Troops from Iraq & Afghanistan Different from Vietnam Vets | Print |  E-mail
Monday, 01 February 2010
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Hello again.

I was talking with some V.A. colleagues, and they were telling me how the new vets coming back from Iraq & Afghanistan are a very different breed 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 and we took our anger out on each other, and on the vets, who came back.  The vets were very angry about being sent out to kill people and then getting castigated for it once they got home.  We traumatized them all over again.  

On the other hand, this new group of soldiers are appreciated by society at large, for putting themselves at risk – even by people who aren’t particularly happy about the wars. That’s one lesson we sure learned the hard way: not to take the politics of war out on the troops who fight them.

Of course, most of our Vietnam troops were draftees.  Nowadays we have an all-volunteer army. (But then again, a lot of the reservists and National Guardsmen thought they were signing up to get some extra money and help out in national emergencies.  Little did they know they’d be away from their families and careers, on their fourth 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 Vietnam troops didn’t know what was happening to them.  Based on what we knew 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 PTS.  But 2-3 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%.

(In any combat situation, the estimates are that 95% of exposed people have symptoms immediately afterward. Gradually these subside over 90 days for most people, even without treatment.  But after about 6 months, there’s a core number - between 22% - 35% - that can’t get past their symptoms on their own and need help.  It will be interesting to see, now that we have women in combat too, whether these stats stay the same.)

This new group in Iraq and Afghanistan knows what’s happening to them, to a much greater extent. There’s been a push to educate the troops and the general public about posttraumatic stress and this new kind of traumatic brain injury, thanks to a strong commitment to the mental health of our troops, found in both the DoD and the VA.  Secretaries Gates and Shinseki have been working hard at destigmatizing mental health issues, in ways never seen before. So that’s another lesson learned from Vietnam, and no small matter.

There’s also, frankly, a different kind of drug abuse going on. These troops are given legal drugs by docs who are now placed downrange 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 twenties.  They’d started thinking about their lives in a more reflective way, especially when they started having combat stress-related difficulties with their relationships and their jobs.  

For the younger troops coming back from Iraq & Afghanistan, there’s an impatience with the talking cure.  They want to get on with their lives and won’t spend time talking and reflecting and pondering.  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 8-4 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%. - 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%.  Last on the list? Yep, you guessed it: sitting with a therapist.  

So now that we’re learning about these barriers to receiving help - some quite positive, by the way (What’s wrong with not wanting to be a career patient, by the way?)- there will hopefully be much more widespread use of self-administered guided imagery downloads - shown at multiple research sites to reduce symptoms like little else, while being a pleasant and self-rewarding experience for the vet - not to mention inexpensive and useable even in remote locations.   

We are getting so much more interest and openness in 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.

