# Post Traumatic Stress Disorder



## Radop (26 Feb 2005)

A lot of friends that I have served overseas with are suffering from or have been released because of PSTD.  Rwanda, Somolia and Afghanistan seem to be the biggest causes of the stress.  Rwanda and Somolia personnel are now at least in their 10 or higher years of service.  Has the military done enough for these soldiers?  Too Little?  Too Much?

Please leave people's names out of this form.


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## Gunner (26 Feb 2005)

RadOp, I don't like your question because it doesn't matter where you do your tour, its what events you experience that may cause a reaction.  A soldier could have gone through a tour of Rwanda/Bosnia/Croatia just fine whereas on an earlier tour in Cyprus, while he was drinking beer and sunning himself on a beach, he could have witnessed/observed/experienced an event that could cause PTSD.  

My personnel feeling is PTSD is being used as a catch all for any problems/ailments/performance/family stress experienced by a soldier who has served overseas.  I have no doubt that some have actual PTSD but they are not always the ones taking advantage of the what the system provides. 

As far as the military supporting these soldiers, I think the military system was ineffective in the early 90s as the CF system of support was broken through lack of experience and knowledge.  Now I think we have swung hard the other way with the system bending over backwards to anyone who walks through the door.

My 2 cents.


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## KevinB (26 Feb 2005)

FWIW - I think the Croatian portion of UNPROFOR shoudl have been included for IIRC that has actually claimed the largest percentage of PTSD case.

 As for Cyprus I had to kill someone there - surprised eh? so was I, a young 23yr soldier with not much on my mind but beer and tits - I wont go into the meet of the story here but it caused me some problems mentally later on.

 The biggest problem I think we have is that we as the CF do not go into the mindset deep enough, in creating warriors - look at some problems 3VP troops have had from Op Apollo.  The upcomign tour 3VP's chain of command had recognised it and is getting Col Grossman (USA) to come in and do his bulletproof mind seminar - which IMHO is excellent.


I still think the CF as a whole does not understand the factor that can cause PTSD and do not do enough to prepare the troop mentally, nor effectively debrief.

YMMV


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## Gunner (26 Feb 2005)

> I still think the CF as a whole does not understand the factor that can cause PTSD and do not do enough to prepare the troop mentally, nor effectively debrief.



Kevin, that is an excellent comment and I fully endorse it.  We have done alot to provide services to soldiers who suffer from PTSD but we haven't done much to mitigate why it develops.

Echo your comments on LCol Grossman.  He is an excellent motivational speaker and his book "on killing" is an excellent read for professional soldiers.


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## KevinB (26 Feb 2005)

His new one "On Combat" is a MUST read.

I also must admit (prior to Infanteer coming in and pointing it out) being a Grossman junkie.  My girlfirend swiped On Combat from me after reading it over my shoudler...  She's a medic but I guess I cant hold that aginst her  ;D


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## Scoobie Newbie (26 Feb 2005)

What's his first name?  I can't find his book online.


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## the 48th regulator (26 Feb 2005)

A group that I found fantastic, that has stuck by my side with mountains of advice can be found at this link;

http://osiss.ca/engraph/home_e.asp?pg=1

It took me ten years to finally admit I may have changed.   Many Many people over the years tried to help.   I have to say though, I did NOT get much help from the military with this until just recently.   So I do not have a favourable opinion about support in that respect.   However, through a former RSM, our Padre, and OSIS I finally did something and got the ball rolling VA has arranged for me to see a doctor (one at the forefront of treating this for members of military which are suffering) , and talk about my feelings.

As a catch all, yep I used to say that too, as I saw a lot of that happening, meanwhile people who truly felt they suffered were denied.   But I would want to be careful of that statement, because as I said I always was the one to pipe up _"Hey look at what I went through you don't see me whining!! Those guys who say they suffer are either weak or faking!!"_. Well, I just didn't want to admit I was one of them.

any way, I agree you should add Croatia...all of the tours saw things that had effects on us.

tess


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## Gunner (26 Feb 2005)

> What's his first name?  I can't find his book online.



David Grossman.  Click on the link below to go to amazon.ca

http://www.amazon.ca/exec/obidos/AS...60730/sr=2-1/ref=sr_2_3_1/701-6869029-3792326

He has spoken a couple of times in Edmonton and if you have an opportunity to hear him speak, it is well worthwhile.


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## Scoobie Newbie (26 Feb 2005)

Well hopefully he makes his rounds to Manitoba.


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## Scoobie Newbie (26 Feb 2005)

P.S.  Thanks for the link.


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## Scoobie Newbie (26 Feb 2005)

Is his book "On Killing:The Psychological Cost of Learning to Kill in War & Society" the same as his book "On Killing"?

http://www.chapters.indigo.ca/default.asp?Ntt=Dave+Grossman&Section=books&Catalog=books&Lang=en&zxac=1


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## Radop (27 Feb 2005)

Gunner said:
			
		

> RadOp, I don't like your question because it doesn't matter where you do your tour, its what events you experience that may cause a reaction.   A soldier could have gone through a tour of Rwanda/Bosnia/Croatia just fine whereas on an earlier tour in Cyprus, while he was drinking beer and sunning himself on a beach, he could have witnessed/observed/experienced an event that could cause PTSD.
> 
> My personnel feeling is PTSD is being used as a catch all for any problems/ailments/performance/family stress experienced by a soldier who has served overseas.   I have no doubt that some have actual PTSD but they are not always the ones taking advantage of the what the system provides.
> 
> As far as the military supporting these soldiers, I think the military system was ineffective in the early 90s as the CF system of support was broken through lack of experience and knowledge.   Now I think we have swung hard the other way with the system bending over backwards to anyone who walks through the door.


I just felt like discussing a topic that is often avoided.  Different people will react to the same stimulus different and one may come away with PSTD.  It could also catch up to the person 10 yrs down the road when they see something on tv.  I saw the video they put out for rwanda on the stress related to overseas tours.  I was far more stressed from that than the tour itself because of all the things discussed in a 30 min video, we experienced in a 6 mos tour.  I agree with most of your comments but it seams like some get help but others dont.  Funny how a WO will tell one of his soldiers to suck it up but a month later he gets put on SPHL.


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## Art Johnson (27 Feb 2005)

A very interesting string but the subject goes much deeper than anything that can be covered here. It is not that long ago that soldiers were put up against the wall and shot for what we now refer to as PTSD. I recall an incident where we had a chap go out under escort for evaluation, he came back, one of the escorts didn't he was sent home as S5.
Tess and I are in somewhat of a similar situation in that we were both seriously wounded. For me things began to catch up to me about five or six years ago, I went for the best part of fifty years before things started to bother me. Now the least little sudden bit of noise and I just about jump out of my skin. I don't get upset about the people I have killed but it really bothers me now about
my buddies who were killed.

Pro Patria

Aye Dileas


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## old medic (27 Feb 2005)

As a side bar note to this topic,

I have created a Mental Health header in the medical index and placed a couple of initial links under it.
If anyone has any other favourite ptsd resources, post it here or pm me and we'll make a list of resources.


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## Radop (27 Feb 2005)

Art Johnson said:
			
		

> A very interesting string but the subject goes much deeper than anything that can be covered here. It is not that long ago that soldiers were put up against the wall and shot for what we now refer to as PTSD. I recall an incident where we had a chap go out under escort for evaluation, he came back, one of the escorts didn't he was sent home as S5.



http://home.cogeco.ca/~cdnsad/

This is the link to the Canadians Shot at Dawn site.  Very disturbing reading on how many were killed just to set an example.  Most were killed by the British without consulting our governmet at all.


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## KevinB (27 Feb 2005)

FWIW - I beleive that 3VP is having Col Grossman over to do his Bulletproof Mind seminar prior to their redeployment to Afghanistan this year.


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## Art Johnson (27 Feb 2005)

An interesting read on this subject is "The Cream of the Crop" by Allan English it is full of statistical information and quotes from reports as far back as WW I. Not an easy read but it does deal with the subject matter of this string and how it was handled by the RCAF during WW II.


"The Cream of the Crop is the first comprehensive account of the Royal Canadian Air Force's (RCAF) selection and training procedures and its policies governing aviators who were considered unsuited for operational duties, especially those judged to have a "lack of moral fibre" (LMF). Allan English assesses the effectiveness of RCAF use of manpower and questions whether the aircrew really were, as the RCAF alleged, the cream of the nation's crop. 

English describes the development of a uniquely Canadian selection system that attempted to match the aptitudes of aircrew candidates to the duties they would perform and the evolution of the RCAF's training program from a haphazard system with enormous attrition to one that became the model for many modern systems. He traces the development of aviation psychology and the treatment of psychological casualties of air combat. English pays particular attention to the LMF controversy and the RCAF's response as well as the effect of morale and leadership on the psychological well-being of, and casualty rates among, Royal Air Force and RCAF bomber squadrons.

In exploring the human dimension of air warfare, an issue that has been widely overlooked in military literature, English demonstrates that personnel considerations have at least as much influence on the effectiveness of air forces as material and technological factors."


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## medicineman (1 Mar 2005)

Funny KevinB should mention Cyprus - one of my first encounters with PTSD came from someone who had been there in '74 when the Turks invaded.

MM


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## Radop (3 Mar 2005)

We had people come down with it in the Golan were the biggest threat was the fall off your bar stool.  I guess I am more critical because I did Rwanda as my first tour and saw Golan as a reward for the job I had done in Kingston.  We considered it the sigs club med.  No Methoquin, no one firing at you, leave camp when you want and no restriction on alcohol.  There were people there complaining about having two to a room yet in Rwanda, we had as little as 27 to as many as 35 in our room.  Our personal space was the width of a barrack box by the length of a cot.  I would have liked to see how they liked that.

