Today is Armed Forces Day, though surely it’s ‘Unarmed Forces’ Day… soldiers back from war, who ought be celebrated also… treated with decency to mend up psychic wounds they carry… ones who display injuries just as much in need of healing as a shattered arm, loss of hearing, a leg no longer all there. Same symptomatology in many Post-Traumatic Stress Disorder injuries: shattered; loss of; no longer there in the way one once was…
Borrowing an image from welding, PTSD can also be seen this way: One or more strong welds have come undone; not from weakness in the welds or in the metal, but from the angles the strong welds have been bent to… the tonnage of stress-weight placed on the those welds–- far more bow and weight than this ’strongest of metals known to humankind’ can sustain.
The word ’stress’ in this diagnosis, is not what we feel when driving in gridlocked traffic, nor when competing for a job, nor when we have ten kidlettes discharging candy in the back seat. PTSD stress means, among other things, the psyche has been injured in a sustained way by horrific experiences …so that deeply instinctive elements of psyche are overwhelmed or disabled ….as though they never existed, or have become unreliable for us to put full weight on, /or exist only in an unrelieved black set of memories and griefs.
Shaun Mullen, veteran, writes at Kiko’s House:
PTSD SCANDAL GETS WORSE
I went pretty deep the other day in “Exposed: A Silent Epidemic Is Killing Our Iraq & Afghan War Vets” I urge you to read both this article and accompanying think piece on the anatomy of PTSD if you care about the kind of homecoming the emotionally wounded veterans are receiving.
If the sense of anger and frustration I feel didn’t come through, then I wasn’t doing my job. But then neither is Dr. Norma Perez, physician in charge of PTSD program at a medical facility for veterans who told her staff to refrain from diagnosing the disorder because too many veterans were seeking government disability payments for the condition.From a shocking article in the Washington Post:
” ‘Given we are having more and more compensation seeking veterans, I’d like to suggest you refrain from giving a diagnosis of PTSD straight out,’ Norma Perez wrote in a March 20, 2008 e-mail to mental-health specialists and social workers at the Department of Veterans Affairs’ Olin E. Teague Veterans’ Center in Temple, Tex. Instead, she recommended they ‘consider a diagnosis of Adjustment Disorder.’“VA staff members ‘really don’t . . . have time to do the extensive testing that should be done to determine PTSD,’ Perez wrote.”
In case you’re wondering, adjustment disorder is a less severe reaction to stress than PTSD. Adjustment disorder has a shorter duration, hence is ‘easier’ and cheaper to treat.
Might I add there is a special place in hell for doctors who violate the Hippocratic Oath to save not tortured souls, but money.
This stunning memo from Dr. Perez, seeming to aim to ‘fix’ diagnoses the way horse races are ‘fixed’ in order to keep money in ‘fixer’s’ own pocket, suggests PTSD diagnosis be ‘downgraded’ to “Adjustment Reaction.”
In my experience as a shrink these past three-plus decades, Adjustment Reaction is a diagnosis for a child suddenly changing schools and having a hard time. Adjustment Reaction is a diagnosis belonging to a person going through a garden-variety, uncontested divorce.
Adjustment Reaction is not a diagnosis for men and women who have been to war, and who suffered serious ongoing or sudden trauma. Perhaps most telling in this shell game of diagnoses, treatment for diagnosis of Adjustment Reaction is most often not covered by insurance.
This means, injured vets of this war, would be thrown down into the same trench dug for previous vets, wherein government whistles and pretends agent orange exposure, for instance, is a figment of imagination, instead of a serious incremental illness. This means vets would be encumbered to pay for much needed medical help, from their own meager funds. This means vets will be left on their own -–for life– to deal with catastrophic injuries suffered while in employ of their own government.
Can a person, any person, feign PTSD? Yes, of course. There are scammers of welfare, there are scammers for Social Security benefits, people who are actually fit but lazy. However, most are not scammers. Our soldiers didn’t just slip in an aisle of the grocery store and become disabled. They went to war, a fighting, shooting, deadly war. They managed to come home.
Not all vets with PTSD are invisible to us: those men you see wandering on the streets in their cammies after their war service, they were no scammers either. If anything, the military system A.W., after war, has scammed many of them out of righteous and timely effective treatments for their most serious war wounds long ago.
Some observers might say, Yes, but they’re drug addicts and alcoholics. I’d say, Yes, many are. Now.
Given their lack of a required and timely medical care upon return from deployments, in many ways, since these soldiers didn’t have best medicine, they’ve been primed to settle for the poorest.
Even now, after so long, were they offered good medicine, solid compassionate treatment, many street soldiers might not accept it. Daily i.v. drip of cheap anesthesia can seem enough. To their minds, others on the street often understand more and better than any cleaner, better-dressed, well-fed outsider.
Too, a most poignant feature of severe PTSD is prevalent in the men who wander: they no longer have consistent touch with a core self. They might try but then refuse help, because the spirit and soul of the soldier is in some way still on duty, back on the Mekong delta or outside of Baghdad, or still in some way, marching NPD, Night Perimeter Defense… to keep all of us and their buds safe from harm.
A fine welder does not throw broken welded metal onto the slag heap, and especially does not re-deploy it back into use, pretending OSHA made up its hazards and safety rules just for the heck of it. The rules about fatigued materials, even at the level of OSHA, are about preserving health and saving lives.
A fine welder repairs the welds that have come undone, often cleaning out most the old material and replacing it with new material that can and will hold well… there’s often a phase too, of ‘letting the metal rest’… but assuredly never again bending the strong metals under extreme pressures which are already well known to break the strongest welds.
The military arm of our government ought have no lesser standards, no less ethos.