by Darren T. Bean
Editor’s Note: The Havok Journal publishes a wide variety of perspectives and welcomes thoughtful rebuttal articles. If you want to add your voice, send submissions to firstname.lastname@example.org.
This is written in rebuttal to The Havok Journal article, “PTS… D? A Disease is Not a Disorder,” by Special Guest Marty Skovlund Sr. I would like to respond to this article to make some corrections, offer more constructive advice, and look at the big picture. First of all, mad-respect to Mr. Skovlund Sr for the work he has done in the past. Our Nation loses whenever another Warrior leaves our soil.
While there is zero evidence to suggest that changing the title of Post-Traumatic Stress Disorder (PTSD) to Post Traumatic Stress (PTS) or Post Traumatic Stress Injury (PTSI) will help provide better care, reduce the stigma of the trauma-based physical response of the brain, there is much to be said about what happens if that change occurs. But first, let us address some of the lowlights of this article.
In paragraph 5, Mr. Skovlund Sr writes that, instead of medications, peer-to-peer interactions with others are what is really needed to effectively treat this injury/disorder/illness.
I am not a medical professional but have been a hardcore study of PTSD since I founded a nonprofit for Veterans in 2010. This statement is not medically or alternatively accurate. While we may have medical professionals who overmedicate us, medication is key for the lion’s share of us to get to the point of counseling. Many of us are in a place, untreated, who refuse to take meds for the sake of refusing to take meds. These meds bring us down to a normal, steady-state, rather than the highs and lows incumbent with PTSD.
Once in that steady-state, we are able to recognize the value of counseling. The purpose of counseling is to identify the root cause of the problem and then work on changing the outcome of the feelings and actions that come from that root cause. Medication alone, or self-medication which many of us foolishly resort to, will not do the job. It only gets us to a place where we can fix or reduce the results of the problem.
The idea that hanging out with other Vets, usually done at one of the many Veteran Service Organizations’ smoke-filled, 24-hour happy hour bars is what is needed is not only wrong but dangerous. First of all, if we have PTSD, the first thing we need to not be doing is self-medication through alcohol sadly reminiscing over that sad day when our problems all began. You aren’t getting better by going to the Legion and knocking back a 12er, a pack of smokes, and 4 beef jerkies. While peer-to-peer interactions are healthy for us to talk about what we are feeling and what is happening to us to know we are not alone in our struggles, it is not the basis of treatment, certainly not in that environment.
In paragraph 6, the author writes that we should link back up with other Veterans to maintain that camaraderie. Again, this is false. To transition out of our military service, something I refer to as Chapter 2 in my blog The Warrior Chapters, we need to learn to interact with the general population and build bonds at church, at work, and in our neighborhood. Again, it is ok to do peer-to-peer, and in fact, it’s good. But making that our outlet for camaraderie keeps us dwelling on the past, stuck in Chapter 2 instead of moving on to Chapter 3, the post-service part of our life. If we stay in that world, we will never successfully move on in this new chapter. The author is also conflating working on PTSD with working on service adjustment disorder. These are two distinct issues.
In paragraph 10, the Special Guest refers to 20 Veterans suicides a day, a rhetorical number that is damaging to Veterans. We glorify the term “22 a day” like it is part of some cool club to belong to instead of using the facts. Ever since the 2nd VA Annual Suicide Report came out, the number has been on average, 17.8, peaking at 18.6 per day. Over 20 was never a real statistic as the first VA report was admittedly only taken from just over 20 states and then extrapolated for the rest of the country. We must stop using this t-shirt selling term and talk about real numbers so we can make real progress.
Now, let us talk about the removal of the term disorder and leaving it at PTS or PTSI. Removing the D and just calling it PTS would be more damaging, stigma-wise, than how it is now. If we do not refer to it as a disorder, injury, or disease, and just call it stress, then we are insinuating that we can “just get over it.” It is not just something we can get over. We need medical attention. The sooner the better.
I would like to see us use the term PTSI as it is a physical change to the brain and, like any other injury, is repairable. Not everyone will be healed but most can. Calling it a disorder and the VA giving you permanent compensation for it, thus telling you it’s permanent and unfixable, is irresponsible. It is treatable and curable for most people if done early. Your brain has rewired due to trauma. It can be rewired through counseling, medication, Eye Movement Desensitization and Reprocessing (EMDR), Stellate Ganglion Block (SGB), etc. But, with that comes work and the possible loss of compensation if fixed, which Veterans hate to do.
We must address this injury like any other, getting professional help to return to “normal” and not just accepting “welp, I have PTSD for life, so, I’ll be the disgruntled Vet”. We also confuse service adjustment disorder with PTSD. PTSD does not involve being a jerk, being angry all the time, hating our coworkers, thinking our boss is incompetent compared to us, thinking our job is meaningless, thinking our family sucks because they have “no idea what we went thru”, drinking hard, etc. That is service adjustment disorder. We are not adjusting to a completely different chapter in life.
PTSI is nightmares, hypervigilance, flashbacks, and avoidance of similar situations, among some other things. There is a chance, also, that if the Diagnostic and Statistical Manual of Mental Disorders V (DSM-5) next version, DSM-VI, changes it to an injury, the Veterans’ Administration (VA) could say that if they fix you, you don’t get compensation for life and do reevaluations, possibly.
I think that the VA possibly reevaluating you, periodically, after receiving treatment, and changing your compensation may not be a bad thing. If you need treatment or medication for life, ok, keep the compensation. But, if you can be healed, and medical professionals will tell you that you can, then why would the VA still give you compensation? The goal is to not have PTSD, right? The goal is not to be disabled, right? The goal is to move into Chapter 3 of our life as a productive member of society, matriculating into society, coaching our kid’s Little League team, passing the plate at church, being a good employee or business owner, and being a good neighbor, being a leader, right? In my humble opinion, the VA does us a disservice by giving us 100% Permanent and Total compensation for PTSD. They are saying what you have is permanent, can never be fixed, so sorry “sucks to be you. Thanks for your service.”
The author, in paragraph 8, also throws in, basically, the old “they have no idea what it is like to have PTSD and what I went through” rhetorical crap that has nothing to do with our treatment and recovery and in fact just makes it worse. It doesn’t matter if “they” know what I went through. “They” aren’t part of MY treatment.
I have spent the better part of this rebuttal apparently slamming the late Mr. Skovlund Sr, father of the founder of The Havok Journal, for his words. Alas, that is not my intention as those were not just his words. Those are the words of a ton of Veterans out there today. I see it every day in forums, chat rooms, social media, and in responses to my blog. So, my goal is not to berate the dead, but rather awaken the living to a better way.
Darren is a 2nd generation US Army retired Sergeant Major; was the founder and President of the Warrior Thunder Foundation, a Veteran nonprofit; developed combat equipment as a DoD civilian for 9 years, and now works for a consulting company that helps the Army modernize its equipment through the use of small and Service-Disabled Veteran-owned businesses as well as companies that employ people with disabilities. He writes a blog that can be found at www.warriorchapters.com