Paula J. Caplan, Ph.D., a clinical and research psychologist, is the author of the blog, Science Isn't Golden, Matters of the mind and heart. Dr. Caplan has written a series of essays primarily about the experiences of those who have been to war. She is very critical of the manner in which the traumatized are treated by the VA and professionals. Caplan is not convinced therapy, medications and labels are of much use in ameliorating the damage caused by war and other traumas. Dr. Caplan also discusses her views on what is helpful.

The essays affirm what many here have been saying.

What Is a Healthy Response to War?
http://www.psychologytoday.com/blog/...y-response-war

Why NOT Call War Trauma a Mental Illness?
http://www.psychologytoday.com/blog/...mental-illness

War-Traumatized People: What to Call Them, How to Help Them
http://www.psychologytoday.com/blog/...-how-help-them

Ongoing Labors of Love: Changing Mental Set about How to Help Wounded Warriors and Others
http://www.psychologytoday.com/blog/...-wounded-warri

Vets Aren't Crazy—War Is
http://www.tikkun.org/article.php/Ca...t-crazy-war-is

[elliemay]

Thank you Byz. There are so many excellent points in these essays. For instance, one point I had never considered was the effect of "taking these struggles behind closed doors".

Bangs head.

I never considered that sequestering a soldier in a room with a therapist was, in fact, telling the soldier - oh no, this is shameful, keep it quiet.

Because that is the model that worked for me, it must be universally correct right?

However, the notion that soldiers would benefit from people listening to their stories is not revolutionary - yet, it would appear that way when people posit it in these essays.

Just like that therapist (who is likely an outlier - at least one hopes) in one of the essays, people shy away from the horrors of war. It takes a well grounded person to absorb, with empathy, the personal experience of someone who has been to war. It's frightening. Especially when it is being told by someone you love. The first impulse is to make it go away.

That's why I do think that a trained therapist can and should be in the mix somewhere - that is if the soldier is comfortable reaching out for and accepting help.

The essays do strongly point out that we have a long way to go before that comfort is realized. If you could only see (and perhaps Byz you have) the paperwork and hoops the soldiers have to jump through at the VA. It's a process that requires months really.

AND the interviewed soldiers are correct. How private are the records at the VA or any other military hospital really? It's a legitimate concern.

There is a crisis intake now for emergent issues, but, again what happens after that?

Also, should the onus be solely on the military and its infrastructure? I strongly and resoundingly contend not. Nonetheless, forgive me if I am a little cynical of the "private, civilian" sector's ability or willingness to mount an appropriate, empathetic and effective response to soldiers. Again, it's a fear issue, among other things.

One small point that I will remain steadfast on, is that PTSD is a legitimate diagnosis that describes a pathological and debilitating response to trauma. PTSD describes an ongoing set of symptoms indicative of a state in which a person's processing and coping mechanisms for trauma have been totally overwhelmed. It's a dangerous state.

Can we drug out the trauma of war in soldiers? Honestly, I don't know. I know a lot of soldiers find solace in alcohol and frankly, I'm surprised that the VA hasn't indicated drinking more as a treatment.

What might really scare some is that propanolol, a beta blocker, has been tested immediately post trauma as a device to interrupt the long term integration of the memory. "here, take this and it'll be like it never happened...."

Obviously, this is a hot button issue for me. Most of the men in my family are, or have been soldiers in the past. My best friend is currently deployed. I live and work near a major military base in the US.

Above all else, regardless of the opinions, I am so grateful that we, and others, are talking about this. Discussing how to help.

Soldiers the world over have certainly earned our utmost consideration and the best, most efficacious attention to their needs.

We may disagree on how to get there, but, we will.

In the interim, there are numerous places online "adopt a soldier" "soldiers angels" etc... where people can get involved in and improve the life of a soldier.

[Open Eyes]

Very good thread Byz,

And Elliemay, your post is very much how I feel too. And I am glad that there is an adopt a soldier site.

