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Bryant Welch

Bryant Welch

Posted: November 16, 2009 01:43 PM

Fort Hood: A Harbinger of Things to Come?

What's Your Reaction?

The Army knew that Fort Hood shooter Major Nidal Malik Hasan was shouting political and religious harangues to patients during his therapy sessions at Walter Reed Army Hospital.

When that happens in a psychiatric setting, it is time to radio Houston that we have a problem.

Instead of admitting the serious break down in Army quality control, each day the Army provides a new explanation of why blame for the Fort Hood shootings should be laid at the feet of Muslim terrorists and not the US military.

This problem the military has in confronting psychiatric problems is longstanding.

Unless there is a dramatic change in the military's use of mental health expertise there will be more Fort Hoods as our troops return from Iraq and Afghanistan with serious psychiatric disorders.

Unfortunately, instead of making the needed changes to improve quality, the military has recently announced plans to paper over the problem by providing our troops with superficial new mental health treatments that could prove very harmful, especially when applied to the severe psychiatric disturbances caused by military duty.

The History

Historically, sensitivity to mental health needs in the military was absent. In more recent times, the sight of homeless veterans on our nation's streets coupled with news stories of veterans' erupting into inexplicably violent behavior made it hard for the military to continue to deny the problem of obviously unmet mental health needs.

The military has not necessarily used its new allocation for mental health resources to provide high quality mental health care, however. Instead, it has tried to downplay serious mental health issues and co-opted mental health resources for other military objectives.

During the first Persian Gulf War, for example, there were seven thousand children who had both parents deployed in harm's way. Then-Congresswoman Barbara Boxer chaired a subcommittee of the House Armed Services Committee and held hearings on the psychological implications of this for the children involved. Three military psychiatrists and I were asked to testify.

At this time, I had been in the forefront of the many turf battles that have characterized the competitive relationship between American Psychiatry and American Psychology. I was relieved to be in a setting where accord seemed guaranteed. Having both parents in harm's way obviously was psychologically traumatic for children. We would not disagree on that one.

I was the first to testify. After I described the psychological trauma this kind of separation could cause for young children and made recommendations how to minimize that trauma, I quickly realized that my assumption of professional concurrence on the matter was ill-founded.

The testimony from the military psychiatrists was all to this effect: "Kids are tough." "Kids are resilient." "Adversity makes kids stronger." And then there was my personal favorite: "Mozart's greatness as an adult was caused by his father's death when Mozart was still a little boy." These were verbatim statements from the military psychiatrists.

In the subcommittee hearing, trained psychiatrists spouting pseudo-psychiatric nonsense were literally trying to convince the panel to ignore the psychological trauma that war causes for children who have both parents in harm's way. Themes of toughness, resilience, and growth through adversity were bastardized and taken to extreme degrees. The military wanted to neglect the psychological trauma suffered by military children, and it used these three psychiatrists to achieve that objective.

The most extreme example of this exploitation of mental health expertise occurred when military mental health resources were used in the service of torture. As I reported last June in the Huffington Post when it came time to develop and implement instruments of torture, psychologists with close ties to Senator Daniel Inouye's office were very useful handmaidens to the CIA and the military.

Dr. Martin Seligman, for example, a recent past president of the American Psychological Association, provided training to a group of CIA psychologists, including those psychologists now known to have developed the torture techniques used by the Bush Administration in its "enhanced interrogation program."

Dr. Seligman is a nationally known psychologist who gained his reputation from experiments applying electrical shocks to dogs. He discovered that when electric shocks are applied to a dog over periods of time the dog begins to act helpless. He coined the phrase "learned helplessness" to describe the post-torture condition of the animals. One can, of course, see why the architects of the US torture techniques felt this body of knowledge might be useful for their objectives.

Dr. Seligman reports that he asked the CIA officials whether the training was being used for torture, but they reportedly replied that his lack of security clearance made it impossible for them to tell him. Apparently reassured by this answer, Dr. Seligman went ahead with his instruction on learned helplessness and what he learned from applying electric shocks to dogs.

The Future

With the current number of suicides and cases of post traumatic stress disorder reaching all time highs the pressure has increased on the military to address the mental health needs of the troops. One would expect that to help address that problem the military would turn to experts in the treatment of post traumatic stress disorder, the primary severe mental health problem requiring treatment. Instead, the military has once again turned to Dr. Seligman.

In August of 2009, in an announcement carried by the New York Times, Dr. Seligman reported that the military has developed a $119 million program to train 1.1 million American troops in the techniques of "Positive Psychology" aka the Psychology of Optimism. "Positive Psychology" was developed by Dr. Seligman. While Positive Psychology has developed some following in the mental health field, personally, I have not been able to find a meaningful distinction between it and Norman Vincent Peale's Power of Positive Thinking. Both emphasize substituting positive thoughts for unhappy or negative ones.

