Topic: The Star: An "Investigation" into Afghanistan and Violence in Canada

[Baloo]

An Afghan veteran's rage
 
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Since returning, Pte. Matthew Keddy, shown in Afghanistan a month before killing an enemy combatant at close range, has been convicted of assault.  Print
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An exclusive Star series investigates how the war in Afghanistan is creating a dangerous new class of offender in Canada – and finds growing evidence in jails, courtrooms and homes across the country

Jun 13, 2009 04:30 AM
Comments on this story  (42)
David Bruser
STAFF REPORTER

Pte. Matthew Charles Keddy sits in the prisoner's box, his second court appearance in as many weeks.

Already charged with beating up his girlfriend, he's in court this time following his arrest on the Reversing Falls Bridge in Saint John, N.B., for violating a restraining order.

In recent days, Keddy has seen the inside of a jail and a psychiatric ward. And in the weeks to come he will be brought before two other judges, plead guilty to assault, listen to his girlfriend's tear-soaked impact statement, and spend five more days in the psychiatric ward.

This is a lonely moment for the 26-year-old infantryman and veteran of the Afghanistan War. On this day, no one from the military shows up on Keddy's behalf, which riles Judge William McCarroll as he tries to set the terms of Keddy's pre-trial house arrest.

Judge McCarroll: "There should be somebody here from the military, right? To take responsibility. And I don't understand why there isn't. I mean, he went to Afghanistan. He did his part. He's back here now. So what is he, cut loose?"

Prosecutor: "They are aware he's got psychological issues. There were programs set up for him that he has not been attending. And their position is ... they're not in the business of 24-hour-a-day babysitting, because they perceive that he is a soldier and has responsibilities himself."

Judge McCarroll: "The word `babysit' certainly doesn't apply to this young man. He's certainly not a baby when they send him overseas, that's for sure."

Prosecutor: "They were aware of the alleged assault of the girlfriend. They were aware of the no-contact order with the girlfriend ..."

Judge McCarroll (agitated, his voice rising): "Were they aware that he was on the Reversing Falls Bridge, going to jump off it?"



LIKE AN ANGRY BRUISE coming to the surface, the cost of the war to Canadian soldiers is starting to show in jails, courtrooms and homes broken by booze and rage.

After serving their country in the heat, grit and unpredictability of the Afghanistan war zone, where hundreds of Canadians have been killed or seriously hurt by unseen roadside bombs, the troops are bringing the violence home.

Spousal abuse. Suicide attempts. Barroom assaults. Drunk driving.

A Toronto Star investigation shows the problem is escalating, presenting police, lawyers, judges and psychologists with a new and dangerous class of offender.

"Your training that the taxpayers of this country paid for should not be used against them under any circumstances," a judge told a soldier convicted of assault. "You need help. You need counselling to get over whatever trauma you experienced when you were in Afghanistan. You're not the same man you were when you left Canada, and that is a sad reality of war."

The Star reviewed court documents and interviewed scores of soldiers – from privates to warrant officers, light-armoured-vehicle drivers to snipers, those with physical injuries and those without – as well as lawyers, law enforcement officials, psychologists and others connected to military communities from Vancouver Island to CFB Gagetown in New Brunswick.

Some examples of post-Afghanistan crime:

In a Winnipeg police station, a soldier-turned-child abuser repeatedly smashes his head against the wall after a detective places him under arrest. He later pleads guilty to assaults that caused a total of 19 broken bones in his triplet sons, and is serving a three-year jail sentence.

On the side of a road in Gatineau, Que., at 6:30 a.m., a young veteran of the Afghanistan war named Yuri Miljevic-LaRoche, his eyes red and breath stinking of alcohol, tries to give first aid to the bicyclist he struck with his car.

In a New Brunswick courthouse, Richard Donald Malley is found guilty of assault after he hit a man in a Miramichi bar hard and often. It happened just days after he returned from Afghanistan. The court hears Malley, 21, may be suffering from a psychological injury.

All the soldiers interviewed by the Star describe an incredible journey that takes them to the Afghanistan moonscape 10,000 kilometres away, where they live in what they call a state of "hypervigilance." Many return looking for a powerful distraction from the memory of what happened there. Others come home feeling empty. There's a void that needs filling. They fill it with booze or drugs or both. These men want to reclaim that feeling of living at the centre of the action. They want back out on that edge. Instead, many of the soldiers in this story end up in the back of a police cruiser or in jail for the first time in their lives. Without criminal records before the war, they now report to a probation officer or child services worker, or both.

"It was after the Breathalyzer they put me in cuffs," recalls Travis Schouten, now living in Sarnia and fighting a see-saw battle with his psychological injury, known as post-traumatic stress disorder (PTSD). "When they did that, I was empty. I had been to Afghanistan, lost friends, done something good, and here I am in the back of a police car, like a common criminal."

Schouten awaits trial after an incident in Whitewater Township, Ont., in which he says he rolled his car into a ditch, injuring one of the passengers.

Retired colonel Pat Stogran, who led the first group of Canadians in Afghanistan in 2002, seemed visibly agitated when presented with the Star's findings, including details of how some of his former soldiers are abusing drugs and alcohol and getting into trouble with the law.

"These guys who are walking wounded, these are the guys who might as well be bleeding out on the Kandahar desert right now," says Stogran, now the Veterans Ombudsman in Ottawa. "I am devastated to hear that.

"What (the Star has) done here validates a lot of the stuff that's been nagging at the back of my brain. You send anybody away to a crap hole for six months and they'll come back changed."

He argues the military must better prepare soldiers for the stress of war, including subjecting them to virtual-reality representations of warlike conditions before they go on tour.

"I don't think the military is doing enough. It's not all about learning how to pull the trigger and strip and assemble your weapon. It's also about seeing the blood and gore and really being able to relate to somebody who's badly mutilated and you have to put tourniquets on. We tried to set up a program of stress inoculation. I brought it to the powers that be."

But Stogran says his ideas were ignored. "I've been ranting and raving. It's fallen upon deaf ears."

Stogran also wants the military to make soldiers prepare "life plans" to get them thinking about how to live a life of purpose after leaving a war zone and the military.

In the meantime, he pledges to ask the military to consult with corrections officials to get a handle on exactly how many veterans are landing in jail. He fears that what the Star found may only be the "tip of the iceberg."

"A lot of the troops are still serving, doing multiple tours, and perhaps still haven't had time for their pot to boil over."



SINCE STROGAN took the first group of troops into Afghanistan seven years ago, 26,800 Canadians have been deployed and 119 have died, the most of any Canadian combat mission since the Korean War. More than 400 have been injured by improvised explosive devices (IEDs), mines, rocket attacks and direct combat. At least 1,000 have suffered severe psychological trauma.

In the past few years, as the military has stepped up recruiting to try to keep pace with its costly commitment (roughly $7.5 billion to date), the damage has escalated.

The number of soldiers killed in action jumped from single digits in 2002 through 2005 to about 30 in each of the following three years. And more than one in five Canadian soldiers and police officers deployed to Afghanistan leave the force with psychiatric problems, a number that has rapidly risen in the past 12 months. The closer a soldier is to combat, the more likely he or she will develop PTSD, which can affect someone who has suffered a critical injury or witnessed death, or who has been threatened with death or critical injury.

Symptoms include reliving the traumatic experience through nightmares, flashbacks or even smells; hyper-arousal that can lead to sleeplessness, irritability and anger; and avoiding conversations, places and people reminiscent of the traumatic event.

Keddy, a foot soldier during his tour in 2007, told the Star he shot an enemy combatant at close range and was never the same. "I went and served my country with honour and dignity and I came back and my life went straight to hell," says Keddy, now 27. His mother, Brenda Love, added: "It was war he went into and somebody else came back. His eyes are dead. You start talking to him about the war, you can see that blackness come over him. It's going to take a long time to get that little boy back."

Meanwhile, the military justice system is seeing a steady increase in disciplinary and criminal matters coming before military courts.


In the court-martial system, where more serious cases are typically dealt with, the number of cases has increased each year since the beginning of the war, with a 16 per cent jump in 2007-08 from the year before.

Records of court-martial proceedings offer a window into a military struggling to cope with stressed troops. In February 2007, in Kandahar province, a sergeant "severely injured" a corporal, dislocating his jaw during an "unauthorized" training session on the use of flexi-cuffs and the handling of detainees.

Also in Kandahar, in the wee hours of Christmas Day 2005, a drunk master corporal ratcheted up an ongoing dispute with a corporal by pointing a loaded rifle at him from less than two metres away. The master corporal cocked the rifle. The corporal, fearing for his life, took the rifle, grabbed his superior by the throat and kneed him in the ribs, released the magazine from the weapon, cleared the chamber and returned the ejected round to the magazine. The court reported that the corporal has nightmares about the incident.

The military says it does not keep data on military members who are arrested off base, charged with a crime or convicted of a crime by civilian authorities.

Repeatedly asked to comment on the Star's findings, the military did not respond.

The mounting cost of the Afghanistan war on the soldiers, their families and communities is troubling a number of judges from Winnipeg to Saint John.

In the summer of 2008, when faced with Sgt. Ronald Anderson, a veteran of two Afghanistan tours and sufferer of PTSD, sitting in the prisoner's box charged with uttering a death threat, New Brunswick Judge Patricia Cumming signalled a new problem facing the criminal justice system.

"More and more the courts are being asked to venture into areas with which they are not particularly well-equipped to deal," she said. "What we're dealing with is a situation everybody talks about – post-traumatic stress disorder. Yet no one here has an understanding of what that actually entails, what risks that puts to the defendant or to others in his proximity or with whom he has a close relationship.

"It is daily life that he's been dropped back into after going through all of these horrific experiences – the loss of friends and comrades in such violent and horrific ways, seeing children die ... I will say that in dealing with these matters in the future, and I expect there will be many more, that counsel may have to consider perhaps more detailed hearings ... upon which the court can actually rely when making these types of decisions."



ON NOV. 24, 2008, in a monotone recitation of the facts, the prosecutor detailed for the court what police had found on Tweedsmuir Court in Oromocto, N.B., four months earlier.

Shonda Lynn Burgess said she and Matthew Keddy had a fight. That Keddy threw a remote control at her before pushing her. The constable reported Keddy had pushed Burgess with both hands, lifting her clear off the ground and onto her butt. The constable saw bloodstains on her jeans and a swollen left arm, and that she had trouble walking.

Prosecutor: "What she has is a cracked vertebrae."

Keddy has pleaded guilty to assault and will be sentenced to three months' house arrest and 12 months' probation.

The prosecutor's summary done, Burgess steps to a microphone in the courtroom.

Burgess: "As I sit here thinking about what to write for my victim impact statement ... I can't do it. I'm going to cry all the way through it."

Burgess pauses, then reads on.

"Being attacked by the man one loves pulls at every part of that person. Matthew attacked me and ended up cracking my tailbone and ending our relationship and in turn making it very untrusting.

"I am not certain as to why this happened on that day. I am not sure that I ever will. I didn't deserve to be attacked."

She cries all the way through the rest of her statement.



IN PETAWAWA and nearby Pembroke, communities heavily populated by military families, where storefronts seem to compete for the highest number of "Support Our Troops" posters, the suffering is not on display.

But it is not far from view.

At the Phoenix Centre for Children and Families, where clients can discreetly enter from a back alley, the military family caseload has rocketed from 12 in 2005 to 85 today, with 20 on the waiting list.

Director Greg Lubimiv says the families are "grappling with issues ranging from anxiety-driven child behaviours like bedwetting and aggression, to domestic violence, depression and marital breakdown."

"More deployments actually compound the stress on many of our soldiers," Lubimiv adds.


Since 2006, the proportion of military family clients at Phoenix who have experienced the stress of multiple deployments has risen from 33 per cent to higher than 60 per cent.

"There is a dramatic increase in marital conflict," says Lubimiv. "And when you have people who are feeling depressed, moving into substance abuse is common. And there is a fair tie-in between substance abuse and violence ..."

A defence attorney who represents many military clients based at CFB Petawawa says that shortly after a tour returns from Afghanistan, he sees a spike in the number of domestic assault charges, some involving a weapon, along with impaired driving and "confinement," which he describes this way:

"It usually takes the form of a complete loss of control, where all hell's breaking loose and a spouse is trying to call the police ... and you're blocking the door, you're ripping the phone out of the wall. That's a classic. The phone rip out of the wall. Happens a lot. Can't tell you how many times guys have had restitution orders to replace the phone. And the phone is often the weapon."

A young corporal, interviewed by the Star on CFB Petawawa, pushed his wife down the stairs.

"We were arguing. I remember I was at the top of the stairs. I blacked out. From what she tells me, I put my hand on her face and pushed. When I snapped out of it, she was at the bottom, screaming and bleeding. I took her to the hospital in (nearby) Pembroke."

On a recent afternoon in the backyard of his small house on base, the corporal sat on the edge of a lawn chair, pumping his knees. Being seen talking to a reporter likely would not promote career advancement. But he figures nosy neighbours will assume a man with a notepad to be his probation officer or child services worker, both of whom make regular appearances.

Chain-smoking, a bucket full of stubbed-out butts within reach, the corporal recalled his tour in 2006 – the snap of bullets, the smell of an exploded IED, a medic screaming, dust everywhere.

"I can remember everything. It's like we were VHS players before the war. Now we're Blu-ray players.

"When I came home, that first day, got home early in the morning, I couldn't be here. I had to get back.

"When you're overseas, your life's on the line. Hypervigilance. You get home, there's nothing."

Not even the thrill of meeting his newborn son for the first time.

"You need to find that adrenaline rush."

The corporal pleaded guilty to assault. He says the judge gave him 18 months' probation and allowed supervised visits with his son. The corporal was only recently allowed back in the home. He visits a psychologist on base every two weeks, is on Cymbalta, an antidepressant, and wears a mouthguard at night. He grinds his teeth in his sleep. The corporal says he needs a new mouthguard because the one he has is badly chewed.



IN HIS FAST FALL from soldier to suspect, Pte. Matthew Charles Keddy, without a criminal record before the war, has shared the same courtroom as drunk drivers and an armed robber sentenced to six years in a federal penitentiary.

Prosecutor: "According to the information the (military is) getting, he's not cooperating with the program."

Judge McCarroll: "Well, if he's mentally ill, maybe that's the problem. Maybe he can't comply. Maybe it's not his fault. Maybe it's as a result of the fact that he went overseas, saw some terrible things and is back here, suffering from some kind of a stress type of situation that he needs help for."

Keddy violated a court order to stay out of Saint John when he went to the bridge. (The order stemmed from the assault charge involving his girlfriend.) On this day, Oct. 20, 2008, Judge McCarroll tells Keddy he must stay on the base, CFB Gagetown, unless accompanied by his parents, and undergo a psychological assessment.

Judge McCarroll: "How about it, Matthew? Are you willing to go through the program that they have up there (on the base)?"

Keddy: "I just want to go home."

Judge McCarroll: "Home with your parents, you mean?"

Keddy: "Yeah. You send me up there, I'm going to go nuts."

The microphone picks up Keddy's sniffles. His voice shakes.

Keddy: "They say they're going to help me, but they don't help me. They don't care ... (sniffling) ... They don't care."

Judge McCarroll (addressing Keddy's stepfather in the courtroom gallery): "How was everything before he went overseas?"

Stepfather: "Oh it was good. He was happy. He was excited about life. He loved Canada."

Keddy: "I was normal."



David Bruser can be reached at 416-869-4282 and dbruser@thestar.ca.

http://www.thestar.com/news/canada/article/650299

[Journeyman]

Standing by to painted with a broad brush -- all Afghan veterans are now potentially a "dangerous new class of offender," using taxpayer-funded village-burning ninja training against any and all citizens.

I know there's not a hope Pravda the Toronto Star will publish the ratio of how many have served in Afghanistan and not attacked anyone, compared with the number of people in this story.

 

[George Wallace]

Something wrong here.  Unless Keddy is now out of the CF, there should be a "Delegated Officer" at all of his court hearings.  That officer's sole purpose there is to keep the Comd informed; not to provide any assistance or advice to Keddy.  This whole theatrical dialogue provided in this article would be better served up in a theatre, than in the Media.

[Technoviking]

George
I'm so glad you made that post.  I've been a delegated officer before, and it's exactly as you said: you sit, take notes and then info the CO (or whomever) what heppened.

Methinks this is much ado about nothing.

(Not that some people have problems, and this is not to make light of anyone's situation.) 

I do note this part of the article:

There were programs set up for him that he has not been attending..."

  As I understand it, if a member is ordered to attend a medical appointment, and that member fails to attend, then that member can be charged with AWOL. Having said that, I don't know if he was ordered to attend. 

[kilekaldar]

I agree with Journeyman, while I sympathize with the soldiers who came back with PTSD and believe everything should be done to help them, this article really paints us with combat tours as the "crazy vets", baby-killing Nazi sociopath psychos public enemies. I've already had people call me that and worse while I walked on the street in Ottawa in uniform, articles like this won't help the public understand us. If anything it will just generate fear and hatred.

And I would also like to see statistics about violent crime rates from Afghan War vets compared to the general public in the same age group.

[Baden Guy]

Link

Soldier 'not living anymore, just trying to survive'

TheStar.com
 
One man anesthetizes his return from Afghanistan with anything he can find

June 14, 2009
David Bruser
STAFF REPORTER

VANCOUVER ISLAND – The blinds are drawn to keep out the midday sun.

Tinny electronic music pulses from a laptop's small speakers.

The former corporal in the Canadian Army sits shirtless and sweating in the cool, dark room.

He works his jaw in small circles. He has just snorted cocaine off his stovetop. The appliance is smeared with it.

The Afghanistan war veteran – two tours since 2002 – moved only recently to this new subdivision home, at the end of a street in a small town on the edge of Vancouver Island, as far away from the war, the army and loved ones as he could manage.

The 29-year-old talks fast, each word spilling into the next.

"In a three-week period, I broke a cop's nose, put another guy in hospital, wrote off my Denali, broke up with my girlfriend.

"I'm in and out of depression. I'm unreliable.

"I have to do two things a day: walk the dog and go to the gym.

"Two weeks ago, I got busted for drinking and driving. I blew three times over.

"I have a bad temper."

He has not slept in 36 hours. He says the night before he swallowed several tabs of MDMA, or ecstasy, and sped through two "eight balls" of coke. He lights a cigarette.

"You wouldn't be able to handle my nightmares.

"Paranoia's a big thing. I keep the doors locked.

"I don't answer the phone. I get groceries at night when there's no people around.

"I want to be invisible."

He is on daily doses of lithium and an antipsychotic called Zyprexa. Plus a supply of Viagra to counter the prescription drugs' effect on his sex drive.

"If I'm off my meds, guaranteed someone's getting hurt, or I lose my crap.

"I can't concentrate.

