I was talking recently with some V.A. colleagues, who were telling me how the new vets coming back from Iraq and Afghanistan are very different from the Vietnam vets they saw decades ago.
Of course, it's a different situation in many ways. With Vietnam, the country was totally divided about the war, and we took our anger out on each other, and on the troops we sent out to fight. They in turn were furious about being told to kill people and then getting castigated for it when they got home. We traumatized them all over again.
This new group of soldiers are generally appreciated and acknowledged for putting themselves at risk -- even by people who aren't particularly happy about the wars they're fighting. That's one lesson learned, anyway: not to take the politics of war out on the troops.
Of course, most of our Vietnam troops were draftees. Nowadays we have an all-volunteer army. They can at least feel it was their decision to be there, and that sense of self-efficacy might add to some emotional resilience. (But then again, a lot of the reservists and National Guardsmen thought they were signing up to get some extra money and help out with a few national emergencies. Little did they know they'd be sent away from their families and careers for months on end, perhaps on their fourth or fifth rotation, fighting real people on foreign soil. So this is a complicated point and not as straightforward as it looks.)
Also, back in the 60's, we didn't know a whole lot about PTSD and our troops didn't know what was happening to them. Based on what we understood from World War II, we tried to prevent them getting PTSD by limiting their time of service to a year (for Marines, it was 15 months). And, sure enough, they came back with a smaller incidence of posttraumatic stress. But two to three years later, lo and behold, they developed delayed onset PTSD and the percentages were right back to being the same as WWII -- somewhere between 22-35 percent.
Sidebar: In any combat situation, the estimates are that 95 percent of exposed people have symptoms immediately afterward. Gradually these subside over the next 90 days for most people, with or without treatment. But after about six months, there's a core number - between 22 - 35 percent -- that don't get better on their own and need help. It will be interesting to see, now that one in nine soldiers exposed to combat are women, whether these stats stay the same. There is considerable cross-cultural evidence from natural disasters around the globe to suggest that women and children are more vulnerable to PTSD than adult men, given exposure to the same traumatic event. Sorry girlfriends, I don't like it any better than you do.)
This new group of active military in Iraq and Afghanistan knows what's happening to them, to a much greater extent. There's been a push to educate our troops and the general public about posttraumatic stress as well as TBI's (traumatic brain injury), thanks to a renewed commitment to the mental health of our troops, found in both the Department of Defense and the V.A. Secretaries Gates and Shinseki have been working hard at destigmatizing mental health problems, in ways never seen before. So that's another lesson learned from Vietnam, and no small matter. Still, career soldiers still worry a lot about stigma.
There's also, frankly, a different kind of drug abuse going on downrange nowadays. Our current troops are being given legal drugs by docs who are placed in the combat theatre with them. The drugs keep them de-stressed enough to keep functioning. They come back home accustomed to anti-anxiety pills, and to a lesser extent, to anti-depressants and pain pills. So many are dependent on them and want to continue with them after their service. This is different from the Vietnam vets who abused multiple illegal drugs and got in trouble with the law for it.
And finally, with many of the Vietnam vets, by the time they came into the V.A. seeking treatment, they were in their 30's and more amenable to counseling than these younger soldiers in their 20's. They'd started thinking about their lives in a more reflective way, especially when they started having combat stress-related problems with their relationships and their jobs.
For the younger troops coming back from Iraq and Afghanistan, there's impatience with the talking cure. They want to get on with their lives and don't want to talk, and reflect and ponder. They're saying, "Don't make me a career patient. I need to get to work. I need to help take care of my kids. I cannot come in during your office hours of eight to four for a 12-week course of Cognitive Behavioral Therapy. Give me a pill or a relaxation audio to calm me down, and let me get back to my life."
Keep in mind that two separate surveys -- one at the Durham V.A. and one at the Phoenix V.A. -- established that these new vets prefer getting their help via audio self-help by 72-75 percent -- through their own iPods or MP3 players. (That's another difference: this is a population that's comfortable with downloads.) Medication scores next highest at around 55 percent. Last on the list? Yep, you guessed it: sitting with one of us therapists.
So now that we're learning about the new barriers to receiving help -- some quite positive, by the way (Indeed, what's wrong with not wanting to be a career patient, anyway?), I expect the V.A. will get more flexible in how it offers services. And there will hopefully be much more widespread use of self-administered guided imagery downloads -- shown at multiple research sites to reduce symptoms quickly and pretty dramatically while being a pleasant and self-reinforcing experience for the listener. Not to mention inexpensive and useable even in remote locations.
We are getting so much more interest and openness to guided imagery than even a year ago, from both the DoD and the VA. These are great trends, very hopeful. I do believe we're gonna seriously help a lot of vets.
