of Governor Lincoln Chafee in a veterans’ event organized by Dr. Paul Block of Psychological Centers and Stephen Hourahan of Family Service of Rhode Island, the Governor issued a proclamation of Days of Listening to Veterans, in which he urged citizens to listen with respect and without judgment to a veteran’s story. The Lieutenant Governor, Elizabeth Roberts, read the proclamation that day, and in discussion afterward, she said that she would propose a similar resolution for the Annual Meeting of the National Lieutenant Governors Association. She did that, and I am delighted to report that it was adopted.  The text is at http://www.nlga.us/wp-content/uploads/AM-2013-Resolution-in-Support-of-Listening-to-Veterans-Day-FINAL1.pdf  I hope that readers will look at it and, noting that it urges each state to declare a Day of Listening to Veterans, will urge the representatives of their respective state legislatures and/or their governors and lieutenant governors to introduce and pass such a resolution.

Last February, thanks to the kindness of Phil Donahue in allowing us to screen his important film, “Body of War,” as a fundraiser for the otherwise unfunded WJJHP, we raised just enough money to engage videographer Shawn Curley to create a video in which I respond to Frequently Asked Questions about the project. Actor John Ross Clark kindly donated his time to participate as well. The 19-minute video is now at http://whenjohnnyandjanecomemarching.weebly.com/the-welcome-johnny-and-jane-home-project.html just below a description of the Project. For those of you who prefer reading text to watching videos, much of what is in that video is in Chapter 6 of my book, When Johnny and Jane Come Marching Home: How All of Us Can Help Veterans.

Recently, Terre Thomas – who since 1980 has been a member of the National Board of Directors and Governors of the amazing St. Jude’s Hospital founded by her father, Danny Thomas – generously hosted in her home an event attended by a truly remarkable group of her friends and colleagues, each of whom works tirelessly in various ways to make the world a better, more compassionate place. When I spoke to them about the WJJHP, they asked for a list of specific ways that they could help. One of those attending was Stanley Silverberg, who kindly helped me compile that list, which is at the end of this essay. If anyone reading this would like to help out in any of those ways, I hope you will contact me.

Last week, I was one of the two speakers – Kay Lindahl, author of The Sacred Art of Listening[iii] was the other – in a webinar organized by the wonderful Sande Hart, who does sterling work with Compassionate California and The Compassion Games.[iv] With listeners/participants from across the country and other nations, we spoke of the simplicity and power of listening.

The people at Wellness Works in Glendale, CA -- who have a history of caring about veterans and their families and helping them in nonpathologizing, alternative, low-risk ways – had a successful meeting of people who want to do the listening sessions and are setting up their first sessions.


“Welcome Johnny and Jane Home Project" -- Can You Help In Any of These Ways?

1.     Read existing WJJH Project description on existing website to see if it needs editing for brochure.

2.     Create logo and maybe graphics or find photos for brochure.

3.     Do layout for brochure.

4.     Print brochure.

5.     Put brochure on WJJH website.

6.     Use social media to get the word out about the Project, giving welcomejohnnyandjanehome@gmail.com address for veterans and prospective listeners who want to participate.

7.     Do outreach to veterans’ organizations and municipalities and civic, social, political, volunteer, education and higher education, and faith-based groups, as well as members of Congress and state and local legislatures, chaplains, alternative service providers, and media people to spread the word and specifically to
(A) gather participants
(B) locate local spaces for the listening sessions
(C) find local coordinators to bring veteran and listener together in a space.

8.     Mail or email brochure to those in #7.

9.     Do ongoing follow-up of #7.

10. Create and keep a data-base of information from #7.

11. Create media kit that includes the brochure and contact information from people who have participated as veterans or listeners.

12. Try to get media stories about the Project (ongoing).

13. Arrange for/host events where Paula can speak about the Project either in person or via Skype.

14. Create and keep up a list of everywhere the Project is being implemented on whatever scale.

15. Create section on website where both veterans and listeners can post comments about the listening sessions they did and can communicate with each other (anonymously if they choose).

16. Find someone to monitor #11.

17. Create section on website where veterans and listeners may (anonymously if they wish) report the fact that they have done a session … or how many they have done, so we can have a minimum notion of how many have been done altogether.

18. On the section in #13, have a place where a listener can request a baseball cap, bumper sticker, or mug that has the words “I listened to a veteran’s story” on it, and we will send it to them.

19. Arrange for the items in #13 to be produced and donated or paid for, as well as shipped when they are ordered.

20. Brainstorm about what the caps, bumper stickers, and mugs for the veterans who participated could say on them.
Get Veterans’ input regarding what they would like the wording to be.

21. Seek volunteers who will help with any of the above and help Paula respond to various requests for information and support.

22. Find donated recording studio space and editor’s time to make audiobook version of When Johnny and Jane Come Marching Home (which has won three national nonfiction awards and includes a chapter about the listening sessions).

23. Raise funds for the above, where possible.
-------------------------------------------------------


[i] http://whenjohnnyandjanecomemarching.... and also at http://www.psychologytoday.com/blog/s...

[ii] http://whenjohnnyandjanecomemarching....

[iii] http://www.sacredlistening.com/sal_au...

[iv] http://prezi.com/dmcqkfiqoikx/state-o...

Healing Without Harming: The Listening Project Takes Off Across the Nation

First published on July 13, 2013 by Paula J. Caplan, Ph.D. in Science Isn't Golden @ http://www.psychologytoday.com/blog/s...

More than two years ago, I posted here an essay called "The Astonishing Power of Listening," which I wrote because I found it heartbreaking that so many people seemed to have forgotten the power that listening has to heal...or had been persuaded that only therapists really know how to do it the "right" way (http://www.psychologytoday.com/blog/science-isnt-golden/201104/th...). And I wrote how listening helps without requiring that the speaker be classified as mentally ill.

