Living with an OSI.

[Greymatters]

Speaking out of ignorance here...

Is there presently any methods to help prevent PTSD, like some kind of mental training beyond just the training you get when joining? Or is it to unpredictable and random, as well dependent on the individual and previous life experiences?

There is a model out there that explains it and I have a version of it I modified for talking about different cultures.
Its primarily to do with adaption and acclimation, but a lot has to do with a persons personality and experience as well...

 

[SeanNewman]

SFB,

I concur that Grossman's term Bullet-proof is a little misleading, but I don't think even he means it as invulnerable.

The term Bullet-resistant makes a lot more sense but doesn't sound as sexy and maybe that's why he chose it.

If I understand you correctly, that doctor debunks the term more than the content?  It would be hard to debunk decompression time and having your country support you, etc.

 

[Armymedic]

You do not understand correct. He debunks the concept that training and other can prevent you from developing PTSD.

Supports and resources after the events do not diminish the occurrences of people who suffer from the disease, it does however mitigate the effects and allow for quicker recognition and treatment for those who suffer.

I can not debate the subject more than that because I read Grossman several years ago and do not recall the particulars, and now have limited my reading to more scientifically proven medical topics.

 

[SeanNewman]

That is why I said resistant, not proof.

I fully agree with you that you can't prevent it 100%, but I disagree if he says you can't do things to lower the amount of cases and for the large bell curve in the middle that it helps.

PTSD is not something like AIDS or pregnancy where either you have it or you don't, it's more like a slider on an equalizer that once you get past a certain point (say 8/10 for argument's sake) you are deemed to have it.

Can you prevent everyone from going past 8?  Of course not.

However, there are a lot of things that can be done to take someone who may have been an 8 and make them a 5.  And for the Army as a whole who may have been a 5-6 they might only be a 3.

 

[Armymedic]

As PTSD is a medical diagnosis (the criteria for diagnosis is listed earlier in this thread), it is a condition that "you have it or you don't".

And if you disagree with the person who the Canadian Forces and others consider an expert on the matter, that is your prerogative, but it does not make you correct. Do not confuse the issue with your layman opinions.

 

[mariomike]

Although not called PTSD back then, it was discussed in the book "Bomber Command" by Max Hastings. Many RCAF members flew in Bomber Command. It goes into considerable detail on the subject of the operational effect of PTSD on heavy bomber crews.
Chapter 8, if interested:

"There was great fear at the top of the service that if an honourable path existed to escape operations, many men would take it. 'L.M.F. ( Lack of Moral Fibre ) could go through a squadron like wildfire if it was left unchecked' says one of the most distinguished post-war leaders of the RAF, who in 1943 was commanding a bomber station. 'I made certain that every case before me was punished by court-martial, and where applicable, by an exemplary prison sentence, whatever the psychiatrists were saying.' "

 

[SeanNewman]

...And if you disagree with the person who the Canadian Forces and others consider an expert on the matter, that is your prerogative, but it does not make you correct. Do not confuse the issue with your layman opinions...

I'm not giving you my opinions, I'm giving you the opinions of other experts.

I am not going to defend everything Grossman says, but he's not shooting these things from the hip.  He quotes many studies on the matter, it's not him making it up and me quoting him.

Once again, even by your own references, an OSI/PTSD is not a matter of yes or no, as much as you say it is.  Yes there is a diagnosis, but that diagnosis is based on a person demonstrating a large mix of symptoms and his assessment. 

Just about everyone exhibits some mild symptoms upon their return, what what is the CF going to do, diagnose everyone?  No, they have set the bar at a certain level and when they feel like the person has crossed that bar they make their diagnosis.

 

[OldSolduer]

I am not going to defend everything Grossman says, but he's not shooting these things from the hip.  He quotes many studies on the matter, it's not him making it up and me quoting him.

Once again, even by your own references, an OSI/PTSD is not a matter of yes or no, as much as you say it is.  Yes there is a diagnosis, but that diagnosis is based on a person demonstrating a large mix of symptoms and his assessment. 