Afghanistan on the other hand was full of new people on their first tours with a bunch of people who had multiple tours.  I think they got influenced by us who had lived in pretty poor conditions.  We thought we had it good but as my quote at the bottom, people still complained about the living conditions of the camp.


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## medicineman (4 Mar 2005)

Kind of goes back to being mentally prepared for what you're going into - be it worst case scenario or reality as it is.  A lot of people don't seem to have the mind set they need when they go to some of these places - being able to stand back and realize they are in a bad place with bad things happening around them and getting on with things.  It also doesn't help that some things tend to be "sterilized" as it were either - the press or the government either ignoring what's happening or failing to mention important events (witness Medak for instance) that tends to trivialize things for the personnel when they get home.  So when people who are trying to vent bring up that they were in a shooting war, others (who weren't there) look at them with that four headed alien look of "yeah, whatever...".  I think (hope) that things are changing in that regard; actions tend to be acknowledged more now and the public seem (a little bit) more informed that we are in fact soldiers and not just heavily armed cops.  All that adds up - a good example of that comes from Vietnam vets, who were by and larged shunned by the American public as the visible scapegoats for the war.

A couple of pennies in the hat.

MM


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## Radop (5 Mar 2005)

well said MM.  I think as well that the general public has taken a more active role in what we do as a military.  As little as 5 yrs ago, I think a lot of people didn't care about our military.  911 changed all that and people realized that we do have a real role to play in Canada and abroad.  If we are a joke as an army how can the rest of the world take us serious as a nation.  With more interest in the military, comes more exposure to how the military treats it soldiers who return home from peacekeeping/enforcing/making or war.  The military had to adjust and not just tell their soldiers to suck it up and soldier on!

Maybe the press isn't so bad ther Col Lebay (I know Spelling)


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## Infanteer (5 Mar 2005)

I think this topic has the potential to be good being that we have some members who have dealt with this matter personally.

Seeing how it is a Forces wide phenomenon, I'm moving it to the general forum.  I'm taking down the poll however, as it isn't really critical to the discussion, it may prove to be a distraction with people squabbling over which mission was "harder" and, as Gunner pointed out, PTSD is a problem we have to deal with on any operation.


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## the 48th regulator (5 Mar 2005)

Right on Infanteer.

This is definitely a topic that has to be seen, discussed, recognized, and helped.

The old proverbial "Patton Slap" still exists as an attitude in our Military, I know, I did it myself.

tess


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## Art Johnson (6 Mar 2005)

Tess tell me it isn't so. I have taken the odd guy behind the barracks and talked to him but have not had to resort to physical violence.

I was at an NCO School in Korea, I had allready been through two of them in Canada, but this school was run by a bunch of clowns. I believe I lasted all of two weeks when I asked for a RTU. The Adjutant and the CO wanted to know why so I told them. That night one of the Camp Staff came to me and said that one of the instructors wanted to see me behind the tent lines. When I arrived the instructor and some of his buddies were there waiting for me. At the time i hadn't noticed that a chap by name of Corcoran of the Royal Welch Fusiliers had followed me out. The instructor told me what he thought of me and I replied in kind. He thensaid take a swing at me and I replied "You invited me out here you take the first swing then I will kick the shit out of you." that was the end of the situation. This chap Corcoran seem to me to be such a quiet unassuming person  he didn't seem he would say boo. I found out later that he kicked the shit out of three Patricias in nothing flat. My point is be damn careful who you invite outside.


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## the 48th regulator (6 Mar 2005)

More in the sense of the verbal slap as opposed to the Physical.

Hey I have done it.  Look around the forces, or even on forums like this and you Will hear of people talking about how some guy uses it as an excuse to get a pension.  No doubt there are some that do use the ptsd as a way to get a bit of gravy, but if they want to go through all the bs of the red tape, have at 'er.

I know of the shite I have had to deal with regarding my physical jazz and the DVA, and I look at the new mountain I have to climb regarding the disorder, and you know what?  I want to say eff that....I am happy where I am at and don't want to deal with all of the explaining, tests, third degree etc etc. 

And who suffers, me, my family, and any other troop that is going through it as well.

Lead by Example. . . . .the 4th principle of leadership according to the little card issued to me....Should I lead the example and seek help, so that not only I find the help, but others will follow with their challenges...

Or should we just criticize the cheaters, scare the suffering, and kid ourselves that all is ok and the system does not fail us, as they are getting better at recognizing and treating this disorder for us.

Dunno, just my late night rant...

Dileas

tess


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## Art Johnson (7 Mar 2005)

Tess you and I have spoke about this before, don't let the BASTARDS grind you down. I'll get back to you.

Aye Dileas


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## pipesnake (8 Mar 2005)

The nearest I got to combat was Oka, (Mercier Bridge Montreal to be specific), and taking a few rounds of friendly fire around me during some live fire training. I have no issues of PTSD. 

I did face some other issues when I got out however. Particularly two things which I have never really spoken about and I have no idea why I feel the need to right now. 

One, I felt very guilty about seeing my friends going to Somalia and Bosnia without me being there with them. I felt like I let them down. This took some time to get over and I still have those feelings to this day from time to time. 

Secondly I was not well adjusted to civilian life when I left the infantry. I went to college. I didn't start to speak to people there for several months. I had an attitude that I was better than them. That they didn't deserve my respect. I was young and arrogant. I still had the very aggressive tendencies that are developed as an infantry soldier. I took me a long time to adjust and once again become normally social. I don't think the army does a good job in preparing young infantry soldiers for release to the general public. It's somewhat akin to setting the wolves among the sheep.


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## Radop (12 Mar 2005)

pipesnake said:
			
		

> One, I felt very guilty about seeing my friends going to Somalia and Bosnia without me being there with them. I felt like I let them down. This took some time to get over and I still have those feelings to this day from time to time.
> 
> Secondly I was not well adjusted to civilian life when I left the infantry. I went to college. I didn't start to speak to people there for several months. I had an attitude that I was better than them. That they didn't deserve my respect. I was young and arrogant. I still had the very aggressive tendencies that are developed as an infantry soldier. I took me a long time to adjust and once again become normally social. I don't think the army does a good job in preparing young infantry soldiers for release to the general public. It's somewhat akin to setting the wolves among the sheep.



I know when I was in the infantry, I wanted to do everything with the people in my platoon.  We went to movies together and out for coffee, etc.  I think that feeling a loss when your comrades go away without you, especially into harms way is a natural reaction.

I believe your second point is why the military has started allowing soldiers who plan to release whether getting out after 1st, 2nd BE or during their IE can go to the SCAN sessions.


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## Veterans son (12 Mar 2005)

Radop

Thank you for starting this topic.
As someone who has never been in the CF(let alone been on tour),
the topic helps me try to appreciate the stress CF personnel
go through on tour.
I can never really understand(having never served)but thank you
to those who served/are serving in the CF.

My father was a double veteran(WW2 and Korea).
What sort of support services were available to those
returning from war?

Thank you to Mr. Johnson ,Tess and others who have contributed
to this topic! 

Sincerely,
Mike
whose father served with the RCE in WW2 and the Korean War


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## Art Johnson (12 Mar 2005)

It is difficult to reconcile today's Army and DVA to that which existed after WW II and Korea. At that time we still had large Veterans hospitals. Sunnybrook in North York had one block, "D", dedicated to what were refered to as sycho cases. PSTD was more or less described as Shell Shock. The treatments were varied particularly for those who were extremely disfigured. Shortly after I left Sunnybrook a young chap who had served with The RCR in Italy committed suicide, he had lost most of his face and had been in Sunnybrook for about 10 years undergoing facial reconstuction and councilling but finally gave up the fight.
Another chap from The RCR worked in the limb factory he had had his lower jaw shot away and always wore a thick bandage around where his jaw would have been. He was fortunate that he had a loving wife to help him survive.


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## Veterans son (13 Mar 2005)

Thank you for your reply, Mr. Johnson!
This is an important topic to discuss, in my opinion!


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## the 48th regulator (13 Mar 2005)

Hi Veterans son

This may help you and your father, I know that the Scarborough Office of the V.A, handles many Vets from WW2 and Korea for PTSD.  They use and excellent Doctor that specializes in this disorder for soldiers of that time period.

Maybe you should contact that office, if you live inthe east edn of Toronto, that is.

tess


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## Veterans son (13 Mar 2005)

Hello Tess

Thanks for your reply!
Sadly, my father passed away 3.5 years ago.
Dad never talked much about his service in WW2 and Korea.
I was just wondering what sort of counselling was available for
those veterans who had PTSD. 
 I don't believe that my father had PTSD though.

Thank you again for your reply and your contributions to this
important topic! 

Sincerely,
Mike


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## medicineman (14 Mar 2005)

It's sad to say, but the Canadian Army hasn't really dealt well with mental health problems up until recently.  One just needs to delve back into history - the First World War was a real eye opener for many and it took until nearly the end of it for "shell shock" and other terms to not be viewed as cowardice.  Lessons learned - well they were and then filed in Drawer 13 in time for the Second World War, when all those lessons had to be revisited and relearned.  Again, it took awhile.  Korea  - haven't a clue about, as I haven't seen any literature about that.  Other conflicts and ops Canada has been involved in, I've either experienced some or seen the results of.  Even in the last 10 years there's been a big change, though there was a time when it was changing, then became something that went by the wayside either for lack of funding, knowledge or GAFF.  Now it's more of  a priority.  As far as counselling, I doubt there was much counselling for any of the folks that came back from those conflicts.  I know my late grandfather, who fought in France and Burma/India in the Second World War was affected by some of what he saw.  He'd talk about an awful lot, even tell you he had killed a few people, but would clam up about certain things, like liberating POW camps in Burma.  At that time, things like that were things you saw and then just dealt with by yourself and/or took out on others.  