Robert Dove, a longtime counselor, tells the story of a phone call he took from a young man who was intensely upset and who began to describe the terrible things he had been through. As Robert listened, the young man began to weep. Robert told the young man that he understood why he was crying, given all that had happened to him. The young man corrected him, saying he was crying not because of his disturbing experiences but because no one had ever listened to him before.

A New York Times article published in late December and sent to me by my colleague, psychologist Dr. Janet Mindes, was the latest documentation of the healing power of support from the community when people have been traumatized, and of course respectful listening by someone from the community is an important kind of support.

Having worked a long time with people who had been harmed in the mental health system, about a dozen years ago I began increasingly to meet with and listen to a population that was new to me: military veterans, many of whom had also been harmed in the mental health system.

I started a project that consists of pairing one veteran with a nonveteran who simply listens -- truly just listens, without asking questions or making comments but just giving the veteran the gift of the time and space to say whatever they want to say and to be silent when they choose, something that many have never been offered before.

This is about helping veterans and also helping others who suffer and who are also helped by this kind of listening.

I want to tell you what has happened in the couple of years since I began the listening project, which I call The Welcome Johnny and Jane Home Project (WJJHP), because at the time I started it, aiming to have every nonveteran listen to the story of a veteran from any war, I met with considerable skepticism. When the book in which I proposed these sessions -- When Johnny and Jane Come Marching Home: How All of Us Can Help Veterans -- was published two years ago, the publicist who tried and failed to get me a single interview in any of the national media told me that editors and producers said, "Why should we interview her about that? We can get Colin Powell to talk about what veterans need."

At that time, Colin Powell was not talking about listening to veterans, but happily, this past Memorial Day in a public speech at a holiday celebration, he strongly emphasized the importance of listening to veterans. So did the wonderful writer Sebastian Junger in a Memorial Day weekend piece in the Washington Post (http://articles.washingtonpost.com/2013-05-24/opinions/39502742_1...

With high and increasing rates of suicide, homelessness, substance abuse, and family breakdown among veterans and high rates among the general population, it is clear that the skyrocketing numbers of Americans diagnosed and treated as mentally ill have -- at the very least -- not sufficiently been helped by traditional approaches used in the mental health establishment. In contrast, there is massive evidence that ordinary human connection and social support are healing.* Although some therapists are wonderfully helpful, some either do not help or are frankly harmful, and the astonishing numbers of psychotropic pills ingested across this country and the globe only help some people sometimes but harm far more (this last was painstakingly and powerfully documented by Pulitzer-nominated Robert Whitaker in Anatomy of an Epidemic).

Listening is not a panacea, but it is often very helpful and does not add to already-suffering people the burden of believing themselves to be "sick," of thinking that they somehow should be "over it" ("it" being whatever trauma they have been through) by now.

The Welcome Johnny and Jane Home Project is now happening all over the country. Among other places, in Ohio, Steve Stone has galvanized people in a number of organizations in his area —  including an Iraq War veteran and Purple Heart winner who is a student at North Central State College and works for a country veteran support administration; NCSC President Dr. Dorey Diab; The Ohio State University-Mansfield Campus; and the 179th Airlift Wing of the Air National Guard — to plan a series of events just before Veterans Day to kick off the project. That in itself would be wonderful enough, but in addition, Stone plans to expand the work for use with survivors of trauma other than war as well. Also important is that Stone chose to do this in his role as a Trustee of North Central State College, although his day job is Executive Director of the Mental Health and Recovery Board of Ashland County (Ohio), because he does not want this "to be mis-perceived as a mental health initiative" rather than a nonpathologizing, community-oriented one.

In Huntington, Indiana, and Portland, Maine, individuals have begun the WJJH Project. At San Jose Community College, a faculty member immediately acted on my suggestion that faculty members throughout the country offer course credit to both veterans and nonveterans who do a listening session, thus helping bridge on their own campuses the awful divide that Col. (Ret.) David Sutherland calls the "epidemic of disconnection" between the two groups.

When I spoke to a small group of very smart, perceptive, caring people in Joshua Tree, CA, sponsored by Mil-Tree Collective coordinated by Cheryl Montelle, that very night Marsha Straubing, who teaches listening at Antioch University, volunteered to do a listening session, and a Vietnam veteran that same night told me privately that his way of dealing with his own war trauma had for decades been to listen to others, and now he was ready to have someone listen to him. I paired them up, and they soon did a listening session that was important and rewarding for them both.

The vibrant organization called Wellness Works in Glendale, California (http://biz123.inmotionhosting.com/~wellne31/), which has already been providing nonpathologizing, alternative ways of healing -- such as acupuncture and massage -- to veterans has taken up the WJJH Project mantle in their area. Headed by Mary Lu Coughlin, Kathy Lynch, and Wesley Cloys, on July 27 they will hold an orientation meeting where prospective listeners will meet each other and have a chance to discuss Chapter 6 of my book (the chapter about the interviews), the brief video with responses to Frequently Asked Questions about the Project that will likely be on my welcomejohnnyandjanehome.weebly.com site within the next week or so, and any other questions they might raise.

Col. Sutherland, who founded and heads the Staff Sgt. Donnie D. Dixon Center -- the nonpathologizing and community-focused orientation of which is reflected in their goal "Enabling our veterans and their families to thrive where they live" -- features the WJJH Project on his Center's website (
The magazine of the mammoth Military Officers Association of America published an article about the Project. And later this month, I have been asked to work with the American Legion Auxiliary to assist interested ALA members and chapters to develop and strengthen their organization's activities to promote veterans' rehabilitation through connecting them with the creative arts activities and listening projects that are underway in their communities.