Follow Belleruth Naparstek on Twitter: www.twitter.com/#Belleruth
Craig Barnes: The Reality of PTSD
Lloyd I. Sederer, MD: War Veterans, PTSD And The Media
Barton Kunstler, Ph.D.: Veterans: Banished and Betrayed
Post-traumatic stress disorder (PTSD) - MayoClinic.com
Post-traumatic stress disorder (PTSD), often hidden, could be diagnosed using ...
Loading comments… 
Do visit our slide show of our Ft. Bliss Restoratio
In fact, I describe most of these elements in my book in the chapter describing the 10 ingredient
Kudos to you. I'll eagerly check out your site. And if you want to add guided imagery to your meditation toolkit, please let me know - we'll send you some. It's an important addition that generates symptom reduction after 6 weeks of listening for most people, and it's a great shortcut for those who can't do intensive treatment for very long or 35 hours of day treatment for any amount of time, because of the demands of work and family..
The business of medicating troops in the field in order to deal with combat issues associated with the horrors of combat is a tough pill to swallow. Prescribed drugs or non-prescr
The whole process of medicating soldiers in the field is disturbing on very basic level. On the level of those who enlisted in the Guard not knowing what they were getting into, I agree-they sd. have but were enticed and blinded by the money. A medicated military desensitiz
Thanks for your efforts and Peace.
broken down and rebuilt
systemetiz
for the good, for the homeland
far far away
the chill of the sands
depleted uranium was effective
lays strew now
its' legacy is remembered today
each day a new child is born
each day a child warrior dies
depleted uranium
glowing through the sands
for the next 50,000 years
new effective shells
to protect the troops
bleeds its' poison
into the sub strata
into the blood streams
of life
to protect our troops
and to make money
the child born has no fingers
one eye, no ears
a heart valve missing
the childs' mother weeps
for she knows about the glowing sands
her childs' future
left by the foreign child warrior
pimpled faces of fear
aware of their wrongs
these strangers in the strange sands
weep in their bunks to go home
deep in the night alone
depleted uranium glows
radiating the next generation
for the good of the homeland.
The child warrior weeps.
Rolf Krogsøther (C) 2010
Seriously, just got this posting on our website that speaks to this point - the writer said it was fine with her (and her brother) to post this here.
May I share that I bought ...[some imagery CDs] ... for my brother...
Amazingly, after so many years of pain and denial and anger, he just recently began listening to the imageries and I am seeing/cha
We'll have the veterans of these campaigns selling rose buds on street corners soon!
Alternativ
"I wish I could tell you about it, make it simple for you to understand
Semper Fi Mac!
If you have any interest in trying guided imagery as an add-on to what you're doing with the VA, it would be my privilege to be able to email you some simple downloads, along with some suggestion
We do have evidence that this and related techniques can frequently help with even long-stand
BR
I'm old enough to remember the return of Viet Nam vets and know several whose lives were left in shambles by the PTSD that they suffered.
Do we yet have the statistic on how many are able to normalize after tours in the present wars?
But you are so right on about the evening calling - we're involved in some guided imagery clinical trials at one V.A.M.C., where the biggest barrier to overcome in starting the study was how the researcher
Additional
In WW2 nearly 2/3rd of the men were drafted whereas over 2/3rd of the Vietnam vets were volunteers
There are a lot of myths built up around Vietnam in the US reinforced by Hollywood where it's portrayed as an American tragedy while we were on a noble mission. The truth of course is that it was a destructio
Watch John Pilger's "Heroes" where one of the veterans Bob Muller makes a point about the "most were drafted" myth very clearly. It was only in the later stages of the war that draft became an issue whereas in 65, 66, 67 it was "USA USA" with Cronkite extolling the virtues of our mission daily on CBS which convinced many naive young boys to sign up for their deaths in a country which they didn't know anything about.
Still, the difference between then and now still holds - Vietnam had draftees; these wars don't. Another consequenc
America is in the awful process of creating its' new "lost generation
May your God be with you America, when the horrors come to haunt your suffering peoples.
Both combat experience and military training themselves transform a person-- and those changes are most obvious (and sometimes painful) upon return to the original setting of home and family.
Belleruth, what helps make that transition easier?
Alison
I also want to mention that the Vet Centers - a great idea that took care directly into communitie
Another issue I didn't address in this piece is the fact that we're now able to save people who in the past died of their injuries, due to dramatic improvemen
http://arm
"The suicide rate among soldiers began to rise significan
The changes in attitude and the learning about effective, new therapies is cause for optimism. But I didn't mean to imply there wasn't plenty to examine and redress. No question about that. And the shocking, explosive suicide rate is getting a lot of attention from this new leadership in the DoD and the V.A. .
My BN Commander calls it "self medicating
It took over a year for the VA to even agree to do the follow-ups when I returned home.
The first appointmen
I still haven't been in.
A shame we started cutting back on VA services at the same time we were ramping up our production of new veterans!! A rather large "Oops", I'd say. I hope you get seen soon. Beer can only take you so far!