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20 August 2013, PTSD & Traumatic Stress News Roundup

August 20, 2013 / no comments

A couple of folks complained that all I seemed to cover was combat-related PTSD. That’s because almost all the PTSD-related news stories that Google serves up are about that population. So, to try and catch any other stories, I broadened my search terms to include “traumatic stress”. One thing this exercise shows me is how under-reported and discussed other populations of survivors are, especially since soldiers make up the minority of those with PTSD. So let’s see what Google offered us yesterday and today:

The Trauma Diet

Dr. Kathleen Kendall-Tackett is giving webinars in “How Trauma Makes You Fat.” She makes the same links between obesity and trauma that have lately been described in the research, but makes a claim that is, so far as I can find, unsupported in the literature, at least in human studies: “The good news is that when traumatic stress is addressed, inflammation and insulin resistance can be reversed.” She’s hyping a book that she will self-publish later this year. The info is taken verbatim from this press release (there is very little real science journalism any more). While I easily found more than one 2013 study that suggests that weight loss has a beneficial effect on PTSD symptoms (as it does on depression, and also for reasons that are as yet unclear), I found no studies that suggested the opposite: that PTSD treatments resulted in weight loss for obese patients. I’ll be curious to see her references when the book comes out, but my guess is at this point they’re confined to conclusions drawn from animal studies.

Fund Raising Efforts

The Republican American featured a story on a motorcycle ride to raise money for PTSD, organized by Arthur Melcher of American Legion Post 43 in Minnesota. They raised about $3000, which will will go into the Post’s “Post-Traumatic Stress Disorder account.” The ride was in memory of Matthew Marc Melanson, who committed suicide after returning from military service in Afghanistan.

Also in the fund-raising department, The Northwestern.com has published a story about Tom Voss and Anthony Anderson, the Iraq war vets from Wisconsin who plan a 2700 mile journey to raise money for Dryhootch. They’ve so far raised about $15,000 of the $100,000 that they’re looking for. The bulk of that comes from a $10,000 donation by the U.S. Concealed Carry Association, a commercial organization that carrying concealed weapons is a “social obligation,” and that strongly promotes gun ownership in houses where there are children.

Send ’em back into the field!

The military’s failure to either “prevent” or to “cure” PTSD has spawned a new philosophy: Redeploy soldiers with PTSD, again and again.

But a diagnosis of post-traumatic stress disorder is not a barrier to being redeployed. Not when the Army needs its most experienced soldiers to wrap up the war. Instead, the Army is trying to answer a new question: Who is resilient enough to return to Afghanistan, in spite of the demons they are still fighting?

As the Army has knowingly redeployed soldiers with symptoms of PTSD – and learned of the remarkable coping skills of some – it is now regularly embedding psychologists with units in the field. They are treating men and women recovering from 12 years of relentless combat, even as the soldiers continue to fight.

It seems the military has discovered that some soldiers with PTSD can continue functioning in a wartime environment, and it’s willing to redeploy them until they crack for good. Although many studies suggest that each successive retraumatization does more damage to the individual psyche, the military is apparently unconcerned with a soldier’s capacity to function in the civilian world, post-combat. The argument that some people seemed to survive years in a concentration camp, and to come out intact, would never be used to justify concentration camps since we know that many of those who were high-functioning in the world of the camps, and who survived many years there, failed to adjust to normal life after they were released, had breakdowns, or committed suicide. There’s no reason to think war is any different: some soldiers with PTSD will continue to be high-functioning combat soldiers, but we have no idea how the 7-tour combat veterans that the article describes will adjust to civilian life postwar. The role of the therapist, in such a combat mill, becomes deeply troubling.

