Stress disorder likely to trouble some soldiers - CP article

[old medic]

Canadian Press Article - 05 Feb 2007

Stress disorder likely to trouble some soldiers
Canadian Press (CP)

CALGARY -- Sometimes the wounds sustained on the battlefield aren't visible at all.

As Canadian soldiers continue to hunt on foot for the Taliban in southern Afghanistan or face yet another suicide bomber while on a convoy, it's not just the number of dead and wounded that rises.

Many of those who watch their friends and comrades being killed or hurt are themselves left with psychological wounds that may haunt them for a lifetime.

Some already realize that the readjustment at home is going to be difficult.

"I've caught myself wondering if I will ever be the same again," one member of the Princess Patricia's Canadian Light Infantry in Afghanistan told Canadian Press. "I wonder sometimes how I'll adjust to not being able to kill guys when they piss me off."

The soldier is a gunner on an LAV (light armoured vehicle) stationed on the front lines in the Panjwaii District, once a stronghold of the Taliban. He is scheduled to return home this month, and said his biggest fear is that he feels nothing about those he has killed.

'DOESN'T BOTHER YOU'

"You wonder why it doesn't bother you to see bodies explode or chopped to little pieces by a machine-gun and know that you did it."

That feeling of numbness, along with anger and an inability to cope, is a common symptom of post-traumatic stress disorder.

Once known as shell shock, its sufferers were originally viewed as cowards. But that has changed dramatically over the past 10 years, and it's now accepted that psychological wounds are as debilitating and can ruin a life.

 

[muffin]

Let's hope the military steps up and helps those suffering from PTSD (and their families).

They have been slow to react in the past.

 

[RHFC_piper]

Let's hope the military steps up and helps those suffering from PTSD (and their families).

They have been slow to react in the past.

There are systems in place.  Between OSISS, Padre's and peer support, we're very well provided for.  It comes down to the individual soldier to take advantage of the resources available... especially reservists, who cannot be forced to go to Operational Stress Injury Clinics, and are seperated from their tour-mates.

It can take time to get to these resources (4 months for me), but they're there and things are getting better.

As for the article;  Since I've been home, I've had issues with dealing with what I've been through and I've found, for my self, that talking about what I've been through helps me wrap my head around it.  I tell people what I've seen and what I've done, to get it off my chest, and I get a lot of strange responces.

In this article, the PPCLI soldier talks about killing people and watching people being 'blown apart';  I'm sure there are a lot of readers questioning the moral issues in this. Not just the actions, but the comfort in talking about it.  In our society, it's not very politically correct to discuss death, or killing... But this is what our soldiers face, and after enough of it, it becomes 'reality' and 'comfortable'.

I've had the same types of experiences from the battle of Panjwayi, being 20 meters from the enemy and watching the results of effective fire (mine and others) and I try to deal with it by discussing it with my fellow soldiers at my home unit (they ask, I tell) and here on these forums (with a little more discretion).  But I've found myself in situations where I'd be discussing my experience and I would get the sence that I've offended the person I'm talking to with my candidness in disclosing the bloody details of battle.

Is this level of comfort with killing and death normal or right?  or has our society become fairly soft? 

While I was there, I talked to a lot of the ANA and the stories they told made every horror story, any Canadian (or even American) soldier has told me, seem like a happy fairy tail.  Not to discount what we've been through, as we all deal with these issues independantly, but every mans experiences are their own, comparable only to their own.  Having a parent die is something we all go through at some point in our life, and for a lot of people, this is the most traumatic event in their life.  for the soldiers out in the front lines, death is a daily event, and becomes as comfortable as breakfast.  And for the people of Afghanistan, sometimes there is only death.

So, as I asked before;  Is it wrong to be comfortable with it?

The soldier in the article says: "I wonder sometimes how I'll adjust to not being able to kill guys when they piss me off." 
This is not quite accurate, but it is true.  It's all situational..  I never felt "pissed off" at those I killed on the battlefield, not that I'd invite them over for tea though, but I've asked myself similar questions;  "Will I be able to control my, now normal, reaction to threatening situations? If I feel threatened, will I attack?"  This is a normal reaction over there, Threat = Attack, much like a cornered animal.  Primal instincts are part of the norm on the battlefield, and when soldiers return the 'switch' (this conditioning) is still left on, and this is part of the now defined condition PTSD.

When the soldiers return home, they will face another culture shock. They will have to deal with this as well as the conditions which follow them home.

