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Crash Landing; The Passionate Eye-CBC

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Zarathustra said:
I'm just wondering, how much is done in the military to prevent PTSD ? Like information on the subject, debriefing, psychological exam on tour/back from tour, things like that. In Dave Grossman On Combat there's a chapter on the subject and information on how to prevent it. Prevention could reduce the claims, legitimate or false.

As someone in the recruiting process, given the choice between getting PTSD and a pension or not getting PTSD, I would much prefer not getting PTSD.

Don't think it can be prevented but I think stress generally can be mitigated with information.  I'm sorting through my own bag of worms trying to come to grips with a few things and am finding the more information and feedback I get, the more piles of crap there seem to be to start digging thru.  This is apparently because I figured I'd just get on with a few things, put them on ignore, and try to not think about stuff...  Well here I am 10 years later at the beginning again and only got here because it became impossible to function, too much crap loaded on top of too much other crap, ergo melt down.  The way its been explained to me is there is a critical incident, a thing or series of closely related things that differ so much from your personal world view of how a thing should be that yer not able to rationalize it so can't file it away.  Ya kinda get stuck.  Then apparently other crap gets loaded on top of the first bunch of crap and before ya know it yer havin a melt down.  So, given this, it makes sense that the sooner you can get stuff rationalized and stored away in your brain normally so that it makes some kinda sense to ya the better off you are.  I think this means that when some shit happens you talk about it.  I think talking about it, just saying the words, makes it real and recognizing something for what it is allows us to start to find a way to cope with it.  I think that's where all the dark humour comes from.  Its a way to get it outside yourself, say it to some other human being, get rid of it and get on with things.  So there we were picking up bits and pieces daily, young shepherds stepping on mines and screwing with UXO, the bodies were stacking up like cord wood, and one morning early it was a 12 year old boy.  There was nothing to do for him but of course ya gotta go find the site the best you can, do the paperwork, find the family...  Two hours later, we're done, clapped my hands together and said, right, who wants breakfast?  I wasn't kidding.  Went in and made pancakes and the whole thing got talked about and normalized (stop looking at me funny) and we were all good to go.  I never got stuck on that.  Out of the 8 people involved I know of only one that did.  There was more to that story than met the eye though.   

I think there's leadership involved here and not some phantom establishment responsibility but that it rests with the people out doing the deeds to make this work just as soon as it possibly can.  That means the group or individual has to be aware they've just had some experience that completely rocked their world, or things have been accumulating and they have to feel like they can turn to the soldier standing next to them and comment on it.  I think this is where it starts.  Trust me, if you store it or think you're going to stuff it down you'll be able to for awhile but its going to eat you from the inside out.  I've seen guys out there so totally strung out with stress that they're on full alert almost 24/7.  They're space cadets, the kind that are braver than you sharing your trench.  You can see the layers of stuff by the way they react to stuff.  Some totally void of any sense of caution.  Instead of going to ground when its raining rockets they're heading to the roof to watch the light show.  UNbelievable.  They don't deal with anything, its all bravado and adrenaline on auto pilot.  I think that's some advanced stages of walking meltdown or something.  Its easy to see when you're looking for it.  I think there's also a sit where a soldier just isn't acting like they normally do, withdrawn or depressed or real bad moods all the time or who does repetitive things for no apparent reason.  Find out what's up.  If its you, go connect with somebody, don't isolate yourself.  I think alot of the preventative or at least early intervention stuff is real simple soldier stuff.  Get to know each other before you go where you're going so you'll know what abby normal looks like when you see it.  Find out all you can about the place you're going, pictures, video, mags, anything, country stats, mission, NGOs there and what they're doing, so when you see something you can put it into some kinda context.  Talk to each other all the time, deal with it when it happens.  Ask questions when you see something you don't understand.  Be curious.  Be a team.  Be organized.  Try to find normal in the chaos.  Know that you can't fix the world but you can do you job real well while your away and when you come back to the world you can understand that you've contributed - feel good about that.
 
armyintheafterlife said:
So there we were picking up bits and pieces daily, young shepherds stepping on mines and screwing with UXO, the bodies were stacking up like cord wood, and one morning early it was a 12 year old boy.   There was nothing to do for him but of course ya gotta go find the site the best you can, do the paperwork, find the family...   Two hours later, we're done, clapped my hands together and said, right, who wants breakfast?   I wasn't kidding.   Went in and made pancakes and the whole thing got talked about and normalized (stop looking at me funny) and we were all good to go.   I never got stuck on that.   Out of the 8 people involved I know of only one that did.   There was more to that story than met the eye though.    