"I've written off two vehicles. I drove one into a lamppost. I ran away from the vehicle and committed fraud. I said my car was stolen. The second car I flipped. I had passed out driving.

"I know I got two warrants out for my arrest in Alberta.

"It's been getting worse. I want to see a psychologist to get help.

"I know where my bottom is. I'm pretty sure I've hit it."

The Quebec native wants his name kept secret to avoid getting into more trouble with civilian police, though he does not seem to care the military knows how he lives. Given the detail he agrees to have published, they will likely be able to identify him.

He lights another cigarette. The laptop chimes a Coldplay song.

"I started gambling when I got back from Afghanistan the second time. I lost $17,000 in one day playing blackjack in Vancouver.

"Anything for a rush."

With the menacing calm of a sand shark, a muscular brown pit bull quietly weaves through and around the man's legs under the dining room table. The dog's name is Deca, after the former corporal's favourite steroid – Deca-Durabolin. Vials of steroids litter the man's bedroom windowsill and dresser top. When he doses, he injects in the behind or shoulder.

The words rush out into the smoky room. He weighs 285 pounds, is generously tattooed and wears camouflage shorts. With the pit bull nearby, he is imposing, though heavier and less defined than he used to be, judging by his Facebook photo album.

"I have a self-confidence issue.

"Having (post-traumatic stress disorder) is shameful. I'm ashamed of myself.

"I found out I wasn't the tough guy I thought I was, and that destroyed me mentally.

"In the army, it's frowned upon.

"You're thought of as being a *****.

"So I moved here."

When he was 22, on his first Afghanistan tour with the 3rd Battalion, he was nearby when his friend Cpl. Ainsworth Dyer was blown up by a bomb mistakenly dropped by U.S. pilot Maj. Harry Schmidt. Three other Canadian soldiers died that night. Eight more were injured.

"What I have is survivor's guilt.

"By the end of the tour, I was wishing I had died.

"I was tired of the anticipation.

"I got diagnosed with severe PTSD.

"Psychologist said I should never have held a weapon after that first tour."

The former corporal says he lasted only a few weeks on his second tour in 2007. He was sent home after testing positive for cocaine.

"The only reason I was doing coke was because of my tour in 2002.

"They reprimanded me for trying to cope with that.

"A major said I was an embarrassment. F---, he never went to Afghanistan.

"I wanted to rip his head off.

"People piss me off. When I'm sober, I'm angry.

"I smoke an ounce of weed a week. It mellows me out.

"You got PTSD, you're not living anymore. You're trying to survive.

"It's f---ing draining.

"I don't care for society anymore.

"And all I want to do is go back to Afghanistan"

[Jammer]

There's more to this guys story than meets the eye I suspect.

[X-mo-1979]

Yes virtual battle training.Awesome.Let's add that to the enormous amount of time away from family.
Why not have a shrink walk around with us out there as well.When stuff goes south he can ask us how we feel,and work on it right there and then.

I think we have enough systems set up now to help people with PTSD.

As for blaming stuff like doing lines off a stove,hitting a lady in a car etc.Idiots do it, and somehow I think PTSD get's blamed to get leniency.

An idiot driving drunk and runs a young lady down is a idiot.

People with real PTSD I sympathize for.However I am getting sick and tired of hearing these people who do things like break 17 bones in an infant's body,and any other non socially acceptable thing blame it on PTSD.

I am so sick of these people.

I'm also guessing VA is paying the guy to snort 8 balls and smoke a pile of dope?
Your tax paying dollars at work.

[milnews.ca]

Something wrong here.  Unless Keddy is now out of the CF, there should be a "Delegated Officer" at all of his court hearings.  That officer's sole purpose there is to keep the Comd informed; not to provide any assistance or advice to Keddy.

I've been a delegated officer before, and it's exactly as you said: you sit, take notes and then info the CO (or whomever) what heppened.

Is there a chance such an officer was there in civvies?  Then again, I'm guessing anyone with a even a military bearing could be spotted in a crowd in court, especially by a reporter.

this article really paints us with combat tours as the "crazy vets", baby-killing Nazi sociopath psychos public enemies.

I thought everyone knew about the "Crazed Ex-(Soldier, Sailor, Airman, Reservist) (insert verb) (insert object)...." headline all set to cut and paste in print newsrooms across the land.....   

Seriously, I have to agree with the "there's GOT to be more than this" school of thought here.

[PuckChaser]

You'd think with this second guy, maybe his steroid use could be the cause of the violent outbursts and bad temper? Oh wait, that wouldn't make a good Anti-CF story.

[40below]

Is there a chance such an officer was there in civvies?  Then again, I'm guessing anyone with a even a military bearing could be spotted in a crowd in court, especially by a reporter.
I thought everyone knew about the "Crazed Ex-(Soldier, Sailor, Airman, Reservist) (insert verb) (insert object)...." headline all set to cut and paste in print newsrooms across the land.....   

Seriously, I have to agree with the "there's GOT to be more than this" school of thought here.

I've covered maybe one or two cases involving Canadian (and American) soldiers in court in Kingston (surprising, but it DOES happen) and the delegated officer is always in uniform. They don't usually attend routine matters such as remands or scheduling dates, as they can pick that up with a phone call five minutes after it happens (and these days the accused is only there by video link from lockup) but they're always there in uniform taking notes at pretrial, trial and disposition.

[Brihard]

I remember receiving an email from David Bruser a few months ago asking me questions about pre and post deployment... This article has been in the works for quite some time.

As easy as the conclusions are to dislike, I wouldn't dismiss it out of hand because of its tone. I suspect most of us know someone who's still grappling with issues from tour, and the basic premise - that more of our buddies are ending up in the criminal justice system after a deployment - seems to be valid. I don't like reading this, but if there's truth to the assertions made - and I think there is - maybe this kind of public attention is what is needed. I was interested to note the part from Col. Stogran about basically being unheeded by the powers that be. It's not the first time I've heard that. The numbers of people in the CF basically on administrative 'hold' while they have physical or mental medical issues sorted out shows that this isn't some sort of phantom problem...

[40below]

Oh, and having read all three parts of the series, I gotta ask from a professional POV: where the HELL is the CF? 'No comment' doesn't cut it. PAOs are paid quite well to field calls like this, and the minister certainly is, where's the CF talking about the PTSD clinics, the evaluation before, during and after deployment,m the fact they'll fly social workers out of KAF and into the field after an incident if necessary, whatever? "Can't talk about specific cases but we can talk about aggregates and programs. Hey Star, want to talk to one of our docs who work with PTSD? You've got two hours with him on Tuesday. Want some stats on the number of people who have gone through our PTSD program? Want to know what training they get at the unit level before deploying? Here's the number of the guy who's in charge of it. What else do you need and when do you need it by? Yeah, sometimes **** happens but we're doing out damndest. Here's the proof."

FTA: Repeatedly asked to comment on the Star's findings, the military did not respond.

This series wasn't put together on a Friday afternoon and published on Monday, the CF has known about this for weeks. Rail against the Red Star all you want but the CF once again proves incapable of getting their own side of the story across by virtue of not even trying.

And let me say this: in any other large organization, public affairs heads would be rolling on Monday if a three-part series came out in the country's largest paper without even a squeak from the people paid to defend its public image (actually that's wrong. There would have been a short, sharp meeting when this came out on Friday and more competent staff would be hired on Monday.) In DND, it's business as usual.

[dangerboy]

Is there a chance such an officer was there in civvies?  Then again, I'm guessing anyone with a even a military bearing could be spotted in a crowd in court, especially by a reporter.

When I was an attending officer I wore a civilian suit and tie. Of course being Brandon the only people in suits were lawyers. Everyone thought that me and the accused (who was also wearing a civilian suit) were lawyers

edited to fix my mistake in terminology.

[milnews.ca]

where's the CF talking about the PTSD clinics, the evaluation before, during and after deployment,m the fact they'll fly social workers out of KAF and into the field after an incident if necessary, whatever? "Can't talk about specific cases but we can talk about aggregates and programs. Hey Star, want to talk to one of our docs who work with PTSD? You've got two hours with him on Tuesday. Want some stats on the number of people who have gone through our PTSD program? Want to know what training they get at the unit level before deploying? Here's the number of the guy who's in charge of it. What else do you need and when do you need it by? Yeah, sometimes **** happens but we're doing out damndest. Here's the proof."

Just to play the devil's advocate (been there, done that, and actually respect reporters who do their homework, maintain context and are fair), there's people who post and read here regularly who've dealt with the media who might ask, "and what proportion of column inches would this info fill up, if shared in any detail at all?"  Especially after their own experiences in sharing information they never saw/read/heard in subsequent coverage.  That's how you end up with cynics saying things like, "you can control what you say, but you can't control what they write".

I realize it'll never be even a crude 50-50 split on two-sided stories (and what stories are only two-sided?), but any ideas/suggestions from your professional POV re:  how to improve the ratio of what's written to what's said?

[Jammer]

This "reporter" had an agenda.
I think that he had already written his story and needed extreme cases to "expose" the military and it's alleged abandonment of former soldiers.
Don't get me wrong, some of our friends are wrestling with demons they will have to reconcile with, but sensationalist reporting like this only serves to hinder their recovery and send them deeper into isolation.

[SeaKingTacco]

When I was a delegated officer

It is actually attending officer. 

[40below]

Just to play the devil's advocate (been there, done that, and actually respect reporters who do their homework, maintain context and are fair), there's people who post and read here regularly who've dealt with the media who might ask, "and what proportion of column inches would this info fill up, if shared in any detail at all?"  Especially after their own experiences in sharing information they never saw/read/heard in subsequent coverage.  That's how you end up with cynics saying things like, "you can control what you say, but you can't control what they write".

I realize it'll never be even a crude 50-50 split on two-sided stories (and what stories are only two-sided?), but any ideas/suggestions from your professional POV re:  how to improve the ratio of what's written to what's said?

Well, I suspect you know who I am and you know what I do, so you know I'm not one of the bad guys, if not necessarily sharing the rarified air of St. Christie, but on an operational level, the CF is very good at explaining itself, given OPSEC and other constraints. And that's both on the level of corporals up to generals.

Where the CF falls down from an image and message management perspective, and I've seen this personally, is given something they DON'T want to talk about, they retreat to familiar procedural silence - "A BOI is coming so we can't prejudice it, all in good time, wait until it goes away." That doesn't cut it for something like this and I would LOVE to see a proper communications strategy from the CF to deal with an issue like this, or a number of others that I've seen them boot away over the years. The public PR industry is very good at this, the CF should, but hasn't, learned from them. PAOs have gotten a lot better in the past 10 years, but communicating with the public, something front and centre with a public corporation (or another government department, say health, which has actual clients and people who rely on it who are not governed by a code of conduct, is a fifth- or sixth priority within the CF. I have my own thoughts about how that formed over the years, but that's a topic for another day.

Be as mad as you like at the paper, I don't work there and I don't care, but if I was on the other side of the fence, I'd be furious that my entire profession was, to paraphrase, painted as mentally unstable, hair-trigger thugs unleashed on society by the government after it trained them to kill, without even a wait-a-minute response from the people who not only employ me, but lots of other people at a higher pay scale whose nominal job it is to publicly dispute such charges.

As for your other point, if you want to be quoted accurately, stay in your lane and stay on message. Sure some people here have had bad experiences with reporters. I've had bad experiences with members who have been, with no good reason, varyingly surly, lying, unco-operative, rude, stupid and incompetent, also from the level of private from general. Does that prove that everyone in the Forces is an a-hole, and the entire Canadian profession of arms is something distasteful if not actually disgraceful by extension? You've got anecdotes, I've got anecdotes. Guess what? The plural of 'anecdote' is not 'data.'

The thing is, the reporter does not CARE about the story. Something bad happened to somone else, but it's just a story and I get paid the same. Bad news doesn't sell papers in a meaningful way, no matter how people with no more understanding of the news business than I have of C-130 landing gear maintenance insist that it does. And by and large you're dealing with reporters who are indifferent and who don't have an axe to grind. They may be uniformed, lazy or ignorant of the Canadian Forces, but they're just not out to "get" you. Be clear, talk about what you know and what you want to get across, and having said what you need to say, STOP TALKING. An interview is not a friendly chat between friends.

[X-mo-1979]

I remember receiving an email from David Bruser a few months ago asking me questions about pre and post deployment... This article has been in the works for quite some time.

As easy as the conclusions are to dislike, I wouldn't dismiss it out of hand because of its tone. I suspect most of us know someone who's still grappling with issues from tour, and the basic premise - that more of our buddies are ending up in the criminal justice system after a deployment - seems to be valid. I don't like reading this, but if there's truth to the assertions made - and I think there is - maybe this kind of public attention is what is needed. I was interested to note the part from Col. Stogran about basically being unheeded by the powers that be. It's not the first time I've heard that. The numbers of people in the CF basically on administrative 'hold' while they have physical or mental medical issues sorted out shows that this isn't some sort of phantom problem...

I totally disagree.
We had retards in the army for a long time.It seems the new generation of them are using PTSD as a fing excuse.
I have also heard talk of guys getting busted for dope and using PTSD as a claim.Yet from the rumor mill they were using it for many years.Just so happened they got caught red handed....and had excuse to go along with it due to having deployed.

Sure I know a couple guys who had issues from the last roto.Those guys are also not running around beating wife's,stabbing babies and doing drugs.They got help from tour(UMS mental health flew out)to Cyprus(breifs, mental health around 24/7 to talk) to home.These guys also had the same care allotted to them,and they ****ed up in the game called life.And decided to claim PTSD.

That's my opinion.This isn't Medak pocket.It's 2009 and we have been killing and being killed for a couple years now.The help is there (and I found rather pushed if you were involved in any major incident).

While I truly believe some members come home with issues,I believe most of these guys were idiots before they left,done drugs they left and now that they got caught it's PTSD.

[milnews.ca]

Well, I suspect you know who I am and you know what I do, so you know I'm not one of the bad guys, if not necessarily sharing the rarified air of St. Christie, but on an operational level, the CF is very good at explaining itself, given OPSEC and other constraints. And that's both on the level of corporals up to generals.

If you're who I think you are, then I know you do your homework - fair enough.

Where the CF falls down from an image and message management perspective, and I've seen this personally, is given something they DON'T want to talk about, they retreat to familiar procedural silence - "A BOI is coming so we can't prejudice it, all in good time, wait until it goes away." That doesn't cut it for something like this and I would LOVE to see a proper communications strategy from the CF to deal with an issue like this, or a number of others that I've seen them boot away over the years. The public PR industry is very good at this, the CF should, but hasn't, learned from them. PAOs have gotten a lot better in the past 10 years, but communicating with the public, something front and centre with a public corporation (or another government department, say health, which has actual clients and people who rely on it who are not governed by a code of conduct, is a fifth- or sixth priority within the CF. I have my own thoughts about how that formed over the years, but that's a topic for another day.

Speaking strictly as a taxpayer, I'm not happy with more of the message not getting out there, either.

Be as mad as you like at the paper, I don't work there and I don't care, but if I was on the other side of the fence, I'd be furious that my entire profession was, to paraphrase, painted as mentally unstable, hair-trigger thugs unleashed on society by the government after it trained them to kill, without even a wait-a-minute response from the people who not only employ me, but lots of other people at a higher pay scale whose nominal job it is to publicly dispute such charges.

I'll agree with you here, and I'd like to see more of Canada's side out there, too.

Sure some people here have had bad experiences with reporters. I've had bad experiences with members who have been, with no good reason, varyingly surly, lying, unco-operative, rude, stupid and incompetent, also from the level of private from general. Does that prove that everyone in the Forces is an a-hole, and the entire Canadian profession of arms is something distasteful if not actually disgraceful by extension? You've got anecdotes, I've got anecdotes. Guess what? The plural of 'anecdote' is not 'data.'

I have no beef with the reporters who do the job, I have a beef with those who, in your words, write while "uniformed, lazy or ignorant" re:  what they're covering.  Without as full a picture as one can collect, how can one explain it properly? 

The thing is, the reporter does not CARE about the story. Something bad happened to somone else, but it's just a story and I get paid the same. Bad news doesn't sell papers in a meaningful way, no matter how people with no more understanding of the news business than I have of C-130 landing gear maintenance insist that it does. And by and large you're dealing with reporters who are indifferent and who don't have an axe to grind.

I'll agree in general, knowing there are still a few weiners among the keeners.  That said, I've worked for media bosses who, although I had no personal axe to grind as a reporter, were happy to wear corporate glasses to selectively choose assignments to be covered - NOT sayin' it's happening everywhere, but it's not happening nowhere, either.

BTW, thanks for the detailed insights from the inside - good to hear from someone in the craft defending said craft.

[40below]

I have no beef with the reporters who do the job, I have a beef with those who, in your words, write while "uniformed, lazy or ignorant" re:  what they're covering.  Without as full a picture as one can collect, how can one explain it properly? 

Well, not a lot of reporters are 'specialists' - most are general assignment (GA), which means today it's a house fire, tomorrow it's city council, next day it's a university funding announcement, to be followed by a police-involved shooting. I'm not an expert in structural fires, municipal governance, post-secondary funding or ballistics analysis, but I don't HAVE to be. I just have to know someone who IS and ask them intelligent questions if I don't understand something.

The budget ain't there at most outlets to add a military specialist to a staff, nor is there a lot of call for it in cities without a substantial CF presence. The secret to reporting is to do your homework, ask questions and put in the legwork. Many don't - I've seen stuff coming out of Afgh that makes me cringe professionally as well as personally. I've always found it's just as easy to get it right. And even of the handful of beat reporters who cover the military in Canada for teh debbil MSM , I can't think of one that ever wore the uniform - not that that is necessarily a hindrance, provided you can do your job properly.

That said, it's a difficult beat. There is next to no public access or transparency to DND the way there is with a city council, a university, a hospital or just about any other institution you care to mention, you can't just wander around a base looking for stories without getting picked up by the MPs, the process to get clearance to talk to someone who wants to talk to you can be ludicrously complex and is entirely shut down during an election, there's OPSEC and everything else, and it is damn difficult to deal with these people – there isn't a 13-year-old girl in the world with thinner skin and feelings that bruise more easily than your average Maj.-Gen when they don't like a story, even when there's nothing actually wrong with the story. They're entirely too used to dealing with people in their COC, and more than once I've had to whip out a notebook and sketch out a basic wiring diagram ("Look, I'm not IN it!") to illustrate that point.

[Jammer]

I would argue that members of the media would be more welcome if they were willing to participate in some of the activities that military member do every day.
All to often I have seen reporters prance about while embedded with us who have a sense of entitlement, and then *****  that they are not getting the "whole story".
Folks like Rosie Dimanno, Christie Blatchford, Lisa LaFlamme, People who have more nads to get dirty and walk the walk get the best stories because they have never betrayed the trust of the people they are writing about.