In announcing the new military program, Dr. Seligman explained his view of the connection between Positive Psychology and military trauma.

"Psychology has given us this whole language of pathology, so that a soldier in tears after seeing someone killed thinks, 'Something's wrong with me; I have post-traumatic stress,' or P.T.S.D.. The idea here is to give people a new vocabulary, to speak in terms of resilience. Most people who experience trauma don't end up with P.T.S.D.; many experience post-traumatic growth."

It is difficult for me to understand how anyone familiar with post traumatic stress disorder in the military could make such a statement. PTSD, once referred to as "shell shock," occurs in veterans who have experienced the horrors of war to such intensity that they psychologically crack. PTSD is the illness depicted in the movies when crazed ex-veterans go on shooting rampages. Unfortunately, these movies are accurate depictions of many very real tragedies for military veterans.

In PTSD, victims are subjected to such overwhelming and horrible emotional trauma that they are unable to regain stability with typical psychological coping mechanisms. Instead, the rattled mind is driven into uncontrollable and rapidly changing, emotionally painful states. The mind oscillates from a full blown, emotional re-experiencing of the trauma to a complete numbing of all emotions, as if the mind were trying to protect itself from being re-traumatized by holding all feelings at bay. Night terrors, panic attacks, depression, and cognitive confusion occur in chaotic fashion to helpless victim.

When one understands and fully appreciates this inner world of the post traumatic stress victim, it is easier to understand why a veteran can go "berserk" killing his family and then taking his own life. It is not a mental state that can be treated by suggesting to the patient that he or she simply re-frame how they think about the situation, as Dr. Seligman suggests.

And yet the US military has bought into this untested notion to the tune of $119 million. This money, of course, could have been used to provide real mental health care to our troops. Instead, it is being used to tell military personnel that they can (and, thus, presumably should) overcome whatever happens to them on the battlefield with the dubious tools of Positive Psychology.

Once again the military is returning to the same pattern I saw in the panel presentation at the time of the first Persian Gulf War. As Seligman's comments indicate, the military is developing a program for our veterans that are based on the same "kids are tough," "they can do it," and "through adversity to the stars just like Wolfgang Mozart" that the Armed Services subcommittee heard during the first Persian Gulf War.

Few who know the military culture think, as Dr. Seligman implies, that the problem with PTSD is that there are too many military personnel diagnosing themselves with PTSD. The problem is just the opposite. Too many members of our armed services are going through traumas that are undiagnosed by themselves or anybody else.

Telling trauma victims that they need to learn to "cope" with these traumas or, as the Positive Psychology approach suggests, find opportunities for "growth" in them, is effective for a military commander trying to drag one last drop of blood out of a soldier. It is not good, however, for the soldier or the society to which the soldier returns. In fact, it simply adds to the already excessive emotional burden the soldiers are carrying.

Conclusion

Our troops have been through enough.

While most Americans have contributed very little to the war effort, other than to adorn our cars with decals of a flag that smugly proclaims our support for the troops, we have subjected them to multiple deployments which none anticipated when they enlisted.

They have gone into battle with inadequate armor. They have watched their comrades die.

We have left the families of the troops without adequate support. We have caused their civilian careers to evaporate and let their businesses fail.

We have done this at a time when others have gotten wealthy and even enjoyed special tax cuts with money that rightfully should have gone to support the troops.

When the troops have returned home injured and in many cases with broken families, we slashed their health care.

Now, when they seek mental health care because their minds are like terrifying roller coaster rides, because of what they have seen in combat, we are going to respond to their PTSD by telling them to be resilient and turn their trauma into a Mozart concerto.

Can anyone see how that might make an already shaky mind crack and grab a gun?

If we can identify the real problem that caused the tragedy at Ford Hood we can possibly prevent such episodes in the future. Alternatively, we can continue to deny the real problem, provide sham treatments for serious psychiatric casualties, and just whoop up more resentment toward Muslims. That's the current plan.

Bryant Welch, J.D., Ph.D. is a clinical psychologist and attorney. He is the author of State of Confusion: Political Manipulation and the Assault on the American Mind. (St. Martins Press, 2008.)


 
The Army knew that Fort Hood shooter Major Nidal Malik Hasan was shouting political and religious harangues to patients during his therapy sessions at Walter Reed Army Hospital. When that happens in...
The Army knew that Fort Hood shooter Major Nidal Malik Hasan was shouting political and religious harangues to patients during his therapy sessions at Walter Reed Army Hospital. When that happens in...
 
