Thursday, July 23, 2009

PTSD IGNORED BY MILITARY

ONLY SORTA

Maya Schenwar over on Truthout brings forth an article that is summarized on the site as “neglect, mistreatment, and abuse are the norm for active-duty soldiers suffering from post-traumatic stress disorder”.

Far be it from me to want to sweep under the rug any sort of mis-, mal-, or non-feasance perpetrated by the Pentagoons upon the troops.

But far be it from me to want to allow to pass for credible any sort of mis-, mal-, or non-feasance perpetrated by manipulative ‘advocates’ upon the rest of Us.

So while I am not here attempting the last word, either to hear myself talk or to convince you of the total rightness of my view, I’d like to kick a tire or two. Better to do it now than several oceans of mistaken ‘policy reforms’ down the road.

“As of the end of March, 346,393 US veterans were being treated for PTSD; 115,000 of those served in Iraq or Afghanistan. That number continues to grow rapidly.”

That is a hell of a lot of PTSD, which – by definition – involves trauma.

But that’s the first problem. And it’s a problem that has plagued the PTSD ‘diagnosis’ since its inception a couple-three decades ago. How do you define ‘trauma’, such that it causes such a serious syndrome of ‘stress’?

It’s a little easier with physical trauma – a missing limb, a life-threatening injury or ‘sucking chest wound’ or head injury … that sort of thing is clearly classified as ‘trauma’. A broken finger or toe is, rather clearly, not.

But once you’re into the realm of thoughts, feelings, and emotions – now you’re into much different territory altogether. No physician or surgeon can see any of those phenomenon, nor bring them into view with some deft knife-work.

This was known from the outset.

But the solution proposed by ‘sensitive’ medicine, liberated from the ‘hierarchical’ and ‘authoritarian’ medical model that was so redolent of ‘patriarchy’, was to allow the patient to define what constituted ‘stress’, and hence to diagnose him/herself. If the patient, therefore, reported ‘pain’ – and who could say if he/she did or didn’t experience the recurrent intrusive thoughts and other symptoms? By freeing ‘diagnosis’ and bestowing its power upon ‘the patient’, the medicine of the day took up ‘spectral evidence’ long after the law had abandoned its diagnostic and evidentiary value.*

This was, according to the usage of the times, trumpeted as ‘progress’ and the ‘humanization’ of therapy, and a major blow against structural ‘oppression’. And, as always, ‘patriarchy’.

But such progress came at a jaw-dropping price. There was now no way to filter any claims of ‘stress’, or the more imposing diagnostic moniker “Post Traumatic Stress Disorder”, through any professional assessment. If a patient said s/he had it, then the patient had it – and the therapist’s role was simply to treat it, and to make the pain go away (as the old song put it).

And again, to make ‘pain’ the trump to all diagnosis was to bring the old ‘spectral evidence’ demon back, this time in medical practice. If somebody says s/he has or feels ‘pain’, how can you test for it? How can you ascertain that independently of what ‘the patient’ says?

Practitioners who tried to impose some sort of assessment, especially if such assessment came to a conclusion other than what the patient claimed, were looking for trouble – and should start looking for a new profession. ‘Insensitivity’ was simply not done in the New Therapeutic Order. To refuse to make the diagnosis would be 'blaming the victim', and you could lose your career over that.

And, of course, given that ‘reforms’ and ‘brilliant new approaches’ have a tendency to ‘migrate’, then what would be good for the psychological therapy room migrated to all forms of medicine, and then into other areas of endeavor: education, job performance and productivity, even the military (where potential soldiers who felt they had had enough simply had to tell their drill instructor – in effect – to go away.

You can see where all of this was going.

And naturally, since the ‘patients’ were also voters, the pols were eager to support this new ‘reform’. What better way to make it look like you’re doing your job and earning your keep than to ‘give stuff’ to the voters.

And, as the military began to attract the attention of ‘reformers’ – specifically of the radical feminist persuasion – then the military brass quickly realized that if their civilian bosses wanted this to ‘go smoothly’, then they would use all their authority to make it go smoothly, and God could sort it out. They had their jobs and promotions and post-career options to think about.

This was on top of the feministical agenda of transforming the military into an ‘employment opportunity’, a ‘right’ that could not be deterred by ‘macho’ concerns about competence, physical capacity, adaptability to the demands of military life (military life would be utterly restructured to adapt to its membership), and the challenges of waging sustained combat (which was never supposed to happen again so who cared about ‘readiness’ anyway? – it was just a macho excuse to prevent women from exercising their ‘full citizenship’.)