[Harris]

I've covered maybe one or two cases involving Canadian (and American) soldiers in court in Kingston (surprising, but it DOES happen) and the delegated officer is always in uniform. They don't usually attend routine matters such as remands or scheduling dates, as they can pick that up with a phone call five minutes after it happens (and these days the accused is only there by video link from lockup) but they're always there in uniform taking notes at pretrial, trial and disposition.

All the times I've done the duty, it's been in civies (At my CO's direction).  Admittedly, with the exception of the lawyers, I'm usually the best dressed person in the court room. It appears criminals don't subscribe to the dress for success theory.

[Bruce Monkhouse]

Everyone one of the inmates I'm looking at right now would jump on the "PTSD" train at the drop of a hat if they thought they could score lenency out of it......................and the media would lapdog them up also.

I'm certainly not saying PTSD isn't a problem, but like lots of things, the idiots/dipwads/f#@#heads will use the specture of it to save themselves.

I wish I could post more details [I can't] but suffice to say one "resident" already tried that last year while here claiming to have been "over there" the year before,.........................about two months later it comes out that he never made it out of Battle School in Meaford and got his release signed while incarcerated here.

I wonder if the Star will have his *cough* story on Page 1 on why the Military is to blame for his troubles.

[X-mo-1979]

Everyone one of the inmates I'm looking at right now would jump on the "PTSD" train at the drop of a hat if they thought they could score lenency out of it......................and the media would lapdog them up also.

I'm certainly not saying PTSD isn't a problem, but like lots of things, the idiots/dipwads/f#@#heads will use the specture of it to save themselves.

I wish I could post more details [I can't] but suffice to say one "resident" already tried that last year while here claiming to have been "over there" the year before,.........................about two months later it comes out that he never made it out of Battle School in Meaford and got his release signed while incarcerated here.

I wonder if the Star will have his *cough* story on Page 1 on why the Military is to blame for his troubles.

Thanks.Thought I was the only one for a while.

[Bruce Monkhouse]

Thanks.Thought I was the only one for a while.

Only one incarcerated here?

Right now you would be, ......six months ago you would have been # 4.

[schart28]

Here is all the series


1.   An Afghan veteran's rage http://www.thestar.com/article/650299
When Canadian military training backfires ... on us An exclusive Star series investigates how the war in Afghanistan is creating a dangerous new class of offender in Canada – and finds growing evidence in jails, courtrooms and homes across the country

2.   How to throw a lemon grenade http://www.thestar.com/article/650530
"I know it sounds a little preachy, but these are the things I do to feel normal... " writes Glenn Brownhall. Brownhall is a former army private who served four months in Afghanistan starting in late 2003. As a soldier with the infantry, he witnessed destruction and death. He was assaulted by his own men, has a bad back and a limp, and takes high-power painkillers. He suffers from post-traumatic stress disorder. In his email to the Star about how to cope with PTSD, he continues:

3.   Vet by vet, a portrait emerges http://www.thestar.com/article/650531
Achingly tragic stories came first in reluctant trickles. Then, a gush of emotion

4.   Would a better man have died? http://www.thestar.com/article/650529
Haunted by unanswerable questions, a former infantry corporal flatlines through life's blessings
 
5.   A veteran's life of self-medicated torment http://www.thestar.com/article/650528
One man anesthetizes his return from Afghanistan with anything he can find

6.   Home is new Afghan war front http://www.thestar.com/article/649681
More than 26,000 Canadians have served in Afghanistan. In the first of a three-part series, we tell the story of one soldier's troubled return

[Bird_Gunner45]

That said, it's a difficult beat. There is next to no public access or transparency to DND the way there is with a city council, a university, a hospital or just about any other institution you care to mention, you can't just wander around a base looking for stories without getting picked up by the MPs, the process to get clearance to talk to someone who wants to talk to you can be ludicrously complex and is entirely shut down during an election, there's OPSEC and everything else, and it is damn difficult to deal with these people – there isn't a 13-year-old girl in the world with thinner skin and feelings that bruise more easily than your average Maj.-Gen when they don't like a story, even when there's nothing actually wrong with the story. They're entirely too used to dealing with people in their COC, and more than once I've had to whip out a notebook and sketch out a basic wiring diagram ("Look, I'm not IN it!") to illustrate that point.

I have to agree complete.  For every yin, there's a yang. In the news world, it seems like that for every FOX news there's a MSNBC.  The CF has received an outstanding amount of POSITIVE feedback from various news outlets since the start of Afghanistan.  That said, the job of the PAOs is to be the even keel between the "far too positive" articles and the "far too negative" and provide the facts.  In this story it seems like the PAO's dropped the ball.  Perhaps these guys are faking PTSD (which is completely shameful) or maybe they're not. Who knows? The disconcerting thing is that the programs and sheer amount of assistance available for pers dealing with PTSD/OSD wasn't mentioned by the military.  In conclusion, if we are going to take the positive stories and the benefits of them (Most of us have had someone say "thank you", buy a coffee at Timmy's, etc) than we have to be willing to take the odd bad one.  Take the lump, make the counter argument, and reflect on the positives.

[George Wallace]

........  In conclusion, if we are going to take the positive stories and the benefits of them (Most of us have had someone say "thank you", buy a coffee at Timmy's, etc) than we have to be willing to take the odd bad one.  Take the lump, make the counter argument, and reflect on the positives.

I agree that we must take the bad stories along with the good............ but wait a minute; where are those good stories?  This looks like a smear campaign, not just a few bad stories.  Is the Star becoming nothing more than the National Enquirer (Toronto)?

[George Wallace]

Here is all the series

Thanks.  Too bad I started reading some of the comments.  Revolting, to say the least.  Another platform for the Nation's Nutcases.

[Bird_Gunner45]

I agree that we must take the bad stories along with the good............ but wait a minute; where are those good stories?  This looks like a smear campaign, not just a few bad stories.  Is the Star becoming nothing more than the National Enquirer (Toronto)?
[/quoteC]

The Star is just a Liberal outpost... if they get back into power than the military and Afghanistan will become pallitable again... just like how Afghanistan is GTG by MSNBC now in the US.  I remember good stories appearing in the Toronto Sun, PLUS they have the sunshine girl.

[X-mo-1979]

Only one incarcerated here?

Right now you would be, ......six months ago you would have been # 4.

Ha ha.
No Bruce I came back from tour and decided body slamming babies and doing cocaine was bad.
I can only imagine the light sentence someone would get for murder with PTSD.Look at the US salior who got stabbed to death in Halifax.That guy who stabbed him got 5 years...after doing this out on parole for stabbing 2 people.
Throw in PTSD you'd be doing "time served".

How you down beat people in there Bruce is beyond me!

[Jammer]

...you could take the one time payout like a friend of mine did and by a nice 35ft boat.

[BulletMagnet]

My question is, there is a phone number at the bottom of the very first article. Have any of the vets here contacted the reporter to refute or at least enlighten this media rep as to the fact that for every 1 issue there are 100's of none issues, guys who have ligit cases of PTSD who get all the help they need and them some. Maybe some one getting this help would/could call him and show him the other side of the story and of course enlighten him as to the fact that many cases of "PTSD" are simply f**cktards using it as a new excuse to cover their indescretions.

[Scott]

Not to be flip BM, but do you think he'd care after getting his first into print?

It's been said before, what sells more?

[BulletMagnet]

Then perhaps finding a different media outlet to refute the Star? What media outlet doesn't like making the other looks foolish.

[X-mo-1979]

My question is, there is a phone number at the bottom of the very first article. Have any of the vets here contacted the reporter to refute or at least enlighten this media rep as to the fact that for every 1 issue there are 100's of none issues, guys who have ligit cases of PTSD who get all the help they need and them some. Maybe some one getting this help would/could call him and show him the other side of the story and of course enlighten him as to the fact that many cases of "PTSD" are simply f**cktards using it as a new excuse to cover their indescretions.

Why wouldnt I write them or call?
Cause I would have said what you said above.These people are simply.....

Plus I'm sure a Paffo can take ****tard and make it sound more appealing.
Why are they not doing it is beyond me.
However I also don't see it as my job.If they want to give me officer pay to tell the media what I thought I'll gladly take it.

Otherwise I'll deploy and come home to my happy healthy life/family.

[MCG]

...that more of our buddies are ending up in the criminal justice system after a deployment - seems to be valid.

Is this a valid assertion?  Are there statistics to back such a conclusion or merely anecdotal evidence?  There are plenty of numbers in the article, but where are the numbers to support this specific claim?  I think the author has employed misleading vividness and you have fallen to the availability heuristic.

[milnews.ca]

Well, well, well, isn't THIS an intriguingly timed development - maybe casts some rationale for the lead-up stories, not to mention the wrap-up "lookit what WE did" story today?

"Ottawa, June 17, 2009 - The House of Commons Standing Committee on National Defence has released its report on the provision of health services to the Canadian Forces, with a focus on post-traumatic stress disorder, entitled DOING WELL AND DOING BETTER (.pdf). The study, begun in February 2008, conducted an objective examination of the root causes of main difficulties facing military health care in Canada today. The report offers 36 recommendations to the Government...."

[the 48th regulator]

http://www.thestar.com/news/canada/article/652775


Heal our soldiers,

MPs tell military TheStar.com - Canada - Heal our soldiers, MPs tell military Counselling for substance abuse, domestic violence among recommendations from defence committee

June 18, 2009
David Bruser
Staff Reporter

The military should do more to help soldiers suffering from psychological injuries by offering counselling for substance abuse and domestic violence, says a new report by federal MPs.

Those recommendations, and 34 others, were made yesterday in a report presented to the House of Commons by the standing committee on national defence.

"There are problems when they come back (from war). They often fall into drug and alcohol abuse and this transfers into violence for the family," said committee vice-chair Claude Bachand, a Bloc Québécois MP. "And they have a hard time getting treatment."

The findings come only days after a Toronto Star series, "War at Home," found a growing problem of post-tour violence that is landing Afghanistan war veterans in jail and their victims in hospital. Some of the veterans interviewed in the stories struggle with alcohol and drug abuse. Many went to war without a criminal record but now report to a probation officer or child services worker, or both.

The Star's stories prompted the Commons standing committee on veterans affairs to launch its own probe. That work will likely not begin until September, and should differ from the defence committee's efforts by focusing on Afghanistan war veterans who are no longer employed by the military and are living far from soldier support networks.

Warrant Officer Roger Perreault, who was injured by an improvised bomb explosion in 2006, is impatient for the veterans committee to get to work, saying he fears that "upon release, there (will be) no support."

Perreault hits his wife Fran in his sleep, and his post-tour behaviour has pushed his eldest child, 15-year-old Marissa, to seek counselling. He has a desk job on CFB Petawawa but considers his career over.

Meanwhile, the defence committee report called for the military to open its doors to registered marriage and family therapists and other professionals not typically found in the military health-care system.

It also said the military should explore how better to prepare soldiers for the trauma of war. In the Star investigation, retired colonel Pat Stogran – who led the first group of Canadians in Afghanistan in 2002 – said he had been arguing in vain for such a measure, including subjecting soldiers to virtual-reality representations of warlike conditions.

The committee report comes after a year of research and interviews.

Since Stogran took the first group of troops into Afghanistan seven years ago, 26,800 Canadians have been deployed and 120 have died, the most of any Canadian combat mission since the Korean War. More than 400 have been injured by improvised explosive devices, mines, rocket attacks and direct combat.

At least 1,000 have suffered severe psychological trauma.

© Copyright Toronto Star 1996-2009 


dileas

tess

[George Wallace]

Quickly skimming that, without my morning coffee yet, I wonder if the intent is to make the CF carry out the functions of Veterans Affairs and create another redundant agency and see specialists employed, but a plethoria of paperwork and frustration for the members in getting the services they need and long waits as they plead their cases several times before their problems are accepted as legitimate.  (A long run-on sentence, I know.  It exemplifies the frustrations many have experienced dealing with Veterans Affairs)

I wonder if the MPs should be pionting their fingers in another direction (Not at the CF, but at Veterans Affairs) and asking why they have let the members down by not sorting out the bureaucracy at Veterans Affairs.  If the blame is being focused on the CF, why do we even have Veterans Affairs?

Time for me to go have a coffee and wake up.

[Jammer]

XL Black...Tks

[Old Sweat]

According to an interview with NDP MP Peter Stoffer (sp?) this morning on CFRA, the Veteran Affairs Committee has been and will continue to study this issue. He seemed to have a good understanding on the responsibilities of DND and VAC for serving and released  members of the CF.

[Baden Guy]

I thought this item would fit with this thread but mods feel free to move.

Well written article in today's Globe and Mail on Major Mendes by
Christie Blatchford and Jessica Leeder
Did we push her too much?'

[Technoviking]

Baden Guy: Thanks for posting that.  What a sad story indeed.  My only problem is with one of the comments on the news site in which some person suggests that she "...learned the true nature of the invasion" and then killed herself because of it.  Holy friggin' moly.
RIP Maj Mendes.

[PD]

Please note that a lot of members are offered a lot of help, and they simply dont take it.  I cannot give details on a public forum, but suffice to say, if a person wants to be violent they will be.  If a person wants to not heal ..they wont heal. A person cannot be forced to stop being abusive.  The cycle of family violence and its dangers are not caused by the military, in fact one would aspire to soldiers that have more emotional control due to conditioning, regardless of experiences in or out of theatre.

[Thucydides]

Frankly,the only paper which has any half decent reporting on Afghanistan (in any regard) is the National Post, which just finished its series on the history of the mission.

The Globe and mail could not even get basic facts like how long we were in Afghanistan correct (end of the "five year" mission?), and the electronic media is really no better. I have put the Star on "ignore" for ages, and suggest the best way to deal with this sort of "reporting" is for everyone to place the Star and all its advertisers on "ignore" as well.

[john10]

Frankly,the only paper which has any half decent reporting on Afghanistan (in any regard) is the National Post, which just finished its series on the history of the mission.

The Globe and mail could not even get basic facts like how long we were in Afghanistan correct (end of the "five year" mission?), and the electronic media is really no better. I have put the Star on "ignore" for ages, and suggest the best way to deal with this sort of "reporting" is for everyone to place the Star and all its advertisers on "ignore" as well.

The articles clearly refer to the mission in Kandahar, which has indeed been going on for 5 years.

[Thucydides]

Oddly the mission began with combat in Kandahar in 2002 (OP HARPOON and OP WHALE in the Sha-i-kot valley), then shifted to Kabul then back to Kandahar. Separating them out the way the G&M did is ahistorical at best, or dishonest at worst (the focus is clearly on the mission during the years that the Conservatives were in power, but avoiding mention of the mission during the period when Liberal governments were in power).

You may draw your own conclusions as to the motives of the G&M editors, just don't hold your breath expecting a correction.

[john10]

Oddly the mission began with combat in Kandahar in 2002 (OP HARPOON and OP WHALE in the Sha-i-kot valley), then shifted to Kabul then back to Kandahar. Separating them out the way the G&M did is ahistorical at best, or dishonest at worst (the focus is clearly on the mission during the years that the Conservatives were in power, but avoiding mention of the mission during the period when Liberal governments were in power).

You may draw your own conclusions as to the motives of the G&M editors, just don't hold your breath expecting a correction.

A correction for what? The bulk of our mission in Afghanistan for the past five years has been in Kandahar. That's what the articles are about. There's nothing ahistorical or incorrect about it.

And what exact kind of sinister motives/dishonesty do you see here? The G&M has endorsed the Conservatives in the last two elections.

You may dislike the G&M, but I really don't see how a series of articles about our presence in Kandahar the past 5 years would be the source of that.

[kstart]

Some sad stories and I can also relate to feeling anger and frustration about them.

You'd think with this second guy, maybe his steroid use could be the cause of the violent outbursts and bad temper? Oh wait, that wouldn't make a good Anti-CF story.

Yeah exactly, "roid rage".  Also the cocaine can't be helping, and by the sounds of it,  sounds like longer term, prolonged use and heavy use (his manerisms, mouth movements-- seen that on the streets in chronic users on an extreme binge).  Cocaine withdrawal can also cause irritability, restlessness, violent outbursts. . .  He probably uses the pot and the Zyprexa for 'coming down' after binges.

Also concerning is that he doesn't have any aversion to needles for the steroids, I hope he's not injecting coke.  Needles + coke + pattern of high risk/reckless behaviours + the doctor prescribed Viagra. . . HIV risks. . .?

From a PTSD perspective, the high risk behaviours (totalling his car, fights, heavy drug abuse, etc.) can be tactics of Avoidance (numbing, distracting symptoms re: PTSD) through distraction, 'adrenaline junkie'-pattern.

But I can't see any of the PTSD issues being resolved, having a chance to heal with the active severe drug abuse.  I think this man's life is at risk, from severa fronts.  Probably would need some in-patient rehab, but he would have to make that choice and committment and stick with it.  Relaspes are also dangerous (miscalculation of factors re: lower tolerance and over-doing it/OD. . . and for a person that has addiction to extremes. . . :/).

Sad, depressing and frustrating.

There can be high comorbity of addictions co-existing with PTSD-- there's programs like Bellwood that treat this  (I think would have to do the dry-out via inpatient rehab for the addiction first stage recovery?).  If he followed through with that, would have a better chance of getting a good trauma counsellor to agree to treating him?

Not uncommon for people to resist, or deny the need for trauma help, but it can also be a hard battle for a person who's very attached to their addiction to make a firm committment and follow through on that committment via addiction treatment programs.

Another concern I have is if he got a lump sum of money via medical discharge from CF-- getting a big whack of money all at once while having an active (and very expensive) addiction-- if he was smart, he'd get himself to rehab and appoint a trustworthy person to hold on to his finances (trustee/guardianship), make it less accessible, less of a temptation.  This guy could be heading for the street down the road and that's sad.

Another issue, maybe not relevant, but re: being close to a blast where he saw his friend get hit. . . even if he himself was not hit by a projectile, not a visible head injury, can still get blast injuries which can cause TBI (traumatic brain injury, e.g. mild) and there can be overlap of PTSD and TBI, there's some similar recovery challenges, re: concentration, and other traumatic effects.

Sometimes it helps reduce the 'shame factor' for survivors re: PTSD, when it's also understood as a brain injury-- which it is, it affects the amygdala and hippocampus regions of the brain (which causes trippy experiences, flashbacks, fragmented memory, anxiety, nightmares, etc.-- the PTSD range of symptoms).

Yeah, there's likely more to this story. . . could even be prior traumas to the combat trauma and sometimes those are even harder to talk about or mention, whereas combat trauma makes some sense, most can understand the connection.  Not uncommon to stick to one trauma that feels safer to disclose, and even ruminating on it as a way of avoidance, distraction from other traumas.  Pick the most violent one to help block recall of the other ones which may be equally distrubing and frightening, hard to bare/tolerate. . . feed self-anger, self-punishment re: survivor guilt (Aphrodite Matsakis has a good chapter on PTSD guilt, in book Trust After Trauma).