Take care and be well,



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Comments (16)Add Comment
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written by Consuelo, February 02, 2010
Yeah! You go Belleruth! I love hearing that people are taking advantage of the audio CDs/downloads. Thanks for a fascinating article. And yes, whenever I happen to meet a Vet, I always say "Thank you for your service."
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written by zottal, February 02, 2010
I love that concept, "career patient", and the new vets not wanting to be one. Sheez, who does? I think we
CAN look at it as a question of balance. It makes sense that younger people are more impatient. I was, too, at that age. Dragged kicking and screaming to therapy at 17 y.o., I felt that by letting a Jungian explore my soul I was handing over the keys of the United States to the Axis in WW II! Desperately needed help and was completely unaware. It's hard to get patients in for therapy, vets or not. Family can help. Often when the police will refuse to intervene before a violent crime is committed, family is the last resort. Was not violent, but I heard of an instance where this happened. Even without violence, a stark need for therapy can be difficult and annoying for a person's family. Yet, I think CBT/DBT is great for everyone.
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written by Linda, February 02, 2010
I wonder if there are studies on their receptivity to body based therapies such as massage, bioenergetics, Barbara Brennan Healing, etc?
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written by Pat , February 02, 2010
Bravo BR! Thank heaven someone's doing the hard work of understanding and explaining these key differences. They're really dramatic yet all we hear usually is that same-old/same-old resignation. The big and wonderful surprise is that returning vets already know how invaluable meditation/relaxation/PTSD recordings can be.
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written by Mary, February 02, 2010
Have a friend coming home from his second deployment (one to Iraq, one to Afghanistan) both in non-combat roles. Wonder what he will need?
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written by Valli, February 02, 2010
What are the stats on suicide rate of returning vets? My son shared with me that another soldier in his Company was lost to suicide. I also wonder what I can do to support my son. I did give him the welcome home pack. I told him I need to do what I can because my father and brother both experienced PTSD. A third generation is too much.
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written by Belleruth, February 02, 2010
Not sure about absolute percentages, but Sec'y Shinseki announced recently that the rate among 18-29 yr old men had jumped 26% between 2005 and 2007. And that an average of 18 veterans commit suicide each day.
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written by George Smith, February 02, 2010
I don't like the comment that "most of our Vietnam troops were draftees." I knew more regular army, as I was, than draftees when I was there in '65-'66. And what different does it make if a soldier was a draftee. They still served their country and 58,000 plus gave their lives. I resent the implication that draftees were less that voluntiers. They bled and died just like us voluntiers.
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written by bb, February 02, 2010
You made me smile and tear up with this note---tho', honestly, for me that's not hard to do these days! Was delighted this past week to see an article in our small town local paper with the headline: "Veterans will get review of benefits related to PTSD" by an AP writer in DC relating that: "The military has agreed to expedite a review of the records of thousands of Iraq and Afghanistan veterans discharged with post-traumatic stress disorder to determine whether they were improperly denied benfits". Progress!
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written by Belleruth, February 02, 2010
George,
You're reading a value judgment in what I said, where I was just stating a fact. I was around then too - I'm 67 yrs old. What do you think I was saying? (Not a rhetorical question. I want to know.)
BR
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written by Belleruth, February 03, 2010
Valli, I just realized I didn't answer the second and more critical question - what can you do to support your son while he's downrange. Mary asked for when her friend gets back.
For while he's overseas, one important way to try and prevent the potential acquisition of PTSD, as far as we can tell, is encouraging him to do self-regulating techniques that inherently stabilize and calm mood when he's at rest or waiting around - so practicing things like yoga, qigong, breathwork, guided imagery, progressive relaxation, breathwork - all of these things put the neurophysiology on 'manual', so to speak. And becoming adept at one or two of those things will help him get back into balance faster and more effectively after a traumatic encounter. We have three quick exercises on the Stress Hardiness Optimization recording, plus some imagery for relaxation and some imagery for sleep.
The Military WElcome Home Pack is better for when they get home. The imagery is more intense and targeted, but it's easier used when completely out of harm's way.
Hope this helps. BR
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written by Valli, February 03, 2010
Thank you Belleruth for addressing both of my questions. My son has been home since 2/09. Thanks again.
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written by Beach Dancer, February 03, 2010
BR , thanks so much for your work with PTSD and your acknowledgement of our veterans. Sincerely hope my brother and son-in-law.....both Vietnam vets will pay attention and see the hope for themselves. Is the Military Welcome Home Pack appropriate for them too......even after all these years ? they are both alcoholics, obviously self-medicating, and one is for sure verbally abusive to his wife.

Thanks
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written by Bonnie, February 04, 2010
May I share with Beach Dancer that I bought the Military Welcome Home Pack for my brother...a Vietnam vet with a VA dx of depression and alcoholism (and perhaps pts...he was reluctant to share the first 2 dx's, tho' could not disguise the truth any longer following a suicide attempt just after the war in Iraq began). Amazingly, after so many years of pain and denial and anger, he just recently began listening to the imageries and I am seeing/chatting via email more and more each day with the brother who 'disappeared' so very long ago. How we wish our Dad and some of the others who are now deceased could be part of this as well. Blessings!
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written by Beach Dancer, February 06, 2010
thanks to Bonnie for the encouragement..........our brother made a suicide attempt on a July 4th several years ago.........as far as i know is still in denial. Glad to know there is still hope. Blessings to you.
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written by Chris desjardins, July 05, 2010
Whatever happened to the research going on in LaJolla CA comparing EMDR to guided imagery combined with healing touch on veterans. I can't find any info on your website anymore.

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