Just about everyone exhibits some mild symptoms upon their return, what what is the CF going to do, diagnose everyone?  No, they have set the bar at a certain level and when they feel like the person has crossed that bar they make their diagnosis.

I agree with you on this one. I've read Col Grossman's writings and I agree with him. Bullet proof the mind,,,,not totally, but you can condition the mind to accept what is somewhat bizarre. I advocated over 10 years ago that instead of making our language "politically correct" we bring back words like "kill" instead of the bland "neutralize". A mild example maybe, but an example nonetheless.

 

[SeanNewman]

I don't actually think I'm disagreeing with that surgeon's assessment but SFB's interpretation of it.

Nobody here has challenged the core of what SFB has said that surgeon has said, in that it is impossible to make someone completely immune to any sort of OSI.

I don't see how that means you can't take steps to make it less though, which is what SFB is also saying.

You can absolutely train a soldier to be more-willing to kill another human, there is no question about that.  And you can also do things to put his mind at ease after he does it, and that's all I'm suggesting.

SFB is implying that nothing can be done and if it's going to happen it will, which IMO is ridiculous. 

But the part about not being able to have a 100% bullet-proof mind is not being challenged.  Only people who psychologically enjoy killing regardless of the circumstances would fit that category.

 

[OldSolduer]

Here's my take on it:

Its my belief that OSIs cannot be totally prevented, but the severity can be mitigated by training the mind. Just as you do PT for your physical well being, I think that the mind can be trained to accept the bizarre.
I also think we live in a "Disney" world, where all the creatures of the forest love each other and cuddle all the time. This is what many of our young people beleive. Its my contentionthat if we correct this "fuzzy" thinking, we'd lower the severity of OSIs.
Training, training, training. Sometimes training the mind is far more important than training the body.

 

[SeanNewman]

MAS,

I've also seen studies on the modern trend toward urban living and how it is having a negative impact on soldiers' minds because fewer and fewer are growing up on a farm and dealing with violent death on a regular basis.

It's not to suggest that killing a cow or a chicken is the same as a human, but if you grow up thinking that it is completely natural to kill things (not enjoy it, but just understand that it happens) you are much better off.

I don't remember it word for word, but it also hinted that it explained why more and more people claim PTSD for something like seeing someone killed in a car accident...these people have gone their entire life without ever seeing anything violent in real life (one of the side points was that movies or games are no substitute and can not get you desensitized to death the way reality can).

 

[mariomike]

I don't remember it word for word, but it also hinted that it explained why more and more people claim PTSD for something like seeing someone killed in a car accident...

It's called "The Circle of Death".

 

[Strike]

Which is interesting and flies in the face of all those who believe that violent video games and movies make people more accustomed to it.  :

 

[SeanNewman]

It's not the accustomed to killing part that was mentioned so much as the accustomed to seeing a real person violently injured/wounded.

This is getting off topic but Grossman states that videogames can be used as part of training a soldier to the point of being more "okay" with pulling the trigger on another person (more so than training on 4-foot squares did in WW2).

This was more based on the OSI part about what happens after that.  You can see people blown apart in movies all the time, and you can even see real people getting blown apart on websites like liveleak and ogrish, but it is not the same as seeing it in front of you.

That's what the farm part was more about, that from a very early age kids on a farm are exposed to flesh and blood, where as that's extremely rare so for a lot of people the first time the see gore (for lack of a better word) immediately in front of them is when they just killed an enemy or the enemy just killed their friend.

Ideally for that person's mental health you'd like that not to be the first time.

 

[Chico M]

A few words if I may.

I have been spending the last year recovering from Delayed Onset / Chronic PTSD .... ( non combat related )

A lot of what Lt Col Grossman is accurate in my belief. Back then we did not have critical stress debrief or anything like it as I was a civilian and we dealt with it by going and getting wrecked. Sadly I did not know any better and after fourteen or so critical incidents I cracked. It took a long time but it happened.