Vietnam veteran, photographer, and storyteller Ted Engelmann contacted me after reading my book and said he thought there should be a National Day of Listening to Veterans. I thought that was a great idea and made many visits to Capitol Hill, meeting with legislative aides of many members of the House and Senate Veterans Affairs Committees from both political parties...to no avail. But in May, when Rhode Island Governor Lincoln Chafee with Family Services of Rhode Island and Psychological Centers hosted in the Statehouse a talk I gave about this work, he officially proclaimed Days of Listening to Veterans, naming several holidays on which citizens of his state are especially urged to listen with respect and without judgment to a veteran's story. I was told that the plan is that on each Memorial Day, July 4th, and Veterans Day, press releases will be issued to remind people of the proclamation and urge them to participate. At my talk, half of those who attended put their names and contact information on a signup sheet to serve as listeners, and Family Services of Rhode Island and Psychological Centers have agreed to provide the space and coordinate the work, helping pair veterans with listeners.

Furthermore, Rhode Island's Lieutenant Governor Elizabeth Roberts, who read the proclamation before the lecture in May, has proposed that the national conference for Lieutenant Governors to be held next week approve a resolution for Days of Listening to Veterans (http://www.nlga.us/conferences/annual-meeting/resolutions/).

I was so lucky that awhile back, when I gave a talk at the Harvard Club of New York, Tony Smith, a coach for transformational leadership, attended and has been kindly and insightfully advising me since then (vsacoaching.com/about-vsa/our-people/...). When I told him I was frustrated that so few people seemed to be interested in becoming involved in the WJJH Project, he gave me this wise counsel: He said that when we see things from a different perspective and believe we know something that might be helpful, we should not become frustrated when our efforts seem not to take hold. He pointed out that I was used to being a problem-solver and that simply offering people a solution if, for whatever reason, they were not ready to hear it could wear one down from the repeated disappointments and the perplexity of why they didn't seem to get it. He urged me instead to consider anything I did to be simply "a conversation" about the Project, and he said, "You never know when one of these conversations will lead somewhere." 

Tony Smith was so right. Jewels of interest have begun to appear in unexpected places, many of which I am not yet naming here, because we have just scheduled initial meetings to get them going. I am so grateful to Tony Smith and to all of the people across the nation who are doing the essential, humanizing work of listening.

-------------------

*see Chapter 6 of When Johnny and Jane Come Marching Home: How All of Us Can Help Veterans

©Copyright 2013 by Paula J. Caplan                                           All rights reserved

For July 4th, Focus on Veterans' Needs

When considering United States Independence Day on July 4, some Americans will think kindly of military veterans, and others will not. To some extent, this depends on our politics, our attitudes toward war in general and toward particular wars, and our knowledge of history and sociology. Those who think kindly will say that the veterans of a particular war or wars or all wars in which Americans have fought have defended and protected the freedom of us all. Others will say that a particular war or wars have endangered the United States and even perhaps our freedom.

Regardless of our politics, though, consider that -- as every veteran to whose story I have listened in the past dozen years has said -- there is absolutely no way to know what war is really like before you go to war. In listening to these stories I have been struck by the integrity and sincerity of the beliefs of each veteran, whether or not their views of their war are the same as mine. Depending on the war, they may have been drafted; they may have enlisted variously because they had no other way to earn a decent living; they may have been promised financial or vocational benefits; they may have been assured they would not see combat; or, they may have hoped to travel and see the world. There may be some who signed on because they wanted to go kill people, but so far, I have not crossed paths with them.

Whether or not we believe it was true, the government when sending every servicemember to every war in U.S. history has told them that defending Americans' freedom is the reason it is risking their lives and sacrificing so many. How appalling, then, that regardless of political party, almost no one in the United States Congress has fought hard enough to ensure that veterans from all wars and their families will have their needs for community connection and understanding, as well as for health, education, employment, and housing adequately met. Indeed, many members of Congress have consistently cast their votes in ways that ensure the opposite.

A prevalent myth is that World War II veterans had a terrific GI Bill that provided generously for all of the above, but that is simply untrue. It is profoundly untrue for Black World War II veterans. My dear friend Sergeant Isaac Pope is a 95-year-old Black man who fought with my late father, Jerome A. Caplan, in an artillery unit during the Battle of the Bulge. Sgt. Pope entered the Army from Kinston, N.C., with minimal education and, like many of the Blacks from the South in their battery, had not been allowed to vote. (How ironic to think about this now, when just last week the U.S. Supreme Court set back voting rights for Blacks and Latinas/os so many decades.) As my father, the white, Jewish Captain of their unit, said about Sgt. Pope, "He was the sweetest guy you'd ever want to meet, and he was so smart and worked so hard that he rapidly became First Sergeant." Their unit was the first Black one "allowed" to go into combat in World War II, because they scored so high on their tests of logarithms, surveying equipment, and so on that their scores overrode the absurd claim that Blacks were cowardly and would run from battle. In fact, they won a Presidential Citation for Meritorious Service for their courage during the Bulge.  Sgt. Pope returned to Kinston, where for decades he worked as a janitor for DuPont. The man is a national treasure. Picture a Black man in the Deep South in the decades after WWII who had the astonishing courage and commitment both to work with the NAACP on desegregation in Kinston and to work as a union organizer. Who among us has ever shown that kind of bravery and care in three such important realms and in the face of constant, life-threatening danger?

As I saw on a recent visit to Kinston, he is greatly beloved in his St. Augustus AME Zion Church. A member of the congregation told me, "Sgt. Pope is our heart." He is also, as my father said, smart as a whip, and he is thoughtful and perceptive in his commentary about historical and current politics and his observations about people. He has an exquisite singing voice (sings in the church choir) and plays the piano and organ by ear. Getting to know him and his loving family and friends has been a gift for me.