The article describes embedded mental health professionals who travel with the troops, and who are charged with keeping them going between combat engagements. Capt. Stacey Krause is “one of dozens of behavioral health experts deployed across Afghanistan.” She doubles as marriage counselor and financial advisor, and is “often the only person on Arian who knows how the soldiers of 10th Mountain are holding up.” She says, that soldiers “can meet the criteria for PTSD but still be able and willing to serve this kind of mission… After multiple deployments, soldiers are able to build robust coping mechanisms.” As any properly trained psychotherapist will tell you, “coping mechanisms” are not the same thing as “mental health”. The former might allow you to endure the combat environment, but it’s the latter that allows you to reintegrate into civilian society. But given the increasing number of combat tours that veterans are accruing, perhaps the army wants troops that can find a “safe harbor” only under combat conditions, who can “cope” only by redeploying over and over again. Says one of the soldiers quoted in the article, “It just seems inevitable that we’ll be sent somewhere again… That’s the one thing we’ve learned from experience.”

This attitude is summed up beautifully by U.S. Army Brig. Gen. Walter E. Piatt, who wants to turn meditation and mindfulness into tools of war. (The irony just never stops, does it?):

“We fight now in a cognitive struggle with an enemy that can’t be defeated through technology. They’ve taken our strengths, big weapons and technology, and changed the game,” Piatt says. “They attack on their terms. They don’t care about civilian casualties. Our best weapons in that fight is the soldiers’ minds.

“You’re not letting your mind wander, you’re focusing straight on. This is what her technique teaches you to do, focus on the task.’’

The rhetoric of “hearts and minds” that was once cynically applied to applied to winning over the Vietnamese people to the American cause has now shifted into a battle for the hearts and minds of our own soldiers. Piatt doesn’t just admit that U.S. soldiers suffer from PTSD, he positively revels in it. The answer? Crazy shit, like the Mind Fitness Training Institute founded by Georgetown University professor Elizabeth Stanley, Ph.D. MMFT® allegedly “blends mindfulness skills training, stress resilience skills training, and concrete applications for the operational setting.” This as-yet-unproven “stress innoculation training”, administered under a registered trademark, has already reaped the benefits of military largess towards those who promise to keep their troops in the field longer. I’m pretty sure meditation and mindfulness have positive effects, but it’s exceedingly doubtful that those modest good effects will overcome neurological stress reactions in the long term. What’s most interesting is the way that meditation techniques have been hijacked from cultures from which they emerged. Meditation and mindfulness are traditionally activities engaged in by those who seek peace, not those who prepare men and women for war. And it’s about as true to the tradition as claiming that the central tenet of Buddhism is “every man for himself.” This kind of training resonates more with magical thinking movements like The Secret (no I won’t link to that garbage), and “failure to meditate properly” will doubtless be listed as the reason that troops are succumbing to PTSD in the field….

Social Media

The Facebook page Military with PTSD was apparently shut down for 12 hours by FB admins, over a post (which I can’t find anywhere) “about God and religion.” The page has 22,000 “fans”, and was started by Shawn Gourley, the wife of a military vet who suffers from PTSD. FB is notorious for banning and unbanning sites at will, so it’s disturbing to read Gourley’s comments: “On our page, I am a certified suicide gatekeeper… And we do have suicidal vets on the page that come to us for help. We cannot contact them or message them… Someone posted on my personal page that they felt like the walls were closing in on them and they don’t know how much longer they can hang on and I can’t respond to her.” It’s even more disturbing to read the words of another page administrator, veteran Marcus Spaulding, who claims, “Facebook put a lot of lives in danger… We have many veterans who come to that page to talk to counselors, to talk to Shawn, to talk to me… They don’t know where else to turn to… We could be burying another vet.” These statements are in direct contradiction to the description of the Facebook page:

We are not doctors or in any sort of health care field. We are just veterans and spouses coming together for support. We are not responsible for suicidal/homicidal content or actions. If you are in crisis, please call 911, go to your nearest Emergency Room, or call 1-800-273-TALK (1-800-273-8255)(Spanish/Español 1-888-628-9454). Veterans, press “1” after you call — or go to Veterans Suicide Prevention Hotline to chat live with a crisis counselor at any time of day or night.

