22 August 2013, PTSD & Trauma News Roundup

August 22, 2013 / no comments

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We know it’s bad… when it happens to a white woman

CNN featured the story of Michele Cross, a University of Chicago student who was diagnosed with PTSD after she returned from her studies in India.  CNN and other news outlets who discussed the story never failed to mention that Cross was a “fair-skinned, red haired” woman, as opposed, one assumed, to all thosee dark-skinned, dark-haired Indian women who inhabit the continent.   The story Cross originally told in a CNN iReport under the screen name of RoseChasm” rack[ed] up more than 800,000 page views” within 3 days of publication. Could it be because Cross herself emphasized her whiteness, her hair color, her blue eyes in a short piece of dramatic prose, full of florid passages like the following:

There was no way to prepare for the eyes, the eyes that every day stared with such entitlement at my body, with no change of expression whether I met their gaze or not. Walking to the fruit seller’s or the tailer’s I got stares so sharp that they sliced away bits of me piece by piece. I was prepared for my actions to be taken as sex signals; I was not prepared to understand that there were no sex signals, only women’s bodies to be taken, or hidden away.

I covered up, but I did not hide. And so I was taken, by eye after eye, picture after picture. Who knows how many photos there are of me in India, or on the internet: photos of me walking, cursing, flipping people off. Who knows how many strangers have used my image as pornography, and those of my friends. I deleted my fair share, but it was a drop in the ocean– I had no chance of taking back everything they took.

If everything Ms. Cross says is true, she endured a level of harassment that was awful. And of course no woman should have to put up with that.  But I find it incredible that in all her description, she did not find it in her heart, even once, to mention what daily life must be like for Indian women, who have been in the streets  protesting a campaign of murder and rape waged against them by their countrymen.  A “South Asian Studies” scholar, Cross did not for a moment contextualize her own suffering — nope, this was all about her.  And the public ate it up—this story of a white woman pawed by native men.  Though Cross claims she is not the only UC student who experienced this harassment, at least one  other woman on the trip attempted to counter the tone of Cross’s narrative.  Katherine Stewart, a black UC student, confirms that there were attacks on women in the program, but takes issue with—what she tactfully does not say outright—the racism evident in Cross’s response. Stewart wrote:

RoseChasm does not address the fact that there are warm and honest men in India. When we do not make the distinction that only some men of a population commit a crime, we develop a stereotype for an entire population. And when we develop a negative stereotype for a population, what arises? Racism….

I understand RoseChasm’s pain, and I too had a hard time readjusting to life in America after my experience in India. I truly hope for her to be well again, but I will not sit back and allow the image of India’s men to be tarnished by an article that does not articulate other sides to India. I experienced love, excitement, and awe in India. And while I did experience unacceptable harassment, I know that my ability to not generalize a population will allow people to see that we must find another way to deal with this issue.

You can bet Stewart didn’t get 800,000 hits in three days.

You’re all whiners… or maybe not

Psychologist Michael J. Hurd (Ph.D., LCSW) rants on delmarvaNow!com about the lack of definition of “trauma.”  This pretty much sums it up: “Our government and educated intellectuals (psychiatrists included) have frankly turned many of us into a bunch of babies.”  His “argument” seems to be that if psychiatrists didn’t go around inventing ridiculous diseases, we wouldn’t have them.  Just makes you want to jump up and run to his office for therapy, doesn’t it?

On the other side of the spectrum is Michael Pond, a therapist who works with First Nations patients in British Columbia. He thinks it’s a good thing that the diagnosis is now “pervasive”:

And before anyone rolls their eyes derisively, according to the updated criteria for the illness in the new DSM 5, the bible of psychiatry, it’s very likely the diagnosis is correct.

I treat a lot of First Nations people for addictions, depression, anxiety and aggression. But the more they reveal the extent of the horror they experienced in residential schools, the more obvious it is to me that my clients actually suffer from PTSD, and all the other problems are symptoms of it.

The pervasiveness of the condition, Pond argues, will help us take the victims of violence more seriously.

Making money off of war…

HeroBracelets.org (don’t let the “org” fool you — it’s a commercial endeavor) was founded by Chris Great, an advertising executive who speicalizes brand development, marketing and entrepreneurship.  His company markets commemorative bracelets to soldiers and their families for prices ranging from $14 to $134.50, says it donates $2/bracelet to “military support organizations.”  One of these organizations is the Intrepid Fallen Heroes Fund (where do they get these names?), to which they recently donated $150,000 in bracelet money (which means they sold at lest 75,000 bracelets, at, say, an average price of $25, which totals to something around $7.5 million earned from soldiers and veterans and families.  IFHF raised money to build a treatment center for Traumatic Brain Injury (TBI) on the Navy Campus of Bethesday, as well as other centers for treatment and study of TBI.  We’re talking big, big bucks here — these centers can cost upwards of $50 million, so HeroBracelets.org’s $150,000 is a drop in the bucket.  But Herobracelets has certainly used this as a PR opportunity, marketing its bracelets as a way to “support our military”:

HeroBracelets.org gives them an opportunity to spread awareness by wearing their bracelet, and it allows them to make a financial contribution to a charity of their choice.” said Christopher and Loree Greta, founders of HeroBracelets.org. “$2 per bracelet may not seem like much, but it has certainly added up – and $150,000 later, it’s allowed us and our customers to make a difference for the thousands of service members and their families who rely on Intrepid Fallen Heroes Fund and the NICoE Centers for treatment of their invisible wounds.

