Paula J. Caplan's Blog, page 4
March 20, 2012
All-Female Settings Help Women Veterans Come Home
As Women's History Month continues, some of the least-recognized women are those who serve or have served in the military. Since women have until very recently accounted for only a tiny fraction of servicemembers and veterans, and since women have not officially been in combat positions (even when they work in combat zones), many people -- including many of these women themselves -- have not even been aware that they are considered "veterans." Questionnaires created by people who want to know if women are veterans are now being altered, so that instead of asking, "Are you a veteran?" the question reads, "Have you ever served in the military?" because if the answer to the latter is "yes," the person is a veteran.
As increasing numbers of women join the military and even go into combat zones, even if not there as official combat troops, the sexism that pervades our entire society helps shape what happens to them. This can range from sexist assumptions and comments to sexual harassment to military sexual assault. One woman said she was welcomed into the military by another woman who had been in for awhile with the words, "Congratulations: Now you are either a slut or a dyke." Women often report avoiding intake of any liquid after late afternoon, because if they have to get up to walk out to use a latrine in the dark, they are in danger of being raped by people in their own units. The military and the Department of Veterans Affairs are working to identify the needs of military women and women veterans and have taken many important steps, but they know that many more changes are needed. Terrific organizations like the Service Women's Action Network (servicewomen.org) are doing crucial education and advocacy work.
In the years since I started listening to the stories of military veterans, many women and men have used the rucksack metaphor, saying, "The burdens of what I experienced in the military and the difficulties when returning home have been like heavy rocks in a rucksack I have carried. Having someone listen to my story has been like having some of those rocks lifted out." Because of differences in the ways that men and women tend to be socialized, veterans sometimes avoid telling their stories to civilians for somewhat different reasons. Male veterans are likely to be reluctant to talk with civilians about their war and home-coming experiences in part because they feel they men are not supposed to be upset, are supposed to tough out and get through whatever emotional pain and moral anguish they have endured. Women who have served in the military are often reluctant to talk partly because they fear that if they talk about their pain and anguish, they risk confirming the belief that women should not be allowed to join the military, but if they have been affected by the usual socialization imposed on women, they also believe that their job is to help others who suffer, to be the nurturer, not the one who needs or asks for support or even understanding.
Some months after my book about veterans appeared last spring, a woman named Kari Granger, herself a veteran, wrote to me. After learning about my work and my advocacy of having civilians just listen to veterans' stories, she wrote to tell me about a program that she had created for women who have been in the military, because, she said, much of what they do in her program's three-day retreats is what she had realized is "an elaborate form of listening."
What Granger and her associates (http://www.sunergosllc.com) address in part is the wrench, the disorientation involved in going from military culture to the civilian world, and this happens whether or not the person was in a combat zone during military service, so vastly different are the two cultures. Of course, if they were in combat zones, that adds a whole host of other kinds of feelings and kinds of disorientation and fragmentation. Many women who leave the military struggle, as do men in somewhat similar and somewhat different ways, with matters of identity, of who they were in the military and who they will be now, of what and how to use what they have done and been and learned to move forward into a meaningful, rewarding future. Granger's program, "Leading with Resiliency and Grace," has included participants who are active duty, reserve, and retired military women, as well as spouses of servicemembers, ranging in age from 21 to 60. According to a report from the first such retreat, held last November in Washington, D.C., the women who attended experienced profound relief just having that much time to attend to the matters with which they had been grappling, to break down the isolation in which so many had struggled, to feel supported, and to have the chance to tell their stories from the past and present and thus to turn toward their future and considering how to shape it.
The importance of having a time and place for such matters is reflected in these comments from participants:
--"All of the interactions gave us a safe environment to let down our walls and be courageous."
--"A class of only women was the most important part; it wouldn't be the same if men were here."
-- "I am not alone — my feelings, perspectives and experiences are recognized as valid by a group of my peers and contemporaries."
The words of these women remind us that human connection and respectful listening make us stronger, more confident, more fulfilled. And in a still-misogynist society, the need for women sometimes to be in the company solely of other women continues. This does not mean, of course, that men are incapable of connection or that they cannot be supportive and respectful toward women, because many certainly are. But it means that especially for women who have worked and lived where they are in the minority and where sex-role stereotypes can pack an especially powerful wallop, these kinds of spaces for safety, support, insight, and inspiration in all-women settings essential. Male veterans have long known how this kind of thing can help, as the remarkable Shad Meshad, a Vietnam veteran and social worker who spearheaded the post-Vietnam creation of gathering places for veterans to talk with each other, showed. Meshad, who now heads the National Veterans Foundation (www.nvf.org), told me that, wanting to emphasize how normal is suffering after being at war and trying to negotiate the return home, he purposely (and importantly, I would add) chose to call those gatherings not "group therapy" but rather "rap sessions." So there we have it again -- the importance of speaking one
March 4, 2012
Update: My Recent Washington, D.C., Trip for the Work for Veterans and Their Families
Here is a brief summary of the work I recently did while in Washington, D.C. It was an energizing and gratifying trip, because the reception I received from the people with whom I met was far more positive than I had dared to expect. Because follow-up with these people and their organizations is progress, I will provide here only a few of the details that are definite.
Major General Tom Wilkerson had arranged for me to meet with Vice Admiral Norbert Ryan, who heads the gigantic and very active Military Officers Association of America, and his top staff members. After a great meeting with General Wilkerson and the MOAA people, I soon received notification that in the coalition we are building to promote the depathologizing of emotional and moral problems resulting from being at war and also trying to readjust back at home and also to promote the use of alternative, low-risk approaches to helping (as we did at the Harvard Kennedy School conference, "A Better Welcome Home," last November), I could now say that the MOAA is supportive. This means that the coalition now includes the MOAA, the National Veterans Foundation, Soldier's Heart and now, more recently, the Women Veterans Memorial (thanks to BG(Ret) Wilma Vaught, who spearheaded creation of that memorial at Arlington National Cemetery), and two other major organizations are in discussion currently about quite probably also coming on board.
I also met with staff from the Veterans Affairs Committee of both the Senate and the House, as well as with Jorge Rueda, who is the legislative aide for veterans for Sen. Bennett of Colorado. With each, the discussion consisted of how they could participate in this work.
At the Pentagon, I had two meetings, one with the truly spectacular Col. David Sutherland and his great staff, including Kim Mitchell, Tony Forbes, and Chris Manglicmot, and one with Lt. Col Brusher and Dr. Kathleen Quinkert. In different ways, these people share our aims and are approaching these in different ways, but both meetings were productive.
In one day I met two women who clearly had much to struggle against and have achieved a great deal. They are Dr. Irene Trowell-Harris, who directs the Center for Women of the VA, and BG Vaught at the Women Veterans Memorial office.
Major General Tom Wilkerson had arranged for me to meet with Vice Admiral Norbert Ryan, who heads the gigantic and very active Military Officers Association of America, and his top staff members. After a great meeting with General Wilkerson and the MOAA people, I soon received notification that in the coalition we are building to promote the depathologizing of emotional and moral problems resulting from being at war and also trying to readjust back at home and also to promote the use of alternative, low-risk approaches to helping (as we did at the Harvard Kennedy School conference, "A Better Welcome Home," last November), I could now say that the MOAA is supportive. This means that the coalition now includes the MOAA, the National Veterans Foundation, Soldier's Heart and now, more recently, the Women Veterans Memorial (thanks to BG(Ret) Wilma Vaught, who spearheaded creation of that memorial at Arlington National Cemetery), and two other major organizations are in discussion currently about quite probably also coming on board.