Sgt. Pope has diabetes, so the walks he used to take around his neighborhood were essential for his health, and he loved to take them. A long time ago, he had to stop. He told me it was not safe because of the gangs in his neighborhood. Recently, he submitted his first application to the VA for what had long been coming to him, and after the usual, unconscionable delay that characterizes the VA system, he was flatly turned down.

He soon had a heart attack and open-heart surgery, then moved to the beautiful, new North Carolina State Veterans Home in Kinston. But he gets nothing from the VA. To call this "scandalous" is a whopping understatement.

Another dear friend for whom I have tremendous respect recently retired from his remarkable career as a military leader. When I told him what happened to Sgt. Pope with the VA, he said, "I do get a check from the VA, and you know when I get it? At the very end of the month. Want to know why? Because if I die during the month, they don't have to pay it."

By no means is only the VA at fault. Congressional legislation is aimed to support veterans from the current wars has been puny. Often, it looks great but is riddled with problems. Let me describe just one of many examples.

Veterans enrolled in institutions of higher education receive some financial support for their studies but are required to take a certain number of courses, an impossible expectation for someone reeling from what they went through at war -- or even being in the military for some years but not going into combat -- and then trudging the difficult path of "readjusting" after returning home. Imagine trying to concentrate enough to take notes in one class, never mind to take a pop quiz or write one term paper, while images of your best buddy having been blown apart by an IED keep bursting through. Now imagine trying to do the work of even two courses in one semester. But if you don't meet the requirements, you lose the financial support for your education. And many women in particular have told me that they returned from Vietnam or Desert Storm, delayed higher education because of tending first to family responsibilities, then found that some years later when they wanted to finish college, the term of their benefits had expired.

Another example of the abysmal ways we treat veterans of all eras: In order to obtain many kinds of benefits, they are required to be diagnosed as mentally ill. As a result, it is not uncommon to hear veterans ask for these diagnoses, because they are suffering, and they have been told that mental health professionals are the best ones to help them, so they desperately want to have that care paid for. Too often, though, they suffer terrible harm directly as a result of being given those labels -- about which they were never warned -- ranging from losing custody of a child to having trouble getting a job or health insurance to losing the right to make decisions about their medical and legal affairs. For those who want to stay in the military, being so labeled can mean a halt to career advancement, including through the route of being denied security clearance. I have received an avalanche of emails from people who were traumatized by war, military sexual assault, or both but who -- instead of being told that of course they feel devastated and offered reasonable support, were told that that emotional devastation is proof they are mentally ill and been diagnosed with personality or mood disorders. The implication of this is that they allegedly had the disorders before going into the service and that those are the causes of their upset. When a military or VA mental health professional declares that your emotional suffering was not due to something that happened while you were in the service, they will not provide the insurance coverage for the support and help that you deserve and that is far more likely to reduce your suffering than are the massive numbers of prescriptions for psychiatric drugs they hand out.

Regardless of our politics, it is our government who in the name of us all has sent people to war, and it has been too easy in our war-illiterate nation for most of us to stay unaware not only of how too many veterans are treated but even that they are human beings. I started The Welcome Johnny and Jane Home Project (whenjohnnyandjanecomemarching.weebly.com), which consists simply of having a nonveteran listen -- truly listen, not speak, not question, and certainly not judge -- to whatever a veteran from any war wants to say. This has been healing for a great many veterans from all wars since WWII, and the nonveteran listeners have often described themselves as transformed by what they heard, by the discovery of the common humanity they share with the veteran. It is poignant that before doing the listening session, many listeners expected to have nothing in common with the veterans, proof that nonveterans too often fail to understand that veterans are human beings. It is also evidence that many nonveterans fail to be cognizant that, as Col. Anthony Henderson, head of the wonderful Warrior and Family Support Program in the Pentagon, said in our symposium at the Psychologists for Social Responsibility conference, "We veterans came from your communities. And we come back to your communities. And we want to be part of them again."

Col. (Ret.) David Sutherland, who started that Warrior and Family Support Program and now heads the important, community-oriented Staff Sgt. Donnie D. Dixon Center as part of Easter Seals (
I have been trying for a couple of years to persuade members of Congress to pass a resolution to declare National Days of Listening to Veterans. Vietnam veteran Ted Engelmann made this suggestion after hearing about The Welcome Johnny and Jane Home Project, and the resolution I have proposed consists of the declaration that on Memorial Day, July 4th, and Veterans Day, every nonveteran should listen with respect and without judgment to the story of a veteran. Former Congressman Robert Filner (from California) introduced such a resolution, and Congressman Charles Rangel became a co-sponsor, but it went no further before that session of Congress ended. Despite expressions of great enthusiasm from the legislative aides of many members of Congress, including many on the Senate and House Veterans Affairs committees, no one else in Congress has become an advocate for the proposal. Happily, Rhode Island Governor Lincoln Chafee in May issued such a proclamation in May, the first governor to do so (The proclamation can be seen at http://www.google.com/url?sa=t&rc...) . Subsequently, Rhode Island Lieutenant Governor Elizabeth Roberts submitted a proposal for the National Lieutenant Governors' Conference to pass a similar resolution at its meeting later this month. Let us hope that these wonderful steps will prove to be the first of many in individual states and in the U.S. Congress. 

Another way to mark July 4th is to contact your members of Congress, members of your state legislature, and contact your governor and lieutenant governor, sending them the above information about the Rhode Island proclamation, and urging them to introduce and work for the passage of similar ones.

