Saturday, May 23, 2009

Memorial Day: Post Traumatic Growth Disorder

Three or four times a day I see a story and think, "I should blog about that." Writing requires a measure of solitude, however, and what most hovers around me is usually cacophony. So instead of posts, little mental Post-It notes get written which then stick on each other, pile up and fade into the past. But one of those post-its boomeranged back from a week and a half ago, with personal connection, starting with a soldier going postal on a base in Iraq:
The 44-year-old signals specialist from the 54th Engineering Battalion, based in Bamberg, Germany, was charged with five counts of murder and one count of aggravated assault for Monday's shooting, which killed two military doctors and three soldiers, at a combat stress clinic at Camp Liberty, in Iraq.

Russell had been relieved of his weapon a week earlier, after making some "inappropriate remarks," his fellow soldier said, and he'd been referred to the stress clinic for counseling. But each day, the counselors "sent him back to his base," where Russell complained the doctors were refusing to take his symptoms seriously or give him the medication he thought he needed.

On Monday, the soldier says Russell was being transported back and forth to the mental health clinic by his staff sergeant escort.

After yet another argument at the clinic, he and his escort had just returned to Russell's brigade headquarters. That's when he "assaulted his escort, stole his weapon," and held him at briefly at gunpoint. Russell snatched away the keys for the vehicle, and drove back to the treatment center, where he allegedly opened fire.


The overpowered escort rushed inside to alert his command, and the battalion's physician's assistant immediately called over to the clinic, but it was too late. The call went through "just in time to hear the gun shots."

These "stress clinics" were supposed to be part of the answer, with hundreds of thousands of troops reporting symptoms of post traumatic stress, and the more severe post-traumatic stress disorder.
The clinic Sgt. Russell attacked had denied him medications he repeatedly asked for, and the new treatment he instead received is the brainchild of my wife's ex-fiancee, Major Thomas Jarrett. Shortly before a desperate, enraged vet shot up his clinic, he had this to say to a USA Today reporter:
Jarrett tells soldiers he is "fed up of hearing about" post-traumatic stress. He said he wants to talk of growing from trauma and becoming stronger because of it.
"Thriving through your combat experience" is Jarrett's mantra. All in-theatre personnel are urged to view a 90-minute video of his rap, and those who exhibit signs of PTSD will sometimes be discharged to Camp Victory to attend his "Warrior Resiliency and Thriving" class. That a positivist "Post Traumatic Growth" schtick has been enthusiastically adopted by the military should surprise no one; at this point, sending soldiers into reserve just because they're burned out by years of hunting Haji would mean calling the war off. As to the consequences, only 24 US soldiers committed suicide in the month of January, a militarily acceptable loss rate. Yet something of crucial significance is being obscured in the hokum, and bears a disquieting psychological parallel with a previous catastrophic American failure.

Can it be so bad, really? In a different way, yes it can. When soldiers in the Roman legions broke down and wouldn't fight, their comrades were gathered to watch them beaten to death. When German soldiers on the Eastern Front in World War Two went AWOL ( or eventually, lost their weapons or ate too much food), they were executed. The US military isn't there yet, but in denying unpleasant facts and routinely giving its current and former soldiers the shaft, it has moved decisively in that direction. The Af-Pak war is heating up and troops are going on their 3rd and 4th combat tours. Neither legions nor SS units were asked to do the same, and war's intensity now is much higher, its operations more sustained. Including night operations, historically very rare and now routine. The psychological toll may be worse than anyone wants to admit, and Sgt. Russell represents far more than an unfortunate incident.

Following WWII, clinical psychiatrists analyzed personnel data amassed with the goal of learning how to better maintain combat effectiveness.
Study results were unexpectedly and dramatically clear: all sane soldiers broke down if their combat exposure was longer than 90 days. Correlation between combat and acute breakdown was unpredictable, even curvilinear at first, but the correlation gradually tightened over time to almost 1:1. After 90 days of combat exposure, 98% of soldiers experienced incapacitating breakdown accompanied by lasting psychic distress. The 2% still functioning were psychopaths suffering from full-blown insanity, which combat progressively accentuates.

For the otherwise sane soldiers who came to the end of their ropes,
the term "Post Traumatic Stress Disorder" was coined. Based upon the data, the psychiatrists concluded that warfare had surpassed the ability of human beings to endure it. This insight in hand, the Pentagon soon set out to find a pharmacological means of adapting humans to industrial combat. (For a powerful overview of combat's psychological effects and the US military's generally futile attempts to ameliorate them, see Richard A. Gabriel's 'No More Heroes: Madness and Psychiatry in War.')

When I was a small boy, about 5 years old, I remember meeting a man named Sonny Seeley at a camp picnic. He was commonly referred to as Uncle Seeley, though not any known uncle of mine. He was not a common visitor, and seemed from some far-off branch of the family. As they prepared foods indoors, I heard my grandmother and Aunt Sophie talk about what beautiful letters he had written them during the war, but how when he got home he hardly ever said another thing, what a shame; my impression is his letters were from North Africa. As he sat in the aluminum folding lawn chair in the pleasant sun he didn't venture much, and would stammer what was to me an uninterpretable tremulo when someone came up to greet him or ask a question. His whole body was trembling badly enough to not be able to speak intelligibly. He shook when he sat, his knees shook when he walked all skinny and gangly, like a stick puppet over-tensioned, hunched, unable to un-slack, even 20 years and more after whatever he'd been through.