No veteran should be dependent on a Facebook page as a lifeline, and if the site administrators see themselves as providing such a service, then they’re acting in a deeply irresponsible fashion. While online communities and fora can be very helpful for people with medical and psychological conditions, they are no substitute for local support networks, qualified therapists, and treatment centers. Online communities attract all kinds of people, and there is no way to certify who is who: real vets mix with fakes, and qualified therapists mix with well-meaning amateurs who are simply not equipped to deal with the problems they are attempted to help solve, and with quacks who “prescribe” fake cures. A responsible administrator would nip in the bud any relationship with a veteran who seems to be growing dependent upon the page, and suggest they redirect their focus to a local source of help. Instead, the two administrators who were quoted above seem to revel in the alleged dependence of the vets with whom they interact.

More media “diagnoses” of PTSD

Fox News is reporting that actress Amanda Bynes, who has been hsopitalized for schizophrenia, has PTSD, and that story is being echoedfox around the web. The PTSD “diagnosis” apparently comes from “a source close to” Bynes. The anonymous source claims, ““There are no drug problems involved, it’s all mental. She has deep anger and PTSD, which tripped a psychotic episode… She is very ill, but manageable. Amanda genuinely wants to get better and has wanted to get better for some time.” The source also claimed her PTSD “stems in part from the pressures of her Hollywood career, in which she shot to Nickelodeon stardom as a child…” and from “very deep-seated conflict issues with her parents.” It’s news to me that child stardom and the pressures of Hollywood are causes of PTSD, and “deep-seated conflict” is a far cry from traumatic abuse. I don’t know Byne’s specific history, but the point is that neither does Fox, which is lobbing out a faux diagnosis based on alleged symptoms.

And now from Big Pharma…

Tonix Pharmaceuticals is promoting cyclobenzaprine, the active component of TNX-102, a new sublingual tablet, at the International Pain Society’s 9th World Congress on Myofascial Pain. In December of 2012 Tonix raised $2.3 million to further develop TNX-102 (CNS Drug News, 6 December), which is a proprietary formulation of cyclobenzaprine (CBP). Tonix pitches the drug as a treatment both for fibromyalgia and PTSD since both seem related to poor sleep. Tonix claims that “the unique qualities of TNX-102 SL provide for rapid absorption into the bloodstream and rapid excretion from the system. This is ideal for a bedtime medicine to reduce next day somnolence. In addition, since TNX-102 SL avoids first-pass metabolism by the liver, a psychoactive metabolite of cyclobenzaprine, norcyclobenzaprine, is not generated. TONIX believes that this metabolite contributes to reduced long term efficacy with the off-label chronic use of generic cyclobenzaprine.” Since the military is cutting down on the number of benzodiazepines it prescribes, this would leave the billion-dollar military pharmaceutical market wide open for Tonix. The results they’re reporting are from non-clinical studies; clinical studies won’t start until later this year. I’ll follow this drug as it moves through testing and towards the market.

17 August 2013, PTSD News Roundup

August 17, 2013 / no comments

Bad Science Department

Sometimes the names of the trauma-focused therapies that folks come up with make me shudder all by themselves, they’re so weirdly Orwellian. That’s the case for “reprogramming therapy,” of which Accelerated Resolution Therapy (ART) is being hyped as the latest and greatest “cure.” Here’s the headline: “Scottish nurses are to be trained in a treatment for post-traumatic stress disorder that works by reprogramming the brains of combat veterans.” Though it sounds like a kind of Orwellian brainwashing, it’s yet another version of Francine Shapiro’s endlessly “promising” (no-longer-so-)new therapy, Eye Movement Desensitization and Reprocessing (EMDR). EMDR and its variants have proved no more effective than any other trauma-focused therapy, which means they’re moderately effective at relieving clinical symptoms in the short-term, for a very small segment of the population that suffers from PTSD (the 20% of women, and about 12% of men with no co-morbid psychological disorders). The description of how ART works is pretty weak: “The patient is asked to move their eyes back and forth while recalling traumatic events, a process which is thought to “unlock” the memory and enable the therapist to start a discussion aimed at detaching the associated negative emotions.”