MM


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## the 48th regulator (14 Mar 2005)

> C B C . C A     N e w s     -     F u l l     S t o r y :
> --------------------------------------------------------------------------------
> 
> 
> ...




Hmm the Government has finally decided to take a step forward.  Hopefully this will be in time for when our next generations serves (Sarcasm) 

At least it is a step in the right direction.

tess


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## T.S.Rea (17 Mar 2005)

An important point that should be raised concerning the issue of PTSD is that a critical component of treatment for condition must come from the people you serve with.

I have no doubt a general condition called PTSD exists, some events or similar patterns of events causing some acutely imbalanced patterns of neuron firing in the old grey matter.  It is no different than any other type of injury.  Accept it, respect it, deal with it.

However, putting unthinking faith into the psychiatric profession to provide a full solution is asking for trouble.  Psychiatry is an industry like any other with thousands of career-oriented professionals and a multi-billion dollar pharmaceutical industry behind it.  Much of the posts in this forum lament the state of our armed forces and how screwy much of it is, psychiatry is no less screwed up.  As like the military, many don't give a ..., many don't have the time or skill to do much, and most dangerous of all are those that have convinced themselves of their own competence and are quite willing to prove it at your expense.  I have been the unfortunate victim of this profession, and could offer a hundred stories of the appalling stupidity of the 'experts' in the field along with a dearth of credible third-party cross-verification.  When you read '1 in 5 soldiers' or '$222 million in grants', remember the Mobile Grave System, Dieppe, etc., and who is directly gaining from it.

Studying military history aids in the development of soldiering skills, but it will never make anyone the infallible expert on the subject.  If you were given a new bit of kit, say the new XC-2151 Proton-Laser Death Atomizer, it does not hurt to understand a little or a lot about its inner workings, but ultimately you and the members of your unit have to figure out how best to use it.  The success or failure of it depends on what you do with the knowledge you have, only a modest portion of that knowledge (along with erroneous information) comes from the scientist that built the damn thing, and most of the useful knowledge will come from a range of people directly or indirectly involved with it.

Serious stuff, you earthly existence is not blessed, and life is far too short.


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## PPCLI Guy (17 Mar 2005)

Can a doc type tell me the technical difference between Critical Stress Reaction and PTSD?  I feel that we may be over-diagnosing...

Dave


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## pbi (18 Mar 2005)

Dave: While we await for the doctor to get here, here is my take. CSR is much more immediate and usually short-term. It will be experienced by a far greater proportion of people exposed to an incident-almost all of us will show some aspects of it. But, for most us, it will pass. (Grossman talked to us about this at the PPCLI LS this week). PTSD, as I understand it, develops later, after the incident(s) and after CSR. Only a relatively small percentage of those exposed will develop it, although there is some evidence that there are both indicators for vulnerabiilty and good ways to reduce the chances of developing it. It is not just a temporary "reaction": it is a "disorder". I stand to be corrected on all of this.

Cheers.


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## PPCLI Guy (18 Mar 2005)

Pbi - yeah, thats what I tohought the difference was. I still have this nagging feeling that we are too quick to diagnose PTSD - and I am in no way denigrating the concept of the disorder, the requirement (indeed moral imperative) to treat it, nor those who suffer from it.


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## alfie (17 May 2007)

I have been experiencing some PTSD effects lately, been out over 25 years now. Noticed some help available guessing through Vet Affairs?


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## the 48th regulator (17 May 2007)

There sure is Brother.

The first place to start is here

http://www.osiss.ca/

They will guide you in every aspect.  Do not be troubled in the fact that it is government sponsored.  All peer support staff is drawn from former soldiers, that have gone through what you are.

Trust me, they can help, and I am also available to answer any questions.  PM if that makes you feel comfortable

dileas

tess


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## alfie (17 May 2007)

Thanks for the link, I will pm if I can't find what I need


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## the 48th regulator (17 May 2007)

Alfie,

They helped me in my time of need, and they will do the work to help you.

Again, I am here if you have any questions brother.

dileas

tess


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## tannerthehammer (10 Jun 2007)

I think everyone who goes on tour comes away with some sort of PTSD, but some have it to a lesser or greater degree...We had a guy just come back from A-Stan and I was chatting with him about about his time away while we were on a ruckmarch and I got a sense that it affected him as it seemed like he didn't really want to talk about it...

I remember being at a recent ceremony where he was presented with a plaque from our unit and the CO talked about how his gun was the only one in the battery that had a direct hit on a Taliban vehicle and after he stopped talking everyone clapped...I understand why we are over there and that we have a job to do but it really struck me when I heard people clapping to the fact that people had died, even if they are the enemy...


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## 2018 (14 Jun 2007)

Well said, tanner. A-Stan and many places before that present us with crazy situations that training doesn't match. We all come away affected in one way or another. The best hope is that the affect is a positive one, not regrets, ill health or other bad effects. Thankfully, as seen above, there is lots of aid for those that need it.


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## Red 6 (14 Jun 2007)

I wouldn't say everyone that serves in combat gets PTSD, but I believe everyone who serves in combat is affected by it in some way.


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## Armymedic (14 Jun 2007)

I concur with Red 6's comment.

Not everyone gets diagnosable PTSD, in fact much less common then you would think. Every single one of us though endures significant stress when put into that life or death situation. How we deal with it afterwards makes a huge difference. SOme enjoy the "rush" of combat, others rather not admit they just took another persons life. 

And just because PTSD is the military mental affliction d'jour, does not mean you will get it. People deal with death and dying all the time. Not every single instance does someone come away with PTSD.

If we did not hinge a financial reward to the diagnosis and worried more about detection and proper treatment, I believe that it would not have become a popular excuse it has become.


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## the 48th regulator (14 Jun 2007)

St. Micheals Medical Team said:
			
		

> I concur with Red 6's comment.
> 
> Not everyone gets diagnosable PTSD, in fact much less common then you would think. Every single one of us though endures significant stress when put into that life or death situation. How we deal with it afterwards makes a huge difference. SOme enjoy the "rush" of combat, others rather not admit they just took another persons life.
> 
> ...





Trauma of any sort is the cause; however it is the follow up treatment of the soldier that exacerbates or helps to heal the Syndrome in people.

PTSD, is not some communicable disease that someone picks up, it is how your mind handles a situation.  Treatment, however, be it a talk or downright therapy is needed to help the soldier, so that he may be integrated into the military back to the level he was before the trauma.

dileas

tess


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## Armymedic (14 Jun 2007)

the 48th regulator said:
			
		

> Trauma of any sort is the cause; however it is the follow up treatment of the soldier that exacerbates or helps to heal the Syndrome in people.



Not entirely true on both counts. 

1. It is the experience of extreme stressful situations which have made your mind push your body to invoke the "flight or fight" response, usually but not exclusively events which may involve the person to believe that their life or some one else very proximal, live is in real or perceived danger. It is the physiological response that imprints the memories/event recall that are so common to PTSD suffers.

2. Preconditioning thru training and the knowledge of peer and family support prior to the event has been noted to reduce the cases of PTSD in cbt veterans. 

If your statement was 100% correct, then each and every soldier wounded, or close to the the cbt deaths in Afghanistan would have PTSD. This is definately not the case.


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## the 48th regulator (14 Jun 2007)

St. Micheals Medical Team said:
			
		

> Not entirely true on both counts.
> 
> 1. It is the experience of extreme stressful situations which have made your mind push your body to invoke the "flight or fight" response, usually but not exclusively events which may involve the person to believe that their life or some one else very proximal, live is in real or perceived danger. It is the physiological response that imprints the memories/event recall that are so common to PTSD suffers.
> 
> ...



Alright,

I will print this up and let my doctor know in our next session.

Boy, has she got it all wrong....

So the follow up from the military, has no effect what so ever in helping the soldier?  The time decompressing, interviews and such?

dileas

tess


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## Armymedic (14 Jun 2007)

Perhaps she does...

Medicine is not an absolute, and understanding mental illness....

But I ask: Why, by percentage, do persons in support trades (in US and Cdn militaries) report higher incedences of PTSD then do cbt arms soldiers?


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## the 48th regulator (14 Jun 2007)

St. Micheals Medical Team said:
			
		

> Perhaps she does...
> 
> Medicine is not an absolute, and understanding mental illness....
> 
> But I ask: Why, by percentage, do persons in support trades (in US and Cdn militaries) report higher incedences of PTSD then do cbt arms soldiers?



Don't know, are there detailed facts on these statistics?

dileas

tess


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## GAP (14 Jun 2007)

St. Micheals Medical Team said:
			
		

> Perhaps she does...
> 
> Medicine is not an absolute, and understanding mental illness....
> 
> But I ask: Why, by percentage, do persons in support trades (in US and Cdn militaries) report higher incedences of PTSD then do cbt arms soldiers?



I would suggest one factor. 

What is the most common thing for a cbt arms soldier to do after contact and things have settled down......talk, talk, talk, they describe every step of everything that happened from their POV, and it goes around and around....Black humor, jokes, teasing, it is all part of talk...


