20 August 2013, PTSD & Traumatic Stress News Roundup

August 20, 2013 / no comments
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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.

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14 August 2013, PTSD News Roundup

August 13, 2013 / no comments
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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.

 

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