Since even variations on EMDR that don’t use eye movements all seem to work about the same, it’s pretty hard to argue convincingly that eye movements are the key to “unlocking” the memory. The idea of “unlocking” is purely metaphorical anyway, since there’s no proof that the memory mechanism (whatever it is) “locks” or “unlocks” at all. Since we don’t (even the neuroscientists) have good models for the mechanisms by which we remember, forget, revise or associate, “explanations” like the above are no better than “just so” stories, and often worse than no explanations at all. Sterling University of the UK is teaming up with University of South Florida (USF) to implement ART, which was developed at USF. The rationale is a an allegedly successful study “carried out among 80 war veterans in the US found that the proportion showing signs of PTSD fell from 90 per cent to 17 per cent after four sessions or fewer. (When I found the study, it did not seem to include any war veterans. See next paragraph.) Incidences of depression in the same group dropped from 80 per cent to 28 per cent.” The people who report on science these days are so dim that they don’t understand that stats like this are like giving half a baseball score. A drop from 90% to 17% sounds pretty stunning, but it sure would be nice to know the response rate in the control group (if there was a control group), if they accounted for the placebo effect, and if there was a follow-up study to find out if the treatment had lasting effect. So I poked around and looked for the study (not referenced in the article).

“Brief Treatment of Symptoms of Post-Traumatic Stress Disorder (PTSD) by Use of Accelerated Resolution Therapy (ART®)” wasn’t hard to find. It was published in June of this year in a relatively new open-access journal called Behavioral Sciences. It’s so new that it’s published a total of 45 articles and I can’t find any record of its impact factor. This doesn’t make it a bad journal, and it’s from a reputable publisher, but a more robust study would have found a more prominent home. So let’s see what the study says… 1) Those selected for the study suffered from PTSD, but veteran status was not a criteria for inclusion; 2) 77% of the subjects were women, and 29% were Hispanic: those numbers are not representative of the population of British veterans (none of the subjects appeared to be vets); 3) 17.5% of the subjects dropped out before the end of the study, and 18.2% of the remaining subjects dropped out before the 2-month followup, which means that they collected full data on less than 70% of the full group of participants (54 people); 4) they excluded substance abusers (which would exclude 64%-84% of veterans with PTSD); 5) there was no control group, and all therapists were trained in and administered only ART therapy, which means that the effect of researcher allegiance on the patient was unaccounted for; 6) all data was self-reported. So there is no way to know if the amazingly large effect they reported was due to ART or simply a product of entering any kind of very short-term trauma-focused treatment. Section 4.2, “Possible Therapeutic Mechanisms,” is pretty funny. I’ve rarely seen a longer list of “may be.. postulate… may help… may occur… may simultaneously…” and so on. The chain of conjecture continues for miles. Some of it is just plain pseudoscientific gobbledygook: “… ART involves an additional therapeutic element known as the ‘Director’ intervention that directs the patient to establish a new narrative to address ‘unfinished business’ in much the way that Gestalt techniques are used experientially to achieve positive results. Success of the intervention is determined by the therapist asking the participant to pull up the original distressful [sic] images, and reporting being unable to do so.” In light of the fact that the study did not include combat veterans, the final line of the paper is telling: “Future controlled studies with ART are warranted, particularly given its short treatment duration, and in light of current heightened emphasis on health care cost constraints, as well as the very large clinical burden of treatment of PTSD being experienced from the lengthy wars in Iraq and Afghanistan.” To me, this just screams: “We’re gonna sell this to the military!” And, of course, the military bought it: the DOD paid for the initial research, and now ART® (don’t forget that trademark!) is a product now offered to British war veterans.

PTSD Made Them Do It!

