mTBI, PTSD and Stress (Catch All)

[marct]

Hi Op Shrink,

Interesting comments, especially about the use of specific terms. I have similar experiences with "crafting" terminology to match the groups and individuals I've been counselling. I'd be interested to see if you are (or have) incorporated both active story telling and mythic story telling with some of your groups and, if so, do you find the active story telling coming to resmeble the myths.

Cheers,

Marc

[120mm]

I'm interested in the use of terminology as well.

I am having a hard time with the concept, as I can visualize this geeky dorky psychologist trying to use terminology they are unfamiliar with to "identify" with combat vets, and my first, gut reaction is anger. (Actually, with one exception, psychologists in the past I've encountered automatically engage my "anger" response.)

It would take a skilled individual indeed to avoid coming off as phoney in my mind's eye.

I've found in my own journey that one of my hot spots is posers, or folks acting as if they "understand". Because frankly, most have no frame of reference.

[Ethereal]

I'm interested in the use of terminology as well.

I am having a hard time with the concept, as I can visualize this geeky dorky psychologist trying to use terminology they are unfamiliar with to "identify" with combat vets, and my first, gut reaction is anger. (Actually, with one exception, psychologists in the past I've encountered automatically engage my "anger" response.)

It would take a skilled individual indeed to avoid coming off as phoney in my mind's eye.

I've found in my own journey that one of my hot spots is posers, or folks acting as if they "understand". Because frankly, most have no frame of reference.

Long time reader..... first time poster,

Can you share some of your experiences which have made this such a "hot spot" ?

E

[Op_Shrink]

Guys thanks for the feedback and insight. I don't take any offense at initial reactions being anger when it relates to combat support personnel conveying they understand the war fighter experience. And I agree there are a fare share of psychologists and doctors who that have little military bearing. That being said I genuinely care about my war fighters and respect what they do. In my experience being genuine, giving respect, and explaining your actions go along way in gaining the trust of war fighters. I don't over do it with military jargon in therapy; just a few select words to make it more relatable to their mindset. I have found the war fighter to be very sensitive to wanna-be 11B providers. I always taught my interns to be genuine and never act like you know more or have done more than what you have. I have deployed 3 times: once to Kuwait/Pakistan and twice to Iraq. I don't pretend to be a war fighter; just a shrink who desires nothing more than to support them and their families. I am in the SOF community now and have found it rewarding to support operators. Please keep firing away with questions and comments. It is appreciated. Sorry it I didn't answer anyone. I was trying to track everything. Have a good one.
Doc

[Ethereal]

Doc, I spent nearly 2 years of my life as a trainee in JFKSWC and can only imagine the stuff you deal with on a daily basis.

Welcome aboard Doc, we need many, many more of you out here in the field; chronic stress is destroying some of our best dudes.

E.

[Op_Shrink]

Thanks Ethereal. SWCS has been a rewarding experience. There is a nice mix of things to do and sure beats working in a hospital every single day. You an 18 series guy? I am off to do some ILE stuff. Have a good weekend.

[120mm]

Guys thanks for the feedback and insight. I don't take any offense at initial reactions being anger when it relates to combat support personnel conveying they understand the war fighter experience. And I agree there are a fare share of psychologists and doctors who that have little military bearing. That being said I genuinely care about my war fighters and respect what they do. In my experience being genuine, giving respect, and explaining your actions go along way in gaining the trust of war fighters. I don't over do it with military jargon in therapy; just a few select words to make it more relatable to their mindset. I have found the war fighter to be very sensitive to wanna-be 11B providers. I always taught my interns to be genuine and never act like you know more or have done more than what you have. I have deployed 3 times: once to Kuwait/Pakistan and twice to Iraq. I don't pretend to be a war fighter; just a shrink who desires nothing more than to support them and their families. I am in the SOF community now and have found it rewarding to support operators. Please keep firing away with questions and comments. It is appreciated. Sorry it I didn't answer anyone. I was trying to track everything. Have a good one.
Doc

Thanks for the response, Doc. My initial reaction is actually based on my four years of working with Psychologists in the prison system, all of which were regular pieces of work. That is overlain with some epic fail stories/experienes from buddies who have sought counselling or been ordered to take counselling by their chain of command post-2001.

Because I have personally encountered one professional psychologist who was worth a crap, (out of a cast of hundreds) and one amateur who was frankly outstanding, I know there is some goodness to be found within the field. Unfortunately, the paucity of effective psychologists/counsellors in my own experience has led me to distrust the field as a whole. Apparently there is more art than science, and it takes a high skilled individual to be effective.

