Monday, January 12, 2009

thoughts from Ilona Meagher about PTSD

Reaction to DoD Decision Against Awarding Purple Heart to Veterans with Combat PTSD

This week's news that the Purple Heart will not be considered for those coping with the psychological wounds of war has gotten a reaction from many quarters. The military decoration is awarded for "being wounded or killed in any action against an enemy of the United States or as a result of an act of any such enemy or opposing armed forces."

Through August 2008, 2,743 OEF and 33,923 OIF veterans have received the distinguished medal (of ~1.7 million given out since its modern inception in 1932; more Purple Heart history), which brings with it "enhanced benefits, including exemptions from co-payments for veterans hospital and outpatient care and gives them higher priority in scheduling appointments."

In extended, a selection of some of the debate on the matter. These are lengthy and multiple pieces, but are quite enlightening to read through if you have the time. The issue touches upon a slew of concerns dealing with our positions on tradition, progress, science, psychology, honor, equity -- all well worth examining.

One irony pointed out in the debate over the modern definition of what a combat wound is or is not comes from a Florida mental health counselor, who points out that our present-day enemies are foremost using terror as a weapon against us.

Their attacks are intended to deliver wounds of fear.

Our political and military leaders, therefore, have termed this ideological struggle of our time The War on Terror[ism], finding that descriptor to be the most appropriate for the current generation of war -- an ideological battle to end all battles.

It's quite an interesting insight when considering this debate, since the DoD has ruled that these wounds (the very wounds that our campaigns in the Middle East are named after) don't qualify for the Purple Heart. Interesting paradox, no?


Of course, fear itself does not bleed visibly.

Fear is something felt and experienced in the mind (and the body responds, as well to this emotion). If we know nothing else about traumatic stress, we know that fear borne of terror is the lead quantifiable and diagnosable cause of PTSD.

The first element of PTSD, as defined in the DSM-IV:


309.81 DSM-IV Criteria for Posttraumatic Stress Disorder

A. The person has been exposed to a traumatic event in which both of the following have been present:

(1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others (2) the person's response involved intense fear, helplessness, or horror.


Terror definitions:


1. Intense, overpowering fear.
2. One that instills intense fear: a rabid dog that became the terror of the neighborhood.
3. The ability to instill intense fear: the terror of jackboots pounding down the street.
4. Violence committed or threatened by a group to intimidate or coerce a population, as for military or political purposes.

Winning the War Within

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