©2013 copyright by Paula J. Caplan                                              All rights reserved

 

Remembering Both the Dead and the Lost Among Us: Memorial Day Connections

Published on May 26, 2013 by Paula J. Caplan, Ph.D. in Science Isn't Golden

My late father, Jerome Arnold Caplan, was a gentle, gracious, loving, smart, hardworking man who was happiest when doing things for others. He was drafted and sent to fight in World War II, where he and his artillery battery were completely surrounded by the enemy in blinding snow in the terrifying and crucial Battle of the Bulge. He was Captain, and his men were Black soldiers, nearly all from the Deep South and thus poorly educated and prevented from exercising their right to cast votes in elections. Only after he died in 2009 did I learn from his First Sergeant, Isaac Pope, that when my father -- knowing that his battery was about to be sent to war -- learned that the men had been deprived of the right to vote, in Sgt. Pope's words, "It just about made him crazy" (something never before or since said about my father), and, according to Sgt. Pope, my father "wrote to Washington, D.C., to General Eisenhower," demanding that they be allowed to vote before risking their lives for their country. They got to vote. Not even my mother knew that story, so utterly unassuming was my father.

Wanting to understand his experiences at war -- how his gentle soul survived those horrors -- was the first force that drove me to begin listening to veterans' stories and urging others to do the same. This project of having a nonveteran simply listen with respect and without judgment to the story of a a veteran from any war has become The Welcome Johnny and Jane Home Project and is spreading throughout the country. (see whenjohnnyandjanecomemarching.weebly.com for information, and contact me through that site)


From my childhood years, I remember every December, my father would tell the stories of the December of the Battle of the Bulge. And every December, I asked myself why, though he told the same stories every year, I could never remember them in between his tellings. In 1995, I sat alone in my room, watching the video my friend Caroline Kinsbourne had made of him relating those same stories. As I watched, I heard a sentence that he must have spoken annually but that had never truly reached me. That time, when I heard him say, "I was a Forward Observer," it reached me. It broke through, and I broke down. I hit the "Stop" button, and I wept. Somehow, I knew that a Forward Observer goes out, alone, closer to the enemy than anyone else, to locate them and radio that information back to his comrades. That, I think, was what had kept me from taking in his stories of war: I adored my father and could not bear to think of him in such danger and alone.

At that moment, I began to want to understand how war -- and coming home -- had been for him and how it had been for veterans from every war. This in part led me to write both my book, When Johnny and Jane Come Marching Home: How All of Us Can Help Veterans (whenjohnnyandjanecomemarching.weebly.com), and my play, SHADES, which just had its world premiere at Los Angeles Theatre Center.


In the leadup to Memorial Day this year, I had the honor and privilege of doing two events about listening to veterans. They were hosted and attended by very different people, but all grasped the importance of these listening sessions as an essential way to eliminate what Col. (Ret.) David Sutherland has called the "epidemic of disconnection" between American veterans and nonveterans. The disconnection leaves too many veterans in soul-crushing isolation while, regardless of their politics and how they feel about war in general or particular wars, they bear the burdens of the effects of war. On May 18, I delivered the keynote address and participated in a panel discussion with wonderful colleagues in Portland, Maine, sponsored by the local chapter of Veterans for Peace. By the end of the day, one-third of those attending had volunteered to be listeners, and the VFP chapter is organizing to provide space for the sessions and put listeners in touch with veterans.

On Friday, May 24, I spoke in the breathtakingly beautiful Governor's State Room in the Rhode Island Statehouse for an event sponsored by Rhode Island Governor Lincoln Chafee, Family Service of Rhode Island (FSRI), and Psychological Centers (PC). In a room with silken, red wallpaper and furnished with plush red seating, the audience facing me could see just behind and above me a portrait of George Washington, whom someone yesterday called "the first American veteran." By the end of the morning, more than half of those attending had put their names on the sign-up sheet for volunteer listeners, and both FSRI and PC had offered to provide space for listening sessions and to coordinate the contacts between listeners and veterans.


Nothing could move me more than this...and as I write this essay, I remember vividly what a great listener my father was, the intensity of his focus reflected in his eyes as he concentrated on what others said to him.

After When Johnny and Jane Come Marching Home was published two years ago, I heard from Viet Nam veteran Ted Engelman. He had read the book, loved the listening session idea, and said he thought there should be a National Day of Listening to Veterans. I have been trying to persuade the U.S. Congress to pass such a resolution -- perhaps for Days, in the plural, to include Memorial Day, Fourth of July, and Veterans Day, though the idea would of course be not to limit listening sessions to those days, but although this has not yet happened, Rhode Island Governor Lincoln Chafee took a groundbreaking step on Friday, the day I spoke at the RI Statehouse. He declared that day Veterans' Listening Day, referred to Col. Sutherland's concern about the epidemic of disconnection and to the high rates of suicide among veterans, and said that on the three abovenamed holidays, nonveterans should listen with respect and without judgment to veterans' stories. The proclamation with the Governor's signature and gold seal was read by Lt. Governor Elizabeth Roberts, and Psychological Centers Director Dr. Paul Block later informed me that the plan from the Governor's office is to issue a press release each year on each of these holidays to remind citizens of the listening sessions.

I hope that many other Governors and the U.S. Congress will follow suit.

As I remember my late father on Memorial Day and always, and as I work to inspire others to do the listening sessions with living veterans, I think also of people in three other categories. One is of certain homeless veterans. Whenever I hear the latest statistics about the alarmingly high rates of homelessness among veterans, it saddens me to know that these are underestimates. One reason is that so many veterans have fled into the mountains or the woods and live away from their communities, wrestling in complete isolation with the ways that war haunts them. There is simply no way to count these veterans, but we must not forget that they are out there.

Another category of people I think of, who live not in the mountains and the woods but somewhere closer to the rest of us, are those who, like a dear friend who is a Viet Nam veteran, live in tragically partial existence, so heavily drugged with usually many psychotropic pills that they sleep their days away, can barely walk, and have become so detached from their feelings and even their ability to think clearly that they are disconnected from even those closest to them and cannot begin to heal.