--------
It's an interesting form of reporting, like a mini "ethnography", a glimpse at a person's experiencing at that moment in time.  I wonder about the reporter ethics re: how valid is a person's consent to an interview when they're clearly intoxicated (rapid speech, coke effects, etc.)

(I'm not a 'professional', I just live with PTSD (prolonged, multiple exposures) and in lieu of treatment accessibility at times, I've self-educated (cause it sucks to have no power, so it's taking some power back for myself and for my own recovery, to not be passive just cause things don't work out, 'out there').  I've witnessed others in really bad states, re: PTSD with active addictions, etc. and found that really painful.  They have to make those first steps towards treatment, and continue to actively strengthen their committment to recovery, one day at a time-- can't do it for others. . . (and it hurts to be powerless over that).

--------

About PTSD Education:  there's a lot out there now on the net.  A lot of it comes from the States, because there seems to be a lot of funding, research institutes, etc.

Here's some examples (consider it a 'mini-bibliography'  )

http://www.centerforthestudyoftraumaticstress.org/csts_items/CSTS_understanding_postdeployment_stress_symptoms.pdf

http://www.camh.net/about_addiction_mental_health/drug_and_addiction_information/cocaine_dyk.html

http://www.ptsd.va.gov/public/pages/coping-traumatic-stress.asp


http://www.ptsd.va.gov/public/pages/overview-mental-health-effects.asp

Really good one on TBI, and it's relation to PTSD (some TBIs might go unnoticed, but nonetheless present problems down the road, good FYI):

http://afterdeployment.org/media/elibrary/mtbi/index.html#/5/zoomed

[mariomike]

About PTSD Education:  there's a lot out there now on the net.  A lot of it comes from the States, because there seems to be a lot of funding, research institutes, etc.

I am not an expert. This is just my observation - opinion:
When the psychiatric hospitals began deinstitutionalization 30 years ago, it put a lot of mental health experts out of work. Many found employment with the emergency services. CISD was introduced in 1983. Attendance at debriefings was sometimes mandatory back then after a critical incident. It was believed by some, at the time, that the cumulative effects of trauma would inevitably lead to PTSD in the workers.
This school of thought was reconsidered in the wake of 9/11. Nine thousand counselors descended on New York City after the attack on the World Trade Center. It was later found there is a substantial number of people that rely on their own internal resources to handle a crisis. That people are more resilient than some may believe. I read that intervention may actually undermine some people's natural means of dealing with critical incidents. 

[kstart]

I am not an expert. This is just my observation - opinion:
When the psychiatric hospitals began deinstitutionalization 30 years ago, it put a lot of mental health experts out of work. Many found employment with the emergency services. CISD was introduced in 1983. Attendance at debriefings was sometimes mandatory back then after a critical incident. It was believed by some, at the time, that the cumulative effects of trauma would inevitably lead to PTSD in the workers.

This school of thought was reconsidered in the wake of 9/11. Nine thousand counselors descended on New York City after the attack on the World Trade Center. It was later found there is a substantial number of people that rely on their own internal resources to handle a crisis. That people are more resilient than some may believe. I read that intervention may actually undermine some people's natural means of dealing with critical incidents. However, CISD seems to help some people.

I'm not an expert either, so I had to look up CISD (Critical Incident Stress Debriefing), just to familiarize more.
 
General CISD concepts:
http://www.aaets.org/article54.htm
And they're saying the first 12-24-72 hours are critical. . .

Efficacy studies not conclusive, re: samples, populations? http://ps.psychiatryonline.org/cgi/content/full/51/9/1095

I think it is an important thing to emphasize people's resilience and to respect that.

In support of your POV, this was a good article and a story to people's reactions and shifting reactions re: CISD:

http://www.emsworld.com/article/article.jsp?id=2026

And on where and what the role of Psychological First Aid can be, which also respects people's own inner resilience:

Thus, what role should mental health play in modern emergency services? Several organizations and researchers have addressed this issue. Leading psychological researchers who specialize in traumatic stress,29 NIMH22 and the WHO23 have recommended that competent mental health personnel provide psychological first aid to trauma survivors. This includes such things as listening to rescuer concerns, conveying compassion, assessing needs, ensuring that basic physical needs are met, and protecting the rescuer from further harm. Most important, those who do not wish to talk should not be compelled to talk. For those who want to talk, somebody should be there simply to listen not to provide any sort of care or intervention. In addition, education and information can be provided to better help personnel understand psychological trauma, specifically what to expect and where to get help if needed. If additional help is needed, affected personnel should be referred to competent, licensed mental health professionals with experience treating trauma-related stress. Psychological first aid is not an intervention technique, but only provides practical supportive care while at the same time respecting the wishes of those who may not want to discuss what happened or are not ready to deal with a possible onslaught of emotional responses in the early days following exposure. They do, however, recommend that competent mental health personnel be available within two months of a critical incident to screen and assist any personnel who may be developing stress-related symptoms or PTSD

I don't want to create panic about PTSD, I think having some knowledge re: prevalance and intensity of symptoms and signs to look out for which may indicate a need to get things checked out, can help, because earlier intervention I think can prevent total loss of capacity and 'global functioning' which become bigger recovery challenges, a higher climb back up.  It can make recovery more manageable, re: earlier intervention vs. if it's left for later intervention.

If it's left for later intervention and the situation deteriorates to the extent where it has escalated to an 'urgent crisis' (risks to self/others), I just think it can add more time to recovery time, because usually at that point, it can take time to medically stablize enough, before being able to learn and be receptive to learning PTSD coping techniques (because PTSD-worn out system, can have huge impacts cognitively, due to overwhelment by symptoms).  It just has added challenges when there are further associated 'secondary losses' as a result of deterioration, like this fellow with the addictions problem, isolated from his family, loss of capacities-- that's hard, but it is still recoverable, but it will take diligent work at it.

In those cases it's necessary to learn a new set of coping skills to deal with the impairing effects of chronic, untreated PTSD.  Before I got hit with PTSD, I was high functioning, I could multi-task, get things done on the fly and could thrive under deadlines, etc.  I wasn't emotional (I had a good functioning 'container' around that, till it just got too full and started to spill, which I hated because I had good control-- it's a hard loss, and I had prided myself on being tough enough, resilient enough, having come through some stuff and refusing to accept limitations-- I enjoyed challenging it, resolved to rise above), very professional and could handle a lot.  But the PTSD had a scrambling effect on my brain and now I do need to make lists and stuff to compensate for this loss of functioning which I just took for granted before (the PTSD interrupts routines and plans, it comes down, not by choice, and not when more convenient, but there is new coping skills, which have reduced my recovery time post- [some]PTSD symptom-event).  Sometimes is less to do with adjustment of attidude towards external things as it is adjusting one's attitude towards oneself, and learning some patience and compassion (hard to do). 

I had resilience which worked prior to the development of PTSD and some denial and suppression made it more possible to function (and it's needed through times of handling crisis re: safety of self/others), it's just that it seemed to catch up with me (triggered via a another big-T, Trauma, "staw that broke my back", injured my brain) and became a situation of having to deal with it, but with some changed capacity levels due to PTSD-brain injury.

  ran out of space   Just trying to express newer challenges when PTSD has become full-out and the levels of debiitation it can cause and escalate to greater difficulty when not treated.

[kstart]

When the psychiatric hospitals began deinstitutionalization 30 years ago, it put a lot of mental health experts out of work. Many found employment with the emergency services. CISD was introduced in 1983.

It was probably believed to be a good field to explore and some are genuinely committed heart-wise and if they believed the CISD was an effective and useful method.  I also wonder, there's not enough studies re: different populations re: traumatic impact (e.g. families, with kids experiencing traumatic event(s)/loss simultaneously-- for children [and they're stuck there], family is primary support, but if they're damaged too and need help. . . problems re: resilience-- but kids are very resilient, can compartmentalize (but that can become a habit, and a problem for later on down the road. . .)

One thing I will say, is there can be some less scrupulous 'counsellors' out there who can foster over-dependence, by neglecting to teach coping skills so that the client can be self-empowered by them, to gain confidence in handling tough situations on their own.  Is it a money grab?  Or a counsellor who has poor boundaries, or is it important for a time being (early stage recovery), but forget to shift gears, and it's habit (or transference, creating over-rescuing behaviours).

As for de-hospitalization, well in Ontario (I'm familiar with some resources that would/can serve e.g. Petawawa Base), there was a lot of cutbacks to medical care, some "austerity measures", same members as in Federal government right now.  Not saying it wasn't necessary, but there's likely some casualties (and some you can see at the street level, hiding in addictions, etc).  It wiped out a trauma program at the Royal Ottawa Hospital (headed by Dr. Cameron, which had a lot of efficacy-- I believe he moved to Uplands Base, OSI clinic).  PTSD is not treated by their "Anxiety Program" though technically PTSD, by DSM-IV, is categorized as an anxiety disorder.  PTSD in the general population can be about 8%-- in the States, that's 1 in 13 people will experience it at one point in their lives.  Other programs are privatized, e.g. Homewood, Bellwood and need private insurance, and priorities given to certain groups.  A few other psychiatrists (OHIP_covered) in the area, did get special training re: trauma treatment (Dr. Sequeira, Dr. Frazer, Dr. Wellburn-- associated with Ottawa Trauma and Anxiety Clinic [which does offer some professional training to professionals, and supervision re: trauma treatment].  Reliance on 'civilian resources'/OHIP_funded, can be hit or miss re: if they have trauma/PTSD/DID training.  And this does effect service delivery, because untrained professionals can unwittingly do more damage than good, teach bad coping habits, etc.  There's a professional Code of Ethics, to not deliver treatment for which one is not qualified by training or experience/supervision.  There is a professional duty to keep current on research and treatment methods. 

Ottawa Anxiety and Trauma Clinic was a 2 year waitlist for OHIP (Provincially funded help); then 4 year, then 6 year, then no waitlist, cancelled, but I do know of some CF getting fast-tracked in and also because their medical coverage includes non-OHIP funded psychologists, trauma experts here, and elsewhere.

PTSD can be devastating, involve a lot of losses, but it can become manageable with the right treatment access.  It takes new skills to adapt to it a newer condition vs. pre-PTSD/absense of full-PTSD.  New "Mental Health Program" was introduced past few years, accessed via Family Services Ottawa (Parkdale) and Catholic Family Services (Olmstead/Vanier/Ottawa)-- psychologists and social workers with some trauma-training.  I got on the list right away and it was only a year wait till a phone back from one of them (but I had finally tracked down a social worker with PTSD-treatment knowledge)  Just saying, it was a lot of work, years of work, trying to track down appropriate help and not having 'case management', while suffering in the crisis of PTSD for quite a long time.  Got into a clinic associated with U of O, and so got access to social worker and a GP--both with proper training. 

Psychiatrists can be years waiting as well, hospitalization, no guaranteed of post-hospital treatment/access/monitoring of medications.  Some GPs will only treat one thing at a time (re: billing and trying to make their own political statment), well chronic PTSD, and new studies confirming the chronic stress and lowered immune system (actually causing alteration in the genes), so it's frustrating when relying on GP for medical and meds refill help.  PTSD can be really hard on the body, throw a lot of things out of whack.

It's good to do research from the ground level, because one hospital here it may still be possible to get some after-care.  Otherwise re: meds, it's a wait till it's a crisis, and can go into Urgent Care Consultation Clinic via ER to get get meds re-adjustment, and up to 6 follow-up appointments, to check on meds change efficacy. 

I had a bout of nightmares by night and flashbacks by day, un-fkng-relenting, lasting daily and nightly for 4 months straight and it was exhausting and overwhelming-- 'blender brain"-- too much PTSD hyperarousal symptoms-- it was hell, body just wasn't able to re-stablize so it kept feeding hyperarousal symptoms, bad cycle.  Seroquel was the 'magic drug' for me that finally put an end to that-- I took it for about a year and I haven't been bitten back like that since.  I also don't use illegal drugs and I abstain from alcohol (though I'm able to have a drink or two and stop, if I chose to-- I didn't inherit the family 'gene' vs. other siblings).

I know people can get caught up in 'war stories' or 'story-lines' of whatever sort related to trauma.  Me, that's not good for me to do (it just triggers more, and I can flood-- flashbacks, one upon another and it can create further debilitating dissociation and risk getting into that crazy cycle of extreme, unrelenting hyperarousal symptoms).  Meditation practice was a good thing to learn-- breathe and ground-- remembering to remind myself that "it's just a memory, it's just recall, it's not happening right now. . .I'm safe and others are safe at this moment. . .and I can look around me and see [objects in the room, name-game, name them, notice colours, shapes, use my 5 senses awareness to help re-ground in the present moment" and not to push myself to over-process right away till, body's physiology is calmed.  This method can work, and with practice, reduce recovery time post-flashback (and body awareness meditation can also help notice things pre-flashback, and a way to avoid getting hit by them).

I'm not sure where this comes from, I think it might be Babette Rothschild's work.  Good book is 8 Keys of Recovery. . . i think that might be where 'flashback management technique" comes from.  The challenge is trying to re-learn patience and self-care from reacting to percieved threat (when the phsyiology is also geared up in anticipation of it), which re: PTSD re-living it, thematically or directly (triggered) (cause trauma, crisis situations required some immediate action-- I think combat people, EMS understand that-- can't sit and twiddle the thumbs, re: crisis situations).  PTSD re-living of a traumatic event, the threat can be percieved threat, as if it's happening in the moment, a product of trauma and not the actual reality at the moment, ti's just memory recall, though it can be really disorientating (but sometimes the alarm system is there for a reason, and situation needs to be re-appraised, if it's not an immediate external crisis/threat to deal with, but need to stablize PTSD physiology first, to help get clear).

If I over-relied on help actually being there, I'd be totally screwed.  I also know that I do have some good inner resilience, which is confidence-building and I keep a generally positive attitude (but not always possible in the midst of PTSD-re-experiencing hell).  Personally, I wouldn't want 'rescue' all the time, I think that would drive me more nuts, someone over-doting on me-- I stay away from 'overly-clinging' people (can be toxic, especially a looney co-dependent [tends to be some darker, hidden agenda's, psych-vampire stuff going on ), can be a bit much and also disempowering, robbing me of realizing my inner resilience.  I need some privacy, time alone, just need to not over-isolate (e.g. weeks on end-- that can get too easy to do and harder to get out-- can develop some 'agoraphobia' in the extreme).

At the same time, I don't think it should have had to have been so difficult to try to track down ptsd-help-- taking years, just to get some help and guidance on how to cope with symptoms, and get some training I can use on myself.  Hospital without private insurance, they have no resources to refer a PTSD person to, to get the right help, to help get a handle on the symptoms which can be super disorientating, and cause a lot of loss of time and functioning, and wear down hard on one's self-confidence.

If CF neglects keeping up with demand for community resources and the spill over into civilian resources which are also seriously underfunded and not up at all with demand for them. . . it's just something I hope they can keep on top of and take it seriously, IMO.  Regardless, there are things a person can do in the meanwhile of longer waitlists, and can self-educate, maybe find some support groups.  Alanon can be helpful for families coping, find the right group that feels right.  Also Alateen, for teens-- it can help with getting some perspective-- there's the benefit of 'experienced-others', who have encountered and overcome some similar challenges, it can reduce some alienation.  There's some basic self-care, resilience strategies, checklist, pointers and guidance that can be found (earlier post, I provided some links), but it can also become overwhelming if in a situation of on-going crisis, to read too much.  It can help to prepare a bit ahead of time, some ideas, and things to look out for (easier then trying to learn while in the midst of on-going crisis, where one's energy can be over-tapped, overwhelmed, harder to learn new things in those times-- that's why there's training-- combat, and medical have a core of training before heading into crisis).  "In times of peace, prepare for war".

   continued. . .

[kstart]

Some things about Petawawa access, community resources (continued) and related to the corporal story, and present waitlist for families in Petawawa for help (first Star Article)

Addiction treatment is probably easier to access vs. trauma treatment, at least in the past, I've noticed that.  4-6 month wait for inpatient vs. many years re: trauma treatment-- at the civilian level, no private or specialized health care plan.  Some good programs e.g. Rideauwood and they can do referrals and provide counselling while waiting, etc.  AA/NA something to do, try out while on a waitlist.  If there's addiction co-occuring with PTSD, or anxiety, depression, it's worthwhile to start attending to that, then when there's access to trauma help, could lessen the chaos a little more, to make it easier, and be more receptive to learning and practicing new skills.  What's not good is to get over-used to constant crisis, and melt into a denial numb, while things continue to escalate, and especially if things continue to escalate to becoming more dangerous-- and that can be common (e.g. experience of battered women [or men] ).

I don't find that everyday people, lay people have much understanding re: PTSD, but it's good to try to keep up a support network, people to even try to enjoy some non-traumatized time with, distraction, healthy activities, etc.-- can go a long way.  But I don't really find that there are many people who are safe, trustworthy to talk about harder stuff (some listeners are overly-dramatic, and I don't find that to be helpful; or judging, and using their own frame of reference, but not understanding the particulars of the challenges of coping with PTSD, vs. coping with hard situations but not impaired by PTSD-- so, you get 'pop psychology' which some might work for non-PTSD-- just change your attitude about things. . . I think the attitude might have to change from within, one's attitude towards one's own suffering and to learn to be compassionate that way, empathy, vs. self-loathing, shame-based, overly sensitive to external labels, or attitudes of others who don't understand.   I also believe that a lot of others don’t like to admit encountering situations that may be beyond their immediate comprehension (so there can be a tendency to over-compensate, block out, put others on ignore-- because certainly feels better, ego-protecting-- it can become easier to just disregard and I think that can be a fairly common experience of PTSD-survivors among others, and it can feel alienating, lead to more isolation even, to get control over those wounds-- things hurt more when already down, over-stressed, impatient).

Normal is trying to chase away any uncomfortable feeling, and that's a survival technique, has a functional purpose and can be for a while (can't afford to fall apart in the face of immediate danger). . . [. . .but till it all comes crashing in  but not necessarily does that happen to all people, many variables which mitigate who's more at risk for PTSD vs. not: exposures, proximity to events, prior traumas, duration/prolonged stress, etc.).  Normal to PTSD, is numbing by habit, but it can also become more problematic, because the tension can escalate anxiety and exasperate symptoms, and be much worse then feeling it through, letting it pass (but in a bad state, it's hard to grasp that it can pass, but that can be learned through more evidence and experience of things passing, and it being okay-- and building tolerance for what doesn't feel tolerable at the moment).  It's trial, and error, and a learning process.  Self-loathing maybe be more common generally in this culture too and when pushed to the limits and beyond. . . loud awakenings, not wanted usually (and it sucks to lose power over it, like what PTSD barrage of symptoms can do). 

