Fort Hood Exit Strategy
With the recent tragedy at Fort Hood, the time has come to face up to two facts: War is Hell -- this we know. War is not conducive to mental health -- this we don't want to realize.
And it may be that if a little war is bad for one's mental state, a whole lot of war is a whole lot worse.
Leaving aside the merits of this particular war, and more detailed information about Major Nidal Malik Hasan, the 39-year-old man accused of Thursday's mass shooting at Fort Hood, Texas, if we look at the inherent contradictions of his situation, it's easy to imagine how any one of any background would feel terrified and entrapped under the following conditions:
• Possessing first hand knowledge of the combat experience and the severe mental damage it inflicts upon deployed military
• Knowing how successfully (or not) the military is able to address post-traumatic stress disorder (PTSD)
• Facing deployment, (and unlike other military heading into deployment), having prior knowledge of the hazard to one's mental health and psychological status
It's safe to say that the majority of those facing deployment, have no real clue what they are in for. But Major Hasan undoubtedly did. How did that affect him? Further he,
• Received his medical and psychiatric training as a military officer
• Was therefore beholden to the military for the cost of that training
• Had no way to leave the military
As heinous and reprehensible as were his actions, correctly or mistakenly, Hasan saw no way out of the military, no way out of his deployment. Sadly for all concerned, firing a gun was his exit strategy.
I am sure that soon all the "bad apple" stories will briskly circulate. But before they do, let's ask: Isn't it possible that being a military psychiatrist could readily induce outsized cognitive dissonance in susceptible individuals? Is there a point when it could just become too much?
Cold, calculating, numb, sedated, and murderous. Bonded first and foremost to comrades in arms. Is this a prescription for mental health, a solid marriage, successful parenting, or even a good night's sleep? Of course not. But these are the traits cultivated and inculcated in servicemen heading to battle.
Upon returning they can change into civilian clothes, but they can't so easily shed their traumatized neurology. For many, the military becomes a form of life long entrapment, a club that once joined, can't so easily be left behind, for economic, social, and psychological reasons.
By definition, a military psychiatrist is acting under military authority-- is that a conducive environment for building therapeutic trust or helping your clients?
A couple of months back, I attended a program lead by a military specialist in treating returning military suffering from psychological distress. First of all, this specialist, himself a combat veteran, appeared to be traumatized. Empathy was for sissies. Maintaining the military code trumped facing up to the pain. PTSD, he claimed, could be dealt with by snapping out of it.
"Just change your attitude," he reported telling his clients.
This "expert" didn't want to call a spade a spade. He didn't want to call it post-traumatic stress. He wanted to call it "combat stress." That was more manly. In fact, the entire thrust of his therapeutic approach could be captured in a single sentence: "Figure out how to conform to military codes, and appease higher ups, but don't admit to psychological damage."
His demeanor said: "Men, emulate me." But I've never see that anywhere in the psychological literature is "stuffing it" the recommended approach.
I can't say for sure whether this attitude is endemic to military psychiatry. I hope not, and would welcome hearing about the numerous mental health professionals in the military who do a lot of good. I know that guided imagery has been proven successful with CDs available for addressing PTSD at www.healthjourneys.com
But the basic problem is that when you train people to be eternally hypervigilant, bond them as one in a killing group, put them through traumatizing experiences, and then upon their return signal that retaining the military code is more important than their personal mental health, then I can guarantee you several things:
• They won't feel safe in receiving mental health treatments in a military context
• They won't easily find their way to helpful treatments for fear they violate their military code and bonds with their fellow officers
• It will be harder for them to down-regulate their automated stress reactions and heal
• They won't be safe for their families and loved ones people to be around
• Ours will not be a safe world
In going to war to create safety, we have to take a hard look at what came back.
Until we can admit all of this, how can we help troubled people in the military? Or for that matter, find safety as civilians?
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Kamran Pasha: A Muslim Soldier's View from Fort Hood
I spoke today with a friend who is a Muslim soldier stationed at Fort Hood. He and Hasan prayed side-by-side at the mosque the morning of the massacre. He agreed to share his story with me if I granted him anonymity.
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The military has been actively working to combat the stigma associated with seeking psychological health care. Refer to the Real Warriors Campaign, sponsored by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE). As posted on the DCoE website this campaign is “a multimedia public education effort designed to combat the stigma associated with seeking psychological health care and encourage service members, veterans and their families to use the psychological health resources available to them”. http://www.dcoe.health.mil/ForWarriors/RealWarriorsCampaign.aspx
Let's see.... get lots of training in the most efficient and lethal methods of taking the lives of others... give up all sense of morality and individuality to an external authority figure... live in a walled-off city that worships and honors the military mind-set every hour of every day... hmmm, makes one wonder why more of this stuff doesn't happen.
"...firing a gun was his exit strategy." I'd buy that, had he aimed the gun at himself.
Orlando shooter, US army Fort Hood shooter both linked to psychiatric drugs
http://www.naturalnews.com/027425_drugs_drugs_violence.html
Very important article!