And then, of course, war came.

And its stern tests graded harshly the mushy products of an era that didn’t see itself as ever being accountable to consequences. One thing about combat: you can’t just tell it to go away when you’ve had enough. **

Schenwar uses as her ‘hook’ the story of an Airman diagnosed with PTSD in 2007 (as if any military doctor can refuse; it isn’t worth the loss of job and career). This Airman gets “only a 15-minute monthly session with a military psychiatrist – mostly to prescribe medications and a brief bimonthly session with a psychologist”.

I hold no brief for the professional organizational integrity of military medicine and psychiatry – and more than I hold any brief for military lawyers or God-haunted Fundamentalist chaplains – but it can’t be hard to see an alternative explanation here, different from Schenwar’s oh-so-Correct plaint that the military organization is heartless in this matter.

Specifically, the military medicos have had to give him a PTSD diagnosis as a matter of Correct policy, and now have to somehow find a way to keep up the appearance of ‘treatment’ without dissipating their limited resources on this ‘case’ (and, by precedent, tens of thousands of other similar ‘cases’).

Worse, the use of medications has become the most ‘efficient’ and ‘cost effective’ way to do that. So what we have is an increasing use of medications to solve what may well have – at the very least – substantial elements of what used to be called ‘immaturity’ or some form of ‘developmental’ problem or even a character-problem.

This would be a problem in any civilian setting, but in the military setting – where ‘reality’ and ‘consequences’ can’t be wished away by altering your ‘perceptions’ or getting a friendly reporter to spin your story as a ‘victim’ – then a nation is setting itself up for a serious fall. Such a drop in combat efficiency – not only by a bad policy but by the acceptance of large numbers of developmentally ‘fragile’ (to put it nicely) individuals – is lethal to the very purpose of a military.
And that purpose – contrary to Correct enlightenment – is not to provide happy job opportunities, or to satisfy a hugely dubious ‘right to serve’, but rather to successfully sustain victorious combat operations. (And looking at it that way, perhaps Our rather poor showing in combat these days has something to do with all this.)

And Schenwar adds that now this Airman “has endured constant harassment within his unit”. Well, suppose he is ‘fragile’: his unit-mates may well be insensitive and impatient with him, but do you know of any human workplace where such a dynamic is not possible, and indeed understandable? (Which is not to say that I like to see ‘harassment’, although learning how to deal with it can be quite a maturing experience.)

And worse, especially in the military setting, any unit-member who can’t do the assigned tasks sets up the rest of the unit for extra work to compensate for the shortfall. And that’s bound to cause some upset, as well as stretch even thinner the unit’s effectiveness.

But there’s more. The Airman admits to having had “suicidal ideations” (which is a rather complex professional vocabulary for the average bear). In addition, temporarily assigned to such non-onerous duties as being a parking-space monitor on base, the Airman is not only embarrassed but suffers as well from “serious knee and back problems”.

The lad is something of a train-wreck, physically and psychologically. I’m not familiar with him personally, but the possibility of ‘maturational fragility’ looms rather large, simply from a reading of his multiple ‘issues’. And in an achievement-oriented organization such as the military – where failure to achieve stuff can get you and the unit killed, and wars lost … all of this is hardly unforeseeable.

The big question is not why the military won’t let him out, but why they let him in in the first place.

And here is where the feminized, ‘sensitive’, job-opportunity modern and Correct military is now paying the price of a too-thorough and too-easy rolling-over to the demands of the feminist agenda: having allowed in whole bunches of not-robust ‘soldiers’ and ‘sailors’ and ‘airpersons’, and having twisted reality into a pretzel in order to justify it without admitting to a profound falling-away in maturational and competence standards, the military now cannot either classify these individuals as unsuitable or start letting them out without seriously reducing its troop strength and creating an awful ‘back door’ precedent.

“The military has to cultivate a culture of commitment”, says the head of the Military Counseling Network. So it can’t start letting out everybody who should be let out, without devastating its retention numbers and creating a huge morale problem for those capable troops who would rather be doing something else, are yet willing to fulfill their commitments, but would start to wonder if whole bunches of unhappy souls were given a pass to walk out the door.