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## Roy Harding (14 Jun 2007)

St. Micheals Medical Team said:
			
		

> ...
> 
> But I ask: Why, by percentage, do persons in support trades (in US and Cdn militaries) report higher incedences of PTSD then do cbt arms soldiers?



Just an uneducated guess on my part (but _somewhat_ informed, as I was both Inf and CSS in my career) - it's the Regimental system.  Cbt Arms soldiers "belong" to something - a large family if you will.  A Regiment is there for them, complete with members who understand (approximately) what they are going through.  CSS soldiers, on the other hand, are pretty much on their own.

I'd be interested in seeing the stats reflecting a breakdown of those current CSS soldiers who still belong to a Regimental structure (I'm thinking RCEME here), and those that don't.  I'd also be interested in the comparisons between today's CSS soldier and those who (at one time) belonged to "Regimental Families" - I'm thinking RCASC, here.


Roy


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## Red 6 (14 Jun 2007)

We need to be clear about the difference between combat stress and post-traumatic stress syndrome. It takes time, sometimes a long time, to sort your way through the memories of what you lived through in combat. It's always struck me (since my retirement anyway) how much support you get preparing for war in the US Army but the "After" is pretty much yours to figure out for better or worse. My hat's off to any man or woman who wears the uniform , esecially those who serve on the sharp end of the spear in war. 

This is just my own hip pocket opinion, but I think too many young kids get saddled with the stigma of PTSD from professionals who are wanting to help, but don't themselves understand what war is. I don't subscribe to the idea that only combat veterans can help other combat veterans, but I always have wondered about it. I went to some voluntary counseling several years ago at the VA here in the states and the counselor was nice, but kept trying to push me into a Vietnam sort of box. He just couldn't get that my experiences were totally different so I never went back.

I'll bet there are a lot of guys and gals here who've sat out on their back porches and watched the leaves falling or whatever figuring it all out. War is without a doubt the shittiest deal out there. In my small exposure to it myself and watching my dad cope with World War II until the day he died, I feel qualified to have that opinion. Just because a Soldier feels confused or lousy or blue about his or her experiences doesn't mean there's something clinically wrong that needs to be medicated. I'm not venting or anything and it seems like most folks in this thread have pretty much the same opinion as me. 

One of the toughest hurdles and probably a big contributor to PTSD is how different war makes you feel in comparison to everyone else. The Army is a huge cocoon and I've been acquainted with several career Soldiers down here who never had a problem with PTSD while they were still in the Army. But when they retired and left the Army behind they went into tailspins. This definitely doesn't happen to every career Soldier, but the Army provides a structure and let's face it, when you're a leader you're on stage all the time. Like I wrote above, once you leave the Army, you're on your own.


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## the 48th regulator (14 Jun 2007)

Very good points Red,

It took me over a decade to realize the demons that were eating me up.  I healed fast, damn fast, and felt untouchable.

So over the years I continued to abuse myself, and those around me.  After I started to have little ones, and the the loyal support of my wife, I realised that I had to control myself.  The temper, the self abuse, the lack of care.  It all had to end.  Nights waking up in cold sweats, just drenched, passing it off as "I am not weak, and I will not let anyone know"

The wife saw it all.  Now, I enjoy life. I dig what I do, however, time really gouged a valley in my soul.  I at times still feel that I let the boys down by leaving early.  I wonder what would have happened if I could have returned fire.  

I see all the goings on In the sandbox, and wish I never left, but then I remind myself "Could I actually been a danger to those around me?".

I still feel both my scars, inside and out.


Geez, all that and I didn't have more than one beer! 
	

	
	
		
		

		
			





dileas

tess


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## Greymatters (14 Jun 2007)

St. Micheals Medical Team said:
			
		

> 2. Preconditioning thru training and the knowledge of peer and family support prior to the event has been noted to reduce the cases of PTSD in cbt veterans.



I agree strongly with this.  Your prior environment and preconditioning help to reduce the mental shock to the system that in turn usually leads to PTSD.


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## the 48th regulator (14 Jun 2007)

GreyMatter said:
			
		

> I agree strongly with this.  Your prior environment and preconditioning help to reduce the mental shock to the system that in turn usually leads to PTSD.



Along with proper follow up after deployment, wouldn't you agree?

dileas

tess


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## Red 6 (14 Jun 2007)

the 48th regulator said:
			
		

> Along with proper follow up after deployment, wouldn't you agree? dileas tess



I'm not sure so much about the preparation because I'm not sure how much anything other than war can prepare you for combat. I hope that makes sense. I mean, we can learn battle drills, first aid and buddy aid, convoy procedures, call for fire, etc, etc., but there are some things that there just isn't any way to prepare for. In regards to post-operational issues, without a doubt, unit cohesion is the best cure for combatting PTSD. There just is no substitute for sitting down with your buddies who you lived it with and getting all the excess baggage sorted out. In the US Army, this is very hard for reserve component units and the Army has been struggling to get a fix for this problem. At least from the outside, Canada's regimental system seems to be an intelligent solution to this problem, but that's just my read as an observer.


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## HItorMiss (15 Jun 2007)

Since Tess was so open and honest I can be to...

Tess wonders what it would have been like to be able to go back, I did go back and while in the process of getting myself able to go back I so focused on my physical and how best to regain my ability to soldier that I never not once dealt with anything that happened to me and those around me. Then when I did get back I had the mission to complete and so again my mind churned through that and again I avoided dealing with the nagging whispers in my head. They chattered when it was quiet and would always sit there wriggling in my brain waiting to get out just under the surface but so long as I had a focus and mission or a goal they were just that... whispers. Then I came home and I had nothing to drive me foreward or the keep my head occupied.So late at night I would see the faces floating in front of my eyes or when/if I slept I would wake up in a near panic. Thankfully I can't remember anything I ever dreamt I still don't but what I do know is I still don't sleep a full night, I still wake up at the slightest sound and I still find myself on the edge of control of alot of things. I am angry deep down inside red hot rage angry. I am angry at myself and no I wont get into why but suffice it to say that it's not going to go away anytime soon. 

Here is the uplifting part I know I am not "OK" I have known that for a bit now and I am working to fix that. Do I have PTSD as is the fashionable term is....I don't think so I think I have a good deep case of CSR and survivors guilt just compounds the problem. The CF is there to help and the CoC has been diligent at spotting people who don't come foreward themselves. They are easy to spot to or at least the serious case's are. I know a few that are lurking on the fringe and seeing guys getting help is slowly making them get help to, call it a positive to peer pressure. The Regimental system is for this aspect of military life a damn good thing to have, I for one am glad it exist.


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## Red 6 (15 Jun 2007)

I will just say this to Tess and HoM: You are not alone. Soldiers have an idea that they're tough and and can take it. Thanks to you both for sharing your stories, because it takes a huge amount of courage to write these things so people can read them. Just yesterday morning, an old Army buddy called me on the phone. We recruited together in Oceanside, CA a long time ago. Anyway, he just retired last year and found me on AKO. He served in OIF I and was relating to me some of what he went through. He said he'll never forget the first time somebody actually shot at him. What was funny to me was, he said right after it happened, he remembered one morning drinking a cup of coffee in our station and listening to me and another Desert  Storm guy talking about the exact same thing.

There are gates we go through in our lives and some of them you can't go back through. Combat is one. I don't know if there is any comfort in this, but many have made the transition back to what I'll call normal life for want of a better term. I encourage you to acknowledge the fact that you've changed by what you lived through, but don't forget that you're still the same person as you always were.

It takes time to sort out everything you experienced overseas. You have to give yourself the space to do that and understand that sometimes, the only answer is time. There are so many questions combat can leave you with and honestly, there just aren't any answers. It's so random and we're always looking for reasons trying to get to the "WHY". This is the hardest thing, but sometimes, you just have to let it go. 

Combat stress is a normal reaction to the experience of war. You go through this kaleidescope of emotions and feelings and it all happens so fast. Plus, the whole world is moving 101 mph and you're living this roller coaster of ups and downs. When we get back home and have time to start decompressing, that's when things like what you've related start happening sometimes. 

I will shoot you a PM, HoM.

Mark


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## Greymatters (15 Jun 2007)

the 48th regulator said:
			
		

> Along with proper follow up after deployment, wouldn't you agree?



No argument there!  I see it as being in two parts though.  First, an official debrief needs to be done with all returning soldiers.  Ive seen it done for units, but a lot of individuals who were temporarily assigned to those units and then went back to their original units when the tour is complete arent included in this process.  Coming back to your unit and having no one give a damn about what you did or experienced is tremendously frustrating and aggravating.  Second is just as youve said, having available the resources and groups at a later time when you realize youve got some issues to deal with.


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## jaawod (25 Jun 2007)

GreyMatter said:
			
		

> No argument there!  I see it as being in two parts though.  First, an official debrief needs to be done with all returning soldiers.  Ive seen it done for units, but a lot of individuals who were temporarily assigned to those units and then went back to their original units when the tour is complete arent included in this process.  Coming back to your unit and having no one give a damn about what you did or experienced is tremendously frustrating and aggravating.  Second is just as youve said, having available the resources and groups at a later time when you realize youve got some issues to deal with.



I agree with this post completely.  I am in a CSS unit and while I haven't been overseas yet (although I am leaving in a few days to do so),I have seen quite a few people who were attached to units as individuals come back.  Almost all of these people are changed in one way or another.   I truly believe a large part of that is due to the lack of a support system (a regiment of peers) who have done the things they have done and seen the things they have seen.   Associated with that is of course the ability to discuss it after.