I also met with staff from the Veterans Affairs Committee of both the Senate and the House, as well as with Jorge Rueda, who is the legislative aide for veterans for Sen. Bennett of Colorado. With each, the discussion consisted of how they could participate in this work.
At the Pentagon, I had two meetings, one with the truly spectacular Col. David Sutherland and his great staff, including Kim Mitchell, Tony Forbes, and Chris Manglicmot, and one with Lt. Col Brusher and Dr. Kathleen Quinkert. In different ways, these people share our aims and are approaching these in different ways, but both meetings were productive.
In one day I met two women who clearly had much to struggle against and have achieved a great deal. They are Dr. Irene Trowell-Harris, who directs the Center for Women of the VA, and BG Vaught at the Women Veterans Memorial office.
February 12, 2012
Protest Against DSM Diagnoses Increases
_ This was just posted initially at http://www.psychologytoday.com/blog/s....
I post it here because of my concern about the ways that people devastated
By Paula J. Caplan, Ph.D. Created Feb 12 2012 - 11:45am
Alarms Sounded About Harm from Psychiatric Labeling
Readers of this blog may recall that I recently wrote about the decision of some therapists not to disclose to their patients that a widespread claim that emotional suffering is caused by chemical imbalance is actually false (http://www.psychologytoday.com/blog/science-isnt-golden/201201/po...).
Note, then, that the vice-chair of the task force for the forthcoming edition of the "Bible" of psychiatric classification, psychiatrist Darrell Regier, wrote just last year: "While we agree that human feelings and behaviors exist on a spectrum that contains some overlap of normal reactions to disease states, psychiatry also recognizes that there are real and discrete disorders of the brain that cause mental disorders and that can benefit from treatment." (1)
The spurious basis for claims that the vast majority of emotionally suffering is based in chemical imbalances and "broken brains" is only one of many reasons for protest in both the United States and many other countries against both the current edition of the manual and the one now in preparation. In a February 9, 2012, Guardian article titled "Psychologists fear US manual will widen mental illness diagnosis," (2) health editor Sarah Boseley notes that both psychiatrists and psychologists in the United Kingdom are speaking out against the forthcoming Diagnostic and Statistical Manual of Mental Disorders.
It is clearly the case that certain physical problems, such as brain tumors, traumatic brain injuries, degenerative neurological conditions, exposures to chemicals and other toxins, food allergies, certain vitamin or mineral deficiencies, to name just a few, can cause changes in mood and behavior and cause emotional suffering. That is not even a question. But many such problems are overlooked in the rush to label the symptoms of these conditions as simply psychologically caused.
Of course the concern about psychiatric diagnosis is the way that nearly emotional state except for happiness and serenity have come to be labeled signs of allegedly brain-based disorders in need of medical treatments and techniques.
Boseley quotes Til Wykes, professor of clinical psychology at Kings College London, as saying. "The proposals in DSM-5 are likely to shrink the pool of normality to a puddle with more and more people being given a diagnosis of mental illness."
These are some of the factors and concerns that led the PLAN T Alliance to adopt a slightly amended version of the recent, courageous statement by the International Society for Ethical Psychiatry and Psychology about the DSM. The PLAN T Alliance statement reads as follows and can be found at http://www.facebook.com/groups/PLAN.T.Alliance/doc/379404732073957/
"It is the position of the PLAN T Alliance (Psychiatric Labeling Action Network for Truth) that the Diagnostic and Statistical Manual for Mental Disorders (DSM), a publication of the American Psychiatric Association, is a political rather than scientific document, one which damages human beings. Despite the position of its authors that it is primarily descriptive, the DSM supports the perpetuation of myths about mental, emotional, and behavioral disturbances in individuals which favor pseudoscientific, biological explanations and disregard their lived context. The evolving editions of the DSM have been remarkable in expanding psychiatric labels for alleged "mental illnesses" with no scientifically substantiated biological etiologies.
The forthcoming DSM-5 edition continues this process while attempting to deepen indoctrination of mental health providers, consumers, and third-party payers into the fallacy that problems in living result from problems in biology. Adherents of biopsychiatric explanations and pharmaceutical manufacturers are the primary benefactors of public acceptance of this myth. Beyond research and technical studies which repeatedly demonstrate the inherent lack of validity and reliability of the DSM as a classification system, psychiatric labeling has real consequences in discriminating against and oppressing the disadvantaged, creating unnecessary obstacles to employment, housing, and social acceptance, lending false credibility to the concept of psychiatric disability, assaulting self-worth and self-efficacy, and undermining reestablishment of positive life-striving by inducing "behaviors to label" among people who have been so labeled.
In the PLAN T Alliance's view, conscientious and ethical provision of services to those suffering from mental, behavioral, and emotional disturbances is primarily a moral, social, political, and philosophical enterprise. The PLAN T Alliance supports helpers who wish to eschew use of the DSM-5 and its prior systems. The PLAN T Alliance recommends public scrutiny and skepticism regarding the DSM, as well as a constructive dismantling of the psychiatric-pharmaceutical complex through which it is continually supported and redeployed."
(1) http://www.guardian.co.uk/society/2012/feb/09/us-mental-health-ma...
(2) Ibid.
© Copyright 2012 Paula J. Caplan All rights reserved
I post it here because of my concern about the ways that people devastated
By Paula J. Caplan, Ph.D. Created Feb 12 2012 - 11:45am
Alarms Sounded About Harm from Psychiatric Labeling
Readers of this blog may recall that I recently wrote about the decision of some therapists not to disclose to their patients that a widespread claim that emotional suffering is caused by chemical imbalance is actually false (http://www.psychologytoday.com/blog/science-isnt-golden/201201/po...).
Note, then, that the vice-chair of the task force for the forthcoming edition of the "Bible" of psychiatric classification, psychiatrist Darrell Regier, wrote just last year: "While we agree that human feelings and behaviors exist on a spectrum that contains some overlap of normal reactions to disease states, psychiatry also recognizes that there are real and discrete disorders of the brain that cause mental disorders and that can benefit from treatment." (1)
The spurious basis for claims that the vast majority of emotionally suffering is based in chemical imbalances and "broken brains" is only one of many reasons for protest in both the United States and many other countries against both the current edition of the manual and the one now in preparation. In a February 9, 2012, Guardian article titled "Psychologists fear US manual will widen mental illness diagnosis," (2) health editor Sarah Boseley notes that both psychiatrists and psychologists in the United Kingdom are speaking out against the forthcoming Diagnostic and Statistical Manual of Mental Disorders.
It is clearly the case that certain physical problems, such as brain tumors, traumatic brain injuries, degenerative neurological conditions, exposures to chemicals and other toxins, food allergies, certain vitamin or mineral deficiencies, to name just a few, can cause changes in mood and behavior and cause emotional suffering. That is not even a question. But many such problems are overlooked in the rush to label the symptoms of these conditions as simply psychologically caused.