The military has nobody to blame but itself here. You can still get court-martialed for deliberately injuring yourself, thereby making yourself unavailable for missions. The sense of that is clear enough. But then, in the feminist Age, pregnancy had to be classified as “non-medical”, such that if you get yourself into such a condition (let’s not go into ‘finding yourself’ – as if by inadvertence – in such a condition) then you are not prosecutable for making yourself unavailable for missions. Indeed, you – not the military – can then say whether you want to stay in the military or – ummmm – not. And the brass happy-face it all as just a ‘thang’ that has no big effect on military operations or morale. WTF?

Now, with all of the ‘stress’ and ‘pain’ service personnel, the military is doubly in a bind. If they start letting out all the ones they probably never should have let in to begin with, they lose large numbers of troops. And they open the – you should pardon the expression – Pandora’s Box of having their ‘pregnancy’ policy – and much of the core of the feminist-driven program itself – opened to scrutiny. And that would not be a pretty thing at all. And most of the male troops have probably already seen through the bullplop anyway, even if the media haven’t chosen to.

And on top of this, you are now in a hugely demanding and losing set of wars, involving Fourth-and-Fifth Generation combat that is even more frakking than the old-fashioned WW2 stuff.

Good grief.

And, on top of that, your troops who are sufficiently capable of engaging in that sort of combat, but are not Grade-A combat paragons – the classic ‘hot dogs’ and ‘devil dogs’ – will indeed be far more exposed to genuine PTSD and will need serious help. And your ‘dogs’, hot and devil, are going to wind up carrying the brunt of the whole thing, thus burning themselves out (when, that is, they are not simply eliminated by hostile fire).

Do you see how a whole era’s worth of baaaad policies, accepted by a careerist senior officer corps, imposed by feel-good pols and doctrinaire advocacy cadres, have now ‘synergized’ into a frakfest, a train-wreck of lethal proportions?

And, last but not least, We are presented with a second PTSD horror ‘story’, this one about a female NCO “recently diagnosed with military sexual trauma” (italics mine).

You will have trouble finding that ‘diagnosis’ in any of the major professional listings. It apparently is meant to provide benefit-of-science to the experience of having had a bad or unhappy sexual experience in a military setting. Yes, there is the possibility of being genuinely raped and assaulted; but there is an even larger statistical probability of having had that ‘unhappy sexual experience in the military setting’, with all the possible sub-categories that are latent in that ‘unhappy’.

This, of course, takes Us back to the feminist insistence that women must be allowed to serve, but not in separate units (where, alas, their statistical inability to carry out the missions might become – the horror! – too obvious to spin away).

Their ‘plan’, evinced over the years, was that a) the military is too ‘male’ and too ‘macho’ in the first place; b) there isn’t going to be any more old-fashioned combat; c) the military can afford even a “20 percent reduction in combat efficiency and effectiveness” in order to feminize itself; d) but anyway feminization and combat efficiency aren’t mutually exclusive.

Consider, if you will, that these confident assertions are even half-wrong (hardly an impossibility when you consider the track-record of Beltway elites in matters military in the past 50 years). Can you imagine the lethality of their consequences upon military effectiveness?

Consider as well that their further assertions are also wide of the mark: that military command and education can eliminate ‘sex’ among troops – in the rear or at the front , and that mixed-gender units can be trained to see each other merely as fellow-professionals and not as sexual and relational opportunities. Among a largely teen-aged force, or a force composed of chronological ‘adults’ who really haven’t matured beyond a teen-worldview (also not improbable, when you consider how many cohorts of children since 1980 have now grown past the age of 18).

Do you have enough impossible things to believe before breakfast yet?

And yet this must be considered ‘national policy’, even ‘national security policy’, and it has been pursued doggedly for decades. Yes, I’m saying it is primarily a matter of national security, and not simply a groovy new approach to ‘job opportunity’ or ‘equal opportunity’ or ‘gender equality’ or ‘sexual equality’ or what have you.

None of this can end well.

And the media are best advised to actually try to follow Walter Cronkite’s path, rather than simply chirping respectfully about how they too share his illustrious professional heritage.

Because the America that fought and lost Vietnam was at least materially and economically strong enough to absorb that defeat; and its citizens resilient enough to buck up and get on with life.

That is not in any way the case today.

And all of those genuinely hurt troops … will wind up standing in line for treatment with much larger numbers of unhappy individuals whom the brass and the pols should never have brought into the military to begin with.

They will be the most un-noticed casualties of all.