In Denver, a military veteran named Daniel Abeyta was arrested for allegedly shooting two women and blowing up a propane tank. The CBS Denver headline was “Neighbors say shooting suspect is vet with PTSD,” but that’s not mentioned in the article until the final paragraph: “Neighbors said Abeyta… suffers from post-traumatic stress disorder and is involved in a difficult marriage.” It’s always fun when your neighbors diagnose you for the news media and then the news affiliate headlines the hearsay. In other news, 43-year-old Dinalynn Inez Andrews Potter, a retired Navy vet, allegedly jumped on stage and clobbered elderly soul singer, Lester Chambers when he sang a song dedicated to murdered teenager Trayvon Martin. Apparently Potter’s claim she has PTSD makes this “not a racial attack” in the eyes of the arresting officer, even though Potter yelled, “It’s all your fault, you caused this shit,” before she knocked the frail singer on his ass. This “It’s not racism, it’s PTSD” stuff is just silly. It’s not like the two are mutually exclusive. PTSD doesn’t change your political beliefs or give you prejudices you didn’t have in the first place, even though it might remove your inhibitions to acting on them.

16 August 2013 PTSD News Roundup

August 16, 2013 / no comments

Yesterday I talked about the military funding yoga as a PTSD “treatment”. Today, it’s military funding for studies on transcendental meditation. I don’t have anything against yoga or TM; in fact, I practice TM because it makes me feel more relaxed, and yoga is great for stretching. But that doesn’t mean it’s a “treatment” for people with posttraumatic stress. According to Iraq war veteran David George, “Veterans spend a few hours learning how to meditate with certified TM instructors and can work on the skill independently after that. Veterans never have to take a pill or go through Veterans Affairs for health care.” I guess not having to go through the VA and endure its notably lousy treatment of soldiers and vets with PTSD is a plus, whether TM works or not, but reporter Megan Cloherty of WTOP is not real strong on the science. The treatment is being pushed by Sarina Grosswald of the David Lynch Foundation. The Lynch Foundation runs Operation Warrior Wellness, and claims on their website that “More than 340 peer-reviewed studies, including research funded by $26 million in grants from the National Institutes of Health, document the effectiveness of the TM technique for relieving stress and stress-related disorders.” 340 peer-reviewed studies? Really? A pubmed search gives me only 44 studies that include the very broad keywords of “meditation + post + traumatic” in any field. I’m not sure where the other 296 studies are hiding, and the site doesn’t say. My guess is that they don’t exist. The only study on TM and PTS that was actually listed in the promo material for the Operation Warrior Wellness program includes Ms. Grosswald as an author, was uncontrolled (meaning that it was impossible to measure the effects of TM against a group of people who did not engage in the practice) and included only five veterans. (The authors claimed that the vets showed “significant improvement”, but I’m not sure how they measured that, since significance testing on a group of 5, with no control, is pretty much impossible. That this passed peer review in Military Medicine simply underlines the journal’s low standards, and you don’t get much lower than an impact factor of 1). But, hey, that was enough for the DOD to dump $2.4 million dollars into studying TM among vets at the San Diego VA Hospital. Maybe it’s the inanity of the reporter, but I’m not impressed by Greenwald’s assurance that TM works because “in brain scans taken during TM, the prefrontal cortex of patients’ brains lit up.” Sheesh.

And though the DOD and the VA can throw hundreds of millions at “foundations” that push pseudoscience, and pharmaceutical companies that push expensive drugs, they can’t seem to do much for guys like Howard Berry, whose son, Josh, committed suicide after battling PTSD for years. Josh had been wounded eight years before by Nadal Hassan, the Fort Hood shooter. Berry believes that soldiers with PTSD “need more” than the government is giving them. He’s right, of course. Unless militaries admit that the psychological cost of war and violence are ongoing, and last lifetimes after combat has ended, they will never provide adequate services to soldiers and veterans. Iraq war veteran Sgt. Mike Bergman might agree. A Colorado 9 news article says of Berman: “Looking back, he knows he changed forever when he saw the faces of the first three people he killed. His message to the politicians and military leaders: thousands more like me are coming home.” The article also mentions Curtis Bean, “a sniper, who also attributes his PTSD to his decisions to kill.” It’s clear enough to the soldiers that killing people is bad for you, even if extenuating circumstances (like a declared war) make it necessary. But the military is so invested in the notion that “war makes men” that they’ll never admit that war breaks men, and especially not that it breaks strong, normal men who were perfectly healthy and psychologically well-adjusted before they got into the military.