Of course the concern about psychiatric diagnosis is the way that nearly emotional state except for happiness and serenity have come to be labeled signs of allegedly brain-based disorders in need of medical treatments and techniques.
Boseley quotes Til Wykes, professor of clinical psychology at Kings College London, as saying. "The proposals in DSM-5 are likely to shrink the pool of normality to a puddle with more and more people being given a diagnosis of mental illness."
These are some of the factors and concerns that led the PLAN T Alliance to adopt a slightly amended version of the recent, courageous statement by the International Society for Ethical Psychiatry and Psychology about the DSM. The PLAN T Alliance statement reads as follows and can be found at http://www.facebook.com/groups/PLAN.T.Alliance/doc/379404732073957/
"It is the position of the PLAN T Alliance (Psychiatric Labeling Action Network for Truth) that the Diagnostic and Statistical Manual for Mental Disorders (DSM), a publication of the American Psychiatric Association, is a political rather than scientific document, one which damages human beings. Despite the position of its authors that it is primarily descriptive, the DSM supports the perpetuation of myths about mental, emotional, and behavioral disturbances in individuals which favor pseudoscientific, biological explanations and disregard their lived context. The evolving editions of the DSM have been remarkable in expanding psychiatric labels for alleged "mental illnesses" with no scientifically substantiated biological etiologies.
The forthcoming DSM-5 edition continues this process while attempting to deepen indoctrination of mental health providers, consumers, and third-party payers into the fallacy that problems in living result from problems in biology. Adherents of biopsychiatric explanations and pharmaceutical manufacturers are the primary benefactors of public acceptance of this myth. Beyond research and technical studies which repeatedly demonstrate the inherent lack of validity and reliability of the DSM as a classification system, psychiatric labeling has real consequences in discriminating against and oppressing the disadvantaged, creating unnecessary obstacles to employment, housing, and social acceptance, lending false credibility to the concept of psychiatric disability, assaulting self-worth and self-efficacy, and undermining reestablishment of positive life-striving by inducing "behaviors to label" among people who have been so labeled.
In the PLAN T Alliance's view, conscientious and ethical provision of services to those suffering from mental, behavioral, and emotional disturbances is primarily a moral, social, political, and philosophical enterprise. The PLAN T Alliance supports helpers who wish to eschew use of the DSM-5 and its prior systems. The PLAN T Alliance recommends public scrutiny and skepticism regarding the DSM, as well as a constructive dismantling of the psychiatric-pharmaceutical complex through which it is continually supported and redeployed."
(1) http://www.guardian.co.uk/society/2012/feb/09/us-mental-health-ma...
(2) Ibid.
© Copyright 2012 Paula J. Caplan All rights reserved
January 24, 2012
Powerful Psychiatrists Push False Theory on Unknowing Souls
_ Just posted @ http://www.psychologytoday.com/blog/s...
January 24, 2012 by Paula J. Caplan, Ph.D. in Science Isn't Golden on Psychology Today website
NPR Broadcast Reveals Shockingly Demeaning Views of Patients
It is widely believed that National Public Radio has a liberal bias. Let us then consider the following: Yesterday on "Morning Edition,"(1) several psychiatrists acknowledged there is not a shred of evidence that low serotonin level causes depression, revolutionary talk in light of the rampant bias in the mental health system - accepted unquestioningly by far too many laypeople - that troubling emotions come from well-established chemical imbalances and thus can be cured with drugs that affect those chemicals.
Consider this quotation from the NPR story: "Chemical imbalance is sort of last-century thinking. It's much more complicated than that," says Dr. Joseph Coyle, a professor of neuroscience at Harvard Medical School. "It's really an outmoded way of thinking." Pretty clear message from Coyle, who edits the Archives of General Psychiatry.
A strange feature of many media that are generally considered to be liberal is their ardent promotion, as though it were a liberal attitude, of this outmoded, chemical imbalance or even "broken brain" theory of emotional suffering. They seem to think that it is a liberal view, because everyone has the "right" to take psychiatric drugs to "fix" their chemistry, but they are alarmingly irresponsible journalists to promote that view in the absence of revealing the whole truth about (1) the often damaging effects of those drugs, (2) the absence of proof from well-done research about the alleged cause-effect relationship between the chemicals and the troubling feelings, and (3) the known benefits of approaches that are lower-risk and proven to be helpful for many such kinds of suffering.
Here is the bizarre and deeply disturbing part of the NPR story: Alan Frazer, who chairs the pharmacology department at the University of Texas Health Science Center at San Antonio and researcher of the drugs that are marketed under the label (and promise) "antidepressants," announces that it is fine for patients to believe in this unproven theory. Why? It enables them to "come out of the closet" about being depressed. Did Frazer not think how stunningly unethical and probably illegal it is to tell, or allow patients to believe, something that has never been proven? And did the NPR interviewer fail to challenge this practice, or did an editor higher up the chain cut the question (if it was asked) and answer?
Farther on in the story, we learn that University of Texas psychiatry department chair Pedro Delgado shares Frazer's view. He notes that uncertainty itself can be harmful to people, so that "clear, simple explanations are so very important." Says Delgado, "When you feel that you understand it, a lot of the stress levels are dramatically reduced." Ah, yes. But Dr. Delgado, why tell them the low-serotonin fairy tale? Why not say the stork brings depression, and prescribe eye of newt and toe of frog? My, my, once a helping professional chooses to manipulate and lie to the patient, there are so, so many fascinating lies to choose from.
Everyone who is currently ingesting drugs that affect not only their serotonin levels - often in highly individualized and unpredictable ways, which can change over time and begin having the opposite effects - but heaven knows what else, should be told about this NPR story. It reveals a disgusting contempt for people who are already suffering.
This is exactly why increasingly, people (including but by no means limited to the recently-formed PLAN T Alliance) are struggling against the massive enterprise that is psychiatric diagnosis, since there is little or no solid science behind it, it does not improve outcome (i.e., does not help patients feel better), and it often causes harm. And everyone who is in or considering going into the mental health system needs to know that the most fundamental building block leading to every kind of harm in that system is psychiatric diagnosis, because once you get a label, too many therapists (though of course not all) will assume you have a chemical imbalance, urge you to take drugs to fix it, and even choose not to tell you the truth when it is known.
How do you think that all the people who obediently ingested the pills the doctor ordered on the basis of unproven theories, many suffering horribly to the point of suicide because of drug effects, would feel if they knew this story? War veterans who are being told right and left that being devastated by war has made them mentally ill and that they need "antidepressants" to raise their allegedly low serotonin levels are one massive constituency of mistreated souls. And they are not the only ones, of course.
If any readers of this essay have never listened to someone so harmed by psychiatric drugs that they tried to kill themselves, I hope you will. It will break your heart. These people are among us, and for many, it is all the more tragic, because people close to them pushed them to take the drugs by saying, "If you love us, you'll take the pills." The more people know the truth, the fewer such dangers there will be.
(1) http://www.npr.org/blogs/health/2012/...