I understand that the military's outside support system (phyciatrists and such) has greatly improved in the last 10 years, but in my opinion the greatest thing we can do for soldiers minds is try to return th comraderie that was once felt, but now seems to be absent.


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## 1feral1 (25 Jun 2007)

From my tour, I have since heard that some have their PTSD problems. In my opinion, each of us deal with trauma in a different way, and overall, it all effects each and every one of us differently. I do worry about this one person in particular, but at least the issue is being addressed thru the proper channels. 

Since my return from my deployment I have some things I have noticed is at times. On occasion I find it hard to concentrate, have some sleeping problems, some anxiety issues, a little hard on the Canadian Club at times (more so when I first got back), rather intense night sweats (some serious sheet soakers - ha!), re-occuring dreams of reliving certain moments in those dreams both normal daily 'routine' shyte, and some of the rather twisted times. I can be impatient, easily bored, and at times moody, and even short fused and aggressive with strangers. As time goes on (it was 3 months yesterday I arrived home) these seem to deminish in their frequency, which is good. To top it all off, then there was my relationship issues too, as within 6 days of returning from the war, she was leaving. A well planned thought out thing, adn being honest, I was away for 11 months all up. So, this deployment did cost me a best friend and what i thought was a woman who understood me. i guess not. Seven years waisted, but it could have been worse, it could have been 27 yrs, as there are others whocopped it worse that I did. 

I had some difficulty accepting 'thunder' from my first lightening storm, as I had no doubt become conditioned somewhat overthere, as IDF and bombings were frequent every day. No I was not diiving for cover, or freaking out, but the first thing that came to mind was mild adrenaline rush, and in my mind I said 'holy phuck'! ha!  I have spoke about this to other Vets, and they all felt the same, and we all laughed about it.

For me personally, I think I have the basic issues many Vets have, and if my Uncles can survive D-Day thru to Holland, then I can handle 207 days I spent in Baghdad. I do tend to down play the dangerous times, and blow it off with some good jokes. The humour was ever present, and I miss the mateship in a big way.

You know the best thing about it all is I am not alone, and thats a fact!

Every single one of us that comes back has a story.

My 2 cents,

Wes


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## Fusaki (26 Jun 2007)

Here's my .02...

I think a big help in regards to my own mental health has been the fact that I had an interest in PTSD and CSR before I had deployed. I picked up On Killing and had read it beforehand, and I had On Combat waiting at home when I returned. One of the biggest points I get out of Grossman's work is that to be forewarned is to be forearmed. Instead of playing "catch up" in the aftermath of critical incidents I found myself saying "Oooohhhh.. So THATs what he was talking about". I had understood that a Combat Stress Injury is just that - an injury - and I accepted it as another risk of the job. I know that in our line of work a soldier can lose his life, a limb, take a bullet, or get hit with combat stress. Knowing that it could happen to me just as easily as the next guy could step on an IED really helped to set my mind at ease. In hindsight, knowing that it could happen and mentally preparing myself for that eventuality probably went a long way. 

I also had the benefit of mechanical distance. I spent most critical incidents inside a LAV turret, feeling insulated from the chaos outside. I saw the world through a thermal viewer, feeling calm and detatched while others dealt with combat more intimatly. While I still felt the effects of combat stress reaction, they were not as intrusive as others have had to deal with.

The other key I've found is leadership. To have someone you respect slap you on the back and say "Good Job" makes a HUGE difference. It helps to wash away any self-doubt after the fact, making it clear that you did the right thing. On the flip side of the coin, I believe that poor leadership can pre-dispose a soldier to a combat stress injury. Everyone makes mistakes, but to emphasize mistakes made by a soldier during a critical incident leads to all sorts of second-guessing. I understand there must be an honest after action and lessons learned, but good leadership understands the difference between constructive criticism and destructive criticism. If the soldier can make a mistake but come out feeling confidant that he knows what to do next time, its much better then him thinking he's just a shit-pump who couldn't handle the pressure. A leader needs to be able to know when to praise, know how to communicate faults, and have the good judgement to know when an incompetant soldier really needs to be replaced.

Just my own observations...


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## 1feral1 (26 Jun 2007)

Veryt true Wonder, I had read On Killing before I left (Defence Library copy), ended up buying while in theatre (thanks to the US APO, ha) a copy off ebay, along with On Combat, which tended to be more police related. These books aided in educating myself on the feelings and answered heaps of questions in my mind. I identified with them both, but more on ON Killing than the other. Still both make a good reference set to have.

All the best,

Wes


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## Greymatters (29 Jun 2007)

Wonderbread said:
			
		

> The other key I've found is leadership. To have someone you respect slap you on the back and say "Good Job" makes a HUGE difference. It helps to wash away any self-doubt after the fact, making it clear that you did the right thing. On the flip side of the coin, I believe that poor leadership can pre-dispose a soldier to a combat stress injury. Everyone makes mistakes, but to emphasize mistakes made by a soldier during a critical incident leads to all sorts of second-guessing. I understand there must be an honest after action and lessons learned, but good leadership understands the difference between constructive criticism and destructive criticism. If the soldier can make a mistake but come out feeling confidant that he knows what to do next time, its much better then him thinking he's just a crap-pump who couldn't handle the pressure. A leader needs to be able to know when to praise, know how to communicate faults, and have the good judgement to know when an incompetant soldier really needs to be replaced.



Good post and I agree 100%.  I had a good boss who did this for me after my last big tour, helped put me back on my tracks when the train was setting up for derailment.  It certainly helped that he had gone throgh the same process a few times so he knew what I was going through.


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## Armymedic (29 Jun 2007)

There is a ton of ancedotal evidence (can't really study it because leadership is not a qualiative thing science can study) that says this is correct.

One example know personally to me is from 2 Fd Ambs deployment to Rwanda. 2 medical sections worked side by side in the wards post genocide, so they seen many of the same horrorfying experiences.

1 section of eight, all diagnosised with PTSD, the other section, not a single one.... The difference was the attitude and leadership qualitites of the MCpls pre, during and post mission. 

One told his troop to prepare for the worst having seen the news reporting from the area. He allowed them to use black humour, made them buddy up and talk to each other, highlighted the good things and positively corrected any breaches in conduct immediately because the job was not done until the end. This sect talked evenly about both good and bad things....

The other, the MCpl did not allow black humour, allowed his troops to miss shifts because they wanted to avoid doing something bad, and did not provide any positives to his subordinates at the end of a shift, and just went an hung out by himself. 

Of the second section...I know of only one that is still in the CF.

Again, it is also a case of mental preparation before the events that help as well.


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## Dissident (29 Jun 2007)

Wesley  Down Under said:
			
		

> Veryt true Wonder, I had read On Killing before I left (Defence Library copy), ended up buying while in theatre (thanks to the US APO, ha) a copy off ebay, along with On Combat, which tended to be more police related. These books aided in educating myself on the feelings and answered heaps of questions in my mind. I identified with them both, but more on ON Killing than the other. Still both make a good reference set to have.
> 
> All the best,
> 
> Wes



Ditto


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## 3rd Herd (29 Jun 2007)

the 48th regulator said:
			
		

> Don't know, are there detailed facts on these statistics?
> 
> dileas
> 
> tess



The US has good detailed statistics, there is nothing available yet in Canada for public consumption.  And the studies that have been done in Canada do not have a big enough test base. Although that seems to be changing. Part I think due to military members being more educated than past generations therefore realizing something is wrong. Secondly, a demand to have what is wrong fixed. But here is the key, those in the world of mental health have had their heads in the sand for so long we are "new". This argument I do not really buy either as VAC facilities were filled with two wars worth of "test subjects". As for the root cause I kind of like the work coming out on a actual chemical change within the brain itself.

Edit to add:

NCPTSD website is down so the US will have to wait . 

So I found this;

 "An early neurological study tested 654 Army veterans before deployment to Iraq in 2003 and again after returning in 2005, finding mild impairments in memory and attention lapses, but significantly faster reaction times when compared to other veterans not deployed to the theater.  These warrant further investigation.  VA also will analyze combat veterans' deaths from diseases in hopes of publishing mortality studies in the future.

"One early scientific study  indicated the estimated risk for PTSD from service in the Iraq war was 18 percent, while the estimated risk for PTSD from the Afghanistan mission was 11 percent.  Data from multiple sources now indicate that approximately 10 to 15 percent of soldiers develop PTSD after deployment to Iraq and another 10 percent have significant symptoms of PTSD, depression or anxiety and may benefit from care.  Alcohol misuse and relationship problems add to these rates.  Combat veterans are at higher risk for psychiatric problems than military personnel serving in noncombat locations, and more frequent and more intensive combat is associated with higher risk"(http://www1.va.gov/OPA/fact/returning_vets.asp)

"Approximately 317,000 veterans with a primary or secondary diagnosis of PTSD received treatment at VA medical centers and clinics in FY 2005.  More than 50,000 veterans received PTSD-related services at Vet Centers during FY 2005. Nearly 16,000 Operation Iraqi Freedom and Operation Enduring Freedom (OIF/OEF) veterans were seen for PTSD at VA medical centers from fiscal year 2002 to 2005.  Another 3,000 OIF/OEF veterans were seen in VA’s Vet Centers during that period."(http://www1.va.gov/opa/fact/docs/ptsd.doc)

Veterans Being Compensated for PTSD

Period	Sept. 05
Pre-WWII	     -
WWII	25,278
Korea	10,944
Vietnam	179,713
Gulf War	19,356
Peacetime	9,087
Total	244,846

As for those down under it seems that the University of Melbourne has eithier completed but results not released or not completed a couple of interesting studies on both the sleep loss and nightmare issue.
http://www.acpmh.unimelb.edu.au/research/currentProjects/sleepDisturbance.html
http://www.acpmh.unimelb.edu.au/research/currentProjects/nightmares.html


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## the 48th regulator (29 Jun 2007)

Very good post 3rd,

However, my response was directed towards this question;



			
				St. Micheals Medical Team said:
			
		

> But I ask: Why, by percentage, do persons in support trades (in US and Cdn militaries) report higher incedences of PTSD then do cbt arms soldiers?