Veteran Curtis Bean, mentioned above, turned to art as a method for handling his pain. He founded an organization called the Art of War Project, which held a show in May of this year. I dropped by his website to see his paintings and was impressed by his work: he paints with bright, bold colors, and captures monstrous and beautiful images with a combination of comic art and graffiti on canvas and wood. Photojournalist Ashley Gilbertson also practices a kind of art therapy. In the process of working through his own PTSD and guilt over the death of a soldier in Iraq who preceded him into danger and paid the cost, he began photographing the rooms of the young American soldiers who had been killed in the war. The series, “Bedrooms of the Fallen,” is powerful because it evokes the memory of fallen soldiers as they were when they lived in the civilian world. The rooms are untouched, and they evoke a loneliness that’s without solace. On the one hand, each room looks as if its owner has stepped out for a moment, and on the other hand there’s a sense of frozen stillness—one can almost see the dust settling deeper by the day.

And to sum it up today, we can consider the inhumanity and downright creepiness of Thomas Donnelly’s war-loving editorial in that bastion of ethical rectitude, The Wall Street Journal. Donnelly waxes nostalgic; he wants to bring back the days when soldiers were seen as “models of self-control, courage and patriotism.” He also makes absurd claims: “It is possible to identify those who are most prone to stress problems, and that has more to do with nonmilitary issues—again, substance abuse, money and family problems are the culprits—than with the experience of combat or deployment to a war zone.” His lip curl when he states firmly that military commanders have “long known” this, is almost visible. We just have to keep out those pesky undesirables, and war will turn back into a manly game for manly men. After all, as humans, we have an “underlying, primal instinct for violence.” As if all this dick waving wasn’t enough, he then insinuates that the claims of rampant sexual harassment and abuse put forward by military women are baseless since (he quotes a woman here), “there is no evidence that the military has a higher rate of sexual assault than, say, colleges and universities). Finally, he invokes the myth of the “civilian weakling” who prevents the manly soldier from doing his job: “By regarding soldiers… as victims and patients, we are in danger of foisting our very own, very civilian and very modern, therapeutic pathologies on people who don’t need them and whose ability to do their jobs—that is, keep us safe—is likely to be diminished.”

If you haven’t already puked on your shoes from the above Rambo redux, you may wonder where he draws his evidence for the claim that we’re creating “epidemics that aren’t.” On August 7, JAMA published a longitudinal study called “Risk Factors Associated with Suicide in Current and Former U.S. Military Personnel,” by LeardMann, Powell, et al. The study, which took place over almost 8 years, found that “suicide risk was independently associated with male sex and mental disorders but not with military-specific variables.” So this is a suicide study, although Donnelly uses it as if it debunks any link between PTSD and military service. I’ll talk about the study later, and what it really does or doesn’t show, in a separate essay, but I wanted to point out this pretty sneaky dodge on Donnelly’s part. His other piece of “evidence” that real manly man soldiers are being maligned by women who serve in the military comes from Gail Heriot, who claimed in an article for the Weekly Standard (July 8, 2013) that “there is no sexual assault crisis” in the military, and that it is the military itself that is being “harassed.” Heriot’s conjecture that sexual assault is simply over-reported is taken by Donnelly as a fact. Others have critiqued Heriot, including attorney Roger Canaff. Given that Heriot has crusaded against anti-harassment courses, calling them “propaganda,” and a “rather blatant form of racial and sexual harassment,” and that she sees anti-discrimination laws as a form of harassment against employers, I think her agenda is pretty clear. Of course, agendas don’t matter if you have the facts to support your arguments, but Heriot doesn’t.

14 August 2013, PTSD News Roundup

August 13, 2013 / no comments

I’ve been meaning for some time to do a regular round-up of articles on PTSD that show up in Google News. Ive been put off by the combination of annoyance and depression they usually evoke, but I’m shaking that off today, and getting to work. So here we go….