 
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10:43 AM on 11/18/2009
Or maybe when soldiers announces that he has conscientious objection to the war or duty he is ordered to, and must resign, the army should let him. It wasn't until Dr Hasan was cornered by having his resignation refused and being ordered to Afghanistan, the war he most objected to, that he broke.

Or is that too simple? When a guy says "I have a crisis of conscience", is listening too difficult?
03:55 PM on 11/17/2009
Thank you Bryant for pointing out the shallowness of Seligman's views. His celebrity status relies on dubious research (that would hopefully not pass ethical committee approval these days), and the coining of the catchy phrase of 'learned helplessness'. Now he's floated another - Positive Psychology, and touring the world spruiking its benefits. I'll try floating a phrase - Slogan Psychology. Hope it catches on
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Uggg
09:08 PM on 11/16/2009
What you all fail to miss is that the Major was part of the mental health system of the military, He worked around Mental Health Professionals every day and they missed it under current Political Correctness that the Government requires all military personal have to follow.
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Bryant Welch
10:40 PM on 11/16/2009
I don't think anyone has missed that argument. In fact, I reference it in the blog. Any Muslim psychiatrist could have diagnosed Major Hasam as being disturbed, presumably without fear of being attacked on PC grounds.
11:25 AM on 11/17/2009
"Any Muslim psychiatrist could have diagnosed Major Hasam as being disturbed, presumably without fear of being attacked on PC grounds."
So what your saying is that a MUSLIM psychiatrist and only a MUSLIM psychiatrist could have diagnosed Major Hasam as being disturbed but not a Christin or Jewish psychiatrist?. I would think that ANY psychiatrist should have been able to speak up without being attacked on PC grounds. Political Correctness is just as responsble for killing those people as Hasam was.
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09:13 AM on 11/17/2009
Bryant,
Thank you for this continued exposure debunking the use of positive psychology to treat PTSD, Seligman's continued involvement with the military, and the military's coverups of PTSD. With all the sensationalized MSM coverage of Hasan, much more attention needs to be focused on the reality of what went wrong.
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yogini4
Think deeper!
08:44 PM on 11/16/2009
Congratulations on an article full of sound thinking and sound clinical practice. I could not have said it any better myself. You may be interested to know that there is a group in the military who have a great deal of savvy about PTSD. They are the Chaplains. I had the pleasure of meeting Captain Mark Smith of the USCG at last weekend's conference of the International Society for Stress Studies. He is part of an initiative to train every chaplain in the military to deal effectively with PTSD and the spiritual crises that attend this painful state. Let us hope that they, at least, may get this right. The military machine has too many conflicting agendas. Let's face it, if people understand the brokenness of PTSD and the consequences for the remainder of their life, who will sign up for war? It saddens me that psychology professionals come down on the side of war rather than healing.
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Bryant Welch
10:45 PM on 11/16/2009
Thank you for your kind comment. I am delighted to hear about the Chaplains. I also should have made it clear that there are many good psychiatrists and psychologists who are appalled about the situation. Some have even volunteered services to the military but been turned down. I agree with you about the implications of people really understanding and seeing the kinds of experiences that are the cause of the PTSD. I don't know if you saw Bill Moyers show on Veterans on November 8. It was outstanding and your comments remind me of it.
07:36 PM on 11/16/2009
"Historically, sensitivity to mental health needs in the military was absent. "

Perhaps the most frightening thing is that historically alot fewer made it home as well. Whatever criticisms one may have about innadequate armor the life saving occuring on the battlefield is light years beyond what used to occur.

That seems likely to increase the incidence of psychological trauma ratio's in returning soldiers meaning the innaddequate plans of yesteryear will likely be even more innaddequate. We definitely owe these men and women more than think happy thoughts.
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BlackJAC
It's better to be a black king than a white knight
05:59 PM on 11/16/2009
In all seriousness, how do we differentiate between a freakjob advertising his intentions and a regular Joe just venting his frustrations? After all, zero tolerance means never having to say you're thinking.
05:39 PM on 11/16/2009
First, the mental status of this Major is not known. Second, the Army is tied up by Government direction on political correctness. Any attempt to state the obvious is now called hate speech. Third, each Memorial Day we acknowledge soldiers who gave up their life for their country. These soldiers believed enough in their country to make this sacrifice and are admired for it. This Major has portrayed himself as a committed Muslim. Read the slides of his presentation published in the New York Times. Then read "Islam and the Jews" by Mark Gabriel, "The Social Justice of Islam" by Syed Qutb, and finally "Violence Unveiled" by Gil Baillie. I see no point in further blaming the Army for the impossible task of Iraq and Afghanistan. How is this Major wanting to give up his life for his religion different? This article fails to address this point which is how important his beliefs are and how they appear threatened by US actions in Iraq and Afghanistan. His slide show reveals this.
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BlackJAC
It's better to be a black king than a white knight
05:58 PM on 11/16/2009
Why do you hate America?
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Bryant Welch
07:41 PM on 11/16/2009
As you say, "First, the mental status of this Major is not known." That is the point. Given his known behavior we should have found out what his mental status was before sending him to treat our troops.
04:17 PM on 11/16/2009
This article seems to hinge on the assumption that Maj. Hasan suffered from a psychiatric problem as a result of his time in the Army, such as PTSD.
Maj. Hasan, however, never deployed, spent most of his career in school and (judging by his medals) was never one to go the extra mile or make himself known; typically a requisite for promotion at an Officer's promotion board.