©2012 by Paula J. Caplan All rights reserved
January 24, 2012 by Paula J. Caplan, Ph.D. in Science Isn't Golden on Psychology Today website
NPR Broadcast Reveals Shockingly Demeaning Views of Patients
It is widely believed that National Public Radio has a liberal bias. Let us then consider the following: Yesterday on "Morning Edition,"(1) several psychiatrists acknowledged there is not a shred of evidence that low serotonin level causes depression, revolutionary talk in light of the rampant bias in the mental health system - accepted unquestioningly by far too many laypeople - that troubling emotions come from well-established chemical imbalances and thus can be cured with drugs that affect those chemicals.
Consider this quotation from the NPR story: "Chemical imbalance is sort of last-century thinking. It's much more complicated than that," says Dr. Joseph Coyle, a professor of neuroscience at Harvard Medical School. "It's really an outmoded way of thinking." Pretty clear message from Coyle, who edits the Archives of General Psychiatry.
A strange feature of many media that are generally considered to be liberal is their ardent promotion, as though it were a liberal attitude, of this outmoded, chemical imbalance or even "broken brain" theory of emotional suffering. They seem to think that it is a liberal view, because everyone has the "right" to take psychiatric drugs to "fix" their chemistry, but they are alarmingly irresponsible journalists to promote that view in the absence of revealing the whole truth about (1) the often damaging effects of those drugs, (2) the absence of proof from well-done research about the alleged cause-effect relationship between the chemicals and the troubling feelings, and (3) the known benefits of approaches that are lower-risk and proven to be helpful for many such kinds of suffering.
Here is the bizarre and deeply disturbing part of the NPR story: Alan Frazer, who chairs the pharmacology department at the University of Texas Health Science Center at San Antonio and researcher of the drugs that are marketed under the label (and promise) "antidepressants," announces that it is fine for patients to believe in this unproven theory. Why? It enables them to "come out of the closet" about being depressed. Did Frazer not think how stunningly unethical and probably illegal it is to tell, or allow patients to believe, something that has never been proven? And did the NPR interviewer fail to challenge this practice, or did an editor higher up the chain cut the question (if it was asked) and answer?
Farther on in the story, we learn that University of Texas psychiatry department chair Pedro Delgado shares Frazer's view. He notes that uncertainty itself can be harmful to people, so that "clear, simple explanations are so very important." Says Delgado, "When you feel that you understand it, a lot of the stress levels are dramatically reduced." Ah, yes. But Dr. Delgado, why tell them the low-serotonin fairy tale? Why not say the stork brings depression, and prescribe eye of newt and toe of frog? My, my, once a helping professional chooses to manipulate and lie to the patient, there are so, so many fascinating lies to choose from.
Everyone who is currently ingesting drugs that affect not only their serotonin levels - often in highly individualized and unpredictable ways, which can change over time and begin having the opposite effects - but heaven knows what else, should be told about this NPR story. It reveals a disgusting contempt for people who are already suffering.
This is exactly why increasingly, people (including but by no means limited to the recently-formed PLAN T Alliance) are struggling against the massive enterprise that is psychiatric diagnosis, since there is little or no solid science behind it, it does not improve outcome (i.e., does not help patients feel better), and it often causes harm. And everyone who is in or considering going into the mental health system needs to know that the most fundamental building block leading to every kind of harm in that system is psychiatric diagnosis, because once you get a label, too many therapists (though of course not all) will assume you have a chemical imbalance, urge you to take drugs to fix it, and even choose not to tell you the truth when it is known.
How do you think that all the people who obediently ingested the pills the doctor ordered on the basis of unproven theories, many suffering horribly to the point of suicide because of drug effects, would feel if they knew this story? War veterans who are being told right and left that being devastated by war has made them mentally ill and that they need "antidepressants" to raise their allegedly low serotonin levels are one massive constituency of mistreated souls. And they are not the only ones, of course.
If any readers of this essay have never listened to someone so harmed by psychiatric drugs that they tried to kill themselves, I hope you will. It will break your heart. These people are among us, and for many, it is all the more tragic, because people close to them pushed them to take the drugs by saying, "If you love us, you'll take the pills." The more people know the truth, the fewer such dangers there will be.
(1) http://www.npr.org/blogs/health/2012/...
©2012 by Paula J. Caplan All rights reserved
January 20, 2012
Military Researchers Avoid Looking at War's Role in Veterans' Suffering
_ The Naval Medical Center in San Diego "is studying whether an anesthetic used during childbirth could help relieve symptoms" of war trauma. http://www.npr.org/blogs/health/2012/01/16/144672190/ending-nightmares-caused-by-ptsd?sc=fb&cc=fp
To help relieve the emotional and/or moral anguish of those we have sent to war – for the United States government sends our servicemembers to war in the names of all of us citizens – is a wonderful thing. Anyone who has listened to the story of any war veteran who has experienced even one of what I have called the Eight Plagues of War (When Johnny and Jane Come Marching Home: How All of Us Can Help Veterans, MIT Press, 2011) and which include profound grief, terror, shame and guilt, despair, moral and existential confusion and crisis, and loss of innocence, will want to reduce that pain.
If you look, though, at the article about the San Diego center, what you find is unsettling: The researchers wondered what caused war veterans to relive horrific war experiences repeatedly in their dreams. Does it not occur to them that perhaps that very horror and any of the Eight Plagues leads veterans to relive those experiences while they sleep? These are not mentioned. It is unimaginable that people actually working in a military medical center are unaware of these emotional plagues. So what keeps them from naming them and looking head-on at how they lead to the nightmares? Perhaps it is because those in the military are not allowed, as I suggested in my book, to point out that war itself, not some curious, highly specific, chemical reaction in the brain as the researchers in the current article propose, is the source of the trouble. I have learned that some employees of the military and the VA are fearless about naming war as the cause of veterans' emotional pains, but others have been taken to task when have done so. The unpredictably of one's superiors reaction would be intimidating.
These researchers may understandably recognize that they themselves lack the power to stop the wars and are no doubt admirably eager to help ease the suffering they see.
A somewhat less justifiable reason is that they may be so immersed in the medical model, and especially the "psychiatric drugs can cure all" part of it, perhaps also fueled by money from Pharma, that they do not think outside that narrow box.
So what are they investigating? They are looking at a chemical property involved in part of the sleep cycle and want to see about treating it with drugs. Despite the serious harm I have seen come to people because of many different drugs, if the Naval Medical Center researchers discover a way to reduce the veterans' nightmares without causing them still more trouble, then good for them. But it cannot ever be sufficient, because their approach is explicitly symptom treatment.
What is wrong with symptom treatment? Sometimes, though not always, but often when war is the cause of emotional pain, it is important to look at the symptoms as cries for the veteran and those who want to help the veteran to look at what led to the symptoms. As a society, we are quick to say that people who drink to try to forget their troubles should not do so, that they need to look at the problems and figure out what to do about them. With regard to veterans, as every veteran I have listened to has told me, even if alcohol or prescription drugs or illegal drugs suppress some of their symptoms, the problems do not go away, and they often take other, sometimes more dangerous forms. The technical term that therapists use for this is "symptom substitution." Taking a drug does not eradicate the fact that your best friend died in your arms as you carried him to the medic. Veterans need to have us share and help them bear the pain of such memories, and it can help some, just as when any civilian loses someone close to them, talking with others about the person who has died and how desolate one feels can help.