This article clearly demonstrate these issues, as well as the needs to address them.  But the public should also be aware that there are, like I said, Systems in place.
When troops leave Afghanistan, the go to a third party location for Decompression, usually Cyprus, where counsellors and speciallists are ready to help.  They're there with thier peers and encouraged to talk.  Once they're home in Canada, they have access to peer groups and services like OSI to help them cope. Even the reservist augmentees have access to these resources.  It's not as hard to get help as it once was.

I hope all that helps. 
For anyone who's interested in the mindstate of war fighting (and hasen't already read them) I'd suggest reading 'On Killing' and 'On Combat' by Lt. Col. David Grossman.  I've read both several times and they've helped me understand where I've been, what I'm going through.

 

[3rd Herd]

Interesting seeing the article coming out of Calgary. As for the clinic here there is a wait list(6 weeks) but depending on situation it changes. My assessment was done fairly quickly and rather well. Now the wait is on again for treatment. Muffin, I could not agree with you more. VAC is STILL a royal pain to deal with but the OSISS staff here have been absolutely fantastic and have some what made dealling with VAC easier. Just an aside I have yet to meet a VAC employee that is service most have book learning instead of BTDT and sometimes just do not get it. Best quote of late from a social worker (re professional bureaucrat) " I have seen plenty of dead bodies and I am not bothered by it so it should not bother you".

 

[hotelquebec9er]

Thanks for speaking up RHFC_piper!

 

[Roy Harding]

Excellent post RHFC_piper, you give a perspective that (thankfully) not many are able to.

Take care of yourself.

 

[medicineman]

Best quote of late from a social worker (re professional bureaucrat) " I have seen plenty of dead bodies and I am not bothered by it so it should not bother you".

Better than even odds that they had nothing to do with making those bodies dead.  I myself have never had an issue of dealing with dead people in and of themselves either - however, have had a few issues with a couple that I was involved with either trying to make them no longer dead or that I feel may have been dead as a result of actions I may or may not have done (whether those actions/inactions were contributory or not) and have to live with those. 

As Piper noted, it's all in the eyes of the beholder and how the beholder in turn chooses to deal with it.

Good luck to the two of you.

MM

 

[Armymedic]

Let's hope the military steps up and helps those suffering from PTSD (and their families).

They have been slow to react in the past.

That was the past.

Also in the past, our soldiers were not properly prepared for what they would possibly see or encounter (I am going on another 6 month UN sponsored vacation to this place called Yugoslavia). Now troops are well briefed on what to expect and what is expected of them, i.e. better ROEs, more open source news reporting etc.

I believe now soldier will be better at dealing with thier experiences than they were in the past.

 

[muffin]

I am glad to hear some things have gotten better - my father was diagnosed back around 95-96 so things were not as easy then.


muffin

 

[TangoTwoBravo]

I believe that the CF has effective mechanisms in place, although of course that is a subjective opinion.  Institutionally there are procedures in place, although of course no procedure or mechanism is perfect.  One thing that we do have, however, is leadership who have an idea of what the issues are through personal experience (mostly gained in the 90s but also on previous Afghan tours). 

After one incident I was approached by senior NCOs and officers who had been through similar incidents on previous tours.  While I was not in their chain of command they were concerned about me and wanted to know that I was OK.  While no two situations and people are identical, they understood on some level what was going on in my head.  I think I had suppressed emotional responses during the time of the incident and it took a couple of days for those emotions to begin surfacing.  I was able to be fairly clinical about the whole thing for about two days, but then cracks started to show.  Basically I had a mixture of anger and grief.

A WO in particular kept checking on me and advising me to go see a professional, even though he didn't notice any symptoms.  He just knew what was going on.  After a couple of days I went to the Role 3 and asked a med tech out front about CISD.  She was busy moving stuff but she dropped everything and within minutes she had linked me up with a very relaxed US military mental health professional.  Thirty minutes later I walked out feeling pretty upbeat.  I still had some emotions to work out, but I had a framework in which to place them and I knew what to look out for.  I did the same thing later in the tour and had similar outcomes (this time with a Canadian worker), although I think I was a little more bitter at that time and I probably came across that way.  The Cyprus time was helpful, if a little hazy.  Back in Canada I had post-tour screening three months after redeployment which involved a fairly in-depth interview.  Everybody is supposed to go through this screening.  A point to note was that being in a "dry" camp may have helped a little in the long run.