I think of this guy with the addictions, the former corporal and he seems to be struggling a lot-- there seems to be an attachment to preferring to be and feel invincible (and part of that has been needed, confidence, re: walking into where there's crisis, and threats to safety of self/others), and that can cause more stress, vs. self-respect, acceptance, trust in oneself, keep faith, etc.  . . . it can be hard challenge to make that leap, but if working on PTSD and the challenges of abstinence from addiction, that can be learnt and can get beyond that impasse and a lot more recovery then can start to happen.  It can be a hard fall from feeling the high of  “invincible” and then to “invisible” even.  The corporal could have been a great soldier at his time, ‘first in, last out’ (I used to be fearless, I liked that time ).  Reality is that no-one is truly invincible, sometimes it’s a matter of luck, to not have the experience of ‘wings clipped’ and falling hard to the ground.  It felt good to not have to feel any pain .  .  ., it’s a hard loss, when the system breaks and pain comes flooding in, when not wanted and when no-longer so easily containable.  PTSD itself, feels like a constant fear of ambush, by the symptoms presenting alone.  Try to get things done and bam, get hit with it. . . Frustrating and having to clear the fallout.  It’s different training requirement, not operating on external situations, securing scene, containment, apply training, but coming back to operate on internal situations which is entirely new and hard to be objective without some training for that (and even a bit of outside guidance, to help with the training), internal landscape.

-----------

There's a John Prine song, "Sam Stone", I've discovered it seems to resonate a bit with some of the Viet Nam Vets, in a way, like some blues, validates suffering, a person who's isolated themselves, and addictions to chase away the pain, puts some honour to those who've lost comrades due to PTSD/addictions and brings a sense of presence to that suffering, numbness, soul struggle/faith, etc. 

http://www.youtube.com/watch?v=xSeBEgFjGLA

(Might not like the accompanying picture. . . I have a feeling it might reflect some feelings of some left behind, hidden-injury sufferers.  It's haunting, disturbing.  Can hear in Prine's intro to the song, re: a visit to the Washington Memorial [the VN one also misses a few, e.g. one‘s who flew into Cambodia, not sure if that ever got resolved, but I personally know that it hurts a few]):

http://www.youtube.com/watch?v=cqLLglEfbbU&NR=1

There are some choices, but not all can see that or have the faith (or enough left) to rise to the challenge and the endurance it calls upon re: recovery and to take the leap despite stigma or shame to seek help when it‘s become problematic.  I think it calls upon a newer courage (and not commonly acknowledged, or understood, and still always uphill re: stigma, etc.) for that particular challenge.  Sadly, there have been a few who've lost faith (even temporarily, but enough for it to be fatal and taking an unhealthy path to cope) and it's also an old story, years long.  PTSD stats I think are similar re: percentages, Civilian general population and Military (?) around 8%, mitigating factors, as I’ve mentioned some previously re: duration, exposure, proximity, pre-conditions (prior traumas) etc. (more from the links in previous post).

Another version of the song here-- comments show that it does resonate with Vietnam Veterans, families, survivors:

http://www.youtube.com/watch?v=cqLLglEfbbU&NR=1

(I thought it was Johnny Cash at first, the low voice).  There’s another video tribute, using a Dylan song (Eddie Brickel cover), “Hard Rain’s A Gonna Fall”, some honour to the experiences in general, validating (makes me cry sometimes, and some images are reminders for me) but also affirming.  The metaphor of a “Hard Rain’s Gonna Fall”, reminds me about acceptance of PTSD.  Dedicated to the families and  ISAF survivors of the Afghanistan war, with a nod to all NATO partners.

I can’t handle ‘over-sentimentality’, but I find these songs resonate with me, a level of real, that for me, feels translate-able to PTSD-experience (metaphorically even)  but not over-dramatic (as is the habit of media at times, everyone has learnt to sensationalize, over-dramatize), distortive in that way.  I feel there is a ‘middle ground’, not to abandon, and disregard real challenges and struggles (and the urge to sweep it under the rug) and to be active and pro-active to help support, have those options available.  Temptations in people can go to extremes of avoidance, denial, shame of problem challenges (stigma) to being overly dramatic about things.  The middle ground I think is a mature stance, and responsible.  These fallen soldiers, and one’s with ‘invisible injuries’ are our brothers and sisters, CF family, I also see it in the context of the larger ‘human family’ and I feel compelled to stand with them (at least in spirit).  So I’m compelled to try to myth-bust,  challenge stigma, misunderstanding and would wish to express dignity to the experience, and respect for others who are affected (not achieve-able alone, but if there can be a ripple of some helpful understanding that can help others).  I think a lot of positive things have happened within CF, and that’s really good to see.  But there can be problems, re: resource shortages re: qualified and competent professionals re: PTSD and families. . . There’s been some positive changes, past 10 years re: ‘the system of support resources“, but still some challenges which preparation ahead of time can help mitigate escalation into deeper troubles.

[kstart]

I don't know if I've just mucked this up.  Writing about it to try to help normalize it, don't know if it helps de-stigmatize or help others currently experiencing, struggling with it.

While some reactions to the Star articles, I could feel the discomfort of anger, frustration.  It's not cool with me at all, if the PTSD dx is misused to escape accountability for really bad behaviours (e.g. assault) and I feel particularly angry about the case of wife assault, in the first story.  I feel PO'd that a person would allow their behaviours to escalate to violent acting out on others and not take that as a cue to seek immediate help and follow-through on that.  I've seen a 'dark side' to PTSD, where the survivor, mistakenly believes they are the only one's affected, not taking into account their families (I lived that in childhood), e.g. get mad at the wife, because "she wasn't there", etc. and think it's okay to take out anger aggressively on another.   Anger treatment, there are effective, non-destructive (or less destructive to self or others) ways of releasing it and a person is responsible for their actions, and if they've lost self-control ability, it's their responsibility to self, family, CF family, society. . . to seek treatment, no BS.

In the second article, re: the corporal and the addictions that have taken hold.  From my experience of people deep in the throws of a serious addiction problem, a reluctance to get help, because the hold of the addiction is so strong (it's looked like a person is split in half, two personalities, one is the addict, which seems to sabotage and create further resistence to seeking help [so, it's not always a case of lack of access to helping resources, but the addict-self taking a strong hold over the person, sabotages, and is a barrier to get through to seek out some help).  A person resistent to taking the steps to get help, might latch on to excuses, like "no help there for me, I've been abandoned by the Military, or the system, etc.", it becomes self-perpetuating distortive thinking, denial, they can even believe the lie (addict-part's lie), because they haven't actually 'reality-tested' for themselves to actually actively seek help.

Using the "PTSD-card" as an excuse or as a way to manipulate others is not acceptable to me. 

Also, if that guy did smarten up and seek addiction help and while through the harder parts, appoint a Power of Attorney, Gardian to restrict access to $ temptation to spend on drugs (particulary sticky re: cocaine addiction and can go broke and lose everything fast = plus the gambling mistake) till he can regain a sense of self-control again, and tested and practiced-- that person would also have to be strong enough to resist manipulation.  It sucks to see a person lose everything and keep sinking (and in the worst case scenario, lose their life by accicent, or suicide, etc), the bottom can be raised up.  Having the military training, should be able to be teachable, recover some to help get through tough spots, and towards greater recovery (but if it escalates, then sometimes will need to stablize on meds for a bit, so more ready to learn). 

Anyway, I wrote a lot and apologies, I don't mean to dominate the thread.  There could be up to a 1000 CF members (+ add in families) who could be facing struggles-- not a guarantee either, not deterministic, but just that risks are there.  It's a risk factor, re: exposures, not all develop full-out PTSD, some is acute PTS-effect, etc.  Being prepared can take some anxiety out, it can also create anxiety too, so it's about attitude and how to keep balanced, grounded with it.

[mariomike]

And on where and what the role of Psychological First Aid can be, which also respects people's own inner resilience:

Kstart, it's funny to remember what  Psychological First Aid was before CISD. It was a hard-hat and shovel spreading asphalt for six weeks, or until you got your mind right. Just the threat of that helped develop "inner resilience". Perhaps that is why many of us schooled in that era resented mandatory CISD. You know they actually made us sit on the floor, hold your partner's hands and stare into his eyes - without laughing!? The union stepped in and put a merciful end to it.  Management agreed because it was putting a strain on operations, and costing overtime. Especially when crews started telling the psychologist how much fun it was making time and a half to eat cookies and drink fruit juice.

We had very little Psychological First Aid training for patients and families in emotional distress back then. But, we did the best we could to help people without being judgmental. "Help others, help yourself", they told us. I believe that to be true.  Incidentally, attempted suicide was still a crime in Canada when I went through the academy. Most of us treated suicide attempts, no matter how weak, seriously. It wasn't our job to judge people. Although there were a few tough-guys who thought it was funny to make certain suggestions to them. That made no sense to me because we would be the ones sent back there.

Maybe we relied on the straight-jacket a little more than we should have back then because we didn't know any better.
I mentioned deinstitutionalization. Turning the mentally ill into the streets. It was overwelming. A total failure, in my opinion.
I have no doubt the warm transfer lines did in fact save lives. I remember occasions when they traced open lines for us to respond to.

You have a lot of good information and advice on the subject.

[kstart]

Kstart, it's funny to remember what  Psychological First Aid was before CISD. It was a hard-hat and shovel spreading asphalt for six weeks, or until you got your mind right. Just the threat of that helped develop "inner resilience". Perhaps that is why many of us schooled in that era resented mandatory CISD. You know they actually made us sit on the floor, hold your partner's hands and stare into his eyes - without laughing!? The union stepped in and put a merciful end to it.  Management agreed because it was putting a strain on operations, and costing overtime. Especially when crews started telling the psychologist how much fun it was making time and a half to eat cookies and drink fruit juice.

We had very little Psychological First Aid training for patients and families in emotional distress back then. But, we sincerely did the best we could to help people without being judgmental. "Help others, help yourself", they told us. I believe that to be true.  Incidentally, attempted suicide was still a crime in Canada when I went through the academy. Most of us treated suicide attempts, no matter how weak, seriously. It wasn't our job to judge people. Although there were a few tough-guys who thought it was funny to make certain suggestions to them. That made no sense to me because we would be the ones sent back there.

Maybe we relied on the straight-jacket a little more than we should have back then because we didn't know any better.
I mentioned deinstitutionalization. Turning the mentally ill into the streets. It was overwelming. A total failure, in my opinion.
I have no doubt the warm transfer lines did in fact save lives. I remember occasions when they traced open lines for us to respond to.

You have a lot of good information and advice on the subject.

"You know they actually made us sit on the floor, hold your partner's hands and stare into his eyes - without laughing!?"

 
Whoa. . . couldn't find a 'barfing smiley' to accompany my reaction to that

The union stepped in and put a merciful end to it.

  --Thank goodness!

Psychological First Aid was before CISD. It was a hard-hat and shovel spreading asphalt for six weeks, or until you got your mind right. Just the threat of that helped develop "inner resilience".

There's an old Zen saying, "chop wood, carry water", kind of a way to calm the mind, and re-ground.  Can also apply 'mindfulness skills", be intuned to the body/physiology, work safely to prevent injury-- can work out some anger via physical work (or exercise), can pray or meditate while doing it (provided not in immediate combat zone. . . ?)-- there are opportunities for choices for inner resiliency through that experience.  (My brother works hard labour, he treats some of it as active meditation, allows him to enjoy it better and it's grounding--he's fast, but not reckless-- wraps 20 skids to another's 2, very efficient--he's an older worker [maybe more attention to efficient energy expediture ).

This makes a little more sense, CISD post-combat field event, a little more direct and to the reality, check it out:

http://www.usmc-mccs.org/LeadersGuide/Deployments/CombatOpsStress/generalinfo.cfm

[quoteHold regular “hot wash” After-Action Reviews (AARs)
Marine leaders are already familiar with the hot wash or After-Action Review (AAR) as a tool for gathering and sharing information with their Marines after significant actions or events, in order to promulgate lessons learned and to improve future performance. These same AARs can also be effective tools for Marine leaders to help their Marines achieve a common understanding of what happened and why it happened, and what purpose was served by their actions and sacrifices. Open and honest two-way discussions during a small-unit AAR can help reduce excessive feelings of guilt or shame, and help restore lost confidence in peers or leaders. AARs can also help identify which Marines in the unit are experiencing persistent stress injury symptoms. Helping Marines make sense of their combat experiences, restoring their confidence in themselves and each other, and ensuring that seriously stress-injured Marines get immediate help all promote readiness and healing and prevent long-term disability.
][/quote]

I also like the clarity of their terms:

Definitions
Combat Stress:
changes in mental functioning or behavior due to the challenges of combat and its aftermath. These changes can be positive and adaptive (e.g., increased confidence in self and peers), or they can be indications of distress or loss of normal functioning that may be symptoms of a combat/operational stress injury (see below).

Operational Stress:
changes in mental functioning or behavior due to the challenges of military operations other than combat.

Stressor:
any particular mental or physical challenge or set of challenges.

Stress Adaptation:
the normal, reversible process of coping with a stressor, usually by either changing oneself physically and mentally to be better suited for that particular stressor, or by becoming numb to the mental and physical effects of that stressor. Stress adaptation is always temporary, and it always fades after the stressor is no longer experienced.

Combat/Operational Stress Injury (COSI):
potentially irreversible changes in the brain and mind due to combat or operational stress that exceed in intensity or duration the ability of the individual to adapt. Symptoms of stress injury normally resolve over time as the injury heals, but intervention may be needed to promote healing in some cases. COSIs can be of three types, differing mostly in the cause of the injury: (1) traumatic stress injury, (2) fatigue stress injury, and (3) grief. Many COSIs include components of more than one type of stress injury, since trauma, fatigue, and grief are not mutually exclusive.

Traumatic Stress Injury:
a stress injury caused by the impact of specific events involving serious or sustained threat to one’s own life, or a loss of life or serious injury witnessed in another.

Fatigue Stress Injury:
a stress injury caused by the wear-and-tear of unrelenting exposure to operational stress during long or repeated deployments, often compounded by concurrent stress from other sources such as family problems.

Grief:
Stress caused by the loss of someone who is cared about, such as a buddy, leader, or family member. Although everyone who lives long enough suffers the loss of others who are cared about, and grief is a normal healing process, it is important to recognize that losses of close friends, valued leaders, or family members inflict mental and emotional wounds that take time to heal, and may interfere with normal functioning until they do heal.

Posttraumatic Stress Disorder (PTSD): a traumatic stress injury that fails to heal such that the symptoms and behaviors it causes remain significantly troubling or disabling beyond 30 days after their onset. PTSD is not the only stress disorder that can result from unhealed stress injuries; others include clinical depression and anxiety, and substance abuse or dependence.

Combat/Operational Stress Control (COSC):policies, programs and actions designed to prevent, identify, and manage COSIs

I remember reading "A Soldier's Account" up on CBC, one guy was a field ambulance/medic, pretty intense journey, and they got pinned down for 3 days because of heavy fighting.  I could see the grounding of getting meals happening, but then getting shot at. . . and there's a lot exposures, re: injuries, bodies, etc.   Looks like a situation which guarantees fatigue, plus other risk factors.

Your point about resilience is important and I want to come back to that.  There are normal stress reactions, normal PTS-effects, which in most cases can clear up on their own; it's a matter of knowing the threshhold of when it's a good time to seek help.  Also re: mild TBI, often that can clear up in a year on it's own (several factors of resilience, including the body's natural healing ability), but for about 10%, it doesn't clear up naturally and so they may need to seek out help. 

I still think the Star articles are opportunities for learning and reflection-- it's not generalizable, in research terms it's some 'qualitative data', anecdotal, but it can have some value re: presentation of issues which can be work exploring.  Some of his experience is validated by some statistics as well, meaning he's not alone, not a single case.  I've noticed that some of the US VA-related sites are no-holds-barred, very direct, informative and responsive.

--------
Corrections from previous posts:  Math error -- re: PTSD rates, in the States "1 out of 13" does not equal 8%, lol-- there were different stats, 1 out of 13 males, and higher rate for females (hypothesised re: various kinds of traumatic exposures, non-military-combat +). . . and Dr. Wellburn-- not sure if that was a psychiatist, might be a psychologist (not OHIP-funded).  I do know some of the best of help are servicing CF members, what concerns me is shortage of that kind of quality relative to demand, present and future.  Also, re: psychiatrists, check out 'past findings' via College of Physicians and Surgeons. . . better to research before the fact. . . some do have a sick pathology that was not corrected by disciplinary actions (pay attention to targetted gender). . . curiously short waitlist. . . bs a person in recovery doesn't need, can create setbacks-- consumer warning, take reasonable precautions, trust in your self.

[kstart]

Re: Resilience

http://www.apa.org/helpcenter/homecoming.aspx

The number and intensity of stressful experiences notwithstanding, most returning personnel and their families should be able to bounce back successfully.

Even those who have learned resilience skills, however, should not expect homecoming to be effortless or free of emotion. It is quite normal to experience days or several weeks of mild to moderate symptoms of depression, anxiety, and anger, even if the initial homecoming was full of joy.

Children, for example, reassured with the safe return of a parent or sibling, may now feel they can express some of their negative feelings of fear or anger over what they may have experienced as abandonment.

Normal Is What Works for You
There are no standard or normal stages for homecoming. The process varies from person to person. Understanding that homecoming has its own brand of stress is a first step in the process of a long-term successful reentry for military personnel, their families, and the community.

and Resilience Tips Re: Homecoming:

10 Tips for resilience during homecoming
Early in the process, identify people who can help--a friend, clergy, mental health professional, financial advisor--and seek help if needed. Some of these sources can supply emotional support, while others can provide direct help with day-to-day problem solving. Resolve to be open about problems and work on resolving them together, either with family members or those professionals who can help.

Dismantle big problems into manageable small parts. Then, attack and solve these parts as a means of rebuilding confidence. A step-by-step approach can eventually resolve the larger problem.

Be an active player, not a passive victim. Social involvement through religious organizations, hobby groups, exercise clubs, social groups, etc., helps individuals rejoin the community.

Don't put off solving problems. Begin to work on problems immediately; inaction can reinforce the feeling that a problem is out of your control.

Don't seek solace in drugs or alcohol. This not only fails to resolve the problems at hand, but creates new ones.

Recognize that family readjustment problems are normal. Don't blame others for your distress, and don't blame yourself excessively.

Keep things in perspective. Cynicism or excessive pessimism about life and the future can become self-fulfilling and have a negative impact on you and others. Keep things in perspective-- not every problem is a catastrophe. Although it sounds simplistic, a positive outlook helps raise morale and increase resilience.

Recall how you met past challenges and use the same strategies to meet the stresses of homecoming. By facing current problems with an eye to solutions, you are more likely to achieve a sense of progress, of "getting ahead" with life.

Realize that the stress of homecoming can magnify other daily stresses, so make allowances for yourself and your family.