Many of the points raised by the auther here are significant points, perhaps if only in a public awareness of a questioning of labeling and what that may mean not only for a patient, including servicemen, but for society as well. On the onehand it can relay a message of, finally someone has named my symtoms that I cannot seem to explain to others or even understand on my own. But on the other hand, it is a label and with that also comes fear and limitations not only by a patient but by the field of psychiatry and psychology. And, the ongoing question is, how to we treat it? And that lends to an array of trials and errors both by therapists and phychiatrists with a combination of drug and therapy approach that is the supposed appropriate protocal for treatment.

In my own encounters with men who have served in a war, there is an ongoing anger that lays the bricks for resentment and fear. And just as this essay describes there is a battle to treat and yet hide and even more so, deny and tell but don't tell advocacy. And as stated in this essay what the truth means is limitation. In other words if you admit this than you can never do this and that. And it is not only troublesome for the soldier but also for one who struggles with other trauma and the symptoms they try to understand. But in that trying to understand there is a need for some type of seclusion because of the stigma attached as not only having trouble readjusting but a real fear of rejection. Within that lies a tremdous amount of guilt and anger leading to the desire to discontinue exitance altogether.

I have talked about my encounter with a war vet and how he described the necessity to not disclose his personal issues and that he was also told by the military that it is better not to try to address it as there is no real help. And he had no reason to lie to me and I was actually not surprised at his statement. Because if men that were inlisting were actually told of the many side effects as is described on the bottle of any medication, they may not enlist. So, given that right and that now there is a choice in the matter and we do not presently have a drafting in place, there may be many men that choose not to enlist. And there would only be one option, forced enlistment. And if the truth were told it would cause more ramifications with the government regarding a freedom of choice and a man actually being forced to participate in something he has no ability or capacity to do. And it has been known that when this does occur it puts other men in danger on the battlefield.

When men sign up to service our countries needs it is no wonder they come home angry at the general public. Tell, but do not tell is basically saying man up and dont complain because you will only be given more restrictions and isolation. In a way it is not unlike someone who has been abused and is threatened by their abuser to keep silent, is it not? So one cannot help but understand the anger and even the consideration for a desire to consider the option of just not existing anymore once one is set free from the active duty of war and all that it entails. Experience it but don't bother talking about it or trying to explain it, no one will listen or believe you. Because when you go thru all the bruocracy of it and come out the other end there is not going to be any cure for being denied and lied to so just move on.

It is not working and no wonder, tell, but do not tell. I read a post last night of a soldier that is trying to figure out, what do I do and I don't want someone to say, "Welcome HOME" and he was very angry. I had proposed an idea to him to work on a letter telling the citizens "What do you want us to say and do?" He considered it and even wondered where could it be seen by everyone?" My reply was not to think about that, but to concentrate on the letter and I also told him, "It is going to take time and be harder than you think, so expect that." It was quiet for a while and then he was there and he stated, "Your right, it is hard, harder than I thought". And he had other posts and talked about the action and some of what he was feeling and even appologized as he had been drinking so, it may come out wrong. And I replied, "Just let it out".

This man comes and goes, talks some and then there is silence. And I really wonder, "How is he doing, what is he doing?" And I really, really want to know. And he has spoken of possible therapy and how he can tell his family. He doesnt know how to tell his family, they wont understand will they? I dont want to tell them I am truely struggling and what that really entails in my mind, how could they understand? And all that I could offer is that even though I have not fought in a war, I have this designated label called PTSD and I cannot seem to explain it to my family either. And my reply also suggested to just accept that your family loves you and get therapy and the therapist can talk to your family. And that has been my hope as well. I want that other entity to sit with my family and tell them how I do feel angry and I am afraid and confused and what I feel is real, and very troubling and has no real time line for recovery.
And that somehow, as stated in this essay, I am experiencing a normal reaction to trama and they need to understand that and instead of expressing ways to ignore and externalize, I need to address what I have internalized and understand that it is NORMAL TO INTERNALIZE even when one is unaware that has taken place even when one has tried to EXTERNALIZE events and tramas. In other words it is possible and probable that even though a person trys to find ways to EXTERNALIZE during a tramatic event, they have, in spite of their best efforts, INTERNALIZED these events. And they already punish themselves enough with the feeling of failure to be steadfastly capable of EXTERNALIZING these said events.