Heyzoos!

That would be at the same time I was overseas.   Where were you posted, that is if it is ok for you to talk about it?

dileas

tess
 
armyintheafterlife...excellent post, thank you for putting that into words
 
Armyintheafterlife,

  That was the best post yet, print copy cut that needs to be used at the PTSD  CISD intro lectures or given to ever soldier by his NCO on the back of a LAV got 5 mins brief!!!!!!!!well said. :salute:
 
the 48th regulator said:
Heyzoos!

That would be at the same time I was overseas.   Where were you posted, that is if it is ok for you to talk about it?

dileas

tess

That story is from Eritrea, Sector West, Oscar18, 2001.
 
Here is what I have to say,    PTSD, Battle fatigue, shellshock, Operational Stress Injury (OSI), Lack of Moral fiber or what ever you want to call it ... Psychological injuries are real. OSI's are not targeted like a snipers bullet who and where and why they hit is not very well understood, but let me say again these injuries are real.   Medical literature, history, and the many Soldiers / Veterans I work with on a daily basis prove this fact.

I admit I am not neutral on this subject, I am a Peer Support Coordinator (PSC) with the Operational Stress Injury Social Support Program (OSISS).

I will also admit to have some of the same thoughts of some of the other posters of this board.    

However what I would like every one to consider The Ombudsman's recent report on PTSD reported that only a possible 3% of people are malingering with OSI's.   I would suggest to everyone that we should let the Doctors and other Medical Professionals out there deal with these people.

We as a community of Veterans must focus out attention on the 97% of Veterans who may need help.

I would also like to share with you my thoughts when I am working with people;

1 I have to ask myself how would I like to be treated if I asked for assistance?  

2 â Å“ If I judge this person what happens if I am wrong? What is going to happen to this Veteran or this Veterans family? Do I want this persons blood on my hands? Of course not, I will quite happily let some Doctor make that judgment.


If any one would like more information check out www.osiss.ca   and don't hesitate to contact your local rep. Or you can contact me at peersupportvan@aol.com

"For those who understand, no explanations is necessary
For those who don't, no explanation is possible"

 
Vinny,
          Your point is well taken, I would like to take exception with two of your points but agree with the remainder of what you said.

"OSI's are not targeted like a snipers bullet who and where and why they hit is not very well understood, but let me say again these injuries are real. ¦"

  IMHO I disagree, PTSD is always described this way, it makes people like me feel that in some way given the same situations another soldier would not have gotten PTSD. That thought makes me feel somehow I am weak. I know this is not true and am convince that anyone given the same situation would have been in the same boat as myself, some worse off none better. The thought that we don't know and it may or may not affect a soldier is exactly what gives rise to the thinking that it is a weakness. It will be difficult for anyone to convince me that PTSD is not a given when in a specific scenario it is like the bullet that hits its mark, the result is tissue damage same for PTSD all will be affected no exceptions to the rule (unless as I stated before you are psychotic)

" I will quite happily let some Doctor make that judgment."

  This last point is part of the problem, some not all med staff IMHO are doing soldiers a disfavour by diagnosing them with PTSD when other mental illness diagnosis is relavent. (and yes I am not a doc) It is those diagnosis that give the other cases a bad name. I know this is a controversial statement but in my personal observation I have seen it first hand. This may be because the DM on the subject was changed, if it went back to what it was in the mid 90s many cases would not be granted the PTSD diagnosis they would however get other mental illness diagnosis that is just as valid for treatment but is not PTSD.

 
Vinny,

Welcome aboard!

Thank you for the fantastic post.  Groups like the one you are part of have been at the forefront in helping those of us that have suffered in silence.  It is phenomenal, that former members of the military, have come together to form a group such as yours.  I want to say thank you for being at my side with my journey for the last 12 months.