Accept as inevitable some setbacks in the return to "life as normal"--whether they are emotional, financial, physical, or job-related. At the same time, be aware that the skills of resilience can help you bounce back.

[kstart]

Resilience Tips, General and Through Recovery:

From:  http://www.apa.org/helpcenter/road-resilience.aspx#

10 Ways to build resilience
Make connections. Good relationships with close family members, friends, or others are important. Accepting help and support from those who care about you and will listen to you strengthens resilience. Some people find that being active in civic groups, faith-based organizations, or other local groups provides social support and can help with reclaiming hope. Assisting others in their time of need also can benefit the helper.

Avoid seeing crises as insurmountable problems. You can't change the fact that highly stressful events happen, but you can change how you interpret and respond to these events. Try looking beyond the present to how future circumstances may be a little better. Note any subtle ways in which you might already feel somewhat better as you deal with difficult situations.

Accept that change is a part of living. Certain goals may no longer be attainable as a result of adverse situations. Accepting circumstances that cannot be changed can help you focus on circumstances that you can alter.

Move toward your goals. Develop some realistic goals. Do something regularly -- even if it seems like a small accomplishment -- that enables you to move toward your goals. Instead of focusing on tasks that seem unachievable, ask yourself, "What's one thing I know I can accomplish today that helps me move in the direction I want to go?"

Take decisive actions. Act on adverse situations as much as you can. Take decisive actions, rather than detaching completely from problems and stresses and wishing they would just go away.

Look for opportunities for self-discovery. People often learn something about themselves and may find that they have grown in some respect as a result of their struggle with loss. Many people who have experienced tragedies and hardship have reported better relationships, greater sense of strength even while feeling vulnerable, increased sense of self-worth, a more developed spirituality, and heightened appreciation for life.

Nurture a positive view of yourself. Developing confidence in your ability to solve problems and trusting your instincts helps build resilience.

Keep things in perspective. Even when facing very painful events, try to consider the stressful situation in a broader context and keep a long-term perspective. Avoid blowing the event out of proportion.

Maintain a hopeful outlook. An optimistic outlook enables you to expect that good things will happen in your life. Try visualizing what you want, rather than worrying about what you fear.

Take care of yourself. Pay attention to your own needs and feelings. Engage in activities that you enjoy and find relaxing. Exercise regularly. Taking care of yourself helps to keep your mind and body primed to deal with situations that require resilience.

Additional ways of strengthening resilience may be helpful. For example, some people write about their deepest thoughts and feelings related to trauma or other stressful events in their life. Meditation and spiritual practices help some people build connections and restore hope.
The key is to identify ways that are likely to work well for you as part of your own personal strategy for fostering resilience.

Some of the CBT techniques can go a long way as well in facilitating healthy, balanced perspective.  Through difficult times, added stress, it can be a challenge to maintain-- know how to find 'home' (back into positive thinking).

I think returning home, post-deployment, some extra care, is a good idea, knowing that stress will be a normal part of that transition.

I think this is one of the best sites I've uncovered re: Post-Deployment/Return-- useful for both returning CF and for their families.  It's straight-forward, clear, seems to address a multitude of issues with practical coping tips, options.  Knowing what is normal to expect re: returning service members and for families, can help reduce some stress-- just understanding that some of the stress is very normal:

http://www.ptsd.va.gov/public/reintegration/guide-pdf/FamilyGuide.pdf


This can be some comfort (vs. my sounding the alarm re: PTSD as if it's deterministic/guaranteed-- I'm just an example of very late intervention [not by choice-- access issues]):

Most service members coming from war zones will have stress reactions. But only a small number will develop PTSD. The Army produced the “Resilience Training” program (https://www.resilience.army.mil/) and the Navy and Marine Corps produced the Combat Operational Stress Leaders Guide (www.usmc-mccs.org/LeadersGuide) to help service members and families understand how a wartime mindset is useful at war but not at home.

I can't access the links above, and I don't know if CF would have similar programs (?), but it's interesting.  I think the Resilience Training program was once called "Battlemind.org"?  If I imagine being in dry, dusty Afghanistan, maybe I'd want to go on a canoe trip, be around lakes or ocean, lots of Canadian greenspace, different smells, pines, spruces, Maples (Sweet Home Canada )  I think I read somewhere about some programs in the States of outdoor adventures, for service members, families, including members with physical injuries which can limit some mobility, facilitating easier access to Nature. . .?  "If I had a million dollars", or owned a great resort, that would be a pleasure to be able to offer that, a great way to    My exposures to Nature, helped me build imagery to use for "Guided Visualization Technique" -- I can take a 'vacation' anytime, and it helps re: symptom management (especially, e.g. hypervigilance symptoms. . . just have to remind myself, recognize it when it's happening and take a mini-vacation  ).  It's to have safe imagery, of a safe place, a pleasant place, that doesn't have traumatic reminders. . .

Anyway, I think back to the corporal who's struggling with addictions and PTSD, whether some preparation and training earlier on could have helped prevent a deeper slide (not always the case, I'm just wondering. . .).  The issues are likely much more complex, several factors.  He was young on his first tour-- only 22 years old?  That's one of several risk factors re: combat OSI, but it can affect anyone.  Likewise with the one from the other story who assaulted his girlfriend, if some earlier preparation could have helped prevent things from going that far?

I know that CF pursues excellence and I have a lot of respect for that as what it is, an on-going endeavour and there is so much to be proud of


These resilience factors, "hopeful outcomes" and "positive view of oneself"-- these are strong assets and when strengthened, it's power against external shame (e.g. from stigma) and protection from internalizing it.  It's strength to rise above.  Under stress, or not understanding that it's even normal stress it's a challenge to maintain it, but it can be recalled.  Also, volunteering, service, helping others, that's also useful for perspective, IMO.  Compassion directed at others can also bring a gift, or an opportunity to learn a compassionate attitude with oneself, and this can build resilience through PTSD hassels.  Getting down to a level of active listening, practicing for some years (without hinderance from excessive judgement, pre-conceptions, garbage from shaming cultural attitudes, etc.), but acceptance, re: where a person is at and what they are presenting is a useful experience. 

The 'inner critic", internalized by various sets of experiences, can influence attitudes in judging others and also in judging ourselves.  I don't want to bible-thump (I'm not a thumper), but there's a passage in Matthew, re: "do not judge, lest you be judged yourself, for the manner in which you judge, you will be judged. . .you hypocrite, first take the log out of your own eye, before you seek to remove a speck from your neighbour's eye".  I think there's a psychological truth to that, not separate from 'spiritual truth'.  So if one gets stuck in the judging, shaming. . . there may come a day of humbling and a harder fall.  It's a deeper level of protection from stigma, because like or not, it's always going to be there to a certain degree (and it comes from lack of understanding, bias, distortion, self-deception), although Militaries such as CF and US ones, are actively seeking to change that. . .

[kstart]

Stigma Busting (because Stigma is an issue the Corporal brought up. . .)

From:  http://www.ptsd.va.gov/professional/manuals/manual-pdf/iwcg/iraq_clinician_guide_app_j2.pdf

When they are happening, traumas often create feelings of intense fear, helplessness, or horror for those who experience them. In the days and weeks that follow, they often create longer-lasting stress reactions that can be surprising, distressing, and difficult to understand. By understanding their traumatic stress re-actions better, Iraq War veterans can become less fearful of them and better able to cope with them. While reviewing the list of effects of trauma below, keep in mind several facts about trauma and its effects:
It is very common to have problems following exposure to war or other trauma. But traumatic stress reactions often become less frequent or distressing as time passes, even without treatment.

Veterans with PTSD often worry that they are going crazy. This is not true. Rather, what is happening is that they are experiencing a set of common symptoms and problems that are connected with trauma.

Problems that result from trauma are not a sign of personal weakness. Many mentally and physically healthy people experience stress reactions that are distressing and interfere with their daily life at times.

If traumatic stress reactions continue to cause problems for more than a few weeks or months, treatment can help reduce them.

(my emphasis added)

Canadian Government:  see pie chart, conceptual representation of directions (intended, work in progress. . .?) re: dealing with health issues, stigma is mentioned:
http://www.veterans.gc.ca/eng/sub.cfm?source=mental-health/health-promotion/framework

From US Marine Corp, showing USMC standards (first paragraph) and in point-form, some issues that soldiers can experience re: stigma and reluctance to seek help:
http://www.usmc-mccs.org/LeadersGuide/Deployments/CombatOpsStress/generalinfo.cfm

Why Marines May Not Seek Help
Some Marines are reluctant to admit to themselves or anyone else that they have been affected by the stress of combat or other operational experiences, and some are reluctant to ask for help for stress injuries that don’t heal quickly on their own. Such reluctances are often due to the stigma that surrounds behavioral health and stress problems, particularly among Marines, who pride themselves in their ability to endure extreme stress. Stigma is the number one enemy of combat/operational stress control. Therefore, it is the duty of every Marine leader, at every level and at all times, to fight stigma — to reduce its interference with stress-injured Marines getting needed help. Fighting stigma begins with understanding its causes, which include:

Not understanding that stress injuries are like other physical injuries — treatable and not the individual’s fault

Believing that adverse reactions to stress are a sign of weakness or personal failure

Not knowing that even the strongest Marine can suffer a stress injury

Fearing that having an emotional problem or getting help for it will negatively impact their careers

Fearing that other Marines will think less of them because they got help for a stress injury

Fearing their peers or leaders won’t trust them as much in future tough situations if they admit to having suffered a stress injury

Not understanding that the longer they wait to get help for stress injuries that don’t heal quickly on their own, the less likely they are to heal fully

Not realizing that avoiding getting help may place their unit members at risk because of decreased readiness and performance caused by untreated stress injury symptoms

Not realizing that avoiding getting help for persistent stress injuries can hurt their careers, relationships, and future health more than accepting help will

A command climate that discourages getting help or tells Marines to just “suck it up” or “get over it”

(Emphasis mine)  Maybe a few things the Corporal wasn't realizing at the time, and seccumbed to more intense addiction issues (self-medicating to cope) as time went by from his first tour. . .?  I think some of the above seems to mirror some of the sentiments the Corporal addressed in his Star interview.

Therefore, it is the duty of every Marine leader, at every level and at all times, to fight stigma — to reduce its interference with stress-injured Marines getting needed help.

Maybe this is a reasonable standard, duty and responsibility?  Is there a similar type of directive from the CF side?  I hear it's been progressively changing for the positive and I've heard some good news way back (before I found this place) about good treatment and I was happy to hear that.

What Percentage of Veterans Have Received Help for Mental Health Problems?
47% of all veterans have sought services at VA
Top 2 reasons: Muscle and Joint Problems and Mental Health
Of the 48.5% who have sought mental health care:
53.3%: PTSD problems
37.8%: depression
(VA data as of 01/2010)

(Source: http://www.ptsd.va.gov/public/reintegration/guide-pdf/FamilyGuide.pdf)  VAC acknowledges anxiety disorders as well (in the presentation from earlier link).  I don't know what CF stats are?  But regardless, this should let others know it's not an abnormal thing. 

Link to a support line: http://www.cmp-cpm.forces.gc.ca/cen/ps/mho-smb/osi-ssb/index-eng.asp
OSI support line. . .

I thought the USMC site was informative, straight-foward, cohesive and realistic strategy re: Combat-OSI (COSI), best attempts. 

[kstart]

An Afterthought re: resistence/barriers to seek help. 

One anxiety/fear I faced was a result of 'physical threats' if I talk. . .  A few things helped.  I used the confidentiality and anonymity of crisis line to discuss some of those issues (not using names) to help me understand more, generally about confidentiality practices, and limitations of confidentiality.  And when I sought help, and finally found some, I didn't use names (without names, they legally can't do anything, or anything that could put my safety at risk by their following limits of confidentiality, fear of a legal process I wouldn't be equipped by enough recovery to handle [court and blinking in and out/disociation, lowers credibility as a witness, just means more victimization, wasn't in a strong enough place to handle that).  I'm not chicken or weak, because I did speak up when others didn't (but that was dangerous, so maybe not smart to do, but I didn't anticipate that escalation and it was shocking)

It was good to know that there were options on a continuum of actions (where I could do the 'right thing', but lower risks to my safety).  I made sure confidentiality issues were cleared and it was safe enough to talk.  I could have maybe got access to help via a clinic, but they film sessions (student clinic) and that didn't feel safe for me (threats on top of trauma can be really constricting, hard for words to leave the mouth re: those particular issues).  Looking back, maybe I could have contracted an agreement-- this doesn't go on film, I don't consent to that one. . . but that was hard to wrestle with rationally at the time of crisis. 

You can have control over the process.

A lesson is learning how to use supports, use anonymity of crisis lines, choosing among appropriate ones per trauma.  You can talk about the traumatic impacts, get help for managing the trauma, but not have to use names (or 'identifyers') if that doesn't feel safe.  Helps to have clarity re: counsellor's procedures, mandates ahead of time then you can know how to work around that, while still able to get some help, to help stablize.  Often some of the 'bad traumas' can also have legal implications (or fear of that process, confusion even because of the traumatic impacts, etc., one thing was on the line re: witnessing, pieces, but not the whole and it was hard to sort out on my own) but there are ways to keep safe.  One situation had already been investigated, but it's not a perfect world (others can be sophisticated, sociopathic, etc.) and that's a lesson too and re: one's locus of control over events beyond one's personal control (despite wishing that one did have the power to stop those actions by others). 

It's hard chit to live down, shatters illusions of safe, fair, reasonable world, etc. and when one also carries a high sense of personal responsibility (and success at handing and managing other tough situations but with better outcomes) and duty and some crimes are not tolerable, offend on a very deep level.  You think the system works, have some faith in it, until you happen to face one of those instances where it doesn't and there's no way reasonable course through it, forced to accept what is not truly acceptable.  There's grief about that to work through, it's invariably loss of innocence, breach of basic trust and it can be wounding.  Solace is in knowing one did the best that that could, and tried where others didn't and to borrow from AA, ". . .grant me the serenity to accept the things I cannot change, change the things I can, and the wisdom to know the difference".  It's a wound, but there is still living, doesn't have to poison every day and every moment of one's life-- enjoy the good moments, because it's still deserved (there were just bad circumstances). 

I guess, this part relates to a wound of "survivor guilt" which can arise from difficult situations, some can be fairly complex.  Good to give the mind lots of rest-periods, don't over-ruminate, remember to practice self-care: routines, hobbies, exercise, relaxing reading, see people (even if it's just for 5 minutes, it can be a healthy distraction to help prevent getting over-stuck in the head); be involved in family, etc.  It's okay to feel pain and accept that (sometimes it's a quality of good character, human, has a good function, even if can't control results, it can just hurt a bit).  The challenge is learning to bare it, build tolerance for difficult painful feelings, without having to resort to numbing, deliberate or automatic.  One you know things about breathing and grounding skills, and further away from the 'crisis stage' of ptsd, new opportunities for healing can occur

In a way this takes courage, to stop fighting it (builts up anxiety, exasperates symptoms), and learn that you can just allow it to pass.  Facing it, not running from it, not over-reacting to it.  Mindfulness training IME, helps with this, it can help build resilience through difficult grief.  Know it will be okay, have faith, trust resilience in others even(CBT training, "don't catastrophize").  I tell myself this, "where there is breath, there is still hope" . . . "and when there is not, well that's in God's hands".  If you listen closely, and in a calm space, sometimes the words you need to hear come from within.  Inner resilience, stuff you might not know is there even, till challenged, tested. . .so it's sometimes a matter of "Trust the Process".  Having a spiritual faith can also be another factor in resiience (I think about the story of poor Job, that guy had it rough )

[kstart]

I don't think I'm in the mood to go over risk factors atm.  But the USMC link, I think did provide a pretty good list, re: combat-related/OSI risk factors.

For people coming back from Afghanistan, some could experience some post-traumatic stress effects (acute-pts) that can normally clear up in some weeks on their own.  It's good to review some of the symptoms of what can be expected (to know you're not actually losing your mind, it's more about just recall of trauma, and it's normal, till things can settle down) and know it can pass.  It helps to be able to have some perspective to put the experiencing into perspective.

This link provides a good context of what to expect, a good guide for both families and returning service member:
http://www.ptsd.va.gov/public/reintegration/guide-pdf/FamilyGuide.pdf


Bringing this back to our corporal here, maybe he wasn't prepared, homecoming post-first-tour-deployment back in.  If you think you're going crazy, it might be tempting to try to drown it out with some excessive alcohol consumption to numb it (the danger is when that becomes habitual coping with that, because it can catch up), or that can be an already existing habit among others.  Maybe even works short term out in the field (not on duty) and maybe not altogether a bad idea (?), but there's also some adjustment time happening post-deployment and re-orientating to new surroundings, contexts, relationships, etc.   I had some VA links for that re: Homecoming and it's just FYI, can read it, put it away, forget about it, but know where it is if/when needed (for self or if concerned about others).  Normalize things.

I think this is a good link re: coping with post-traumatic stress effects which can be normal early post-deployment, these two especially give a comprehensive review of what sort of things can be expected in post-deployment adjustment to being back.  Good guides for both family and service members :
1) http://www.ptsd.va.gov/public/pages/coping-traumatic-stress.asp


2)  http://www.ptsd.va.gov/public/reintegration/guide-pdf/SMGuide.pdf

Self-Care and Coping: http://www.ptsd.va.gov/public/pages/fslist-self-help-cope.asp

(They even have PTSD-Apps for I-phone, the “PTSD Coach“--  That sounds pretty cool.  “Uh, experiencing a symptom. . . What to do. . .” and out pops up some coping options for symptom relief-- sounds handy  )

Anyway can be handy to familiarize with the basics beforehand.

There is also the CF OSI support line:
http://www.cmp-cpm.forces.gc.ca/cen/ps/mho-smb/osi-ssb/index-eng.asp
It's manned by experienced members and so that's maybe a good resource to check things by.

I don't mean to obsess over the Corporal, just treating it as a learning opportunity (and also with some respect, you never know if he comes here, or someone else out there is facing similar challenges, or others at risk for experiencing some difficulty-- knowledge can be power, put things in a context, less panic if symptoms are being experienced, to know they're actually fairly normal and can pass, and likely will).

People have to make their own choices, it's just good to know there are a range of choices to chose from and know you can get through the tougher times and that they‘re normal experiences (but can feel freaky-- when I first got hit with PTSD hard, I had major panic attacks, because I didn’t know WTF what was going on, it just freaked me out, I had no context to understand what was happening-- it was a lot of ‘shocking‘, rapid, overwhelming-- I wish I had had more understanding before hand then I could have eased my way through it better, equipped with skills, what I can do to relieve symptoms in a healthy way.  Having knowledge, some contextual framework, helps with being able to detach from overwhelming experience, re-experiencing.  It felt insane, “losing my mind“, panic attack, heart-rate way up, and shakes and felt alarmed and further panicked, if this happened in public [exit to nearest restroom, splash face with water, try to calm down], it was happening post-trigger-to-flashbacks, but I didn‘t understand that at that time).