With respect to the emotional consequences of war, what has been shown to help is veterans having the chance to tell their stories, just speak their truth, to a civilian non-therapist who will not ask questions, not make comments, not interpret, not grill the veteran but just listen with respect and without judgment. American civilians are often astounded to learn how rarely a veteran has had the chance to tell their story fully and in this way. And our recent Harvard Kennedy School study showed that veterans from World War II to the present wars were grateful and relieved to have that chance and found it extremely helpful. The brilliant Jonathan Shay, author of Achilles in Vietnam and Odysseus in America, calls this the healing power of the communalization of suffering through the telling of the stories.
Regardless of our politics, all of us civilians have the chance to help end the covering up of the real effects of war by resisting the temptation to believe that studies like the one addressed here will solve veterans' problems, and all of us need to help educate this nation about the fundamental importance of learning what war is really like. That will make us a more responsible citizenry, which can only be healthy for the United States, and it will create environments where civilians have listened to veterans' stories and understood what they have been through, thereby helping breaking down the soul-crushing isolation so many veterans experience.
Every time we look away from the real causes of veterans' suffering and just aim for symptom treatment, every time we manage not to think about what war is really like, we distance ourselves from the torment with which many veterans live, we shove them farther from the rest of us, and we increase their isolation, which makes their pain that much harder to bear.(1)
(1)Those wishing to participate in The Welcome Johnny and Jane Home Project, which is the simple listening session described above, please get in touch with me via the Contact form at whenjohnnyandjanecomemarching.weebly.com You might want first to look at the two short videos on the Home page there. I will look forward to hearing from you.
©2012 by Paula J. Caplan All rights reserved
If you look, though, at the article about the San Diego center, what you find is unsettling: The researchers wondered what caused war veterans to relive horrific war experiences repeatedly in their dreams. Does it not occur to them that perhaps that very horror and any of the Eight Plagues leads veterans to relive those experiences while they sleep? These are not mentioned. It is unimaginable that people actually working in a military medical center are unaware of these emotional plagues. So what keeps them from naming them and looking head-on at how they lead to the nightmares? Perhaps it is because those in the military are not allowed, as I suggested in my book, to point out that war itself, not some curious, highly specific, chemical reaction in the brain as the researchers in the current article propose, is the source of the trouble. I have learned that some employees of the military and the VA are fearless about naming war as the cause of veterans' emotional pains, but others have been taken to task when have done so. The unpredictably of one's superiors reaction would be intimidating.
These researchers may understandably recognize that they themselves lack the power to stop the wars and are no doubt admirably eager to help ease the suffering they see.
A somewhat less justifiable reason is that they may be so immersed in the medical model, and especially the "psychiatric drugs can cure all" part of it, perhaps also fueled by money from Pharma, that they do not think outside that narrow box.
So what are they investigating? They are looking at a chemical property involved in part of the sleep cycle and want to see about treating it with drugs. Despite the serious harm I have seen come to people because of many different drugs, if the Naval Medical Center researchers discover a way to reduce the veterans' nightmares without causing them still more trouble, then good for them. But it cannot ever be sufficient, because their approach is explicitly symptom treatment.
What is wrong with symptom treatment? Sometimes, though not always, but often when war is the cause of emotional pain, it is important to look at the symptoms as cries for the veteran and those who want to help the veteran to look at what led to the symptoms. As a society, we are quick to say that people who drink to try to forget their troubles should not do so, that they need to look at the problems and figure out what to do about them. With regard to veterans, as every veteran I have listened to has told me, even if alcohol or prescription drugs or illegal drugs suppress some of their symptoms, the problems do not go away, and they often take other, sometimes more dangerous forms. The technical term that therapists use for this is "symptom substitution." Taking a drug does not eradicate the fact that your best friend died in your arms as you carried him to the medic. Veterans need to have us share and help them bear the pain of such memories, and it can help some, just as when any civilian loses someone close to them, talking with others about the person who has died and how desolate one feels can help.
With respect to the emotional consequences of war, what has been shown to help is veterans having the chance to tell their stories, just speak their truth, to a civilian non-therapist who will not ask questions, not make comments, not interpret, not grill the veteran but just listen with respect and without judgment. American civilians are often astounded to learn how rarely a veteran has had the chance to tell their story fully and in this way. And our recent Harvard Kennedy School study showed that veterans from World War II to the present wars were grateful and relieved to have that chance and found it extremely helpful. The brilliant Jonathan Shay, author of Achilles in Vietnam and Odysseus in America, calls this the healing power of the communalization of suffering through the telling of the stories.
Regardless of our politics, all of us civilians have the chance to help end the covering up of the real effects of war by resisting the temptation to believe that studies like the one addressed here will solve veterans' problems, and all of us need to help educate this nation about the fundamental importance of learning what war is really like. That will make us a more responsible citizenry, which can only be healthy for the United States, and it will create environments where civilians have listened to veterans' stories and understood what they have been through, thereby helping breaking down the soul-crushing isolation so many veterans experience.
Every time we look away from the real causes of veterans' suffering and just aim for symptom treatment, every time we manage not to think about what war is really like, we distance ourselves from the torment with which many veterans live, we shove them farther from the rest of us, and we increase their isolation, which makes their pain that much harder to bear.(1)
(1)Those wishing to participate in The Welcome Johnny and Jane Home Project, which is the simple listening session described above, please get in touch with me via the Contact form at whenjohnnyandjanecomemarching.weebly.com You might want first to look at the two short videos on the Home page there. I will look forward to hearing from you.
©2012 by Paula J. Caplan All rights reserved
November 11, 2011
Emotional Healing Without Pathologizing or Drugging
Thirty caring, hardworking people from all across the United States gathered at Harvard Kennedy School (HKS) on November 2 for an invitation-only conference about ways to help war veterans and their loved ones heal from war's emotional carnage. One unique feature of the conference was that in every one of the thirty programs, veterans are neither treated across the board as mentally ill nor subjected to the high-risk approach of psychiatric drug use (which these days is so often multiple psychiatric drug use).
Much of what helps war veterans heal also helps others struggling with emotional pain.
The atmosphere in the room of the conference, hosted by the Ash Center for Democratic Governance in HKS, was one of profound caring and respect for those who suffer. The variety of approaches would have been astonishing to those who believe that help for suffering comes only in two varieties: Drugs and psychotherapy.
Given the huge and rising numbers of war veterans who are isolated, homeless, experiencing family breakdown, abusing alcohol or drugs, or committing suicide, it is clear that the vast numbers of therapists in the military and the VA systems, combined with the vast numbers of prescriptions for psychotropic drugs handed out in those systems and in the private sector, are at the very least woefully insufficient.
In a subsequent essay some weeks from now, I will describe the approaches in detail and name the names of the programs. But for today, Veterans Day, what is important to know is that at the conference, speakers described their work, which ranged from the use of the arts to help with healing to the training of service dogs to help bring vets gently out of terrifying flashbacks to various community initiatives to Native American re-entry rituals to training vets to work for nonprofits and many, many more.