Shoosmiths’s Access Legal (a site that advertises legal services to soldiers, so I’m not sure how it’s Google “news”) features a piece on the Bundeswehr’s decision to give psychological tests to recruits, in an attempt to “prevent” PTSD. Working backwards from a study that showed that most soldiers who suffer from PTSD after combat also survived traumatic experiences before combat, the German Defense Ministry has adopted the suggestion of Prof. Dr. Hans-Ulrich Wittchen, a professor of clinical psychology at Dresden Technical University. The theory seems to be that if they send fewer traumatized soldiers into battle, then they’ll get fewer traumatized soldiers after battle. Good luck with that, I say. The study referenced in the article is probably this one, published in September 2012. A study of inpatients in a German Army hospital, it found that in about 40% of patients, there was evidence that psychological trauma pre-existed military service. Not very surprising, really, since the same study admits that in the U.S. general population, some 61% of adults had been exposed to traumatic events, and a German study showed that 26% of men had been exposed to trauma, so that means the estimate of 40% of Bundeswahr vets with pre-military service trauma is not nearly as far off the average as the news report would have it seem. The study is worth reading, though the sample was small and skewed heavily towards inpatients. As for the Bundeswahr’s decsion, it could have some interesting results. Since we know that compounded trauma results in more cases of PTSD severe enough to impair function, it could be that screening out “pre-traumatized” soldiers will reduce the severity of PTSD, if not its incidence. This could be practical in Germany, where there’s a universal draft and the number of soldiers sent into combat is very small in comparison to the number of soldiers who serve. A screening program like this would never work in the U.S., though, since the population most likely to enlist is most likely to be pre-traumatized by the various oppressions endemic in U.S. culture/society. Pre-screening U.S. army recruits might mean rejecting over 60% of applicants on those grounds alone. At any rate, pre-screening may not be very effective for troops repeatedly exposed to combat, or exposed to moderate threat to life over long periods of time, since that trauma also compounds.

Australia has a new $2.5 million MRI facility that will be used to scan the brains of Australian and American soldiers in an attempt to “follow how the brain is healing and recovering.” This looks like ABC News pulled it directly from an institutional press release. Yay, more pictures of the brain! I guess I should be happy at this “cutting edge research,” except that we already have a whole helluva lot of pictures of the brain that haven’t told us much about what’s going on inside people’s heads. If you read the story, the main point of all this scanning is to generate interest in scanning so that more people will want to be scanned.

And as if I weren’t already disappointed enough in President Obama, like his predecessors he’s emphasizing as-yet-nonexistent cures over real preventive measures. Though the fact sheet of the “National Research action Plan for Improving Access to Mental Health Services for Veterans, Service Members, and Military Families,” is going to throw (away) $107 million on creepy projects like discovering and developing “biomarkers” to prevent, detect and treat PTSD, and a nifty new classification system for traumatic brain injury (TBI), I see a whole lot of nothing aimed at violence prevention. On the other hand, Obama never misses an opportunity to collect data, so of course there are ear-markers for data-sharing across agencies, service branches and scientists. Our soldiers can look forward to more decades of playing guinea pig for big pharma and the military, after they’ve been ground through the combat mill. Shared information would include the Pentagon’s giant blood serum bank, dating back 28 years, and containing samples kept in perpetuity. The military has banked 55.5 million samples from 10 million individuals, including millions of samples from the family members of soldiers and from civilians who applied for but did not enter the military.

Laurie Halse Anderson has written a new book about second generation trauma of war and having a vet with PTSD in the family. It’s called The Impossible Knife of Memory. Fifteen years ago Anderson also wrote Speak, about a rape victim. There’s an interview with the author in USA Today. I haven’t read any of these books, but now they’re on my list. I’ll post reviews when I’m done.