3rd,

Where in the name of jobe did you read all of that in Vinny's post.  You said that you have suffered with PTSD, I suggest you follow the link that was posted by Vinny.  It may guide you into the direction of help that you need.

dileas

tess


 
Just to narrow the arcs a bit, but OSI is what we get from 'Operations..', and that is what concerns us here.  The taxpayers through DND should be on the hook for OSI.

PTSD, on the other hand, is much too vague a category, and may well result from civilian car accidents, date rapes, divorces, family sex abuse, residential schools, etc.

In many cases, the govt should be on the hook for that, but NOT DND/VAC.

I still go back to my assertion that ALL recruits MUST undergo a psych assessment before being accepted for enrolement.

Ten more Clayton Matchees and we won't have an Army left.

Tom
 
PTSD, on the other hand, is much too vague a category, and may well result from civilian car accidents, date rapes, divorces, family sex abuse, residential schools, etc.

In many cases, the govt should be on the hook for that, but NOT DND/VAC.

Correct me if I am wrong, but aren't DND and the VAC part of the government??

And from your expertise, why is it so vague, I believe the the signs and symptoms are fairly clear cut.   A trauma experienced by a soldier is not considered reason enough for an assessment on PTSD?   The actually incident is not the cause, but the trigger.   It is the follow up treatment that precipitates PTSD.   So if ones chain of command is not qualified to recognize the person who suffers, and this troop gradually gets worse, they should not accept responsibility?

Hmn I thought one of the principles of leadership went "seek and accept resp....."

dileas

tess
 
It is, Tess.

My point is that, although there is only one taxpayer, our dollars are divided up through regulations and budgetting.  DND/VAC share the same moneybag.  By all means, they should be responsible for "workplace caused health issues" but they should NOT be responsible for any other health issues any more than if I was working for Telus, Bombardier, or the Bank of Montreal.  THAT funding comes out of another moneybag - as it should.

WE have to sort out the abuse now, otherwise the pendulum will swing to much the other way, and our cadillac treatment will turn into Workmen's Comp.

I think we should put up "WANTED" posters in all of our units and MIRs, urging people to report DND health fraud by encouraging them to report those who brag about their abuses.  You know who I mean, the guys in PAT/PAR platoons who brag to others how they are scamming the system, etc.

Will this cut the abuse? Maybe not, but at least it might make the abusers STFU and not destroy the morale of those who need and deserve treatment.

Tom
 
Tom,

Good points but let me ask you;

My point is that, although there is only one taxpayer, our dollars are divided up through regulations and budgeting.  DND/VAC share the same moneybag.  By all means, they should be responsible for "workplace caused health issues" but they should NOT be responsible for any other health issues any more than if I was working for Telus, Bombardier, or the Bank of Montreal.  THAT funding comes out of another moneybag - as it should.

So I, having gone on a tour as a reservist, get injured, come back and years later find that I am suffering from said injury should I not find accountability with the groups that employed me at the time of incident?  Again, I believe you are misunderstanding how PTSD affects someone, and are indicating that people suffering an injury on civvy time are trying to cash in on the pay out.  PTSD is a gradual disorder, not something that hits at the time of the episode.

WE have to sort out the abuse now, otherwise the pendulum will swing to much the other way, and our Cadillac treatment will turn into Workmen's Comp.

Cadillac treatment, can someone get me the key to that please?  Up until now I was not even able to get the bus pass....

I think we should put up "WANTED" posters in all of our units and MIRs, urging people to report DND health fraud by encouraging them to report those who brag about their abuses.  You know who I mean, the guys in PAT/PAR platoons who brag to others how they are scamming the system, etc.

Brilliant idea, maybe we can even put a small bounty.  This will stop the umpteen other types of medical fraud as well.  So I definitely agree on this one.

My only concern is we are concentrating a lot of well meaning effort into the fakers and fraudsters.  What we should really be doing is devote our efforts in guiding those that are suffering.  Recognizing, helping, rehabilitating, and reintegration.  GO!!  pointed this out in some of his posts, and I believe that is the exact angle to go about it.

That way we can help those that truly need it, and leave the charlatans to the wayside.

dileas

tess
 
Tess,
           I shall explain
   
"Where in the name of jobe did you read all of that in Vinny's post."