I am very interested in how you cope with the taxonomies you are locked into here. It seems to me there is a huge friction point between the psych and the military framework.

[Op_Shrink]

120mm thanks for sharing your experience and sorry it has been such a negative one. So far my military career has granted me quite a bit of freedom in practicing psychology. I think some of the friction arises when Command doesn't advocate for us, which results in stigma for any soldier needing to seek help. I need Command and families to be my greatest advocates. There are always going to be psychologists, physicians, nurses, etc. who are great providers but do not have great military bearing. Also, just because someone hasn't deployed doesn't mean they don't have the skills to help. They just won't really understand, which is okay as long as they acknowledge that shortcoming to the soldier. For me it comes down to genuinely caring about the soldier and their family and taking the time to listen to their experiences and know them. Having a cup of coffee or a guy swinging by the office to talk off line is what I should be taking the time to do. I just want to encourage you that there are quite a few psychologists who have that mindset, especially in the BCT's and SOF community. Well time to work on some more ILE stuff. Have a good one.

[120mm]

120mm thanks for sharing your experience and sorry it has been such a negative one. So far my military career has granted me quite a bit of freedom in practicing psychology. I think some of the friction arises when Command doesn't advocate for us, which results in stigma for any soldier needing to seek help. I need Command and families to be my greatest advocates.

I've had Command that has "advocated" to the point of directing people to attend counselling, that frankly, didn't need it. There is a thin line between getting the right people to the right counselling and seeing PTSD behind every bush.

I think one of the keys for a commander is to hammer the living crap out of individuals who stigmatize and/or make a big deal about someone attending counselling. It doesn't take many iterations to change the unit atmosphere vis-a-vis mental health.

There are always going to be psychologists, physicians, nurses, etc. who are great providers but do not have great military bearing.

I could care less about military bearing. But the military/government system tends to protect the unprofessional and incompetent. That doesn't mean all are, but it is definitely a consideration in this discussion.

I HAVE noticed that folks like Chaplains, Doctors and Nurses sometimes get way too concerned about "military bearing" because they lack a solid indepth understanding of what military bearing really is, and therefore spend an inordinate amount of time trying to "act like a soldier". IMO, they'd be better off just relaxing, being themselves and doing their jobs as best they can.

Also, just because someone hasn't deployed doesn't mean they don't have the skills to help. They just won't really understand, which is okay as long as they acknowledge that shortcoming to the soldier.

A good counsellor is a good counsellor is a good counsellor. Since a good counsellor sets aside ego in favor of accomplishing something to benefit the counselee, deployment or experience in the particular trauma is irrelevant. The "gifted amateur" who has helped me had zero deployment experience when we started talking. Hence my "wince" when you brought up the "missions" thing. If its a vernacular you are comfortable with, great. Otherwise, I would warn against it.

For me it comes down to genuinely caring about the soldier and their family and taking the time to listen to their experiences and know them. Having a cup of coffee or a guy swinging by the office to talk off line is what I should be taking the time to do. I just want to encourage you that there are quite a few psychologists who have that mindset, especially in the BCT's and SOF community. Well time to work on some more ILE stuff. Have a good one.

I am struck by the fact that you are fairly skilled at turning aside my initial approach. I can be very abrasive and outspoken, and am amazed at how many psych/counselling "professionals" cannot do that. Those folks, imo, have no business being in the field, as dealing with angry people is their job.

[Op_Shrink]

I have tried to reply twice, but for some reason it will not post it. 120mm thanks for sharing your experience. I appreciate the candor. I have found the Army gives me quite a bit of freedom when it comes to how I take care of troops and families. While some docs may not have great military bearing they likely still have the knowledge to effectively treat soldiers. However, I concur that military bearing can make or break rapport building with war fighters. I believe the majority of BCT and SOF psychologists have both and willingly admit their shortcomings and pretend to be more than what they are. Have a good one. DOC

[Op_Shrink]

Well its seems my responses went through, but were delayed quite a bit. I enjoyed the reply 120mm. As for being "fairly skilled at turning aside my initial approach" all I can say is that anger is a trait that I see among all war fighters to some degree coming back from deployment. Its all good. Besides I need to know where the soldiers stands so I know how to best help him. In reference to the military jargon in group; I have had nothing but positive feedback from both conventional and unconventional troops. I don't over do it or implement the whole "hooahh" thing. That is lame. It is simply a few terms here and there. Furthermore, I am glad you see a good therapist as a good therapist, regardless of deployment experience. That is refreshing on my end. By the way what is your military background? Have a good one.