NOTES

*'Spectral evidence' is a legal term from the era of witchcraft and witchcraft trials: it means evidence that the person who claims to see it can see, but nobody else - not judges, not juries, not anybody ... you just have to take the person's word for it. Although, in a curious coincidence that was no coincidence, the law was soon to take up ‘spectral evidence’ again, in its ‘sensitivity’ to this, that, and the other claim of ‘abuse’ or the ‘repressed memory’ of same.

**A vivid dramatization of this occurred in the play and then film “Streamers” from the very early 1980s. Having killed two barrack-mates and then been apprehended by MPs, a black military recruit calmly orders them to let him go because he’s ‘quit’ the Army, is going to be leaving now, and they have no reason to be getting in his face with handcuffs. And he believes it. Now any modestly competent therapist could explain this as a form of mental imbalance, but the key here is that such behavior became ‘valorized’ – made to seem a ‘good idea’ and the ‘right thing to do’ not only in the military, but throughout American society and culture. Basically, it’s a variant on the old “I don’t want to play anymore”, although in a far more lethal setting than a kids’ playground.

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2 Comments:

Anonymous armyvet said...

A person is diagnosed with PTSD stemming from military sexual trauma. Men and women experience MST. Your understanding of MST shows your hate of feminism to be directly proportional to your love lost for justice. While you sit at home doing nothing other people out there are working to prosecute those who commit crimes against our troops and take care of those troops afterwards. I guess ignorance is bliss and you are in nirvana.

6:16 PM  
Blogger publion said...

The problems with the PTSD diagnosis, as I see it and as I wrote, are numerous, both in conception and in implementation.

1) Conceptually, the ‘symptoms’ are not easily verifiable by any but the person – the patient – reporting them.

2) In the societal and political atmosphere of the day, it has been made ‘insensitive’ to question the patient in order to make a differential diagnosis or establish the nature and possible etiology of the symptoms, presuming that they are real.

3) In the current military setting, where the brass have for decades prostrated themselves and their services and their troops to the demands of Political Correctness, it is even more difficult for a conscientious practitioner to try to ascertain clearly what symptoms and diagnosis the patient bears.

4) Militarily, since the professional is also a commissioned officer in the military, such attempts to get at the reality and the truth of the patient’s situation and condition can even result in loss of promotability, loss of career, or even prosecution.

MST does not appear as a recognized diagnosis in any of the major listings. It does, however, appear to be another instance of a ‘diagnosis’ invented by advocates and lobbyists in order to dramatize and lend credence to not only what they see as the problem, but also their spin of the problem. So I “understand” MST to be a non-diagnosis, to be something else that is cloaked in the scientific authority of the commonly understood term “diagnosis”.

I not only don’t pretend to have a working understanding of MST as a diagnosis, but I doubt that it can stand conceptually as a genuine diagnosis at all.

I don’t hate ‘feminism’, if the word is defined as a concern for respecting the capacities of females in society and culture.

But I do have grave reservations about ‘radical’ or ‘ideological’ feminism, both in terms of the content of their ideas and the anti-democratic methods by which – with the help of a vote-desperate Congress and a sensationalist media trying to maximize profits – those ideas and methods have been imposed upon American society and culture.

And I am alert to the consequences of all that imposition.

I am not at home doing nothing; I am trying very hard to think things through (having done my time in the field, militarily speaking).

This site has a number of Posts on the problems with military justice at its very core, and also how dangerous it is when deployed in the service of a particular political agenda, to wit the radical feminist agenda.

And if the reports are to be believed, then the crimes to which you refer are, it has to be recalled, being committed mostly by Our troops. And therefore that those seeking to “prosecute” those alleged crimes are, of course, seeking to prosecute Our troops – who already have their hands full with the enemy activity against them.

Taking care of those troops requires the ability to make accurate diagnoses of afflictions (including the possibility that some cases are not valid) and deploy resources in the most rational way to address those afflictions. Otherwise, the whole thing becomes a smoke-and-mirrors game.

As I said in the Post, it’s precisely the troops with genuine wounds and harms who will wind up being short-changed in all of this.

A major part of “ignorance” is the inability or unwillingness to inform oneself and then think through the problem that one claims to be interested in. In these times, nobody who is trying to do that has any reason for being “in nirvana” or anywhere remotely similar.

If you, however, felt pretty good about yourself for the quality of your Comment, and especially if you still do after what I’ve just said here in this Comment, then you have a lot of work to do. Good luck with that.

9:28 AM  

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