Military aims to remove stigma from seeking therapy for post-combat stress

When Capt. John Trylch of the 1st Squadron, 4th U.S. Cavalry Regiment made it safely back from Iraq, he expected things would be different, that he would be different.

“I kept waiting — where’s the change? Where’s the change?” he said. “But you find yourself falling into the same routines. I was surprised by that.”

Trylch is among the more than 80 percent of U.S. soldiers who, new studies are finding, served in battle in Iraq and came back home apparently unchanged, without a psychological problem, despite the stress and tragedy of war.

But he’s well aware of the other 15 percent to 20 percent whose combat duty leaves them with psychological wounds — depression, anxiety, post-traumatic stress disorder among them — that the military is showing interest in trying to treat. Two of Trylch’s soldiers had to be evacuated out of Iraq because of mental-health problems, he said, and more returned from battle with symptoms of depression or anxiety that they hadn’t had before.

A landmark 2004 study by researchers from the Walter Reed Army Institute of Research — thought to be one of the first to examine battle-related psychological problems of active-duty soldiers — found that there was a significant barrier to troops seeking mental-health care.

The barrier, according to the study of more than 6,100 soldiers and Marines who’d deployed to Iraq and Afghanistan, was the belief that seeking counseling would harm military careers and stigmatize armed forces members as weak. Fifty percent of troops in that study showing symptoms of mental-health problems said it would be bad for their career to see a counselor; 65 percent said they’d be perceived as weak; and 63 percent said commanders would treat them differently.

“We all read the study,” said Lt. Col. Christopher Kolenda, 1-4 Cav commander. “We said, ‘We’ve got to do better.’”

The 1-4 Cav, then under the command of Lt. Col. Jim Chevallier and deployed near Samarra, Iraq, joined with chaplains and military psychologists to try to remove the stigma of seeking mental-health care and to bring greater attention to the issue.

They invited the U.S. Army Medical Research Unit Europe, based in Heidelberg, to do pre-deployment and post-deployment mental-health screenings to aid in further research into the types of emotional changes soldiers undergo in combat and how to deal with them.

Additionally, services and information for family members in Germany were stepped up.

“If we got the families comfortable with the process, the more likely it was that they would encourage their soldier to get the help they needed,” Kolenda said. “It doesn’t mean you’re weak. It doesn’t mean you’re going to be treated differently. It’s all about assistance to overcome these wounds.”

After the 1-4 Cav and Brigade Reconnaissance Team returned to Schweinfurt, Germany, 732 of them filled out the mental-health screening forms. Of those, 135, or 18.4 percent, were referred for follow-up psychological care.

But those soldiers also reported a much greater acceptance of mental-health care. Just 9 percent of 1-4 Cav soldiers viewed counseling as detrimental to their careers, 14 percent said they’d be perceived as weak and 17 percent said they thought their command would treat them differently.

No 1-4 Cav soldiers undergoing counseling for post-combat psychological issues were willing to be interviewed about it, Trylch said.

The Heidelberg research unit still is working on its findings from the 1-4 Cav. One of the more intriguing questions being raised is whether it can be determined which of the many terrible things combat soldiers experience are most linked with post-traumatic stress syndrome — “certain exposures that are so intense that they are hard-wired, almost, to produce post-traumatic stress” — as Lt. Col. Paul Bliese, research unit commander, puts it.

According to Trylch and two soldiers under his command, all who saw difficult duty, the absolute worst experience is easy to identify and very hard to forget: the deaths of three soldiers in their unit killed in action — among 10 soldiers and one civilian the squadron lost in its year in Iraq.

Trylch credits his equanimity to the support of family and friends, and time spent thinking.

“Introspection — who I am and what I’ve seen and how I want to deal with that,” Trylch said. “I’ve tried to reconcile them the best that I can so that I can live with it.

“But do I look at the world through a little different set of eyes? Yeah, I do.”

This IS NO shame in seeking out help as you return from war, to help with readjustment and to just talk things out.

This is not a medical issue, that military folks are not to have medical issues that could preclude them from either remaining in the military or moving up in a military career.

Most can actual self refer now, the military allows it and folks should take them up on it.