I haven’t tried this one (would have to be in the mood for it), but it’s a self-assessment tool that can be used when finding oneself thinking about something traumatic, or it’s been recalled:

http://cust-cf.apa.org/ptgi/

Not sure how good it is. . . If feeling adventurous or for entertainment purposes to check it’s validity against your experiencing. . .

I think I can leave this for now.  It can also get exhausting for me to think too much about PTSD (it‘s good to do sometimes, definitely not all the time).  I’m glad I did a bit, because in the process,  I found some handy links I can use myself.  I wanted to respond to feelings from a few sides re: stigma and stigmatizing behaviours and also to the Corporal and others re: respect and care for hidden injuries.  I’m not actually comfortable with personal disclosures, sharing some pieces, it’s one of those risks and it does feel a bit uncomfortable and I know it’s also possible it can put others off (“WTF is this crazy chick on to.” . . ), but for some others who are going through it, it may help validate and normalize some of the challenges and sometimes a shift in attitude can make it easier to bear and it can be done, and found and it’s a matter of learning to trust oneself, that’s the most important, above all and know that within your circle of support, who you feel safe discussing things with, test the waters, go slow. 

"I'll pass the torch" . . . look out for your own health and take care of it, and look out for families and fellow service members

[mariomike]

This book was written by a Canadian psychologist. Obviously controversial, but it may be of interest.
"Manufacturing Victims: What the Psychology Industry Is Doing to People":
http://www.amazon.com/Manufacturing-Victims-Psychology-Industry-People/dp/1552070123

National Post  2000:
http://tanadineen.com/psychologist/interviews/WhoAreTheseGriefCounsellors-National%20Post.htm

It discusses critical incident stress management CISM. CISD > CISM.

[kstart]

This book was written by a Canadian psychologist. Obviously controversial, but it may be of interest.
"Manufacturing Victims: What the Psychology Industry Is Doing to People":
http://www.amazon.com/Manufacturing-Victims-Psychology-Industry-People/dp/1552070123

National Post  2000:
http://tanadineen.com/psychologist/interviews/WhoAreTheseGriefCounsellors-National%20Post.htm

It discusses critical incident stress management CISM. CISD > CISM.

From the National Post article (http://tanadineen.com/psychologist/interviews/WhoAreTheseGriefCounsellors-National%20Post.htm)

Dineen, the author of Manufacturing Victims: What the Psychology Industry is Doing to People, wrote an adamant opinion piece in the Ottawa Citizen in the wake of the SwissAir crash at Peggy's Cove about counsellors roving that landscape in search of traumatized witnesses. "It seems that we have been persuaded that those who witness a tragedy, no matter how indirectly, are themselves victims, because they might be upset by what they saw or felt. And because they were upset, they need professional counselling to recover from the 'trauma' of feeling upset," she wrote.

Is this what your main concern is that CISD "manufactures victims", creates conditions for malingering?

[mariomike]

Is this what your main concern is that CISD "manufactures victims", creates conditions for malingering?

After ten years of developing "inner resilience", we were suddenly being taken out of service by some dude in the radio room.
The truth was, we were young guys having fun. My partner used to say, "It's you and me against the world tonight!" 

I liked to think that the families we served received the support they deserved.

We were / are well taken care of:
http://www.torontoems.ca/main-site/service/psychological.html

"Another nail in CISD's coffin: The facade of that fairy tale we call CISD continues to crumble under scientific scrutiny. Now the Canadians (bless their souls) are getting in on the act and denouncing it as bull$hit.":
http://www.emtcity.com/index.php/topic/2961-another-nail-in-cisds-coffin/

[kstart]

After ten years of developing "inner resilience", we were suddenly being taken out of service by some dude in the radio room.
The truth was, we were young guys having fun. My partner used to say, "It's you and me against the world tonight!" 

I liked to think that the families we served received the support they deserved.

We were / are well taken care of:
http://www.torontoems.ca/main-site/service/psychological.html

"Another nail in CISD's coffin: The facade of that fairy tale we call CISD continues to crumble under scientific scrutiny. Now the Canadians (bless their souls) are getting in on the act and denouncing it as bull$hit.":
http://www.emtcity.com/index.php/topic/2961-another-nail-in-cisds-coffin/

In that discussion thread, some criticism re: CISD about it's potential to harm, did make sense, by some of the examples given.  A common exposure event (same event), a potentially vulnerable time (critical incident) +  witnessing a co-worker's traumatic reactions to the event, can have a further traumatizing effect, because it can pull out not only empathy for the other worker, but over-identification with that worker's pain-- and that can create further confusion.

I had some experiences, front-line work and also witnessing effects of burnout among co-workers and supervisors, and it was dramatic and painful to witness, people coming in strong, optimistic, competent, full of hope, gifted people, but the general pattern was not to last longer than 2 years at it.  Some got smart and pulled before extreme breakdown-- the organization was really sick.  I don't know if this was covered in the book you recommended, re: manufacturing victims, but the "Karpman Triangle" pattern-- when those dynamics get activated, toxic and it can be drawn out under certain experiences/situations/contexts-- I think it exists.

The report that was referenced in that thread re: "Rescuer" presumption, not only flawed and over-generalization but it's not a static thing, IMO, because certain situations, stressors can bring out it's companions as well (Karpman Triangle: victim-persecutor-rescuer"-- and these roles can shift and oscillate among a traumatized group of people into sequences of maladaptive acting and reacting and not healthy coping, trauma adaptations (inwardly or outwardly), but cause a lot of pain and confusion-- I think probably happens in organizations, families, units, under extreme stress, maybe an indicator of later-stage burnout-- something that is preferably prevented, or addressed earlier.

I'm really glad to see your organization has a smart expert on the scene and I like especially that she researches, oversees issues of organization structure. . . you guys shouldn't have the additional types of problems, added toxic crap, destructive stuff

I've experienced situations of that level of toxicity in a few contexts.  I didn't get help for the trauma of that, because no access to a specialist to help with that overwhelment/confusion, but struggling with the damage to career trajectory, and struggling to put the effects of those experiences into a context, "that's what that was, I can avoid that in the future, by. . . it can be safe to seek out employment with. . . I know when I should get out when. . .  this presents. . .and continues, and response of organization is poor. . .situation unlikely to be corrected when. . .".   

Books that helped me piece together some conceptual understanding of that type of trauma and toxicity were Pat Carnes' Betrayal Bonds (addresses workplace trauma dynamics, connection to other toxic dynamics situations) and works of Charles Figley, re: other types of traumatization, including "compassion fatigue"/*vicarious traumatization* (witnessing extreme suffering, extreme traumatization in others, e.g. if a parent has PTSD untreated, unstablized, or in other contexts of group traumatization), "simultaneous traumatization", "famlial traumatization",-- direct traumatization vs witnessing types of trauma.  I need these to help me with clarity, and sorting out what happened, why the impact, what's causing this stuckness-- important, because it made me afraid of work-- and obviously I can't live like that (one could laugh at that, but for me, it's genuine, constrictive hurt, stuck. . .real grief to move through).  I came from a bad situation and I walked into a few and didn't get out on time.

As an outsider, but I can see ways in how militaries have evolved and sensible planning and organization of roles, job specialization-- there's lots of things already built into it which can prevent those kinds of severe secondary traumatization.  It also interesting even in ancient texts (e.g. Art of War; Bagavagita [Khrishna dialogues], Way of the Samurai, etc.; martial arts training-- which included meditation), eastern origins, some mindfulness, perspectives, character/leadership development, strength and resiliency training. 


I had good training pieces to handle the work I did and effective use of it, I was grounded in a professionalism and ethics (not over-rigid, but the training was the right guidance for handling situations of crisis, etc.), but I had no preparation for what happened at the organization level-- it totally caught me off guard, and I was student working in it, low on the ladder. . . it was an unfortunate choice of organization, but live and learn. 

I had no preparation for PTSD either, nothing would fully prepare, but it helps to have a context and in learning practical coping for symptoms-- and the 'flashback management" techniques are key to that, IMO, IME.

Without that training, flashback can cause severe dissociation, like what we hear about, combat trauma and acting as if right back there at the time of trauma (e.g. "combat-soldier[or medic, etc.]-in-afghanistan-ego-state)-- it is like that-- I've had flashback experiences of earlier trauma, and freaky to be in a child-ego state-- dissociated back to that (makes it scary if it's happened downtown, and am suddenly and literaly a lost child, can't remember where I was going and where I came from-- very disorientating and a frightening experience-- I can be consciously aware of it, but there's a brain stuck, and can't get the 'right in the brain' ego state to come back, but it does-- no memory of the trigger though. . . but I care less, as long as it's over and I can regain functioning).  Flashback management technique is a tool that can be utiized which I think can prevent flashback from progressing to more extreme dissociative states.

My case, I've needed to do some grieving, the most important function of that was to correct maladaptive coping and decision making affected by things like survivor guilt and had become a pattern, not getting out of bad situations that are unnecessary, don't need to be there. . . it's to correct trauma-repetition, trauma-compulsion-- had bad programming, needed debugging

Aside from that, I like Babette Rothschild's work on PTSD, the best is she said, you don't even need to do memory retrieval to heal from PTSD.  I think it has to do with mastering the "flashback management techniques"-- which for me seemed to be a core of the problem, and the major symptom not addressed by the quack helpers I encounted (OHIP covered psychiatrist) and if it's managed, a lot of other PTSD symptoms are more manageable, prevented even from becoming debilitating, more complicated dissociation, etc..  It seems, IME/IMO to correct body-brain disregulation, freeing up mind again (it's not free in dissociative states, IMO).

http://www.amazon.com/Keys-Safe-Trauma-Recovery-Take-Charge/dp/0393706052/ref=sr_1_1?s=books&ie=UTF8&qid=1311834298&sr=1-1#reader_0393706052

I got some intel from Homewood (been on the waitlist a long time. . . -- only because I don't have specialized private health insurance-- not the same for CF-- be glad about that-- they are trying to look out for our CF, and other crisis workers) a view of some of their approach and I think it's really sound.  Even more elaborate grounding techniques, which is good, because in the past, trying to restablize from flashback, didn't spend enough time on the grounding-- it's a learn from experience, as you go kind of thing, what actually works best for you. . . experiential learning, but the guidance is good.  If body-brain not restabiized, can get side-swiped by more flashback/dissociation, IME.  It takes good self-discipline to practice, an adjustment to patience to work at it.

[mariomike]

What sorts of resilience training did you guys get? 

There was none of that when I joined. The culture was different then. They sent us through the old Department of Emergency Services academy downtown. They closed it in 1975 when the community colleges took over in Ontario. Psychology is on their curriculum.

[kstart]

There was none of that when I joined. The culture was different then. They sent us through the old Department of Emergency Services academy downtown. They closed it in 1975 when the community colleges took over in Ontario. Psychology is on their curriculum.

Curious. . . has anyone considered introducing Mindfulness-Based Stress Reduction, it makes sense as something that could be useful, reducing stress, re-stablizing stress response if that has become problematic. . .?  It would have to be studied. . .

http://ottawamindfulness.ca/Programs/English/tabid/208/Default.aspx
Mindfulness-Based Stress Reduction program, some freely offered for low-income and/or if there's extra spaces. . .

Based on Jon Kabat-Zinn’s work, Full Catastrophe Living
http://www.amazon.ca/Full-Catastrophe-Living-Wisdom-Illness/dp/0385303122

What I like about these approaches is that IME, it's empowering-- so it's not about focusing on deep processing (which can be too much reminding, too much victimization-pain), it's simple awareness, not feeding into story-lines, combat-exposures.  It teaches brain-body to let go, without mind getting in the way (normally mind can focus on problems/pain because it wants a resolution, some relief, some power and control over what's causing discomfort but it can create more discomfort, and exasperate stress symptoms).  I think it has therapeutic value,  because it's a way of re-establing connection with internal safety and it can calm stress physiology, re-stablize.  It feels good, good relief, IME.  It's being used in some clinical settings, hospital settings e.g. for things like chronic pain.

US military literature are acknowleging benefits of meditation and yoga as assistive re: stress, OIS, etc.

------------
IME, through the experience, I noticed my mind's tendency to cling to things, attach to thoughts, images, etc. (problem normal, but also problematic re: PTSD symptoms, flashback).  IME, it's a good bridge, supportive re: practice of 'flashback management'-- possible to stop it before it leads to dissociation-- the idea is stabilizing body's physiology and re-orientating to present moment.  The meditation, "savasana"/progressive body scan, not only is cool e.g. if suffering chronic pain, because can notice parts that are experiencing pain and in those moments can get momentary relief-- which is very empowering (cause mind can focus on it, when it's hard to ignore and that can a sense of victimization by it-- same with PTSD reminders, the frustration re: intrusive symtoms, fatigued by it, feeling disempowered by it, impeding functioning, not appreciating opportunities where things are working okay, which can build hope and resilience from).  PTSD-- when physiology is over-booted, not re-regulating, I find I'm more suceptable to futher flashbacks, and 'tremors', e.g. earlier panic attack bites back, heart-races up again for no reason (I need to quit smoking too).

I struggled re: teaching myself CBT, because the tendency of avoidance (which is just automatic, about trauma stuff), but MBSR seems to make it easier, after some time practicing it, making it easier to work with other tools.

I think Judith Herman, in her book Trauma and Recovery, hit an important point re: the importance of Safety and Stablization-- supporting coping skills development for symptoms and deep processing attempted too early can cause more problems, add to them.  I think this supports some of the concerns re: CISD, pushing people to talk.  Self-empowerment via stress reduction techniques would seem more useful as a response to critical incident or just that as a form of resilience training.

Also critique re: a lot of practicioners didn't spend that time with clients, doing that important work-- and not helping them develop symptoms-coping techniques, created bad dependence, and some of those people have been in therapy for years and they phone their therapist at all hours, years, non-stop-'therapy'. . . sad, not apparently that helpful (nor for either client, nor therapist. . . potentially sick and toxic).

It's abuse, IMO.

I think that the results of that sort of conduct and poor research, poor appropriation of methods, also made it less likely re: government cost-benefit anaylsis, re: funding of provincial health care to cover therapy for PTSD.  I lost big time.  But I hope things can catch up and see the cost-effectiveness re: symptom management training-- the other stuff, yes, using other supports, sparingly is fine, some can relate to feelings, thoughts about things-- have some moments of grief, move on, pace it, nothing gets resolved all at one-- that's normal stuff, the human experience.

I had an 'idiot psychiatrist' and I think he claimed to be competent to handle PTSD-- I think just to keep his job (so he wouldn't admit to anything like needing some updating, re-training. . .) .  It was at the university clinic (not a univeristy with any good psych programs-- research-oriented, not clinical.  Not sure about all his  motivations: maybe self-deluded, burnout, sick attachment, narcisstic/voyeuristic, etc.  Trauma teacher I had recommended I fnd a female psychiatrist (so, maybe sick dynamics re: rescuer-night in shining armour delusions of the psychiatrist--- sick things can happen-- maybe he didn't want me to get better, because he liked feeling important. .  I don't really know. . .).  Ran into an even sicker one, still allowed to practice depsite past findings-- predator-- and used "PTSD" as an excuse for it-- which was total BS.  Really slim pickings re: civilian help, with no private health ins.

I do know, it was Not what I needed, nor was asking for.  I asked very specific questions, what can I do when this happens; how can I stop it?  He had nothing to offer and said the PTSD would "go away on it's own eventually. . .", but it had been past weeks, months and years, post-trauma and a fair bit of accumulation that came to a head, including presenting situation, of burnout happening at workplace. . . which I guess he had no conceptual understanding.  Pushed me to keep fighting it, but I had no power over it, nor expertise, but I recommended they get a consultant in to help clean up some problems, re: roles negotiation, reasonable expectations, properly thought-out-- so there is effective functioning, not overwhelmed, stressed and burnt-out people-- suffering that was preventable.  Anyway, whatever it was, he was not very reality-oriented.  He probably got sick because of lack of training, and learned helplessness because not skilled.

I had few options re: PTSD help, and that's been a structural problem, not my fault.  I didn't need to lose those years, but it wasn't my fault, either.  Some bad choices because of unresolved grief, true (and sticking habits, and needing to re-evaluate what is right, and with respect to my own health), but I didn't know.

The PTSD injury is real, and IME the flashbacks were the main problem, relief of those, changes things significantly, frees up freedom, choosing, learning, functioning. . . more ability to 're-join the human race"

Talking about PTSD too much, not healthy for me and I guess it brings up grief (and a triggering mental process), re: impacts of secondary traumatization, underneathe my concerns, and my hopes that access to PTSD treatment is available for those who really need it. 

I hope things can change for the better for civilian community re: provincially funded care when they can realize cost-effectiveness of newer techniques vs. on-going disability.  I think if I had that flashback management introduced to me way back when the PTSD had become chronic and debiitating, I would have been able to get back up quicker and a lot less problems, stone here gathering moss-- I can manage the rest and I can manage symptoms better.  I know grief, comes and goes, and doesn't have to stick, let go of a little bit at a time-- I think the MBSR is also beneficial orientation that way as well. 

It was the debiitation by caused by symptoms that was the hardest re: that creating the worse sense of victimization (by the PTSD, losing essential freedom over my time and space when it interupts, and not knowing how to recover from those), draining-- it was hard to plan things, follow up on committments, keep routines, get out more, see people, etc..  Less to do with story-lines or horror, terror and all that muck, if the flashback can be managed, can feel what one needs to feel, to help let go, once stablilized post-symptom/flashback and not going into the dissociative ego-state (re-living the hell).

I don't see how PTSD can be misdiagnosed, if the practicioner is in-tuned with symptoms presentation and focused in that way, re: delivery of support, teaching coping for the presenting symptoms?

[mariomike]

I'm really glad to see your organization has a smart expert on the scene and I like especially that she researches, oversees issues of organization structure. . . you guys shouldn't have the additional types of problems, added toxic crap, destructive stuff

There is also a departmental chaplain.
But, in my opinion, leadership was / is the most decisive factor in the morale of any organization.
I worked for men I had loyalty and respect for. Many were non-cerebral types from the old school. Getting "reamed out" by some of them was worse than any call I ever did. But, they were real role models for me. I was 18, so perhaps more easily "moldable" than some of the older and wiser individuals who were later recruited from the community colleges.
Later, I learned that some of my role models were less than perfect, but neither was I.
Others, I couldn't take seriously as leaders because I had little respect for them.

To me, stress would mean standing in line hoping for a job, and fear of layoff once you had it.

[kstart]

There is also a departmental chaplain.
But, in my opinion, leadership was / is the most decisive factor in the morale of any organization.
I worked for men I had loyalty and respect for. Many were non-cerebral types from the old school. Getting "reamed out" by some of them was worse than any call I ever did. But, they were real role models for me. I was 18, so perhaps more easily "moldable" than some of the older and wiser individuals who were later recruited from the community colleges.
Later, I learned that some of my role models were less than perfect, but neither was I.
Others, I couldn't take seriously as leaders because I had little respect for them.