Any firm numbers or stats to back this up?

dileas

tess


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## Greymatters (29 Jun 2007)

Do you have a theory? Maybe lack of a certain mindset that combat arms types have?


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## 1feral1 (29 Jun 2007)

Being where we were in Baghdad, we all had equal exposure to the routine nastiness, however the basic LAV black hatted crews were out in it more, as in the RZ, and so were we, but not as often.

As for exposure to harassing SAF, and IDF, it was all equal for everyone in the FOB.

Cheers,

Wes


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## the 48th regulator (30 Jun 2007)

GreyMatter said:
			
		

> Do you have a theory? Maybe lack of a certain mindset that combat arms types have?



The only theory I have is proper follow up.  Regardless of what trade or work you do, if proper attention is paid in helping the soldier to return back to his normal routine, having help available, and properly trained individuals to help him acheive that goal, PTSD can be minimized to the point where the soldier returns back to where he was before the traumatic incident.

dileas

tess


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## 1feral1 (30 Jun 2007)

the 48th regulator said:
			
		

> The only theory I have is proper follow up.  Regardless of what trade or work you do, if proper attention is paid in helping the soldier to return back to his normal routine, having help available, and properly trained individuals to help him acheive that goal, PTSD can be minimized to the point where the soldier returns back to where he was before the traumatic incident.
> 
> dileas
> 
> tess



You hit the nail on the head!

+1 Tess!

Cheers,

Wes


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## RHFC_piper (30 Jun 2007)

the 48th regulator said:
			
		

> The only theory I have is proper follow up.  Regardless of what trade or work you do, if proper attention is paid in helping the soldier to return back to his normal routine, having help available, and properly trained individuals to help him acheive that goal, PTSD can be minimized to the point where the soldier returns back to where he was before the traumatic incident.
> 
> dileas
> 
> tess



I've been skimming this thread for a while, and I didn't really want to post anything, as it hits a little close to home for me... and I have mixed feelings about a lot of what has been discussed here.  But, I just wanted to give a quick sum up of the issues I've been having with returning from tour, problems and the “help available".

Keep in mind, this may not be the case with all soldiers returning, or even just reservists.. It may just be me, and I really hope this is the worst of it, and I'm the only one, 'cause I don't think my psychological problems are that out of control, and it would kill me if someone with real problems (PTSD) was going through this.
Anyway, here it is;

I'm not going to go into the details of my tour... I have already else where, and I've said enough... When I first came home, I didn't have too many issues as I was either heavily medicated (Morphine for pain), sedated (sleeping pills to get me to sleep 'cause of pain) or just happy to be alive.  Then came dreams and flashbacks... which is why I started writing crap and posting it here (I know some of you are sick of it... sorry).  After a few months of that, I finally figured out a way to control it so that I could get some sleep (about 3-4 hours a night) without constantly waking up. This method involved over-the-counter sleeping pills, anxiety medications prescribed by the MIR and the home nursing docs and “meditation” (don’t ask).

I don't like taking pills... not even Tylenol for pain.  Just a personal thing. So I stopped the meds and just forced my self to sleep. 

I had been home for almost 5 months before any contact with the OSI (Operational Stress Injury) Clinic, and even that came with a fight. While in hospital, it seemed as though the docs were more concerned with my physical health than my mental health... which, to me, at the time, seemed reasonable.  But even in Hospital I was having sleep issues (especially when my room mate died from congestive heart failure, which is very loud and disturbing, the last night I spent in hospital... they left him in the room till morning... rough night.)  

The doc at the MIR wanted me to see someone as soon as I had come home from the hospital, but even that was fraught with problems.  At that time, I was under the care of everyone (LFCA, 31 CBG, Local hospital, etc.) and none of them communicated… so none of them organized any kind of psychological help.  In the end, I had to contact the OSI clinic myself. Which, in itself, took a month as I was bounced from contact to contact, left messages and received no reply’s.  This caused a lot of stress.  As all this was going on, I was also dealing with contract and pay issues, all of which I’ve had to solve myself… but that’s another issue, which caused even more stress… for both me and my wife, which cause more stress for me (from the wife).

Once I started appointments with the OSI clinic, I started feeling better, as if a weight had been relieved, but it was short lived.  After 3 sessions, my contact with the social worker at the OSI clinic ended.  The stress began again as I tried to renew contact, as well as contract issues, pay issues, issues with my home unit as well as family related stress.  This time, I wasn’t able to control the stress well.  I began feeling angry and bitter all the time.  Even when I was happy, there was that dark cloud, and it didn’t take much to set me off. I was having increasingly violent mood swings, and my wife started getting more and more concerned.

Then it came to a point.  The MIR was having no luck contacting the OSI clinic, and nether was I.  All the other issues kept compounding… then one day, while trying to hang a gate on my fence in my back yard, it all came apart.  I couldn’t get the latch to fit right, and I snapped.  I hurled my drill across my back yard, punched the gate, breaking a board and tearing open my hand, and then tried to rip the gate, and the fence down.  If my wife hadn’t been there, I probably would have… she calmed me down enough to get me back in the house. But it didn’t end there. I completely broke down; All the feelings I’ve had bottled up erupted again and I found myself completely shut down and shaking… this lasted a few days.

My wife contacted the OSI clinic and tore their heads off.  Then I had an appointment.
She came with me to keep me calm.  I begged these people for help and got no response. All I could think about the whole ride to London (2 hour drive) was how hard it was going to be to talk to someone I already don’t trust. And it was.  How am I supposed to reach out for help when there’s no hand reaching back?

After 2 hours of discussion, it all came together; the social worker I had been seeing was a student… I had no problem with that, ‘cause she was helping.  She had finished her term with the clinic and had left.  The clinic informed me that she should have contacted me, and then insinuated that she had and that I was over reacting or was responsible (this may not have been their intent, but it sure felt that way). 

The excuse they offered next was that, at the time she left, I was showing improvement, and they weren’t concerned.  This sent me off the handle again.  I received no contact from her after our last session, and as much as I was feeling better, I had just begun to trust her, and hadn’t had the opportunity to discuss what was really causing problems.

The rest of the meeting went well, and it left my wife and I feeling a little better, but then the question came up; “what do you want us to do for you, exactly?” 
This shocked me… how am I supposed to answer this?  I don’t know what I need. I don’t even know if there’s anything wrong with me.  So I told them; “I don’t know.  I just know that I’m angry, frustrated, confused, depressed, I don’t sleep and I hate everything... I don’t want to feel this way anymore.  Work your magic.”
Their reply gave me a bigger shock; “These problems aren’t directly related to the incident, are they?”  I had no answer… just rage.

So now I’m taking anti-anxiety meds, suggested by the OSI clinic and prescribed by the MIR.  I’m still angry, and frustrated, but now I calm about it, which make me more confused and frustrated.  The meds are chalked full of some kind of stimulant, which keeps me up, and they don’t get rid of the pain or the dreams, so I sleep even less, which leaves me tired and even more confused.  All this make me depressed… which I hate.  

The OSI clinic has provided yet another social worker, which I am to see regularly and I’m back to work half days at the armoury, and everything seems to be getting better… for now.  But it took screaming, yelling, breakdowns and contact with personnel from Brigade, Area and NDHQ.  And every time something else comes up, no matter how small, all I can think is; “I don’t need this.”

As it stands, there is very little keeping me in the forces… I’m trapped by my wounds and lock in by my financial and medical needs.  The wife doesn’t want to move or change jobs as her career is just beginning, and I don’t blame her… This rules out the regular force.  I can’t do what I did before the injury and I’m not going to be on contract by the time I can go back to school to change careers.  I’m in a grey area hell.
They say the worst thing is never knowing what’s going to happen next… that’s my life.

Just a little note; all of this has been passed up the chain of command in multiple direction, actions have been taken to fix “problems”, but in my mind it still feels like a band-aid on a broken arm or “too little, too late.”  
I can only hope that those of greater tactical importance have learned from all this, and no one else who needs help has to go through what I’ve been through. 

Sorry again for the long rant about nothing.


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## the 48th regulator (4 Aug 2007)

St. Micheals Medical Team said:
			
		

> Perhaps she does...
> 
> Medicine is not an absolute, and understanding mental illness....
> 
> But I ask: Why, by percentage, do persons in support trades (in US and Cdn militaries) report higher incedences of PTSD then do cbt arms soldiers?





			
				the 48th regulator said:
			
		

> Please realize that I am not being facetious, as these answers are helping me.
> 
> At what point would you then recommend OSI or OSISS representatives to step in?  What criteria would be used in recognizing that a stress injury is present?
> 
> ...



Just wondering if anyone was able to come up with answers for my questions.

Any help would be great

cheers

dileas

tess


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## medicineman (4 Aug 2007)

Apologies Tess,

First for not getting that report out to you n a  timely fashion.  I actually was on call last Sunday with one of the coauthors and we had a short chat about that.