A major theme that ran throughout was the irreplaceably important act of listening to veterans' stories of war and attempts to come truly home. The Welcome Johnny and Jane Home Project is a project aimed to have every civilian listen to a veteran's story. This can be done and is being done throughout the country by ordinary citizens who are not therapists. As I have said when people express doubts about whether a non-therapist can help by listening, we used to call it friendship. We used to call it human connection. And one of the few well-established findings in the field of behavioral research is that almost every kind of emotional pain is intensified by isolation.
A study that Heather Milkiewicz and I did at Harvard Kennedy School recently consisted of having civilians listen to veterans who came from every war since World War II, then asking the veterans and the listeners how the session had been for them. The veterans said that it was helpful to them, because they felt safe and had been able to talk about things they had not previously told anyone. (See the second ten-minute video on my whenjohnnyandjanecomemarching.weebly.com home page for a description of how to do the interviews, and it is also briefly described in Chapter 6 of When Johnny and Jane Come Marching Home: How All of Us Can Help Veterans). The civilian listeners were struck by how much they and the veterans had in common, making it clear that most civilians' avoidance of listening to veterans is based partly on the notion that vets and civilians have little or nothing in common. But what they discovered was their common humanity. And the listening sessions reduce the veterans' soul-destroying isolation.
Last week, I heard Lisa Ling say on "The Today Show" that she was doing an episode of her how on Oprah's Network that was about how little the traditional approaches of therapy and drugs are helping veterans. She went on to say that she had been floored to attend a retreat at which yoga was used to help vets, and she bemoaned the fact that there is so little in the way of alternative approaches for veterans. Nothing could be further from the truth, as we saw at the conference, and the importance of everyone learning about what is available is the reason that we are in the process of preparing, with Emmy-winning director Mark Harris, a film about the thirty approaches that were presented there.
For today, Veterans Day, I hope that everyone reading this essay will make a commitment to listening to one veteran's story, if not today, then soon. You will learn invaluable lessons about life, about death, about humankind, and therefore about yourself, and you will bring those lessons into everything you do. Eric Newhouse wrote today about my proposal for a National Day of Listening to Veterans, and he begins my telling the story of one particular veteran at http://www.psychologytoday.com/blog/i...
And a young student in California regularly listens to the stories of vets (http://www.sbsun.com/ci_19310608). Let us all follow this same path.
©2011 by Paula J. Caplan All Rights Reserved
Much of what helps war veterans heal also helps others struggling with emotional pain.
The atmosphere in the room of the conference, hosted by the Ash Center for Democratic Governance in HKS, was one of profound caring and respect for those who suffer. The variety of approaches would have been astonishing to those who believe that help for suffering comes only in two varieties: Drugs and psychotherapy.
Given the huge and rising numbers of war veterans who are isolated, homeless, experiencing family breakdown, abusing alcohol or drugs, or committing suicide, it is clear that the vast numbers of therapists in the military and the VA systems, combined with the vast numbers of prescriptions for psychotropic drugs handed out in those systems and in the private sector, are at the very least woefully insufficient.
In a subsequent essay some weeks from now, I will describe the approaches in detail and name the names of the programs. But for today, Veterans Day, what is important to know is that at the conference, speakers described their work, which ranged from the use of the arts to help with healing to the training of service dogs to help bring vets gently out of terrifying flashbacks to various community initiatives to Native American re-entry rituals to training vets to work for nonprofits and many, many more.
A major theme that ran throughout was the irreplaceably important act of listening to veterans' stories of war and attempts to come truly home. The Welcome Johnny and Jane Home Project is a project aimed to have every civilian listen to a veteran's story. This can be done and is being done throughout the country by ordinary citizens who are not therapists. As I have said when people express doubts about whether a non-therapist can help by listening, we used to call it friendship. We used to call it human connection. And one of the few well-established findings in the field of behavioral research is that almost every kind of emotional pain is intensified by isolation.
A study that Heather Milkiewicz and I did at Harvard Kennedy School recently consisted of having civilians listen to veterans who came from every war since World War II, then asking the veterans and the listeners how the session had been for them. The veterans said that it was helpful to them, because they felt safe and had been able to talk about things they had not previously told anyone. (See the second ten-minute video on my whenjohnnyandjanecomemarching.weebly.com home page for a description of how to do the interviews, and it is also briefly described in Chapter 6 of When Johnny and Jane Come Marching Home: How All of Us Can Help Veterans). The civilian listeners were struck by how much they and the veterans had in common, making it clear that most civilians' avoidance of listening to veterans is based partly on the notion that vets and civilians have little or nothing in common. But what they discovered was their common humanity. And the listening sessions reduce the veterans' soul-destroying isolation.
Last week, I heard Lisa Ling say on "The Today Show" that she was doing an episode of her how on Oprah's Network that was about how little the traditional approaches of therapy and drugs are helping veterans. She went on to say that she had been floored to attend a retreat at which yoga was used to help vets, and she bemoaned the fact that there is so little in the way of alternative approaches for veterans. Nothing could be further from the truth, as we saw at the conference, and the importance of everyone learning about what is available is the reason that we are in the process of preparing, with Emmy-winning director Mark Harris, a film about the thirty approaches that were presented there.
For today, Veterans Day, I hope that everyone reading this essay will make a commitment to listening to one veteran's story, if not today, then soon. You will learn invaluable lessons about life, about death, about humankind, and therefore about yourself, and you will bring those lessons into everything you do. Eric Newhouse wrote today about my proposal for a National Day of Listening to Veterans, and he begins my telling the story of one particular veteran at http://www.psychologytoday.com/blog/i...
And a young student in California regularly listens to the stories of vets (http://www.sbsun.com/ci_19310608). Let us all follow this same path.
©2011 by Paula J. Caplan All Rights Reserved
October 6, 2011
VA Needs to Monitor Its Messages and Practices with Veterans
©Copyright 2011 Paula J. Caplan All rights reserved
You will hardly believe it if you go to this site http://www.armytimes.com/news/2011/10... and look at the picture there.
I lack the technological competence to transfer that photo to here, but do stop reading, go to the site, and then come back.
It's far from April's Fools Day, and in any case this is no joke. The Veterans Affairs Department Medical Center apparently has someone running its gift shop that made the choice to stock a hat with a message that mocks the emotional pain of veterans and implicitly suggests that psychiatric drugs are what they need. Granted, the decision was clearly not made by the top brass at the VA and surely not even submitted for their approval. But the body of the person who placed that order must have icewater in place of blood.
Good for outpatient Tom McCuin, a veteran of the war in Afghanistan, for spotting it, photographing it, and putting it on Facebook and Twitter. But how appalling that in the place where he seeks help for his suffering, he had to encounter that.
The hat is no longer for sale in the gift shop. But veterans continue to suffer, and mockery is one of the last things they need. Another of the last things they need is the knee-jerk use of psychiatric drugs that, as the VA's own top officials have said in their own press releases and as ample evidence has shown, have hurt far more veterans than they have helped. The VA could take the fine work of two of its doctors, David Collier of the Salem, OR, Vet Center and David Kearney of the Seattle VA, and spread their methods throughout the VA system. Dr. Collier has said (I quote him in my book, When Johnny and Jane Come Marching Home: How All of Us Can Help Veterans) that it is not drugs or fancy techniques that have the greatest power to help veterans heal but love. Dr. Kearney uses the gentle, humane approaches of mindfulness and meditation with suffering veterans and has documented that they help them move toward healing.