To me, stress would mean standing in line hoping for a job, and fear of layoff once you had it.

I can agree with all that you have said here.  And I can relate to your feelings of feeling put off by "academic types"-- I've experienced this as well.  University, there were a few professors who were exception and what made the difference was they didn't make a life of 'academica' and had their feet planted in the real world, relevant work-experience which made their delivery of knowledge much more grounded, realistic, authentic vs. theory-lost academics.  When I took courses at college, on program I completed, they all had their foot in the real world and spent years at it-- grounded, reasonable, rational intelligence and the character that was shaped by real world challenges.  I felt way more motivated to learn when I had that type of teacher and the learning experiences were much more pleasurable and didn't jar me.  I had a foot out in the real world, and to experience blunted headed, overly attached to their own theoretical investments. . .closed to opening up issues and seeing them from different viewpoints. . .block-headed intellectuals, not truly rational, reasonable.

I've just seen situations of good people falling hard and leadership at the top was a major problem IMO, the source of the trickle-down and the spread of burnout, fatigue (stress leading others to enable, cover for the missed work, poor job performance of others-- which can be common place in many work environments, but not acceptable and harming when the work is responsible for safety of lives of others).  It wasn't deal with sensibly, consent, formal processes of shifting job roles-- all kinds of factors of burnout and trauma.  It can happen anywhere, but strong leadership, direct, honest, responsible can make a huge difference-- to deal with problems, not let things go on until everyone gets sick. . .

It's often observed in some organizations, a great-divide between 'front-line' workers vs, on high, and problems in decision-making structures as a result, ignoring the ground-level concerns, knowledge of issues from direct-experiencing and being responsive to that. . . potentially worse in non-unionized work (even though have to put up with some bs-- my roommate attended a meeting recently. . . but they got cookies    An academic psychologist made them go through these exercises which really did annoy them. . . things blew up and she ran away. . . ).  It was a situation which needed outside consultation to clear up the mess, better distribution of roles, reduce unnecessary, frivolous stressors. . . (so people had time off to care for themselves better), etc.

I've done a lot of spewing here, even experienced some grief, but that I've learnt some PTSD-grounding skills, able to feel the grief I was needing to feel and let it go.  Feels better.  That's when things are working the way they should be.  The grounding skills, key to stopping spread of PTSD, fried physiology, IME.

I've just had some really bad experiences of the "help" out there, people who were self-deluded about their competencies, abilities and limitations and it harmed, made my illness worse, aggravated it, forced/encouraged process when body physiology not grounded, made the PTSD worse.  I trust people who stick to some professionalism, are properly trained and supervised-- the others were more narcissistic (wrong assumptions about 'having seen it all', voyeuristic. . .?  A bias, faulty pressumptions, no reality checks. . .).

To me, stress would mean standing in line hoping for a job, and fear of layoff once you had it.

Facing homelessness due to disability, loss of income-- not too fun either.  I went through all my savings, lost everything, was hoping I'd get better before the savings ran out, but I didn't and I was a wreck ( I worked before university for some years too).  Also had a problem taking the 'assistance', something I avoided to the end-- I really didn't want to wind up in this situation, I didn't want to become like what I saw in how I was raised, I wanted to do better.  I was hard-working as soon as I was old enough-- worked full time all through full time school-- I didn't want to waste my time, independence was really important for me.  But some relief, because from this far down, can only go up and that's my full intention.  Still healing from an ice accident, might need physio (ankle healed, not shoulder/collarbone, limited movement), if it's covered.  I was hoping for physical labour work-- fitness, exercise good for PTSD health and earn income and get out of this hole.  I enjoyed volunteer work, carpentry, building stuff, being outside. . . as a re-start. . .stave off arthritis if I can. . .hereditary, mom can barely walk.  Having education in social sciences-- yeah, expect layoffs. . . if can even get employed!  My brain is too fried for excessive brain demands (sick for too long).

[mariomike]

"I came to realize that my work was less about saving lives than about bearing witness. I was a grief mop."
From the book by Joe Connelly.

Kstart, the way I looked at it, we were sent into people's homes to help the families. Sometimes, it was enough that we just showed up. Sometimes, they wrote thank-you letters to the department that would be forwarded to us. I still have them. That, and a paycheck, was enough for me.
I am disappointed to learn that victims of childhood trauma do not receive the support they deserve. Perhaps that is why I felt a bit guilty about getting paid to go to CISD.

[kstart]

"I came to realize that my work was less about saving lives than about bearing witness. I was a grief mop."
From the book by Joe Connelly.

Kstart, the way I looked at it, we were sent into people's homes to help the families. Sometimes, it was enough that we just showed up. Sometimes, they wrote thank-you letters to the department that would be forwarded to us. I still have them. That, and a paycheck, was enough for me.

Great quote.  For sure it makes a difference, sometimes a short brief intervention, even 5 minutes is all it takes, as a witness which helps others re-ground.  That's powerful.  I've appreciated that via crisis line, short, brief, but what was needed.  And life before I got completly unable to function re: PTSD, with the work, I found it very satisfying and rewarding, as witness and seeing things move through to re-stabiization.  I got some good feedback too.  I have a treasure of a drawing a Vietnam Veteran drew (Mohawk-- a longer time for their benefits to kick in re: Canadians who served there. . .), was intense my partners were afraid of his anger. . . I was experienced re: witness to my brother's anger, and respecting it, giving it space, safe expression of it, and it disipates (and giving person the choice, if he wants to be left alone-- street outreach--options for that. . . ).  The drawing he had been working on, just blew my mind away, a symbol that I related to re: flashback falling down and hitting, another symbol for healing, the movement in it, change of state 'medicine animal'.  He asked for interpretation, and I just said what I saw of it, owning that it's only an I-interpretation and answering honestly (without going way out there on it, just observations). . . he awarded it to me, simply tools were used, scrap of poster board and pen.  I've reflected on it, dreamt about it, movement of pen, emotion it it. . . seems like it was an amazing way to express flashback and the 'forces that are happening' with that, it feels like just lands on me suddenly and I struggle to find an anchor (which he had in that drawing) and the intensity, mixed feelings of grief.  It's really trippy, kind of wonder to have received that (he wouldn't know that I was beginning PTSD, I didn't talk about that-- it's not about me when I'm focussed on being present to others, then again, a lot of the people we met in outreach were very perceptive, had gone through long struggles themselves. . .).  A Native way of expressing it, "a lot of 'medicine' in that drawing. . ."

I've also had experiences of running into others, sometimes years after the fact, and they remember me, have been really happy to report to me that things are going better, got housing, employment, etc., proud to say they 'made it'.  That's an honour to see and hear.

Thankfully our sick organization disbanded and something much better replaced it.  There's been a lot of improvements, housing improvements makes a huge difference-- street is too distracting for others to get focus, stability to make other changes.  There are competent mental health workers, who have good support, more advocacy powers (things I had also been asking for, re: improving effectiveness).  Funding though is also precarious, subject to political whims of powers that be. . . affects waitlists, etc.

Also, it is important to trust and have faith in the resilience of others (despite a very imperfect world and imperfect system where people have and do slide through the cracks of social safety net) and I noticed this a lot in that work (sometimes some inspiration), I take less for granted, the gift of that is appreciation. 

Children also do have a lot of resilience, innate survival capabilities to cope with unsafe environments as do some adults in difficult situations.  Learning to anticipate, predict; if absolutely trapped, dissociate to get through it.  Making it out alive in a persistently dangerous situation, I can look back with some amazement, the scale could tip one way or the other. . . that's luck, but also some impressive sophistication.   Problem is, is that when reach adulthood, those coping habits can be automatic, and not serve well.  Similar idea to what returning from deployment, members will experience, a need to shift gears, re-adjust, but that there's been some grounding in normal, away from the theatre experiences to re-aquaint with. . . the transition can be challenging, a bit of stress is a given.

I read a story recently about Vietnam POW, they weren't allowed to talk to other inmates, so they developed a code of communation, re: tapping on walls.  One guy survived the mental difficulty of it, by 'building a house' inside his head, all the plans, tools, etc. and when he made it back home, he got to it, built his house.  That's an innovative adaptation to being in a trapped, highly repressive situation for years.

I encountered a situation in my life where there were simply not enough 'state reources' to get someone out safely enough-- that hurt, death threats, dangerous, unless those threats could be contained and not enough re: legal test of powers initiate that, but I had pain-- a trauma expert would understand what I witnessed re: risk factors, behaviours, etc., state investigated, but the abusers were sophisticated sociopaths-- that re-traumatized too along with awareness of horror.  I tried to get help on that, I couldn't accept, didn't feel closure-- not something I could handle on my own without help and support.  My mind couldn't accept it because it was unacceptable to me.  I got treated really badly in the hospital "medical model", when trauma validation may have equally helped me re-stablize from that, but that's not how they play here.  While still very painful for me, witnessing disturbing behaviours over time, partial recognition by the state, but not full re: another victim.  It tore me up.  I've had to settle with it, and try to have faith in that person's resilience to survive it safely.  I did what I could, I confronted abusers, intense, high key stress, and resulted in safety risks, mine and others. . .

I don't know why I've had to be tortured like this, I would have walked away from situations, but concern for others kept me there, but turns out there are things i don't have power over, I can't control the choices of others, or the pathologies of others when they choose not to get help for themselves (denial of harm, or minimization of harm).  I guess I have a more realistic sense of my limitations and now I avoid situations.

I was really moved by General Romeo Dallaire's (book and documentary, Shake Hands with the Devil) re: accounts re: Rwanda, what kept him there when the orders were to withdraw and try to make a stand, but ouch.  I identify emotionally with that pain, different scales of exposure and extremes, but I'd say I have encountered some evil out there in the world. . . Devil might have won the battle, but at least not my soul.  It's probably not a bad experience to experience this once in one's lifetime, it's sobering, to feel through it at least once in a lifetime, that depth of pain.  But it's dangerous self-sacrifice and can have lasting effects, painful ones, ptsd. . .  It's also hard to stomach and it can be painful being aware of things that aren't right.  I pushed my limitations, realized things that were beyond my personal control.  With anyone's life, there are a lot of things that can be going on, and are simply beyond our personal control and about their choices and sometimes some unfortuante circumstances, complications.

[quoteI am disappointed to learn that victims of childhood trauma do not receive the support they deserve. Perhaps that is why I felt a bit guilty about getting paid to go to CISD.
][/quote]

Crisis services, even though the system is imperfect, does save lives, gives a person a chance to survive another day.  I've struggled for a lot of years trying to find PTSD help.  Support from the crisis lines helped me to survive, even though I couldn't get help for the underlying PTSD for a long time.  I'm glad I survived, it's still worth it and I'm recoverying and I will be back up on my feet.  I've let go of 'material loss', financial losses, realizing they're not that important as long as I have safe shelter and food to eat, and my brother is safe-- I can rebuild, I'll never be 'well-off'. . . having a cottage/place to live on a lake would be a good thing, good to have some dreams anyway.  Some services have improved, but nothing is very stable, it depends on the powers that be.  I struggled, I didn't fit the criteria of some programs geared to age, or ethnicity, etc.  It was hard trying to self advocate while in a crisis state, begging at places, being declined because lack of space, ridiculously long waitlists, of several years. . .

It was really piecemeal-- there are some organizations that work really hard, fundraising and are good organizations.  I could work through one trauma at one place. . . get a coping skill from another. . . really long waitlists, hampering recovery. . .but the central problem was the flashbacks, because that threw everything out of whack (dissociation, losing time, hard disorientating suffering. . . avoiding others so I'm not re-victimized in a vulnerable state and to preserve relationships, be a safe and stable pillar for my brother who has also had a hard time and was younger.)

I've actually done a fair bit of healing here-- there's things others won't understand, unrelateable re: crisis work, burnout.  The issue of good leadership preventing trauma, burnout, hit home.  I've had confusion, not realizing the other connection to not good 'leadership' as in parental strengths, resilience growing up (they're falling apart, while really low general functioning, really sick, and no access to healthy adults).  It's a piece of it, a factor in how it was traumatizing and re-traumatizing re: toxic work environment.  It booted up hypervigilance which makes sense to me now.  What I saw there were trauma adaptations, spread ill-health in the organization, not unlike what happened in a traumatized family and the help just wasn't very good back then either, and it would have relied on parental cooperation and I'm not sure the parent would co-operate.  But children are resilient, can have good survival skills for chaotic situations.

I try to read books, novels of strong characters and build inspiration up from that.  It's important to nurture and build on positive exposures and experiences.  I am through the worst of it.  I have more understanding about the layers of traumatization, the pieces and I can calm myself about it (understand its effects, why is this happening, what is it-- being able to name it, makes it possible to detach enough from it), while being able to face it, and feel what I'm feeling without avoidance/numbing or excessive anxiety.  I've developed some skills on my own, by what I could teach myself.  I've had exposure to some awesome professors, teachers, some truly exceptional people and they're meaningful inspiration, same with some other experiences.  Moments of grace that kept me going, spirituality, etc.

I stumbled into Mindfulness Based Stress Reduction-- it's now getting a lot more attention re: help for PTSD and I know it's really helpful-- I'm glad I had some exposure to that, it makes it easier to adopt flashback management techniques, benefits recovery in a lot of ways re: ptsd, anxiety, depression, other uncomfortable states, chronic pain, etc. IME.  I hope they keep this accessible for others.  I hope they can fund a PTSD program so everyone who needs it can access it, e.g. something like Homewood's program, even if it was available out-patient, a group. . .?  I had access to a women' s group for a trauma, and facilitators could catch when I was starting to flashback/dissociation and remind me to breathe-- need a bit of a mirror because that helps me recognize it better when it does happen when I'm on my own.  Those types of experiences help integrate the coping technique (traumatized self, ego states, hard to access coping skills without some bridge made by a witness who can notice it and let me know-- sometimes I rock slightly, body trying to soothe, automatic reaction-- learning to breathe, reminder to breathe helps [anxiety, breath becomes shorter, not enough oxygen, heart rate affected, more flashback prone, etc.]).  I tried to learn through books for it, but was really limited in how I could approrpiate it.

Some help, but long waitlists inbetween, and brief (4 months max), complicated, re: multiple traumas, different ages, etc.  Crisis support helped lots, 5 minutes on phone could help me get through flashback or other troubling symptoms, and also the effect built a bridge between traumatized ego states and present moment.  When lost in it, it's hard to find 'home' present moment (where there's more power to choose, freedom of the will, apply appropriate coping, etc.).  I'd say there's been some improvement in services vs. when I first broke down-- maybe?  I also wasn't aware, I trusted help that wasn't help, so I missed out on doing harder searching back then.  I mean, actually getting a call back after 2 years waiting, is a big improvement.  Access via Community Health Centres for crisis counselling, also relatively new, past few years (some affordable help)-- it's hit and miss, funding there sometimes, sometimes it's not, so have to keep at it (have a list and go through it and check it monthly, yearly, etc.-- harder to do when cognitively impaired, crisis state. . .but I did get online support, which helped me stick to that and I worked hard at it, stuck with it, despite ptsd distractions).  Resources crisis lines weren't aware of, a lot of research and searching.  It was luck that I finally found a social worker who had some knowledge re: PTSD treatment and could teach me flashback management-- has made a huge difference.

[kstart]

@mariomike,

Thank you for being a witness and for that spot of validation.  I feel relieved and I can let some things go.  "there it is, accept, move on. . .re-focus. . .".  (It was sometimes hard to figure out 'what the h was that?", lol).  There's a balance between being realistic, accepting 'what is' and maintaining positive outlook and to re-build where necessary.  I need to continue to build on wellness and moving forward.  I hope I've been able to help others about understanding PTSD a bit, maybe in expressing, validating some experiences of others coping PTSD and other OSIs.

Definitely the others, CF members and their families, and related fields,  remain in my heart and prayers.     I respect a lot about CF, many virtues, I truly admire. 

I don't comment on all the threads here, but there's some good laughs in here (good humour, etc.-- and needed ), and stimulating discussions

My sincere gratitude-- thank you (and for keeping it real). 

[mariomike]

It goes back to what we said about psychological first-aid, Kstart. I remember one night when I was much younger a lady saw the shocked expression on my face. She took me back downstairs and sat me down in the living room with a glass of water. She could have humiliated me for showing weakness. I was grateful to her. It only took a minute, and I was ready to go back up and do my job. I was determined that it should never happen again.
So you see, sometimes the shoe is on the other foot! 

[kstart]

It goes back to what we said about psychological first-aid, Kstart. I remember one night when I was much younger a lady saw the shocked expression on my face. She took me back downstairs and sat me down in the living room with a glass of water. She could have humiliated me for showing weakness. I was grateful to her. It only took a minute, and I was ready to go back up and do my job. I was determined that it should never happen again.
So you see, sometimes the shoe is on the other foot! 

Yeah, went a long time without that 'first aid', several 'shock' events, and chaos, w/o first aid, so it did fry some of my "circuitry" but is healable.  I try to move on and keep positive, but I also know I do get bit back ayway, so I just try keep prepared for that (I've had some 'false starts' and it's been disappointing).  But nothing wrong with "Hope for the Best, expect the worse''   But what that lady did for you was a good thing and it works and sometimes that's all we need, to pull it back together. 

And that kind of good support is a lot of hope for our returning CF.  There's power, when others are able to lend their presence, ability to listen (often it's not like that way, people get uncomfortabe, lack courage and perspective, but that might not be the case, e.g. CF, or other professional realms).  Good people like that who are available can do lots to prevent ptsd from setting in.

I get aftershocks still (and other's don't get that, e.g. "it happened years ago", but it's recalled as if it just happened, hence some 'shock'-- I wish it wouldn't irk people  , and if it was just understood as 'shock' and no big deal . . . but the crisis line gets it, so that's a lot less stress for me), but less frequent relative to before, so I should be able to pick things up to get employable again-- I hope to find a decent work environment.   I'm going to do my best.  Processing some things helps me desensitize from it, some flashbacks-- can still have but they don't overwhelm, nor cause shock-- that's progress.

I heard back from Homewood, still waiting for that OHIP-covered ward bed (they called re: updating my info). . . I find out that the funding for that is come and go-- that's part of what's been going on (and ever 3 months, there's shifts re: gender they serve, etc.). . . but there should be more, or better soon. . . but no idea how many more years waiting it would be. . .  I can't count on it obviously, I believe I can pull through anyway, it's just been a slower process, but what's time, a drop in a bucket.  So, I'll just deal with it.   "Keep Calm and Carry On"

I get that you've had lots of experience  , and you're stronger for it   That's good    And the psychological first aid is good stuff and if it happens earlier, can probably prevent PTSD from setting in.