A third category of people are those who have been much in the news lately and whose horrible stories are finally beginning to be more widely believed than before. These are the victims of military sexual trauma. They include a great many men, since men still make up the vast majority of the military and of veterans, but women are vastly more likely, proportionally, to be victimized in this way. All of these victims merit our attention, support, and outrage. Any given woman in the military knows she is extremely likely to be assaulted -- and if not assaulted, then sexually harassed, an all the more intolerable burden as women are pressured to prove that they "deserve" to be allowed in the military. And any man who is sexually assaulted has the added burden of feeling that part of the humiliation is having been treated "like a woman," because throughout our country, women are far more likely to be rape victims than are men, and the perpetrators often feel they have a right to commit sexual assault precisely because their victims are women or are men they see as "less than real men." Appallingly often, the victims are told that their upset is not understandably caused by having been assaulted but rather by their alleged "mental illnesses," and they are given diagnoses that convey the notion that they were terribly mentally ill even before the assault took place, and their credibility in reporting the assault is challenged on the basis of their supposed disorders. (see http://www.paulajcaplan.net/files/Mil...

For the sake of our country and of all these servicemembers past and present, living and dead, let us search for the common humanity that we share with them, find ways to reach out and connect, whether we can do so actually because they are still alive or whether we can do so only in sacred memory.

©Copyright 2013 by Paula J. Caplan                                      All rights reserved

My Recent Silence and A Voice That Matters: What's Wrong with Psych Diagnosis Debate

First published on May 21, 2013 by Paula J. Caplan, Ph.D. in Science Isn't Golden

In recent weeks, as the publication of the psychiatric diagnostic manual called DSM-5 approached, and media people paid it much attention, people who know that my work on exposing the truth about psychiatric diagnosis began more than a quarter of a century ago (1) have contacted me to ask why I was not adding my voice to the brouhaha.

I was aware of two of the answers to their question: (i)I had nothing to say beyond what I have been saying for decades, and (ii)I am busy.

Then I realized there was another: I was experiencing a kind of existential nausea, watching the sound and fury whipped up by both DSM advocates and critics and by the media. Why the nausea? I struggle constantly against becoming jaded, but when for decades you've seen powerful people get away with distortions and even lies, lies that hurt the people they profess to help, it's hard not to want at times to flee from the field. In all the frenzy, what was appallingly left out -- as it has always been from the activities of those who have the power to make real change -- was any real work to redress the harm done on the basis of psychiatric diagnosis over decades to living, breathing human beings. More about this later.

How the NY Times Portrays Psychiatric Diagnosis: Thinking Critically About "Sunday Dialogue" about Defining Mental Illness

Originally published on March 30, 2013, here. 

(This is the second of two essays about the New York Times' Sunday Dialogue called "Defining Mental Illness.)

The New York Times asked psychiatrist Ronald Pies to write a statement about psychiatric diagnosis for its March 24, 2013, Sunday Dialogue, and his statement was sent out ahead of time with invitations for others to respond. Some responses would be published right below Pies' piece, and Pies' answer to those responses would wind up the section.

Pies was an interesting choice. His Sunday Dialogue statement was a written as though psychiatric diagnosis were as scientifically grounded as clearly medical problems such as migraines — he says that psychiatric diagnoses are made like diagnoses of migraines, in that they are based on patients' history, symptoms, and observations — and that, if done carefully, assigning such diagnoses can even be humanizing, because patients are relieved to have their suffering given these labels. (For instance, he writes that it is important to tell one diagnosis from another but neglects to mention that the scientific research has shown conclusively that psychiatric diagnostic categories overlap hugely with each other as well as with clearly nonpathological behavior and feelings.) It is reprehensible that he failed to disclose the now well-established facts that psychiatric diagnosis is unscientific, does not reduce human suffering, and causes many kinds of serious harm. What is downright weird is that just over a year ago, he published a strong critique of psychiatric diagnosis (http://psychcentral.com/blog/archives/2012/01/07/why-psychiatry-n...) called "Why Psychiatry Needs to Scrap the DSM System: An Immodest Proposal," in which he advocated doing away with that system in favor of carefully listening to the patient and trying to understand them rather than label them.

After his Times piece appeared, I wrote to draw the attention of the newspaper staff to his striking and total inconsistency, andI asked if they publish letters to the editor about Sunday Dialogue so that this could be made known. The response was that they do not publish letters about that column but that in any case they would not do so "mainly to attack the credibility of the writer; we prefer that the focus stay on the issue." How strange to cast my query as attacking the credibility of the writer rather than to make the point that readers have a right to know when someone given the prominent position of authorship of the lead piece in their special feature totally contradicts himself, because that surely sheds light on the way the issue is addressed.

The first "reader's" reaction printed was by Allen Frances, hardly an average reader, given that he headed the group that wrote the current and previous editions of the diagnostic manual. Frances, whose manuals are responsible for millions more people being pathologized than at any time in history, actually complained in the Times that "the realm of normal is shrinking." Less than anyone on earth should he be surprised. When at his invitation I served on two of his committees and repeatedly sent evidence of the abysmal quality of the "science" he was using to create and justify diagnoses and the devastation caused to people, he not only ignored but actually publicly denied that that was true. (That was why I resigned from his committees, feeling it was unethical and unprofessional to participate in that enterprise.) Even today, he professes to have had no way to predict how many more people would be diagnosed, despite his having added 77 categories to the 297 in the edition published just seven years before. (see Paula J. Caplan. 1995. They Say You're Crazy: How the World's Most Powerful Psychiatrists Decide Who's Normal.)