August 27, 2011
Veterans Affairs Department Fights Court Order to Improve Treatment
©2011 by Paula J. Caplan All rights reserved
Veterans Denied Due Process In Getting Help for Emotional Trauma
More than three months ago, the Ninth Circuit Court of Appeals ordered the Department of Veterans Affairs to overhaul its mental health system, calling it "shameful" and plagued by "egregious delays." At last, veterans thought, they might receive prompt and effective support as they tried to heal from the emotional carnage wrought by war and by the almost unimaginable culture clash between being at war and trying to come home [1].
The court order gave the VA a chance to make a major turnaround; take a good, hard look at what it has been doing that has failed to help and even made many veterans worse; identify those in its system whom veterans described as caring and helpful; try to make the approaches of the latter into its standard; and consider what other, perhaps less traditional approaches they might implement. The Court of Appeals sent the case back to district court so that a plan for providing better care could be devised. This opportunity was especially important in light of the steadily-rising rates of suicide committed by veterans not just of current wars but of earlier ones as well.
Instead, according to a recent New York Times report [2], rather than working with the plaintiffs — the nonprofit groups Veterans United for Truth and Veterans for Common Sense — to come up with a better plan, the VA has chosen to appeal that ruling. This is all the more tragic and mystifying, given that the VA's raison d'etre is surely to assist veterans and given that the court declared that the VA's failure to address veterans' needs constituted an infringement of their constitutional rights, i.e., to receive mental health care and to the timely adjudication of their emotional disability claims.
The court noted that the VA had no suicide prevention officers at any outpatient clinic and that at 70 percent of its locations there was no system to track potentially suicidal patients. Media coverage of veterans suffering from despondency has included alarming stories of those who contacted the VA, said outright — often on repeated occasions — that they wanted to kill themselves, and either received no appointments at all or only many weeks or months in the future or did not even receive a return phone call. Often, these stories are prompted by the fact that these veterans went on to kill themselves while waiting for VA staff to help.
Their ways of dealing with suicidal despair are far from the only major problems in the VA system. [1] For years, its senior officials have acknowledged in their press releases that they try one measure after another to stem the rising tides of substance abuse, family violence, and homelessness. But reports of successful programs are rare. [1] When writing my book about veterans, I was able to identify only two instances of specific programs that seemed to be meeting with success. Those involved the use of mindfulness work and meditation, and in one case, of explicit grappling with the intense and varied, moral conflicts that plague so many vets. [1] There are probably other effective VA programs, but what was striking was the way that, as I tracked the VA's press releases since the start of the United States' war in Afghanistan, those at the top of the VA hierarchy continued to report increases in the manifestations of emotional trauma and other psychological problems.
Recent months have brought reports of the ineffectiveness of psychiatric drugs in treating those with war-caused trauma and of deaths from drug interactions, sometimes interactions between psychiatric drugs and sometimes between those drugs and prescription drugs of other kinds. These reports are particularly disturbing in light of the heavy and increasing use of psychiatric drugs as the primary or only approach to emotional problems for VA patients. [1]
It is hard not to wonder what the top brass at the VA are thinking. Surely they realize that at the very least, their decision to appeal the court order makes them appear unconcerned about providing help for those they are supposed to serve. Bending over backward to give them the benefit of the doubt, we could assume that they have been as taken in as many in the mental health system by the claims of pharmaceutical companies that their products are cure-alls and by the claims of the powers-that-be that psychotherapy is effective for people who have been traumatized by war. It is rare to hear veterans report that psychoactive drugs have been helpful to them, though some do. It is almost as rare to hear veterans say that psychotherapy was the only thing they needed in order to heal, although it is effective for some. Almost invariably, however, those who have moved toward healing have said that connecting with other veterans, connecting with others in the wider community, and becoming involved in activities in which they focus on helping others and/or in creative realms have been helpful.
The VA would far better serve veterans if they dropped their appeal of the court order and instead invested some of their considerable resources in what veterans, rather than Pharma and the traditional mental health community, say they have found salutary. Furthermore, the VA could recognize that it is worth implementing throughout its system the mindfulness, meditation, and moral conflict foci that have been shown to be effective but that few of their staff all ever use. [1]
For now, as the Ninth Circuit Court panel declared, it is shameful that the VA is appealing the court order for it to reduce the suffering of those whom our government has sent to war.
[1] Paula J. Caplan. (2011). When Johnny and Jane Come Marching Home: How All of Us Can Help Veterans. Cambridge, MA: MIT Press.
[2] More excuses and delays from the V.A. (2011). New York Times, August 22.
August 8, 2011
The Silence That Kills: Time to Speak Up about What Veterans Need
I came late to learning what war veterans endure, but in the seven years since I started listening to them and watching how the rest of us respond, I've become aghast at our silence in the face of their pain. As the numbers show, it's a silence that kills. It kills them literally through ever-increasing suicide rates, more vets dying by their own hands than by enemy fire, and it kills their souls and, in little dreamed-of ways, our own. Still worse is the way that the institutions and individuals tasked with helping are actually, eerily promoting that silence that conceals the disorientation, fragmentation, and devastation that many veterans feel.
Two million veterans of the wars in Afghanistan and Iraq now live among us, some of a total of 23 million from all United States wars. And anyone who believes that those from earlier wars, even World War II, no longer suffer from the emotional carnage of war and what for many were the traumas involved in coming home is wrong. The disconnection of most civilians from veterans' pain disconnects us from profoundly important truths about the nature of humanity and connection.
Ninety-three percent of Americans have never even served in the military, and since veterans tend not to tell us what they have gone through, and we tend to avoid knowing, because war is upsetting, and we mistakenly believe that only trained therapists can help. In fact, we mistakenly believe that therapists are taking care of the problem. We long to believe that therapists can undo war's emotional carnage of war, because then the rest of us don't have to think about it.
Americans might be forgiven for believing that government agencies for military personnel and veterans are doing it all, but two recent, major pieces of evidence show that this is not true. The 9th Circuit Court of Appeals recently ordered complete overhaul of the Veterans Affairs' mental health system, calling it "shameful," guilty of "unchecked incompetence," plagued by "egregious" delays. And a new report from the Government Accountability Office shows that its investigators of the Defense Centers of Excellence — created in the wake of the shocking exposé of mental health care (including both neglect and abuse of patients) at Walter Reed Army Hospital — could not determine how or if the DCOE are carrying out their mandate to help war-traumatized veterans or even how their funding is spent.
What to make of the New York Times piece coming hard on the heels of these reports, in which gentle words of laypeople answering the phones at one VA crisis hotline were presented as evidence that something really good is happening in the VA system? These responders, the writer said, tell people how to "get care," which means finding therapists. Although this may seem innocuous, it perpetuates the notion that getting a therapist is all they need. Were that the case, then given the rates at which the military and the VA have hired increasing numbers of therapists during these current wars, the suicide rates would not still be increasing, nor would the rates of homelessness, family breakdown, and substance abuse, all of which continue to rise.
