As an addiction treatment professional, it goes with the territory that we lose people ― good people ― who maybe needed a little more help or time, or who simply made a regrettable choice. Veterans are often among those lost to substance abuse and suicide.
My first and most devastating loss was of a young Marine, Scott,* who had returned to the U.S. from multiple deployments in Iraq and Afghanistan. He was 23 and handsome, classic good looks: blonde hair, blue eyes, solid chin and impeccable manners. I like working with veterans and active duty military because I have yet to meet one without impeccable manners. When I knew Scott, he was living at a VA facility in California. Scott and I spoke often. He liked to watch me needlepoint. I understood Scott, because although we had very different stories, we had both self-medicated our symptoms of post-traumatic stress. We were, in a way, kindred spirits.
Scott had hoped for a career in the military, but had been wounded during his last deployment and could not continue in military service. He walked with a cane and was clearly in pain. Scott had a wife and a child that was only a few months old. He sought treatment at the VA for alcohol abuse related to post-traumatic stress disorder (PTSD).
The last time I saw Scott, he had arrived at the meeting hall earlier than normal. He sat in his usual chair at the end of the first row. He was shaking. I walked up to him right away and asked what was wrong and he told me that he had just come from therapy and was very upset. To treat trauma, the VA often uses exposure therapy. In this type of therapy, the individual recounts (and very often, in their, mind relives) the most traumatic experience(s) of their lives. Exposure therapy is the “gold-standard” for PTSD treatment, according to the VA.
Exposure therapy can be an effective tool for overcoming trauma-related symptoms. For example, if a woman was raped in a park, she may have a fear of going to a park ― and this might prevent her from having a full relationship with her young child who likes parks. By reviewing the traumatic event in the park, the woman may be able to become desensitized and recognize that the trauma stems from an event, not from parks.
Unfortunately for some, there is no catharsis in reliving the worst moments of their lives. For these individuals, there is no desensitizing what goes on with exposure therapy. In fact, the therapy may exacerbate their PTSD symptoms. Scott did not benefit from exposure therapy. He did not tell his therapist that his PTSD symptoms were worsening. Rather than feeling he was a failure for discontinuing therapy or relapsing on alcohol to relieve his PTSD symptoms, Scott chose suicide as a way out of his pain.
Scott died nearly a decade ago. I didn’t know him well, but he was precious and he was pained. I think of him often, particularly on Veterans Day.
Could Scott have been saved? I don’t know. The VA certainly does its best. However, the staggering number of veteran suicides, now 20 per day down from 22 per day earlier in the decade, should indicate that we are not doing enough. Our services are either incomplete or inadequate, or not in the right places or veterans cannot or will not use them. Whatever the cause of the deficit, it is our responsibility to keep our promises to our wounded warriors of all types and do a better job of providing re-entry into our communities. We owe them a debt. We need to pay it.
*Not his real name.