I am glad to see the military is stepping up to the plate and I hope those who have served selflessly will KNOW that we are proud of them but that we also know that what they saw and did there, we can never fully appreciate and to take time to work through those event's only serves the soldier in a positive way, his family in a positive way and set's an example for his/her fellow brother's/sister's in arms.

Being an Iraq vet, I can say that the VA is OUTSTANDING! After years of hearing how bad the VA is, I now see that all the claims are baseless. My only complaint would be that for special clinics, dermatology, urology, etc. the wait can be 1 to 2 months. But for basic and emergency care, they are great. 6 months after I got out (last November) my wife left me for another man, coupled with PTSD and the transition from military to civilian life it was extremely difficult for me. Fortunately, my local VA had a Dr. of psychology who held similar Christian beliefs as me and he has helped me a great deal. I would encourage any vet to contact the local VA for any issue - you will be treated as the patriot that you are.

First things first, thank you for your service to our country. Second things first, welcome to Free Republic!

I am so glad to read of your glowing recommendation's of the VA. I frankly feel as though they have taken lesson's from war's past and improved their system to meet the needs of those of the recent conflicts.

Our men/women deserve the best upon their return from war. Whether they are need of medical care, support for post-combat stress it appears they have made sure this is priority number one and I applaud their efforts. Continue to let us know of your experience's with the system, if that is all right, to give us that insight that many only read through the MSM and sometimes their bias shows and it would be nice to have a first hand account.

As for the specialty clinics, it does not surprise me. My husbands dad, a fine Officer, a fine soldier, a fine Vietnam Veteran as well retired but goodness gracious for him to get his hearing checked and the follow ups and than the devices took many, many months, far to long and frankly unacceptable. I feel strongly that those who have served our country and given their lives for the protection of our country should deserve once retired a jump to the head of the list for medical care. Hey call me patriotic but I as a dependent I would be most happy to give up my appointment, my place in line at the pharmacy to afford one of our patriots that respect and honor, seems the least I can do, but, alas the only thing I can do is offer my number while I am at the pharmacy waiting for a prescription. Before anyone reads this and says what about the Active Duty guys, they all ready jump to the head of the line as it should be.

I am terribly sorry to hear of your marriage ending in such a fashion. I am aware of breakups and it is more than I care to admit to. From the first Gulf War as troops returned to Campbell or the current, Iraqi Freedom where the guys return, to their loved one's in their bed with another. Oh, to give me a 45. Oops, that is kind of strong but I believe marriage is well MARRIAGE.

I am glad that you have been able to use what is available to assist you through this transition in your life. I hope you are the example to other's of what is available and that is OK to access such assistance.

Again, WB, thank you and I am sure that other's Freeper's would say the same, thank you and if there is anything we can do for you, do not hesitate to ask.

FMC

Thank you for the warm welcome. In regards to the VA, I often step back in line to allow the elderly to go ahead of me. My disability percentage (40%) gives me a sort of priority status, but to me, those who have gone before deserve the priviledge. My primary care physician is an outstanding doctor who has received glowing reviews from his patients as well as other doctors in the community. The psychology department at the Lincoln NE VA is (in my opinion) second to none. The doctors and caretakers continually provide the best care available. My psychologist, for example, gave me his personal cell phone number and encouraged me to call him at any time I was in distress - nights, weekends, early mornings, etc. It is for this reason that I encourage all veterans to take advantage of their benefits (you have earned it) and visit the VA. You will find no better value for your money (which is nearly 0 anyway). So no one tries to claim otherwise, I am not paid in any way by the VA, simply a well treated Marine Corps veteran and proud of our VA system and our country. I took the oath and stand by it today, I would for this country and what we stand for.

Thanks for your service.

According to my father and other veterans I've talked to: The Veterans Administration used to be an excellent place for veterans to go for medical services, and it was so up until somewhere after Korea; perhaps some time during Vietnam is when it changed for certain. It became where vets went to die, not be healed. The VA was the absolute worst place for care in the US. Several VA facilities were shut down because the care was just that bad. Interestingly enough, this coincided with JFK/LBJ's tenures... Nothing changed from then through Jimmah's term. I remember visiting VA facilities as a child; they were dirty, insect-ridden neglected buildings.