As for getting the mental health gurus involved, I err on the side of caution when it ocmes to alot of those things - if the resources are available, I encourage and or outright refer people to use them at the slightest inkling of trouble.  If I can't right away, I make do with what I have, be it an MO, mental health nurse or social worker, me and a sat phone, until proper care can be reached.


PM inbound.

MM


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## Greymatters (5 Aug 2007)

RHFC_piper said:
			
		

> So I told them; “I don’t know.  I just know that I’m angry, frustrated, confused, depressed, I don’t sleep and I hate everything..."



Hang in there, brother!  I know the feeling... 

I believe the best therapy out there is a site like this where you can connect with others who have had the same difficulties...


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## Greymatters (5 Aug 2007)

the 48th regulator said:
			
		

> Just wondering if anyone was able to come up with answers for my questions.



Tess, I found your post a bit confusing... Piper posted his message on 30 June, you posted yours 'today', but you refer to two posts in between that arent here?  

But to bash on... reference the OSISS reps, I dont see any point where they should 'step in' (unless you are meaning they are asked to assist with a case).  I believe this should be initiated by one or more of three triggers:

a) individual self-declares a need for OSISS assistance;
b) supervisor or higher recommends a need for OSISS assistance;
c) or, medical, social or mental health worker recommends a need for OSISS assistance. 

Assistance needs to be immediate - not in months, but in days and preferably within a week.  If OSISS cant do this, then they need to get their act together and stop acting like an external specialist.  

At this point it gets a bit blurry - 48th says he had a good experience with OSISS (if i recall correctly), Piper says he had a bad experience with OSISS.  Should we at this point take a poll and see what others think of OSISS services?


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## RHFC_piper (5 Aug 2007)

GreyMatter said:
			
		

> I believe the best therapy out there is a site like this where you can connect with others who have had the same difficulties...



I couldn't agree more.  This site, in particular, has been a great help since I've been home.  Thanks to people I've met here, and my ability to vent frustrations (to people who actually listen) I've been able to get things sorted out.   Example; Since my last post in this thread, I've been contacted by every organization with whom I had problems getting through to before, thanks to certain members who have higher contacts with said organizations.   Things have turned around since then, and everything is starting to piece together.

With that said; perhaps I should have mentioned something about all this when I first came home; 11 months ago. 




			
				GreyMatter said:
			
		

> reference the OSISS reps, I dont see any point where they should 'step in' (unless you are meaning they are asked to assist with a case).  I believe this should be initiated by one or more of three triggers:
> 
> a) individual self-declares a need for OSISS assistance;
> b) supervisor or higher recommends a need for OSISS assistance;
> ...



As much as I agree with you, GreyMatter, there are some issues with these triggers;
a) Individual self declaration: Most soldiers who are in need are, for the most part, unaware of the services offered by OSSIS.  I was first told about OSSIS when I was in Germany (hospital) and only briefly...  I was also on enough Morphine, fentanyl, demerol and other opiate-based painkillers to stuff a horse into a tight coma for a month, so I don't remember much about it, except what comes in hazy flashbacks.  Once I got home, I knew of their existence, but thought they were part of, or another name for, the OSI clinic.  I was also grossly misinformed about what the OSI clinic was and what they could do as well... but that's another issue which has since been resolved.  
But, back on track here, with all that said; of the few soldiers who know about OSSIS and what they can offer, even fewer will take the help, as it is not enforced (which it shouldn't be). But this is much like any other service offered (social worker, OSI clinic, etc.); It is up to the soldier to reach out for help and then accept the help given.  With that in mind, most soldiers are of the mentality that they can 'soldier through' any issues they might have, and ignore the help offered... this is more so the case when the soldier doesn't have the right information... and it usually takes a catastrophic meltdown for the soldier or his/her family to sort out help (been there, done that, know the signs now).  
What is the solution? Like a bad drivers test; there is now %100 solution, but the best answer I can think of is direct initiation of contact by these organiztions to help the soldier understand their options.  As much as it is up to the soldier to reach out, it may help if someones hand was already there reaching back.

b) Supervisor / CoC: Again, another issue;  Most supervisors within the CF are either unaware of the resources available, or of two like-opinions which can be a detriment to their subordinates health; 1) It's the soldiers personal business (one man, one kit), or 2) the soldier can soldier on (the 'old-school' attitude), and as above, it usually goes on until a catastrophic breakdown (not necessarily an emotional one, but sometimes within the chain of command).  As much as it is a supervisors job to stay in tune with their subordinates (know your troops and promote their welfare), generally this can become a 'Too close for comfort' issue which most supervisors don't want to get involved in, and in some cases; neither does the subordinate.  My personal experience;  My current 'supervisor' has to know my every issue to report to higher (a new mandate which came from higher-higher... aka, LFCA).   
As much as I appreciate their new found attention to detail, I am still not comfortable sharing some personal information, which he needs to do his job... not because I don't like him; far from... I think he's a good guy, and a great officer... but because I'm just not comfortable telling anyone   certain things about my physical and mental well being...  Also because of the number of people who have access to the weekly reports he submits.  
Most soldiers (including myself) would not be comfortable with this kind of scrutiny (as necessary as it may be), and many supervisors would be uncomfortable dabbling into someone's personal life.

c) Military Health Services: This is the organization which has the most say and control.  These are the people who need to do the leg-work and push a soldier towards the help.  But the soldier should be made aware of their resources immediately, weather by forcing the issue (medical staff setting appointments with OSI / OSSIS) or by contact from these organizations (OSI / OSSIS initiating contact after being contacted by med staff).  Either way, the military medical side of the house should be all over this... which they are.   Every soldier returning from operation has to conduct a 'post-deployment screening'; this is the opportunity for further help to be pushed... but there are issues with the post-deployment screening system as is (at least for the reserves... due to lack of contact after re-deployment).
But, as it is right now, this is the best, and most effective way for a soldier to organize help; Through the medical system.  If this breaks down for any reason (weather through the HSC or through contact with OSI / OSISS) then there is going to be a gap and a crack for the soldier to fall through.

Consider this; I was once told (by someone in either OSI or the military social services field... can't remember which) that for every one soldier who is receiving the necessary help, there are at least 10 who are not.  This is not any one groups fault, but a gap that is created by everyone involved, including the soldier.  And with more deployments, more soldiers having multiple deployments and the nature of some of the more recent deployments (combat) there will be many more soldiers who will need the help, but will be hindered by either; Lack of information, lack of contact, lack of self-identification.  There are many cogs in the machine, all of which have to be running together or the machine crashed to a hard halt.        



			
				GreyMatter said:
			
		

> At this point it gets a bit blurry - 48th says he had a good experience with OSISS (if i recall correctly), Piper says he had a bad experience with OSISS.  Should we at this point take a poll and see what others think of OSISS services?



I haven't had enough experience with OSISS to have a particularly bad opinion of them, which is really the problem.  I wasn't completely sure what they could offer in the way of help until shortly after my last post in this thread.  But, that really isn't their fault... thats just a breakdown in the dissemination of information (which I find is the basis for most problems in the CF and society in general... but I'll save that for another rant).  Had I known what OSISS does long ago, when I first came home, I may have had more of a need and will to initiate contact with them, but the information just wasn't there... at least not all of it.  All I knew of them was that at some point I might want to talk to them, but that would be sorted out by the people who were taking care of me. Now I have a keener understanding of their resources, and to be quite honest, I don't think I'm in need of their services anymore...  I have a pretty good social support circle going as is. Between my friends from deployment and my unit, my family, the OSI clinic, HSC social workers and these forums, I have many outlets to vent frustrations and discuss problems / issues.
But, I will keep in contact with them, as they may, someday, become a valued resource.

Anyway, Sorry I've turned this into a long-winded diatribe (yet again)... just thought I'd share my insight into issues in which I now have much more experience than I wish I had.  Hope it helps.

The system isn't broken, it just needs a tune-up... and maybe a new oil filer...


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## Greymatters (5 Aug 2007)

Piper, excellent feedback, I hope your words help others who are currently on their way home right now.  

Of note, I just read an article yesterday (Freedom Tags Say Tour of Duty Ending) where the reporter says that the troops are getting 4 days 'decompression' in Cyprus prior to returning home and part of their re-orientation is information on PTSD.


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## the 48th regulator (5 Aug 2007)

GreyMatter,

My questions were not directed at Piper, if you click on the links associated witht he quote, it will help.

Hope that corrects any confusion

dileas

tess


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## RHFC_piper (5 Aug 2007)

GreyMatter said:
			
		

> Of note, I just read an article yesterday (Freedom Tags Say Tour of Duty Ending) where the reporter says that the troops are getting 4 days 'decompression' in Cyprus prior to returning home and part of their re-orientation is information on PTSD.



True; when the troops get to the 3rd party decompression location they are informed of the resources available to them, but only the general details.  Not a whole lot of specifics are available until they get home, then for the most part, it's up to them to utilize the resources.   
Also, PTSD can take months, and sometimes, years to surface... even the most mild signs. It can become difficult for some members to access the resources when they need them if they don't initiate contact immediately... Especially those members who leave the forces after a traumatic tour (there are quite a few in this boat).