Following in the footsteps of many activists, including other veterans, who have walked outrageous distances to try and raise public awareness about their plight, Iraq war vets Anthony Andersonn and Tom Voss are going to trek from Milwaukee to L.A. Their goal is to raise money for Dryhootch, an organization that provides support for vets. Both Andersonn and Voss say they suffer from PTSD after serving in Iraq for five years. Dryhootch was founded by Robert Curry, a veteran of the Vietnam war (and Laos, he says) whom Obama honored as a “Champion of Change.” Andersonn and Voss crowdfunded their walk, and Dryhootch is operating with a “grassroots” online model designed with expansion in mind. In fact, Curry was given a Social Innovator award. But unlike the grassroots organizations of Vietnam Vets Against the War in the late 1960s and 1970s, though, it’s hard to find a shred of politics in any of their material. It’s as if the production of “wounded warriors” has nothing to do with the war itself. You’d think they just grew on trees or something. Another vet, Cpt. Medric Cousineau of the Canadian Armed Froces, is also walking. He wants to raise money to pay for PTSD service dogs. Cpt. Cousineau’s route heads through Nova Scotia, New Brunswick, Quebec and Ontario and he’ll be on the road for a month-and-a-half.

But don’t despair, because in Michigan, those with PTSD may soon qualify for medical marijuana prescriptions. If you can’t prevent the violence and unbearable conditions that create PTSD, at least you can let people get stoned afterwards. And though there’s no proof that marijuana actually helps people with PTSD, it’s certainly better for you than the raft of psychopharmaceuticals for which the medical establishment is so ready write scrips.

In the Everyday Surrealism Department, we feature Ryan Culberson wigging out on the season 8 finale of Real Housewives of Orange County. Given the unreality of anything passing for “reality TV,” it’s always tough to say what’s staged and what’s not. There’s no point even uttering the word “ethics” and the phrase “reality TV” in the same sentence, so let’s set aside the fact that Culberson is, even as I type, in Afghanistan again after serving there in 2005, 2008, and 2011, and that he took a break from combat deployments in order to humiliate himself in front of a national audience for money. I don’t want to talk about Culberson. I want to mention Dr. Mark Lerner, of The Institute for Traumatic Stress, Inc, who is apparently happy to give interviews about the “reality” of Culberson’s “traumatic stress reaction.” Although Lerner emphasizes that one can’t make diagnosis over the boob tube, what he is saying (if he’s quoted correctly, which is a big “if”) is that abusive behavior like Culberson demonstrated (whether authentic or acted) is “a normal reaction to the abnormal events that he’s experienced.” “Normalizing” abuse is hardly at the top of my To-Do list. Lerner, however, makes a living on it, as you can see at his Institute, a certification mill for crisis management that draws on “the same principles being utilized by the U.S. Department of Homeland Security.” His claim is that his training program can “prevent acute stress reactions from becoming chronic and debilitating stress disorders.” Since there’s no clear evidence that any sort of training can prevent PTSD, I’m more than a little dubious.

PTSD: The Futile Search for the “Quick Fix”

February 26, 2013 / no comments

My new article on PTSD just appeared as a Guest Blog on Scientific American’s web site. Please check it out. Here’s the first paragraph as a teaser:

A few weeks ago an article in the Scientific American Twitter stream caught my eye. EMDR (Eye Movement Desensitization and Reprocessing) once again debuted as a “promising new treatment” for PTSD. EMDR, which has been repeatedly called “promising” over the last two decades, works only about as well for PTSD as other psychological treatment modalities with which it competes, primarily cognitive behavioral therapy (CBT) and exposure therapy. These so-called trauma focused treatments (TFT) all garner similar results. TFT have large effects in clinical trials, with two important caveats: 1) the enthusiasm of their various advocates bias the study results towards the treatment the researchers prefer; and, 2) they are effective for a significant number of carefully selected PTSD patients. The sad truth, however, is that current short-term treatments are not the solution for most patients with PTSD. Trial criteria often exclude those with comorbid disorders, multiple traumas, complex PTSD, and suicidal ideation, among others. Even when they are included, comorbid patients drop out of treatment studies at a much higher rate than those with simple PTSD, a problem that has implications for clinical practice….

The heart of the argument is that short term treatments are not effective for the vast majority of those with PTSD, and that violence prevention is the only real cure.