Per allhealth.org's synopsis, which I cannot better: "President Ronald Reagan signed legislation in 1988 creating the Department of Veterans Affairs (VA), which assumed responsibility from the Veterans Administration. The mission, as inscribed over the entrance to VA headquarters in Washington, is simple and sweeping: "To care for him who shall have borne the battle, and for his widow, and his orphan." "

Reagan flushed the old, dead, disrespectful VA down the tubes and created a replacement that is far, far better than what used to be there.

The Reagan Revolution continues, even after his death.

I do not think anyone for a moment would feel you are providing a paid commercial for the VA. I think it is terrific to have someone who is in the cat birds seat so to speak of how they are treated.

As I said I can speak from my father-in-law's point of view, I can speak as dependent and do not get me started on Tricare but if you do a little research on my threads I am sure you will find some where I give a candid and less than glowing review and frankly for me that is all right I know how to work through the system. But, what about the young military family whose loved one is in the Guard and is called up the Tricare system can be very intimidating.

The stigma once associated with post combat stress appears to have disappeared. I understand someone on Active Duty should want to be thought of a soldier's soldier but to give your best to YOUR troops you must be at a 100% and to say that war does not affect you is hogwash. It affect's everyone differently but just knowing someone who has been affected in such a way in the end affects you so take to advantage of the programs that are available is essential and frankly criminal if you choose to not take advantage of it.

Please tell you psychologist that I am appreciative of how he handles his returning warriors it is an example worth applauding and held up to his fellow peers.

It sounds like you came from excellent stock as well, to allow another to go ahead of you. It is the right thing to do and I tell you as I sit in the waiting area at the pharmacy I look at those who came before me, who paved the road for my service to our country, for my husbands service to my country and they are the people whom will pave the way for all that follow after you, my husband, my dad, my father-in-law and all those who have served.

Thank you for reminding me of those who gave and those who gave the ultimate sacrafice, is is something I will give mention in my prayer's this eve.

-FMC

FMC,
We are definitely on same page. Those who have gone before bear the greatest respect and deference. As for TRICARE, I could occupy a website with my gripes. I am not a medical administrator, but I can say that this is a system with problems and need for reform. I am not about big Gov't and programs and so forth, but when it comes to vets and their fams who have sacrificed much for our way of life, we must provide for them! As far as those who feel the need to be a man's man, I can understand. I had my troops under me, and it's more than just that. Most Civs do not understand, the level of responsibility goes beyond work, it goes to LIFE. At this point all I have been able to do is to talk to the vets that I know who have been in those situations and encourage them to alk about their experiences. It's hard though, my own brother had his best friend die in his arms in Nasiriyah, and he will not talk to me, a VA doc or anyone. Nothing you can do in this situation.

I welcome all our Iraq war vets home and encourage them to take advantage of any assistance they can to help them with PTSD or other problems incurred from their service. I wish I had done so.

I served three combat tours in Vietnam as an infantryman - helicopter door gunner and infantry platoon sergeant. I saw extensive combat. I never got the Purple Heart, but did receive other high decorations for my service. I had no physical scars, but I had scars nevertheless.

I retired in 1985 and never sought any help for any of my ailments. The doctors giving the retirement physicals assumed everyone was going to apply for disability, their attitude was so snotty and arrogant I did not apply for any. Of course the same people that treated me so badly retired themselves eventually and I will wager they applied for some type of disability. My PTSD problems got worse My first wife and I devoiced and most of the reasons were from my service. I couldn't let go then and can't let go now. This is why I went to Iraq and worked as contract security providing protection for clients in Iraq involved in the rebuilding of that country. Some of the experiences and sights I saw there were just as bad as Vietnam.

The reasons I never filed a claim with the VA is what I listed above, plus their was a stigma attached to saying you were suffering from PTSD both social and professional. Then was society itself who looked down on Vietnam vets as whiners, drug abusers and killers. Yes, there are people out there they took advantage of the program, but there are a lot more that needed the help and didn't want to be stigmatized. Now I am probably too old and it has been a long time since I left Vietnam and I don't know if I can get the help.

That is why I urge anyone coming back from Vietnam to seek help early and don't be so prideful that you hurt yourself and your family later.

I have held jobs since then that required a security clearance and carrying a weapon. If I had sought help then I would have lost my clearance and the

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