While I agree that those who have served overseas, or perhaps endured traumatic experiences even within the country (such as losing comrades in OIF/OEF) should receive greater care and attention, Maj. Hasan was clearly not one of those.
05:03 PM on 11/16/2009
I think the purpose of this article is to show that the mental health care available to our troops is idealistic and inadequate - not to say anything particular about Nidal Hasan.

Mr. Hasan's story might not be the best showcase of why that's true, but it's a profoundly popular story that helps shed light on the above fact.
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Bryant Welch
05:33 PM on 11/16/2009
Thank you, Crisomg, for responding so much more succinctly than I have!
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Bryant Welch
05:31 PM on 11/16/2009
No, I am not saying that at all. I am saying that whether Major Hasan was a radical Islamist or merely psychotic, when an army psychiatrist behaves the way he is described at Walter Reed it should have been enough to remove him from duty. For example, if he was simply a radical Islamist i waiting to strike his lethal blow it was indicative of instability and very poor judgment to be carrying on the way he was. Had he been monitored he would obviously have been giving himself away. Radical Islamist can suffer from mental illness just as others. Furthermore, mental illness can come from many sources, not just military combat. Major Hassan may have sufferred from a genetic mental illness, from stress brought on by impending military duty, or perplexity caused by moral conflicts. The point I am making is that when for whatever reason an army psychiatrist acts that way with patients to not remove him from duty is a break down in management of the highest order.
04:07 PM on 11/16/2009
It seems we, as a nation, are ill-equipped to determine the difference between what can work - positive thinking, wars of aggression, torture - and what actually works.

That positive thinking CAN work - which it undeniably can - is not the same thing as "it does work." I worked in a VA hospital pharmacy for a couple years and there is just no way those men and women would have been made better by mind tricks.
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BocaMom
04:01 PM on 11/16/2009
The problem is called terrorists, extreme religious terrorists and nuts who hate everything about the West and would like to kill all of us if they have a chance. Hello? What don't you understand?
04:32 PM on 11/16/2009
Even if what you say it true - which I don't believe it is - the point of Mr. Welch's commentary is still correct.

"Unless there is a dramatic change in the military's use of mental health expertise there will be more Fort Hoods as our troops return from Iraq and Afghanistan with serious psychiatric disorders."

The problem is that if we write this off as "just another crazy terrorist" instead of actually trying to determine the cause - and from there a potential solution - acts like Mr. Hasan's are bound to happen again.

But next time it might be a typical, white, Christian, American, college graduate that doesn't the get the intervention he needs and goes on a shooting spree.

Furthermore, Mr. Hasan's fundamentalist religious views may have influenced his thinking. But fundamentalism is not equivalent to violence. Both the Koran and the Bible justify killing to further the cause of their goD, but the fact that there are plenty of fundamentalists from both religions that don't kill is enough to show there were more factors involved.
05:30 PM on 11/16/2009
What don't you understand about Ft. Bragg, Ft. Hood, and Ft Carson?
To name a few.

Hell, google Ft. Bragg and murder and you have to wonder how that place is still open.

Google Ft. Carson and murder.
outnow
Ban the bomb
02:37 PM on 11/16/2009
It is hypocritical to suggest that all is well in out multicultural society in terms of accepting those of other faiths and religions while we wage a war of civilizations on the other. The tensions between these two realities are exemplified in this tragedy. When a psychiatrist is under this kind of conflict, and there is no response, then what can be expected.

The legal and psychological implications of this case will come to symbolize the ambivalence in ternally and expternally our policies create. There is a Catch-22 feeling to all of this.
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Bryant Welch
03:04 PM on 11/16/2009
Yes, I think the proof of what you are saying is in the ongoing debate over whether Major Hasan had a psychiatric disturbance "or" was a fundamental Islamic extremist. To serve in the Army with these conflicts unaddressed by the army is an extraordinary insensitivity to the pressure of an Army psychiatrist (or any other soldier.