[120mm]

As far as background is concerned, I've hit about everything, crossing from Active Duty, to Reserves/National Guard to mil contracting and back. My so-called "career progression" is enlisted FA, College/ROTC, CAV, MI, CAV, MI, CAV, MI, NBC, TRANS, CGSC Instructor, with APMS, Writer/Trainer, DoS LNO, HTS, Atmospherics, Professor of Intel, DIA SOIC thrown in there with time out to do various civilian retail management jobs in there for fun.

I wish someone would do a compare and contrast with the amount of stress involved with dealing with an unthinking, uncaring bureaucracy versus combat. Personally, I'd choose to be in combat over beating my head against a bureaucratic wall every day of the week.

[Kiwigrunt]

I wish someone would do a compare and contrast with the amount of stress involved with dealing with an unthinking, uncaring bureaucracy versus combat. Personally, I'd choose to be in combat over beating my head against a bureaucratic wall every day of the week.

Hehe, I've never been in combat but I think I get your point and might well agree. But......is combat not getting increasingly bureaucratic?

[Ethereal]

Hehe, I've never been in combat but I think I get your point and might well agree. But......is combat not getting increasingly bureaucratic?

I don't think "combat" is an exclusive club for "feelings".......... but, I'm not 120mm, so who knows?

E

[Op_Shrink]

Sorry I have been out of the loop lately. I have been getting hammered with assignments here at ILE and today am down to one last major assignment before heading into wargaming. I have written a paper on warfighter variables. I examined physiological responses, unit cohesion, and personality traits in warfighter motivation and performance. I loaded it with a lot of research and historical examples. Clausewitz "On War" is fantastic. That guy was so ahead of his time regarding psychology and personality traits. Hope everyone is doing well. Love to hear your thoughts. Have a good one.

[Fmr11A]

A guy whose twitter handle is @iammilitary announced the launch of a blog to help him cope with his PTSD: http://trappedinmythoughtsofwar.blogspot.com

[AdamG]

Reading music

Marijuana May Be Studied for Combat Disorder
By DAN FROSCH
Published: July 18, 2011

DENVER — For years now, some veterans groups and marijuana advocates have argued that the therapeutic benefits of the drug can help soothe the psychological wounds of battle. But with only anecdotal evidence as support, their claims have yet to gain widespread acceptance in medical circles.

http://www.nytimes.com/2011/07/19/us....html?src=recg

[ganulv]

but it’s not as if we don’t have a good idea of how to effectively treat PTSD. It’s just that the treatment is multi-modal, not quick, not cheap, and requires a good and adequately staffed infrastructure. Pero esos son otro viente pesos, as they say in Puerto Rico.

[AdamG]

(AP) TOPEKA, Kan. - An Army sergeant accused of killing four fellow soldiers and a Navy officer at a mental health clinic on a military base in Iraq two years ago should be tried for murder but should not face the possibility of execution because he suffers from serious mental illness, a military judge recommended.
Sgt. John Russell, who is accused of opening fire at the combat stress center at Camp Liberty near Baghdad in May 2009 in what would be the deadliest act of soldier-on-soldier violence in the Iraq war, should be held accountable for his actions and face a court martial on the five counts of premeditated murder he faces, Col. James Pohl wrote in his recommendations issued Friday.

http://www.cbsnews.com/stories/2011/...20108375.shtml

The enemy is anybody who's going to get you killed, no matter which side he's on - Yossarian, CATCH-22

[ganulv]

Suicide and the United States Army: perspectives from the former psychiatry consultant to the Army Surgeon General | Cerebrum

The two portions of this piece which most piqued my interest:

Perhaps counterintuitively, suicides among those who have major injuries are rare; more often a minor injury or backache contributes to depressive symptoms, a belief that one cannot “be the Soldier I used to be,” and irritability.

Therapy dogs are now with several of the Combat Stress Control teams in Afghanistan. Soldiers will stop by to pat the dog. Wounded soldiers find that the presence of their service animal decreases their PTSD symptoms and their feelings of anger and fear. Veterans who would not leave the house will bond with their dogs, walk them, and regain structure in their lives.