If he is experiencing a psychiatric disorder, he has additional problems addressing it beyond any prejudices the Army might have against recognizing mental difficulties for soldiers. He is a psychiatrist and probably expects himself to handle his problems effectively. When he found himself not able to do that, he appears to have projected his difficulties outside of his personality -- blaming the military, identifying with suicide bombers, feeling persecuted for his religion. He is saying essentially, "I'm not responsible for my problems, they are a consequence of others' mistreatment of me." That is a nice set up for acting out violently -- the rationalization is that he is seeking revenge against those who have caused his problems. Of course this all requires very significant thinking distortions. It doesn't surprise me that a person trying to meld a psychiatric understanding of the world and a religious understanding of the world would have internal conflict. These are two irreconcilable ways of interpreting the human experience.
Thanks for your comments, TP. My perspective is that any illness, including mental illnesses, arise from a combination of innate predisposition and environmental influences.
If this man was mentally ill from childhood, he should not have been licensed to become a psychiatrist. If he became mentally ill, the environmental factors that worsened his mental state should be considered. Further, as his condition worsened, a colleague, or supervisor should have observed his deterioration and intervened.
If the shooter was a isolated librarian presumably no one might have been in a position to observe his deteriorating mental state, but he was in a psychiatric setting. There seem to be contradictions in being a psychiatrist in such a setting-- one of them being that no one noticed.
Many thanks for this dialogue!
Alison
It seems likely that actively seeking out therapy is frowned on in military settings, just as is reporting sexual assaults and seeking counseling is discouraged. People always ask, after some incident like this, "why didn't they go for help?", but this is why.
I hadn't heard until reading this that he was unable to leave the army because he owed for his medical education.
Members of the Armed Forces can always use their insurance to see a private psychiatrist, psychologist, or clinical therapist outside of the military system. If they go that route, their therapy is bound by confidentiality constraints.
Yes, that's a good point. In general, one would think that a psychologist or a psychiatrist would be the first to seek help when needed. But with certain kinds of issues, it might be harder to admit that one is in need of help, rather than in to the more powerful role of dispensing help.
On the other hand, it's likely that he experienced secondary traumatization from all that he heard, and there has been a shift in understanding what is helpful for that, so perhaps he did not know of anyone in his area, who would be safe or competent to deal with that.
The answer is to open more mosque on military bases...I saw that happen in the 90's...and I thought that Clinton and his cronies were totally off the block on that.
I was on orders to Ft. Hood...I told DA...change the orders or I'm getting out of the Army...They changed my orders...I wouldn't wish Ft. Hood on my worse enemy...
Yes, facing up to this is indeed chilling. Thank you for your comments.
Alison
......
So, to be forced to continue working with people who harass him for his religion, vilify those whose names and faces might be similar to his for no other reason than how the names sound or the faces look, to see that he will soon be deployed to work right in the middle of that became too much to bear.
To me this all sounds reminiscent of stories of school sh00 tings and the reasons for some of those - bullying. Violence is obviously not the answer, but we are a violent society, we tell our members in all kinds of ways every day that violence is frequently a legitimate answer to a problem.
Don't believe everything you read...trust me...no one ever harrassed him for his religion...they would get thrown out of the Army quick...his saying that is BS...he was a punk muslim pro-terrorist...and that's what it boiled down to.
Well said klbrz.
I think the military has, especially in the last few years, been trying to address some of the problems you talk about (the attitude of the one you heard speak, notwithstanding). I just heard they are going to be trying therapy dogs for those returning with ptsd. Not a cure, certainly, but a small step...
I would bet that the biggest problem in this particular case is what you alluded to - cognitive dissonance. I'm sure this guy had more than his share. The war in Iraq was not too subtly framed as a w ar against Is/am. He and those he worked with were being trained that "they" were the bad guys. Yet, he is one of those guys, so he's either not a good Mu5/im, or he's not a good Army doctor, because the argument has already been framed in such a way that the two are mutually exclusive. Bush's literal "crusade" told everyone of Mu5/im faith what he wanted them to know. He claimed ignorance about that, but no one is that ignorant.
cont...
Yes, we do have to find another way.Many experts have said that terrorism should be and can be confronted as a police operation, not through war. And thank you Alison for writing this post without stressing the shooter's Muslim faith, but instead looking at the impossible stressors he himself was subjected to. Whatever the insanity of militant Islam, the fact that he was even given this role as a psychatrist represents a failure on our part, almost, one could say, a kind of sadistic joke. I only hope it begins a national conversation about the price we are paying for the pervasive violence, on all levels, in which our culture is steeped. .
Fort Hood so far this year has had 100 suicides. This whole thing is a terrible shame.
We need to shut down these wars.
One of the bases I was at during the Vietnam War had a lot of suicides. We would hear about them through the grapevine, because officially they were not happening. It was very shocking then, and it is very shocking now. I don't know what else to say.
I have been following for some time "small" articles in the media addressing the high incident of suicides in the military. I wonder why this has not gotten more extensive press coverage.
100, you say, at Ft. Hood? This year? The implications are close to criminal. I am angered at the lack of responsibility our government is taking for our Troops well being on or off American soil.
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