$2/bracelet.  Doesn’t seem like much to do for our veterans, does it.  Especially when it’s them and their families forking over the money in the first place.

Research

It’s rare that clinical studies include PTSD with comorbid disorders, so it was nice to see this August 7 randomized clinical trial on Naltrexone and Prolonged Exposure Therapy in patients with both PTSD and alcohol dependence. It’s tough to do a double-blind study for psychological interventions, since therapists need to be trained in the methods they use. Thus, this was a single-blind study, meaning the patients did not know whether whether they were receiving the medication or a sugar pill, and did not know if they were receiving Exposure Therapy (ET) or supportive counseling (SC). As usual, symptom severity was the measure of success, along with the Alcohol Craving scale: were symptoms and drinking days reduced more by the naltroxene or the Exposure Therapy or by both in combination? The group they studied was mostly between 36-43 years old, about 66% male, and the majority of subjects were black.  (An odd note here — blacks made up 70-75% of those given ET+Naltrexone and ET+Placebo, but only 50-60% of those given SC+Naltrexone and SC+Placebo.)  Also unusual is the fact that combat vets made up only about 15% of the study group. The predominant traumas were sexual assault and physical assault.  Like many other surveys, this one found that there was no significant difference between the effectiveness of Exposure Therapy and supportive counseling, and PTSD symptoms did not decrease significantly in any of the combinations. The study found that the patients prescribed naltrexone drank less often.   The best they could say about Exposure Therapy is that it “was not associated with an exacerbation of alcohol use disorder.”  That’s a good thing to know about one of the most frequently prescribed talk therapies for PTSD: at least it doesn’t make it worse.

Fund Raising

Veteran Doug Setter, and his colleagues Linh Lai and Dave Iten are doing a “four-mile open water relay swim across Bellingham Bay [WA] in honour of American and Canadian servicemen that lost their lives to Post Traumatic Stress Disorder.” Along with other military stressors, Setter blames “the public’s [negative] perception of soldiers” for some of the stress veterans feel when they return home. It’s not clear what the swim is designed to do except “honour soldiers who killed themselves because of PTSD” and “shine a light on the challenges soldiers face with their duty is done.”  The swim is named after a local veteran who committed suicide after a tour in Iraq.

War on Film

Steven Grayhm of Astoria Film Co.(Los Angeles) is trying to raise $750,000 on Kickstarter to fund Thunder Road, a film based on a story told to him by Iraq war veteran Nick Carbonell, who witnessed the death of his best friend on a nighttime operation in Iraq. From the Kickstarter site:

Thunder Road is the story of returning U.S. soldier SGT. CALVIN COLE (played by Steven) whom we meet in present day Detroit as a troubled veteran who suffers from PTSD (Post Traumatic Stress Disorder) and tbi (Traumatic Brain Injury) from multiple deployments to Iraq and Afghanistan. Initially resistant to the VA system COLE must find a way to assimilate back into civilian life before he ends up dead or in prison.

Through his rekindled friendship with his estranged childhood friend PFC. DARRYL SPARKS (played by Matt) who he served on the “buddy system” with and his newly formed relationship with a doctor at the VA Medical Center, COLE finds redemption and salvation through sharing his captivating experience as a combat infantryman. The film also explores the psychological repercussions of war and seeks answers to the growing epidemic of PTSD and tbi in returning soldiers.

A pretty predictable plot trajectory, and certain one right out of the mainstream pop culture representations of PTSD: damaged warrior helped back to health by a wise VA therapist, finds redemption in sharing his story of trauma.  A report on its quality will have to wait until the film is made, but I don’t hold much hope it’ll be groundbreaking. I’m sick of films that imply that the only two choices choices facing a vet with active PTSD are either winding up dead or in prison.  The vast majority of people with PTSD continue on with their lives, dealing as best they can, and commit neither crimes nor suicide.

This notion that sharing a trauma is an end in itself is very popular, despite the fact that thousands of such stories have been shared by traumatized soldiers, and that there’s no evidence that simply sharing these stories actually contributes to improved reintegration or happiness. Trauma survivors who make a practice of telling and retelling their stories, particularly for public consumption, over many years, rarely seem to move beyond the trauma of war.  It cheers the public up to see stories in which an earnest vet, traumatized in war, regains his ability to connect with his emotions and with his significant others, and it’s even better if he then shoulders the burden of dealing with other  vets like himself.  But that’s a rarity — the vast majority of vets who are treated for PTSD by the VA are still under treatment four years later.  If there is “healing,” it’s a slow process and conclusion is far from assured.  And one reason that it’s such a slow path to recovery might be that the public taste for trauma narratives does not seem connected to the public’s interest in ending the circumstances that cause trauma.

And the inevitable PTSD Diagnosis by Media section…

The L.A. Times says that journalist Michael Hastings “may have suffered PTSD from work as a war journalist.” Hastings died in a single-car accident, and in such cases there’s often speculation that the crash was a form of suicide. Despite the claim of journalists Richard Winton and Andrew Blankenstein, the coroner’s report seems to contain no evidence at all that PTSD had anything to do with Hasting’s death. Hastings may well have had PTSD, given his experiences in the war, and he may have said that he used medical marijuana to treat PTSD, but that’s a far cry from PTSD causing a suicide.  Perhaps the L.A. Times journalists confused the coroner’s comment that Hastings had died of “traumatic injuries,” with “post-traumatic stress disorder,” contemporary journalistic standards being what they are.

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16 August 2013 PTSD News Roundup

August 16, 2013 / no comments

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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.

 

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