Last night that young vet came back and he was very angry and talked about it. And my reply was, keep that for the paper you want to write, that is a good one. It is my hope that he will find this an outlet to express his anger and somehow it will lend to that letter and release his frustration and someone is actually listening, and not judging him or even limiting him.

I conclude with the opinion that perhaps we can say one is battling PTSD. But that does not mean it is a permenent mental illness, it is real and a true reaction to trama and perhaps the best treatment is to let it out and repeat if neccessary and there is a way to be understood and
thru freedom of expression without shame can be the true path to healing.

Perhaps what "Welcome Home" means to a veteran is, sorry you had to do that, now you can get back to regular life. But not saying Wow, you have a lot of work ahead at TRYING TO EXTERNALIZE EVERYTHING YOU WENT THRU and we are very ignorant when we say "Welcome Home" because you now know that THE INTERNALIZATION YOU FIGHT IS NEVER GOING TO BE UNDERSTOOD AND YOU ARE GOING TO BE ANGRY ABOUT THAT AND IT WILL LIMIT YOUR ABILITY TO FEEL "WELCOME AT HOME". And please do not think that you will now be forever misunderstood, because we now recognize that you are in fact human and that does not mean we have to exclude you or do anything to aid in your frustration. We are going to work with you, accept you and LISTEN TO YOU and help you WHEN YOU NEED HELP and NO, IT IS NOT YOUR FAULT, AND YOU ARE IN NO WAY WEAK, AND YOU HAVE EVERY RIGHT TO BE ANGRY, yes you have a right to feel the way you feel.

Open Eyes

[pachyderm]

Originally Posted by elliemay

I never considered that sequestering a soldier in a room with a therapist was, in fact, telling the soldier - oh no, this is shameful, keep it quiet.

It might be telling the soldier that -- if it was presented as a requirement. It might be saying that the people of the "system" believe it is shameful -- but they can be wrong too.

Or it might just be just a reasonable compromise and way to cope with what people on the "outside" might think.

[venusss]

So... refusing to view a war trauma as disorder does *not* equal calling the person a malinger?

Glad to know some professional say it too.

will comment later on, when I have more time.

[Open Eyes]

You are asking a question that proposes that if one is not determined to be disordered than the other choice would be a malinger.

I think that Labeling altogether, either/or is NOT going to help the soldiers that come home with psychological issues and extreme stress from what they experience in active duty. None of these men truely imagined the mental stress and after effects that they would encounter during active duty or after active duty. And I truely feel that none of these men have any idealation of becoming a malinger. That type of person would not enlist to begin with. And I think the anger stems from truely struggling but often they do not seek help because they actually do not want to be a malinger or be labeled in a way that they may be deemed unfit to attempt at having a normal life. But the truths they face are of being very misuderstood by all the citizens they encounter and they do not want to be reminded of their difficulties or grouped together and they truely do not feel that saying welcome home is of any comfort at all and they actually feel that it is insulting and condesending. Another commerative designated day does not make them feel anything other than another reminder that they are not really welcome at home, they are angry and confused.

All the little well wishes are not going to change how difficult their condition is for them to understand and deal with. And it is not going to change the fact that they struggle with their families and they themselves cannot seem to understand the dramatic changes they have gone through psychologically. I don't think they signed up to be fighting battles in their mind for the rest of their lives and one cannot blame them for being angry and truely feeling denied of the ability to adjust to being home.
So when someone says that to them it is somewhat disrespectful and that person who utters those words shows complete ignorance in that they think that just because a soldier is home that he actually feels that this home is not going to be the same experience as before he served active duty. There is a vast ocean between saying the words and feeling those words.

Something has really been taken from these men, they often feel it is their very soul.

Open Eyes

Meditation Heals Military Vets With PTSD
http://abcnews.go.com/Health/Depress...inglePage=true
http://abcnews.go.com/Health/video/m...erans-13774520