There are other variables to consider with the "decompression"; 
- As much as the troops don't want to talk about it (publicly) and the CoC wishes it didn't happen, the reality is; while on decompression, troops spend the majority of their time involved in recreation activities... such as drinking and partying...  Not saying there's anything wrong with this, but it can interfere with troops access to resources which could benefit them... also, it sometimes becomes habit forming when they come home, causing even more problems.   I'm not saying the troops shouldn't be partying it up, 'cause god knows they've earned it, I just believe the troops should be encouraged (by their CoC) to take every advantage of the resources available.  By 'encourage' I mean positively... not denial of freedoms; CB-ing the troops to the hotel and keeping the decompression "dry" is not the way to go... it just makes for angry troops who will drink and party anyway, which will result in charges and other disciplinary actions.   Positive reenforcement through incentive might be the best way to go... keep the troops happy and instill the want for accessing help as needed.    This may also defeat the idea that seeking this help is a "weakness"; Recovering from a mental wound is no different from recovering from a physical wound.  Help the soldiers recover and they will be more effective.

- The other issue is that not all soldiers go through the 3rd party location decompression, sometimes its not in the same location, and some soldiers have more time in the decompression location than others.  Example; Anyone who was wounded and repatriated had NO decompression in any 3rd party location (with few exceptions; some were fit enough to go to Cyprus to help the decompression team... but they were working)... Most of us didn't speak with a social worker until months after repatriation, if at all.   Also, after talking to other soldiers from my Roto, both regular and reserve, some had their decompression in Cyprus, some had it in other undisclosed locations... Some were there for 4 days, some for a week (7 days) and some stopped there over night on their way home. It all comes down to available time, flight timetables and many other variables. And, because of previous groups activities in the decompression location, some soldiers were confined to their resort/hotel, with 'no drinking' policies in place... with left them disillusioned and annoyed... not just at the CoC, but at their peers, who ruined it for them before they even got there.   Inconsistencies like these create tension, especially for the troops which get the short end of the stick.

But, like I've said before; there's no 100% right answer.  Those in the know are doing their best to solve the problems for the next group who go through.  As with any system like this, the better care will always be for the troops who deploy after you.


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## HItorMiss (5 Aug 2007)

Piper

I would like to know who did not spend the mandatory time in the Cyprus TLD, because It was just that MANADTORY if you did the full tour. As for the majority of time spent drinking and partying doing recreation activities your damn right they/we did and while doing that we talked and talked and talked. I was not the only one in tears a few times, I had more then on friend cry on my shoulder over this and that, and when the morning came they were better then they had been in months. Your way off base in just about all your assertions and I think it's because you didn't do the TLD and as such only have second hand info. I did it yes, your semi right that it was the basics of the services available but I know more the one soldier who stayed after a lecture or briefing to talk with someone (OSISS being a prime example).

I can't say how you were handled after you came home with me in Sept but I know I was more pissed with people trying to get in my head then I was with being wounded. I turned down services so much they thought there had to be something wrong with me ( I am not the only one talk to the OC he had the same thing) Something in terms of physical medicine were lacking but that all came out in the wash.

That all just my experience though when it comes to being in Canada. But your dead wrong about the TLD IMO


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## HItorMiss (5 Aug 2007)

Oh an as for the the TLD going "Dry" I know of only one group where that occured all the rest were still wet but th added a no booze in your room restriction, which I and many thought was more then reasonable.


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## RHFC_piper (5 Aug 2007)

HitorMiss said:
			
		

> Piper
> 
> I would like to know who did not spend the mandatory time in the Cyprus TLD, because It was just that MANADTORY if you did the full tour.



Well... as stated; none of the wounded who were repat'd (unless they went back in...).  Anyone who was on force protection (reservists) of which there are 4 from my unit; they spent 2 days in another undisclosed location.   Some of the last few to come back who were working in KAF (2 of which from my unit) had a 1 day stop over in Cyprus.  and the other 3 who were with battlegroup from my unit; 1 got the full deal, and the other 2 were CB'd and were there for 5 days.  

After talking to a few from Bravo, they spent some time CB'd and some time free, but there were a few who only spent 3 days in Cyprus (excluding there departure day... which kicked off at 0500h)... BTW, more reservists.  Now, granted, they may have been embellishing their plight, but I found these people to be fairly reliable. 

Everyone I've talked to who went through Cyprus or another decompression location have told me many different stories about their stays... the only common factor between them was the alcohol consumption and parties.



			
				HitorMiss said:
			
		

> Your way off base in just about all your assertions and I think it's because you didn't do the TLD and as such only have second hand info.



True... My info is second hand. I won't deny that, but yours is as well... did you go on every decompression trip?  Were you there for all the platoons and companies who went through?  If it was so consistent, than why are there so many complaints and stories about it?  Why isn't everyone's story the same?  
While at an LFCA leadership symposium, I spoke to two others who were on our tour, both reserve, each with different elements working in theater (NSE and force protection), both went to Cyprus,  both for different amounts of time and neither were impressed... Maybe they got hosed for what ever reason... but again, if it was so regimented and mandatory, why the different stories?  Even from other reservists who were with the battlegroup.... some from our Coy...  All different stories.  Was it different for Regular and reserves?  We they all separated with the Regs getting the mandatory time, and the reserves shipped off early?  I think not. So I guess neither of us can speak for all who went through the decompression.  In which case, disregard my statements on the duration, and start asking around for yourself.



			
				HitorMiss said:
			
		

> your semi right that it was the basics of the services available but I know more the one soldier who stayed after a lecture or briefing to talk with someone (OSISS being a prime example).



I'm not saying the time spent there was a waste... I'm sure it helped some (hopefully most) troops, but could have it been better?   Why only a few soldiers seeking help?  



			
				HitorMiss said:
			
		

> I can't say how you were handled after you came home with me in Sept but I know I was more pissed with people trying to get in my head then I was with being wounded. I turned down services so much they thought there had to be something wrong with me ( I am not the only one talk to the OC he had the same thing) Something in terms of physical medicine were lacking but that all came out in the wash.



It seems as though some were offered a lot, and some are still waiting, weather they went on the decompression or not.   Be thankful you have the luxury of "turning down" support instead of fighting for it.  After long discussions with representatives from LFCA and NDHQ who are concerned with the care of soldiers after deployment I have learned that there are many soldiers who are/were lacking the support they needed.  Now things are starting to change, but very slowly.  Perhaps you and the OC (and others) were given the right amount of attention, but there are many who have already slipped through the cracks and many who are hanging on by a thread... If it weren't such a problem, why are there so many complaints? 



			
				HitorMiss said:
			
		

> That all just my experience though when it comes to being in Canada. But your dead wrong about the TLD IMO



Perhaps I am wrong about TLD... Perhaps it has helped everyone who went through...  Perhaps the soldiers know all about the resources available and are just choosing not to use them.  But that just seems unlikely,  especially when I mention the OSI Clinic and OSISS to other soldiers from my unit, all of which went through the TLD, and they have no clue how to get in touch with them... Maybe it's different with the regular force members then.  

As for those of us who circumvented the TLD system... the fight continues.



			
				HitorMiss said:
			
		

> Oh an as for the the TLD going "Dry" I know of only one group where that occured all the rest were still wet but th added a no booze in your room restriction, which I and many thought was more then reasonable.



(you added this while I was typing.... I type slow)

Again, maybe only at Cyprus, but other locations were dry... and the last few who went through Cyprus were very limited.  I heard all about the "no drinks in rooms" rule, but also about the 10pm curfew, no leaving resort property, no public drunkenness, and the parade of charges that followed... I'm sure we can both name at least one soldier who was charge for their actions in Cyprus.
Either way, the complaints I've heard from everyone very from when they went...  Not so much from the first couple groups, since they seemed to have the most fun, but definitely from the last couple.  Either way, it's of no consequence, as I'm sure most of the bugs have been ironed out, or are being ironed out, since our tour... hopefully.

I'd like to hear more about this from those who just came through the process.


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## 3rd Herd (5 Aug 2007)

From MSM
The usual disclaimer:
http://www.thenews.com.pk/daily_detail.asp?id=66889
Canadian troops decompress in Cyprus after Afghan tour
LARNACA, Cyprus: After tours of duty in Afghanistan, war-weary Canadian soldiers are being treated to five-star luxury on the Mediterranean island of Cyprus to prepare them for the return to civilian life. 

Most of Canada’s 2,500 troops in Afghanistan will undergo “decompression” — military terminology for a programme designed to ease the physical and mental rigours of life in the combat zone. 

After completing their six-month tour on the Afghan battlefront, some 2,100 soldiers are under orders to enjoy five days of sun and sea in this holiday playground before they go back home.

But it is not just gratuitous pampering. The programme is also about mending the battle-scarred minds of those who may be grappling with the pain of loss.

“Some soldiers have experienced the loss of friends and colleagues; that’s why we have mental health staff on hand to deal with such cases,” said Major Michel Ouellet, the 47-year-old Montreal native in charge of a 40-person team overseeing the month-long decompression tour. 

“A fair amount of soldiers will have been affected by such loss. This was expected and that’s why we planned for it,” he said. Since the US-led occupation of Afghanistan was launched in October 2001, 66 Canadian soldiers have been killed there — 22 of them this year alone.......article continues. 

Edit for Tess: some upto date stats from the UK
'Stress risk' for British troops 
http://news.bbc.co.uk/1/hi/health/6927659.stm

........A team at King's College London looked at the effects of the number and lengths of deployment in a random sample of military personnel sent on operations. 

They calculated that those deployed for over the average recommended amount of 13 months or more in a three-year period were 20-50% more likely to have symptoms of PTSD.

.........Ministry of Defence figures show the number of new cases of mental disorders, of all types and regardless of cause, in the first quarter of this year was 0.58% and the rate of new cases of PTSD was 0.03%.


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