In the Times piece, Frances called diagnosis "the essential prelude to effective treatment," though he more than anyone has seen ample evidence that this is untrue. In fact, the chances even that two therapists simultaneously meeting with the same person will assign that person the same label are poor, which of course means that diagnosis is not helpful in choosing treatment or improving outcome. (see Caplan, 1995, as listed above)

And Frances is a Johnny-come-very-lately when in the Times he presents as his own, new idea the proposal for Congressional action that I had initiated in 2002 with the two Congressional briefings I organized while he would continue until recently to defend uncritically his diagnostic empire. He seems to love my ideas, though, because also very recently, without attributing this one to me either, he suddenly proposed that the DSM carry a blackbox warning, one of the nine demands in "The Need and the 9 Demands" documented that I had written and that Jenny McClendon, Leah Harris, Debra Turkat and I had attempted to deliver last November 13 to APA headquarters (
The next response in the Times feature came from Sera Davidow, who wrote as one who was diagnosed but who now directs "a recovery community for others who have been so labeled." She decimated Pies' absurd attempt to draw an analogy between psychiatric categories and migraines by saying that no one "attempted to hospitalize or medicate me against my will for [migraines]," and she describes how a person's psychiatric label often becomes their sole and demoralizing identity.

After Davidow's response came one from Patrick Singy, a historian and philosopher of science, who emphasized the need "to reflect on the much larger ethical, legal and social consequences of creating (or deleting) diagnoses."

Psychiatrist and psychoanalyst Leon Hoffman urged that each person be approached not for purposes of choosing a diagnosis but "as a unique individual" who, with the therapist, will decide on the best treatment.

The New York Times includes in its print edition only some of the responses they post online. My own did not appear in the print edition but followed Hoffman's online. Because some people have asked me about this, I can tell you that I have no idea how they choose which ones will appear in print, but it troubles me that only one response in the print version was from a woman. This is the version, slightly shortened from what I submitted, that appeared online:

"Surprising though it may seem, psychiatric diagnosis is not scientifically grounded, does not reduce human suffering, and carries risks of a wide array of serious kinds of harm. Even more disturbingly, it is totally unregulated, making it even less regulated than the financial institutions in this country.

I served for two years on two committees that wrote the current DSM but had to resign on ethical and professional grounds when I saw the way they ignored or distorted what high-quality research showed but presented junk science as though it were good when it suited their purposes.

The potential damage caused by a diagnosis is virtually limitless, including loss of custody of a child, loss of employment, skyrocketing insurance premiums, and loss of the right to make decisions about one's medical and legal affairs."

Omitted from my list of kinds of harm was the ultimate one: The physical death that too often results from various consequences of psychiatric diagnosis, sometimes caused by the unwanted effects of psychiatric drugs (and their interactions with each other) and sometimes from other causes, with the diagnosis always as the first cause.

Also appearing online but not in print was Laura Delano's description of how her initial relief at being diagnosed as mentally ill soon gave way to her feeling "stripped...of an authentic sense of self and of a connection to those around me, because my 'condition' made me different. Only in leaving behind that psychiatric diagnosis and the treatment it required did I find a path through my emotional struggles to the other side, where I could accept myself as I was, and be fully human again."

Two more responses appeared only online. Psychiatrist Michael F. Grunebaum was an argument that psychiatric diagnosis is a work in progress "with the shortcomings of any human endeavor in which scientific knowledge is incomplete." He apparently is entirely unaware that the DSM is not based on solid scientific knowledge, in contrast to being simply incomplete, and that difference matters enormously. Just ask the people whose lives have been ruined because of the mistaken belief that the labels they were given were scientifically supported and would lead to better things. The other response was from psychiatrist Victor A. Altshul, who pointed out how his profession has horribly stigmatized -- through diagnosis -- large groups of people. And he eloquently echoed the point that people are not their diagnoses: "It's all very well for a patient to know what he [sic] 'has.' But what he [sic] really needs is to know who he [sic] is. When that happens, the 'diagnosis' tends to disappear. It's just too little an idea to account for human complexity."

Finally, there came Pies' response to a few of the comments. Unsurprisingly, he selectively agreed that diagnosis leads to effective treatment, despite the absence of data supporting that claim. He took offense at Ms. Davidow's comments, claiming that it is "unfair" to blame psychiatric labels for the abridgement of civil liberties and excesses of the drug companies and that instead one must blame Pharma. It is nothing less than unconscionable for him or Frances or anyone else to try to steer the blame away from diagnosis, because psychiatric diagnosis is the first cause of virtually everything bad that happens in the mental health system. Few, if any, people have been deemed psychiatrically normal but then had terrible things done to them in the name of treatment or protection of themselves or others.

©Copyright 2013 by Paula J. Caplan                                           All rights reserved

Comedy, History, and the Future of Mental Disorder Labels

Strange Goings-on in the New York Times about Psychiatric Diagnosis
This blog post, of relevance to active duty military and veterans, was  first published March 24, 2013, here.
Today (March 24, 2013) the New York Times devotes its Sunday Dialogue column to the topic of psychiatric diagnosis, and my essay here – which will be the first of two about that column – is focused on the comedy…or perhaps the irony.

Last week, an announcement went forth about the topic for today’s Sunday Dialogue, including the information that the column would begin with a statement by Dr. Ronald Pies, in which he defended the use of psychiatric diagnosis, a topic in the news as the next edition of the psychiatric manual, known as the DSM, is scheduled for publication in May. Pies’ statement was in fact strongly supportive of psychiatric labeling, and the New York Times editors wanted people to send in responses to the Pies piece, some of which they would publish.