   In response to your above,
         Vinny gave an example of PTSD/OSI injury's not being like a snipers bullet, in that it is not predictable....I disagree.....I think it is predictable.

         Vinny said he would rather leave the diagnosis to the med staff, I agree to a point since it is my belief that the med staff are part of the problem and that derives from a poorly altered DSM on PTSD. That poorly altered DSM causes non CF related PTSD?OSI to be lumped in with the CF related OSI issue.

    Tess in your case and all reserve soldiers cases I don't think anyone is advocating that since the PTSD manifested itself after you came back and were away from the CF that it is not an OSI case. The point is that non related CF cases such as TCBF detailed and I have earlier are the issue. TCBF explains the point very well about the difference between CF OSI related PTSD and never been outside the gate cases that would have manifested themselves whether the person was working at the bank or a CF orderly room.

    My comment at the end of Vinny's text was just to enlighten that some of us here have already connected the dots long before OSSIS was around. I probably should not have said it, I retract it with apology to Vinny if he took offence. I have my own opinion of OSSIS.

EDIT:typo
 
Then elaborate your opinion, instead of hiding behind the veil, yet once again.

Vinny gave a example of PTSD/OSI injury's not being like a snipers bullet, in that it is not predictable....I disagree.....I think it is predictable.

You disagree because it is not predictable...sorry there is no room for "it is my opinion and that's that" in this one, PTSD is not predictable.   What is predictable is the manner is the process that can cause people to be affected, you for one who states they are suffering from it should know.   Yet you have not once in this thread, and others, shown that.   Where are you garnering your information?

Vinny said he would rather leave the diagnosis to the med staff, I agree to a point since it is my belief that the med staff are part of the problem and that derives from a poorly altered DSM on PTSD. That poorly altered DSM causes non CF related PTSD?OSI to be lumped in with the CF related OSI issue.

You state that medical staff are part of the problem? Sure and so are people who offer statements based on "what I think".   What do you mean by non CF related PTSD?   Do you even know what is involved in the assessment of PTSD by the VAC??   Let me break it down,   The first thing that happens once initiated by the injured member is you are assessed by psychiatrist, usually one that is associated with VAC.   His evaluation is forwarded to VAC and your family doctor. VAC at this point makes a formal request for your medical documentation to see if the disorder pertains to a particular incident associated with one's military duty.   After they receive it, assess the evidence and the doctors findings, they come to a decision.

So, as for the injury that occurred on civvy time walking to the bank and slipping on some ice, accidentally being attributed to military duty, is not as easy as you are trying to make it out to be.   Some of us find it difficult as it is to get treated for the real injuries, and this has nothing to do with the fakers, but the poor attitudes exhibited by posts like yours and "what you think".   Please offer advice that is based on the experience you have stated you have gone through.

And I am curios as to your opinion on OSSIS, as they do a hell of a job helping us.

dileas

tess


 
Tess,

    I have only my experience and knowledge that I have gained over 10 years of battling this to draw upon, I may not be exactly right all the time on the subject but then no one is as it is an evolving thing. Even the foremost experts in the field are ever changing there approaches and understandings of the issue as they learn more each day.

    I was assessed with possibly having a "Combat Stress" or "PTSD" problem in 1995 by my CO who also suffered. It took until 1997 for the confirmed Combat Stress diagnosis by a US medical doctor hired on contract by DND. The combat stress ended up manifesting itself as PTSD which I have to this day and struggle with ever min of every day. I have been through the entire system and now am on the other side of the issue looking back and what I saw did and was done to me have allowed me to reflect on the good the bad and the ugly. My opinions are just that my opinions from a decade of fighting and survival. I am according to my doc what you would call a success case in PTSD/Combat Stress world. That should give me some small ability to know the subject.
 
Then offer advice and direction,

You only offer negative comments regarding the medical community, help groups, and those statements are always veiled in this mysterious manner.

I have come to the end of my rope when people offer "MY opinion" and "what I think",

And you have still not answered my question on what you think of groups like OSSIS, you allude to them in a negative way.  When here is finally a group dedicated to those like you, and I.