I do believe that many people in the Combat Arms are / were like myself and try to hide their condition in hopes it will go away. In many cases it may, but for me it did not. My employer after twenty five years of service dismissed me while under medical treatment which only added to my stress. The ONLY people who have stood behind me was the CF and my Doctor.
Point is...we have come a long way as far as medication is concerned and we will continue to do so.The support system is now there. From my personal experience I know if someone looks...help is out there. I just hope that if one of my friends comes back from tour looking for help, he still has my number.

Cheers     

 

[Another Mom]

PTSD is more about how the individual brain deals with stress than the individual event/s that precipitated it. Exposure to chronic, unremitting stress can lead to changes in the brain.  The chronic stress  leads to excess cortisol and norepinephrine , which damages the hippocampus. MRIs have shown that the hippocampus is smaller in people with PTSD, possibly due to damage caused by excess cortisol.

I don't think that playing violent video games is causing lots of stress, but having your dad  unexpectedly come in and beat you for playing might and over time, might make you hypervigilant.  Likewise, killing an animal for food on the farm may not be a stressful event, unless it is your pet goat.  A soldier who experienced a lot of chronic stress as a child  (or whose brain releases a LOT of cortisol) may be more predisposed to PTSD than the buddy who may have seen worse things while on tour.

Resilience to stress is complex. Too little stress and there’s no growth. Too much, and it becomes destructive. Infants exposed to uncontrollable stress are more likely to develop PTSD as adults because of the brain changes they experienced early in life.  They are hyper-reactive to everything.

In the US, the National Center for PTSD is developing a a scale to measure resilience.  Their website talks about strategies for soldiers and other involved in stressful situations.

Take care of yourselves out there...

 

[Journeyman]

I don't actually think I'm disagreeing with that surgeon's assessment but SFB's interpretation of it.

Nobody here has challenged the core of what SFB has said that surgeon has said, in that it is impossible to make someone completely immune to any sort of OSI.

While probably not overly relevant, some terms carry weight of their own accord.
Col Randy Boddam, the CF's Director of Mental Health Services, is a psychiatrist; he is not, nor has he ever been, a surgeon.

I now return you to tonight's episode of "He said/She said." 




For some of us, correct facts are important; they facilitate informed opinions.
For you others, apologies for the interruption.

 

[SeanNewman]

Journeyman,

You are completely right in correcting my error.

I accidentally associated someone in charge of something medical as a "base surgeon" as that it what I am used to calling the man in charge of medical matters (so to speak).

My bad; I have no problem admitting when I made a mistake.

 

[Greymatters]

I've also seen studies on the modern trend toward urban living and how it is having a negative impact on soldiers' minds because fewer and fewer are growing up on a farm and dealing with violent death on a regular basis.

When speaking of 'urban', do these studies also include persons who grew up in ghettoes and high crime areas?  These type of people also have a higher 'tolerance' towards being involved in and witnessing violence.

I don't remember it word for word, but it also hinted that it explained why more and more people claim PTSD for something like seeing someone killed in a car accident...these people have gone their entire life without ever seeing anything violent in real life (one of the side points was that movies or games are no substitute and can not get you desensitized to death the way reality can).

This is being debated in the insurance industry.  There has been a substantial increase in the number of claims that include PTSD, but it hasnt been proven whether it is because its actually happening due to lack of exposure to violence, or if its lawyers are just being more aware of the term and how it improves their clients chances for higher settlements... 

 

[SeanNewman]

Grey,

Can't say for sure, and I can't even find the article on Google now (it was a paper copy of some study I read in a Dr's office or something like that).

The extreme-urban part is an interesting point but I don't think there are as many gangstas [sic] in the CF as there are "average" Canadians from modest homes.

Not saying they don't exist, just that the "average" soldier used to have a 60% chance of coming from a farm, and now has a 10% chance (approx of course, but general).