The first source of amusement: This was apparently the same Ronald Pies who just over a year ago wrote “Why psychiatry needs to scrap the DSM: An immodest proposal,” that can be found athttp://psychcentral.com/blog/archives/2012/01/07/why-psychiatry-n... How curious that he would within just over a year write articles in which he takes two such opposite approaches. Why might that be? I will not even speculate. It was interesting that the sources he cited in his critique of the DSM did not include those who have shown over decades that psychiatric diagnosis is not scientifically grounded, does not improve outcome, and carries immense risks of harm. One had to wonder why he cited Allen Frances, who as head of the current edition of the DSM was responsible more than any human being in history for the diagnosing of millions more people than ever before as mentally ill. Frances is a johnny-come-lately to a critique of psychiatric diagnosis, and his is very partial and inconsistent.
Many readers, seeing the New York Times announcement last week, wrote to urge me to write a response and send it to the Times, because I had served for two years at Frances’ request on committees tasked with writing the current DSM, resigning in horror when I saw how fast and loose they played with the science and how they ignored the evidence I presented of the harm caused to so many people because of being psychiatrically diagnosed. (I wrote about this in They Say You’re Crazy: How the World’s Most Powerful Psychiatrists Decide Who’s Normal and in an edited book, Bias in Psychiatric Diagnosis.)

I submitted a response to the New York Times and received a notice that it was being considered for possible publication in the print and/or online versions. It had been shortened considerably. Last night, many people emailed me or posted on Facebook that they were pleased to see that my response had been published. It turns out it was published only in the online version, and neither my response nor that from Laura Delano, a brave psychiatric survivor harmed severely by having been psychiatrically labeled, made the print version. (The online version is athttp://www.nytimes.com/2013/03/24/opinion/sunday/sunday-dialogue-...) It is interesting that in the print version, only one statement was by a woman.

Back to the comedy, sort of. Years ago, I saw a cartoon of a great many men and one woman sitting around a boardroom table, and the caption, spoken by the Chair of the Board, was something like, “Thank you for that excellent suggestion, Ms. Jones. Now, just as soon as one of the men makes it, we can act on it.” Many people who have been harmed by psychiatric diagnosis belong to the Facebook page called Stop Psychiatric Diagnosis Harm or the one called Occupy Psychiatry. Some of them, after reading Allen Frances’ Sunday Dialogue response, wrote to me, worried that they were having disconcerting déjà vu experiences. They saw that Frances suddenly opines today that a Congressional investigation of psychiatric diagnosis is needed, but they would have sworn that as long ago as 2002, I had organized the first of two Congressional briefings about that very subject.(1) At the time, those who wrote to me thought they recalled, neither Frances nor his DSM predecessor, Robert Spitzer, had been willing to acknowledge the unscientific, unhelpful, and harmful nature of their editions of the DSM. They only began to do that a few years ago, when they no longer belonged to the DSM in-crowd and suddenly were shocked, shocked to discover the truth about psychiatric diagnosis. I told those who wrote to me that they were remembering the history correctly.

Those who wrote to me asked if Frances were aware that many years ago, at psychdiagnosis.net, I had started a petition – signed by many wonderful individuals and heads of organizations – calling for Congressional hearings about psychiatric diagnosis. Sure he did. But he never signed. Nor did he or Spitzer sign the one I created in December, 2011, at change.org that is called “Call for Congressional Hearings about Psychiatric Diagnosis” and is still there if either of them – or anyone else – would like to sign. (http://www.change.org/petitions/everyone-who-cares-about-the-harm...)

What prompted me to organize those Congressional briefings, as well as the late-1980s petition challenging DSM categories (which resulted in signatures from individuals and major organizations representing a total of six million people) was the utter disregard by Frances and Spitzer and their cronies of the urging to come clean about their manuals and to try to prevent further harm and redress the harm their editions have caused. In fact, for all their railing about how bad the forthcoming edition will be – and truly, their critiques have often been equally applicable to their own editions, something they only intermittently or quite minimally mention (usually, in Frances’ case, blaming others and saying he could not have foreseen the harm that would be caused, though he had been given ample evidence of harm in plenty of time to have prevented more) – they have yet to call for the American Psychiatric Association, publisher of and profiter from the DSM – to solicit and collect and publish reports of harm from the manual. And where are their calls for the APA – or they themselves as the former DSM head honchos – to prevent and redress further harm?

In the years since the briefings I organized, not one of the many members of Congress I have contacted has been willing to push for Congressional hearings. Whichever party is in the minority in the House or the Senate cannot make the hearings happen, and members of both parties in the respective majorities there have said there are too many important things happenings for them to focus on psychiatric diagnosis. This is troubling, because half of all Americans will be psychiatrically labeled during their lifetimes, and people have, as a result of being diagnosed, lost jobs, custody of children, health insurance, and the right to make decisions about their medical and legal affairs. Victims of sexual assault in the military have had diagnoses used against them, to cast their understandable upset about being assaulted not as understandable but as proof that they have personality and/or serious mood disorders and thus will not have support and help from military or VA mental health professionals paid for. These labels have been used in fact to deprive them of security clearance and career advancement, even to turf them out of the military. (On Youtube under the title “Watch the Stories of Harm the APA Refused to Hear,” you will find a number of brief videos of some of the people who have been variously harmed. Please watch them, then email, post, or tweet about them, please, to help educate the public about these dangers.)
Psychiatric survivors also wrote to me recently, concerned that they might have memory problems, when they read a piece by Frances in which he calls for a black-box warning on the DSM. They thought that psychiatric survivor and veteran Jenny McClendon and I had called for that very black-box warning previously, in a document called “The Need and the 9 Demands” that we attempted (unsuccessfully) to deliver to APA Headquarters. (The story of this and the full text of “The Need and the 9 Demands” is at Caplan, Paula J. (2012). The APA refuses to listen to the voices of those harmed by diagnosis…and refuses and refuses. Mad in America: Science, Psychiatry, and Community. November 19. These survivors’ memories were not impaired. They were right. (Think back to the cartoon described above.)