Everything you state points to a conspiratorial mission to all those involved in the process of healing.

dileas

tess


 
48th

    I have offered advice it appears not to be desired.

  My best advise is for the CF to split the mental health unit of the CF away from the OSI side. Treat soldiers with this that have combat op experience related OSI separate from the normal mental health channels.

  Lobby your CO and all med staff and the leadership to change the DMS back to the restrictive DMS in the early 90s.

On OSSIS .....I attend meetings not as often as I did in the past but I do, my friend is an OSSIS coordinator, I recommend and send anyone who comes to me with a question about PTSD to an OSSIS meeting. If you read all the posts I have made on PTSD you will see that I recommend going to OSSIS. That does not mean I will stop advocating for change to make it better.

  As for people who say "in my opinion" Id rather hear about the effects of a bad trip on acid from a clean addict than from a doctor that studied it in school and never took more than an aspirin in his life.
 
"As for people who say "in my opinion" Id rather hear about the effects of a bad trip on acid from a clean addict than from a doctor that studied it in school and never took more than an aspirin in his life."

- Well, once.... WHOOAAAAA!  .... you almost tricked me there! :D

DSM IV belongs to the APA, not the CF. In any case:


BehaveNet® Clinical Capsule™:
DSM-IV & DSM-IV-TR:
Posttraumatic Stress Disorder (PTSD)

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

When an individual who has been exposed to a traumatic event develops anxiety symptoms, reexperiencing of the event, and avoidance of stimuli related to the event lasting more than four weeks, they may be suffering from this Anxiety Disorder.

Diagnostic criteria for 309.81 Posttraumatic Stress Disorder
(cautionary statement) 
A. The person has been exposed to a traumatic event in which both of the following were present:

(1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others
(2) the person's response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior

B. The traumatic event is persistently reexperienced in one (or more) of the following ways:

(1) recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed.
(2) recurrent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable content.
(3) acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur.
(4) intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
(5) physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event

C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:

(1) efforts to avoid thoughts, feelings, or conversations associated with the trauma
(2) efforts to avoid activities, places, or people that arouse recollections of the trauma
(3) inability to recall an important aspect of the trauma
(4) markedly diminished interest or participation in significant activities
(5) feeling of detachment or estrangement from others
(6) restricted range of affect (e.g., unable to have loving feelings)
(7) sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:

(1) difficulty falling or staying asleep
(2) irritability or outbursts of anger
(3) difficulty concentrating
(4) hypervigilance
(5) exaggerated startle response

E. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than 1 month.

F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Specify if:

Acute: if duration of symptoms is less than 3 months
Chronic: if duration of symptoms is 3 months or more

Specify if:

With Delayed Onset: if onset of symptoms is at least 6 months after the stressor

Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision.  Copyright 2000 American Psychiatric Association





 
TCBF 
        That should help. After reading it I do believe that it is the most recent DSM, not as restrictive as the old but better than the last one. In my opinion (that would be the acid test opinion) the problem starts with the quoted portion below. I have no issue with the entire document other than the 11 words below. This is the portion that gets interpreted by some (not all) med staff very broadly so they can place people who suffer other mental illness into the OSI mental illness area. Thats the rub thats my issue, the rest of the stuff is great and I support it. I think if people would look beyond the personal gut reaction and focus on the issue specific problem they may see some value in what my complaint is about.

"or a threat to the physical integrity of self or others."

This line above is what allowes soldiers with active line experience to be sitting with a purple trade who never left the front gate in Canada. No wonder a soldier would not want to come forward when you lump him into that group. We are doing a disservice to our OSI injured soldiers by combining the two.

All that said lets get specific maybe I need education to change my mind, someone tell me how does a Swiss Air recovery person fit into that description?
How does a cook on a tanker in the Gulf 2,000kms from the fighting (fighting tht lasted 100hours) fit in?
How does a beer and schnitzel tour (Germany) fit in?

These comments are not negative towards PTSD they are constructive to fix the current mess IMHO.
 
"someone tell me how does a Swiss Air recovery person fit into that description?"

You had to be there before you can comment, Swiss Air was horrific and a traumatic event.

We lost people to PTSD.

I shift worked at the Barge in Shearwater. I do not need to say anymore.

Crow
 
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