The army will gain more and more experience dealing with this issue, and the formal and informal mechanisms in place will improve.  Again, my peers, superiors and people outside my chain of command were excellent and I'd like to thank them. 

 

[silentbutdeadly]

I think that the military has excellent staff on Operations and back at home from my experience. The true problem still lays with the CoC. Not to get into to much detail but i think there is still the black cloud of how to deal with personal on Operations with this problem and from what happend to me and a few other personnal we were treated like outcasts by some of the higher levels of command. I was called in the open so some of my peers and friends heard that i was a plain coward and that i lend other soldiers astay and this from the highest in our Chain so i think education still needs to be worked on. Don't get me wrong there was alot and i mean alot of people who came up to me in KAF and said i had alot of courage for what i did and they couldn't do that. What i am getting at is that yes its getting better, way better but we still need alot of education on this subject and we need to get the soldiers who were in these situations out there talking to soldiers going and coming back.

 

[3rd Herd]

from what happend to me and a few other personal we were treated like outcasts by some of the higher levels of command.

Some things never change, but I agree there are some good changes in some cases to little to late. Also they are still trying to figure out how to deal with some of us.

 

[the 48th regulator]

Shared in accordance with the "fair dealing" provisions, Section 29, of the Copyright Act.

Traumatic military deployments linked to problems

Updated Wed. Jul. 4 2007 8:59 AM ET

Canadian Press via CTV News

http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20070704/military_trauma_070704/20070704?hub=Health


HALIFAX -- There is a strong link between traumatic experiences during military deployments and the risk of mental-health problems, suggests a study that also concludes untreated conditions are an "enormous problem'' in the Canadian Forces.


The study, published in the current issue of the Archives of General Psychiatry, was based on Statistics Canada interviews with more than 8,000 active Canadian military personnel in 2002.


More than 30 per cent of respondents reported emotional problems in the previous year, including post-traumatic stress disorder, general anxiety disorder, depression and suicidal thoughts, among others. And personnel who said they witnessed atrocities such as mutilated bodies or mass killings were far more likely to be part of that group.


Furthermore, less than half of those experiencing some level of emotional problem used any form of treatment, such as medication, therapy, counselling or skills training.


Jitender Sareen, the study's lead researcher, said that discrepancy can have significant consequences for military personnel returning home.


"At an individual level, a person can have a lot of difficulties in their personal relationships, difficulties returning to work, thoughts about suicide,'' Sareen, who teaches psychiatry and community health sciences at the University of Manitoba, said Tuesday.


"The relationship between anxiety and depression and alcohol use in males is quite well known. When you're trying to deal with some of these memories of traumatic events, self-medication with alcohol can be common.''


The study also explores why military personnel suffering from emotional problems didn't seek treatment -- a trend that is also common among the general population.


Almost 40 per cent of the personal who had emotional problems but weren't getting help said they weren't seeking treatment because they didn't have confidence in the services available through the military.


"It's hard to know exactly what it was that an individual respondent would have meant by that, but obviously there's an issue, so we have to pay attention to that,'' said Col. Randy Boddam, the military's director of mental-health services.


"There's still a lot of work and we know that.''


Boddam said the military is working to improve care, including hiring more staff and shifting to an interdisciplinary, team-based system to better address the needs of patients.


He said a major priority is to make sure military personnel know the full range of options available to them, while emphasizing the importance of early treatment.


Sareen said it wasn't clear whether the deficiencies expressed by respondents about the available services were real or perceived.


"How much of this barrier is a perception of the services available or in actuality that the services are not good, that's difficulty to tell with this data,'' he said.


Sareen said the findings emphasize the need to improve mental-health services and education. He said the military appears to be taking the issue seriously, with five clinics for veterans suffering psychological problems already open across the country, and five more on the way.


"The survey was part of trying to understand what is needed, and I think having more clinics available is a step in the right direction,'' he said.


Sareen's research explores the sort of emotional scars that were brought into the national spotlight following the 1994 Rwandan genocide, particularly the story of retired general Romeo Dallaire, who led a UN peacekeeping force there.


Dallaire, now a senator, returned from Rwanda suffering from post-traumatic stress disorder. The horrors that he saw in the war-torn country drove him to early retirement and a suicide attempt. In 2003 he was found drunk in a public park near Ottawa, curled up under a bench.


Sareen said some research has suggested emotional problems may be similar in all peacekeeping missions where soldiers are asked to stand idle in conflict zones.


