Friday, November 13, 2009

Military updating tactics on trauma

Military updating tactics on trauma

By Kate Wiltrout
The Virginian-Pilot
© November 5, 2009
After more than eight years of war, most Americans know that PTSD stands for post-traumatic stress disorder.

Now, say military and medical experts, as well as warriors whose minds were scarred by combat, it's time to learn some new acronyms.

The second day of a two-day conference on building resilient warriors wrapped up Wednesday in Norfolk with a suggestion that the "D" be dropped from PTSD. It's normal to be stressed out by trauma, one combat veteran explained, so why label it a disorder?

His suggestion was endorsed by one of the highest-ranking men in the military - Adm. Mike Mullen, chairman of the Joint Chiefs of Staff.

Addressing the conference by speakerphone, Mullen told the 400 attendees that he now uses the term "combat stress" instead of PTSD. He changed his vocabulary, he said, after a service member told him the word "disorder" creates a stigma for sufferers - even as the military is encouraging troubled troops to ask for help.

The conference was sponsored by the Defense Centers of Excellence For Psychological Health & Traumatic Brain Injury. A Department of Defense entity with an unwieldy name, the organization aims to be a one-stop shop for professionals and military personnel battling back from brain injuries and combat trauma.

Headed by Army Brig. Gen. Loree Sutton, it was born out of the controversy surrounding Walter Reed Army Medical Center in 2007. Early that year, The Washington Post revealed that the hospital was unprepared to deal with the long-term needs of combat-wounded troops.

The controversy generated attention from the top brass - and more than $1 billion in funding. Sutton, a psychiatrist with 28 years in uniform, said the Walter Reed scandal was both a tragedy and a blessing in disguise.

"We were laboring under a civilian HMO business model that did not fit the needs of our warriors and their families," she said to thunderous applause, adding that the news reports reignited a "fire in the belly" to solve the problem.

Now, Sutton said, the military has extensive resources and is creating a range of programs to address the long-term effects of concussive injuries common in combat, as well as lingering psychological effects.

She's less concerned, initially, about what the condition is called - is it traumatic stress injury or combat stress trauma?

"From the standpoint of a troop and his or her loved ones," she said, "they just want to get better."

Sutton said her organization is helping to establish standards of care for injuries across the military so that, say, an Army private or a Navy SEAL get the same treatment if they're on foot within 50 meters of a blast.

That treatment might be as simple as a day of rest, she said, to let the brain recover from the concussive force.

The standards must rest on science-based evidence, she said - not a misguided idea of strength.

"That suck-it-up mentality is no longer working," she said.

Senior leaders such as Mullen fully support the idea that a warrior's mind, body and spirit must be healthy and aligned, Sutton said. Young troops who grew up watching TV shows such as "Frasier" and "The Sopranos" seem to accept the idea that getting counseling doesn't mean someone is weak. It's the military's "middle managers" who need to embrace it, she said.

Navy SEALs, Sutton said, have a great phrase for paying attention to psychological health: They call it getting a "neck-up check up."

Kate Wiltrout, (757) 446-2629,


I am glad the Chairman of the Joint Chiefs understands that the stress caused by traumatic events is not a "disorder" rather it is a normal reaction to a unnatural event, the scenes of combat, explosions, the fear of death, etc. The stigmatism to soldiers that raise their hand and say I need help has been a career ender for decades rather than a simple trip to a psychiatrist, the soldiers get labeled as unstable and can't be trusted, since they just can't "suck it up" "man up" or whatever else idiotic terms people higher in the chain of command determine to be appropriate.

Many soldiers have always felt the restraint of asking for help knowing that doing so, would stop promotions, get them harassed by the chain of command, instead they turned to self medicating either with alcohol or drugs to treat themselves. One only has to go back to the Vietnam war where many soldiers were thrown out on Personality Disorders after returning from Vietnam, which denied them veterans benefits and even treatment at VA Medical centers since they recieved a bad discharge, yet the Army primarily returned to this same tactic at Fort Carson as reported by NPR in the past few years.

I feel that if thetroops can get treatment earlier in their lives they may not end up totally disabled by the symptoms of Post Traumatic Stress, they may always have some symptoms but it might not prevent them from being able to keep a family together, hold a job or a professional position, etc, like many WW2 Korean and Vietnam veterans have been largely ignored by society over they years.

Like Colin Powell stated, "you broke it, you own it" this should also apply to the men and women that serve this nation in uniform. It is already supposed to according to the "PROMISE" made when our men and women enlist in the military, if you are killed or hurt by your service the nation will care for you and your spuse and children, it doesn't day we will kick them to the curb and ignore them.

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