Even well-meaning people who say that civilians should thank veterans for their service show an innocence about what effects that act can have. Some veterans appreciate it, but others have deep emotional and/or moral conflicts about what they did during their service. When simply thanked by someone who has not asked to hear their story, many feel ashamed and distanced, and this is often true of both those who regret some of what they did and those who think they did not do enough (saved three buddies from an IED, but failed to save a fourth).
The silence that we must break is about this indisputable sequence: The military puts new recruits through ten weeks of basic training to prepare them physically and psychologically for combat, immerse them in a rigid hierarchy, engraining close bonding with others and inculcating instantaneous responses designed to defend, attack, and destroy. There follows lengthy, advanced training that is often combat-focused. Then, for so many these days, come from one to a great many deployments to combat zones. When they come home, nothing that the military and Veterans Affairs (VA) offer of retraining for civilian life remotely approaches either the length or intensity of all of that military training.
Very little is known about how to achieve the reorientation and acculturation to the vastly different close relationships and interactions with the wider society that characterize "home" in contrast to those in the military and combat. One Native American practice involves a period of explicit addressing with homebound warriors of the need to decompress and re-enter the very different civilian society of family, friends, and work. But the vast majority of veterans have no set of rituals and discussions remotely approaching this Native American one.
Indeed, who would implement such a practice and break the silence? Those in the military are in the best position to understand what is needed, but for the armed forces and the VA, having to acknowledge explicitly that military training has rendered millions of men and women unfit for civilian life would risk undermining the military system.
As for politicians, no identifiably powerful minority of them currently speaks this truth. Those who support current and past wars are not likely candidates to blow the whistle, and those who oppose either particular wars or war in general risk being called unpatriotic if they speak up.
What about mental health professionals, to whom in this country we tend to turn for the answers to virtually every psychological problem? The common "wisdom" among them, as among most Americans, is that servicemembers who have trouble coming home are mentally ill; that is, their problems come from within them rather than from the vertiginous leap from experiences of maiming, death, loss of innocence, and confrontation with moral and existential conflicts to expectations of them as civilians at home. For therapists to speak out about this massive culture conflict as an explanation for much war-caused suffering would be to acknowledge that what they have to offer may be quite limited. Some therapists like to believe that they can help anyone, and some are deeply motivated but devastated to recognize the limitations on what they can do.
One might expect communities of faith to help unmask this culture conflict. That few such communities have taken on this mantle perhaps reflects, at least in part, their conscious or unconscious feelings of helplessness to effect the changes that would be needed on such a massive scale. Perhaps the same applies to the mental health professions.
It's time for all to break the silence and make this a war-literate nation. One civilian chatting at a cocktail party can take every opportunity to bring up the clash of cultures, to note how difficult it is even for non-military people to become accustomed rapidly to a dramatically different set of customs, goals, and values than those in which they have been immersed. Above all, let us each listen nonjudgmentally to veterans tell their stories as a way to help truly bring them home from war.
July 25, 2011
Psychiatric diagnosis used to call military rape victims “sick”
Just posted at
By Paula J. Caplan, Ph.D. Created Jul 25 2011 - 10:35pm ©2011 by Paula J. Caplan All rights reserved
Sexually assaulted servicewomen labeled mentally ill
Think you'd heard it all? Being sexually assaulted apparently is not enough. The Service Women's Action Network reports that it is receiving reports from women serving in the United States military or attending service academies who, after being sexually assaulted and reporting what happened, are diagnosed almost immediately afterward by military therapists as having personality disorders. [http://groups.yahoo.com/group/GSN/mes...]
This is not a diagnosis that has the slightest relationship to the assault, certainly is not a label applied with the intention of describing a consequence of being raped. A personality disorder is considered to be a lifelong maladaptive organization of the entire personality, so it would have preceded the assault.
Why does this matter? Let me count the ways. First, it takes the focus off the perpetrator, because the victim who is supposedly mentally ill, and, by applying a personality disorder label, takes the focus off the assault and its consequences, placing it instead on the victim's life way before the time of the attack. Readers of my blog know I am no fan of psychiatric diagnosis in general, but if you want to diagnose an assault victim, how about choosing a label that is connected with the effects of assault, reflecting terror, despair, hypervigilance, hopelessness?
This also matters because, as if being assaulted is not enough to have to bear, now the victim has the added burden of being told she is mentally ill, with all of the shame and fearfulness associated with that, and it makes the attack itself seem so diminished in importance that she may wonder if it really happened or at least if she is over-reacting.
Furthermore, personality disorder diagnoses have been used by the military before now to try to get rid of people it no longer wants. In the same way that family members of someone who reports that a relative sexually assaulted them may try to eject the victim rather than deal with confronting and punishing the perpetrator, so some people with power in the military and in military academies want to do the same.
Finally, applying these diagnoses can be a way to ensure that victims do not receive Veterans Affairs benefits for the care they ask for in order to recover from the emotional effects of the assaults, because whatever they are feeling is alleged to be attributable to their alleged personality disorders rather than to what happened to them in the military.
This is the kind of practice of which few Americans are aware, and its existence is a manifestation of what should properly be called some form of sickness that needs eradication.
By Paula J. Caplan, Ph.D. Created Jul 25 2011 - 10:35pm ©2011 by Paula J. Caplan All rights reserved
Sexually assaulted servicewomen labeled mentally ill
Think you'd heard it all? Being sexually assaulted apparently is not enough. The Service Women's Action Network reports that it is receiving reports from women serving in the United States military or attending service academies who, after being sexually assaulted and reporting what happened, are diagnosed almost immediately afterward by military therapists as having personality disorders. [http://groups.yahoo.com/group/GSN/mes...]
This is not a diagnosis that has the slightest relationship to the assault, certainly is not a label applied with the intention of describing a consequence of being raped. A personality disorder is considered to be a lifelong maladaptive organization of the entire personality, so it would have preceded the assault.
Why does this matter? Let me count the ways. First, it takes the focus off the perpetrator, because the victim who is supposedly mentally ill, and, by applying a personality disorder label, takes the focus off the assault and its consequences, placing it instead on the victim's life way before the time of the attack. Readers of my blog know I am no fan of psychiatric diagnosis in general, but if you want to diagnose an assault victim, how about choosing a label that is connected with the effects of assault, reflecting terror, despair, hypervigilance, hopelessness?
This also matters because, as if being assaulted is not enough to have to bear, now the victim has the added burden of being told she is mentally ill, with all of the shame and fearfulness associated with that, and it makes the attack itself seem so diminished in importance that she may wonder if it really happened or at least if she is over-reacting.
Furthermore, personality disorder diagnoses have been used by the military before now to try to get rid of people it no longer wants. In the same way that family members of someone who reports that a relative sexually assaulted them may try to eject the victim rather than deal with confronting and punishing the perpetrator, so some people with power in the military and in military academies want to do the same.
Finally, applying these diagnoses can be a way to ensure that victims do not receive Veterans Affairs benefits for the care they ask for in order to recover from the emotional effects of the assaults, because whatever they are feeling is alleged to be attributable to their alleged personality disorders rather than to what happened to them in the military.
This is the kind of practice of which few Americans are aware, and its existence is a manifestation of what should properly be called some form of sickness that needs eradication.