But the new study concludes that peacekeeping personnel who don't witness such atrocities are actually less likely to develop emotional problems than soldiers experiencing combat.


"There had been quite a bit of controversy in the literature, especially on peacekeeping and some of the issues on Rwanda and Romeo Dallaire and how generalizable were those experiences to the general soldier that goes to any (peacekeeping) mission,'' he said.


"If a soldier goes on a peacekeeping mission that does not involve combat or witnessing atrocities, they're not at increased risk.''

An interesting report specifically where it was published, and how the stats were gathered

The study, published in the current issue of the Archives of General Psychiatry, was based on Statistics Canada interviews with more than 8,000 active Canadian military personnel in 2002.

dileas

tess

 

[Wookilar]

Tess, question: Have you read the actual article in "Archives of General Psychiatry" or just the report from CP/CTV? I would be very interested in getting a hold of the actual report.

I'm just wanting a bit more detail (if available) on the breakdown of these 8,000 "active" troops and the question bank used. Does anyone remember any survey in '02? I was on Roto 11, Op PALLADIUM then and we of course got surveys up the hoop, but I don't remember one from Stats Can. I just remember those internal before,mid and after tour ones on morale and such.

Wook

 

[the 48th regulator]

Tess, question: Have you read the actual article in "Archives of General Psychiatry" or just the report from CP/CTV? I would be very interested in getting a hold of the actual report.

I'm just wanting a bit more detail (if available) on the breakdown of these 8,000 "active" troops and the question bank used. Does anyone remember any survey in '02? I was on Roto 11, Op PALLADIUM then and we of course got surveys up the hoop, but I don't remember one from Stats Can. I just remember those internal before,mid and after tour ones on morale and such.

Wook

http://archpsyc.ama-assn.org/cgi/content/short/64/7/843

dileas

tess

 

[Wookilar]

Excellent, thanks. Problem is, I'm not a subscriber. I'm sure someone here at this fine institution I am studying at can get me what I want. Some alarm bells are going off, however, on some of the conclusions they may have made prior to looking at the data.

Examples:

"Objective  To examine the relationships between combat and peacekeeping operations and the prevalence of mental disorders, self-perceived need for mental health care, mental health service use, and suicidality;" and,

"Participants  A total of 8441 currently active military personnel (aged 16-54 years)."

I would like to know the parameters used to differentiate between "combat" and "peacekeeping" operations (if any). Keep in mind the survey data is stated as being from Stats Can surveys from '02. At that time, our "combat" experienced troops were mostly located in one area. Also, the age range is curious. It tells me right away that at least some of the respondents were brand new Reservists that have (probably) not even finished training (I worked MSS for more than a few years, I am familiar with the training cycles of more than a few Reserve units) let alone "been there, done that." Now I am very curious on the questions asked and the response spread offered.

If I do get a copy of this report, I'll post.

Wook

 

[the 48th regulator]

What alarm bells are ringing, I find alot of what the report suggests to be factual and helpful.  Am I missing something?

dileas

tess

 

[Wookilar]

I've studied way to many of these reports over the last few years, and making the data fit in a model is relatively simple once you do the math. You know that old saying about stats....lies, darn lies and stats.

I always take these things with a heavy dose of salt until I see the actual questions asked, the response spread offered, and the method/location of data collection. If they went to Greenwood, Bagotville, Trenton, and Edmonton, they would get very different answers than if they went to Halifax, Valcartier, Pet and Edmonton. I'll see what I can dig up tomorrow at the Psych Department and see if anyone there has the full copy that I can read.

Wook

 

[Greymatters]

Like Tess I found the report results useful but I agree that the date of the report raises questions of whether the information is still valid.   With the numerous deployments to more dangerous places after 2002, wouldnt the current situation be quite different from pre-2002?

 

[medicineman]

I'll have to see if I can pick the brains of some of the research group, since I'm off to Winnipeg to start my psychiatry rotation next week.

I'm with Wook here - we need a bit more than the abstract to really say if this conclusion is the one actually determined by the data, and not predetermined by the researchers (since I'm not a subscriber, I'll have to find the actual journal and read it).  Alot has to do with the cross section of people surveyed, not to mention the actual questions asked, what the group were using as parameters for defining the different ops, etc.  It'll be an interesting read one way or the other I'm sure.

Another saying - "Statistically speaking, 43% of all statistics are statistically useless".

MM