My grandfather and his brothers hosted that picnic, which may well have been on Memorial Day, and were all in that war in one service or another. They sent their wives to bring Uncle Seeley a plate of hot-buttered steamed clams, rolls and potato salad. They plied him with beer cans glistening from the cooler. While he struggled out his thank-yous and precariously worked to hold his paper plate level, I, being young and relatively free of good judgment, asked him why he was shaking. "Shell-shock," someone said in a deep hushed voice above me. "Go play with the Lawn Darts." Lawn Darts were not yet illegal and would arc meaningfully through the air, proving gravity, stabilized by colorful plastic fins. I don't remember ever seeing Uncle Seeley again, and hope he was able to find some measure of relief.

One of my wife's oldest friends, a social worker in Manhattan, once described Thomas Jarrett as "about the least empathetic person I've ever met, and I meet a lot of people." Jarrett's schtick is a bastardized version of some positivist themes of Albert Ellis, an influential psychotherapist he interned with for one summer in the late 1990s. His application for further work with Ellis was rejected, so he never finished his PhD. He never served in combat, and strongly implies that he did. Jarrett's one more fraud in a Fraud War, passing out candy-coated delusions.

Denial is one survival mechanism for when a truth is too painful to face; delusion is another, for when you're not interested in the truth at all. For when it's hanging by the teeth it embedded in your ass. When you stride about in front of grunts who have made fun of the dead and dish warmed-over dianetics, delusion is your friend. Admittedly, denial and delusion are endemic qualities, possibly even necessary to military life, and often aren't obvious. We're set up that way. Truth is harsh, believing in nonsense comes almost as naturally as the urge to spread it. There's more truth to be found in 5 minutes of myths and fables than an hour of nightly news. Speaking of parallels, folk still commonly blame or take credit for protests at home halting the war in Vietnam, a "stabbed in the back" variant. On the contrary, that war stopped because soldiers were increasingly turning weapons on their superiors, mutiny was in the air and there weren't enough combat-ready units left to conduct field operations. Nearing the end, everybody there was just going through the motions.

Vietnam produced more PTSD victims than any other war in American history, both in total number and frequency, despite the Pentagon's emphasis on instilling the desire to kill into recruits, based again on data from WWII and Korean War which indicated only a small fraction of combat troops actually tried to shoot an individual enemy. In their inevitable post-war analyses, the Pentagon fingered low morale of draftees as the primary fault, resolving to go into their future conflicts strictly with volunteers, ones who remain annoyingly human to this day. To quote Richard Gabriel:
"...war exacts a terrible cost in human emotions quite apart from the usual costs calculated in terms of dollars, dead, and wounded. It is a cost every soldier will pay if he is exposed long enough to the horrors of the battlefield. Weakness or cowardice has nothing to do with the probability that a soldier will collapse under the strain of battle. It is not man that is too weak; it is the conduct of war that imposes too great a strain for the sane to endure."
People think soldiers who break down under the strains of ongoing sleep deprivation, constant threat of ambush, seeing friends get blown apart and killing civilians are weak, defective, or somehow exceptions to the rule. They are the rule, it is a well-measured rule, one denoting a reality which does not mesh well with a politically cynical, inherently paranoid "Long War." If indeed we are in a Long War, rather than squander hard power and soldier well-being as if they were limitless, flushing them down strategically harmless hell-holes, the American people would be better served by leaders who recognize that sending troops on combat patrols and driving over IEDs for years straight dulls their effectiveness. Eight years of tactical Action-Jackson approach has served no military purpose but that of potential enemies, who gauge our exhaustion and impending poverty with glee. Modern war serves money, and Iraq and Afghanistan have so far done horribly even at that.

That's one skeptic's opinion. This is not: what's done abroad comes back home
, and there is no such thing as "thriving through your combat experience." That's either craven or self-delusional bullshit conceived to advance one individual's career. Which it has, and which my wife foresaw. When she heard some years ago that Jarrett was going back into the military as a counselor, she immediately expressed a hunch he was going to damage a lot of people. The kind of damage that, she thought, might provoke one of his patients to kill him.

Naturally, when she told me about the news coverage of an ex's half-baked treatment scheme, I remembered the 20-year veteran sergeant who snapped and went looking for the ludicrous son of a bitch who told him to grin and bear it, killing 5 mental health staffers in the process.
I thought of Uncle Seeley shaking, of grunts sent to Tony Robbins seminars, and of new-fangled fates worse than death.

7 comments:

Bee said...

Jarrett reminds me of the drill sargeant who gets popped by the guy "not quite right in the head" in Full Metal Jacket. I would not be surprised to hear of that happening to him - sounds like an asshole extraordinaire.

The military has, for way too long, outright denied the existence of PTSD, and this guy seems to just be waging another round of denial. Sick.

berensma said...

Bee,

there's actually a lot more debate in the psych community about turning trauma into growth than I'm giving him credit for. Still, if your best friend's head gets blown off and his skull knocks you unconscious, I'm not sure it's smart to try to turn that into "growth." Here's the USA Today story:

http://www.usatoday.com/news/military/2009-03-24-iraqsuicides_N.htm?POE=click-refer

Bee said...

berensma, in that situation you described, I think I would be more worried if the person wasn't at least mildly screwed up afterwards.

MarcLord said...

Bee,

It would've been easy to go all ad hominem on this guy's ass, given the other stories I've heard. We all have our problems, and I definitely have mine, but this guy was a real "winner." He was also never in the Special Forces, as the article strongly implies.

Brother Tim said...

PTSD is one of those BS labels given out by the psychiatric academia to justify their existence.

When a human being witnesses, or commits, atrocities ordered by cowards hunkered down in command bunkers, it would be a 'disorder' if they weren't affected.

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