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Welcome to CombatCounselor Chronicle, an E-zine dedicated to giving you the most current, pertinent information on cognitive behavioral therapy (CBT) and mindfulness-based CBT available.

Chris Sorrentino, a.k.a CombatCounselor, is a leader and expert in cognitive behavioral therapy. He combines 30 years of experience in psychology with the discipline from having served as a U.S. Air Force officer for 20 years, 4 of those in combat zones, retiring as a lieutenant colonel in 2005.

The Leader in Military and Veteran Psychology ... Follow Me to Mental Health!

Friday, May 15, 2015

Very Polite Automated Italian Toll Booth Machine

Neapolitans are not exactly well known for being civilized, and because my family is originally from the area I am being polite, but their automated toll booth machines certainly are ... watch this very short video to see for yourself ... "arrivederci"!



Title: Very Polite Automated Italian Toll Booth Machine

Key Words: polite, Italian, toll, booth, tollbooth, tole, machine, arrivederci, Tangenziale, Naples, Napoli, money, funny, viral, video, CombatCritic, travel, value, TravelValue

Wednesday, May 13, 2015

Resilience: Armor for Your Mind

Listen carefully to what I say, but don't believe a word of it. Language and rule-governed behavior have severe limitations, experience does not.

We can't change evolution's work, but we can alter what we pay attention to (mindfulness) and how we REACT to "perceived" threat (acceptance).

Resilience is key to mental health and is something you can enhance through acceptance of and willingness toward aversive events. Are you focusing on the content of your life (thoughts, sensations, emotions) or on the context (what's happening right now)? You do have a choice.

NOW, GET OFF YOUR BUT! Yes, it's spelled right. Replace the word "but" with "and" and accept responsibility for your behavior and your life. Try it, see how it feels.

StayPresent ... StayTheCourse ... BeResilient!

Title: Resilience: Armor for Your Mind

Key Words: anxiety, combatcounselor, depressed, depression, health, kccbt, mental, resilience, resilient, therapy, fear, armor, mind, PTSD, BeResilient, chronicle



StayPresent, StayTheCourse, and BeResilient are Trademarks Of CombatCounselor and 3rd Wave Media Group, LLC - All Rights Reserved

Tuesday, May 12, 2015

Watch The CombatCounselor Channel on YouTube ... Over 500,000 Views!

CombatCounselor During Kosovo Operations - March 1999

                         

CombatCounselor with the first-ever Czech Republic NATO airlift
mission in Skopje, Macedonia during Operation ALLIED FORCE
Russian Antonov AN-124 in the background


Title: Watch The CombatCounselor Channel on YouTube ... Over 500,000 Views!

Key Words:  "CombatCounselor Q and A" "The CombatCounselor Channel" series "Body-Mind-Behavior Therapy" questions viewers show Twitter CombatCounselor YouTube, 

Tuesday, December 9, 2014

Clay Hunt Suicide Prevention for Veterans Act ... Great Idea, Poor Execution

By C.T. Sorrentino, LtCol, USAF (Ret)
      LPC, NCC

In regard to the Clay Hunt Suicide Prevention for American Veterans ACT, the legislation states:

Clay Hunt Suicide Prevention for American Veterans Act or the Clay Hunt SAV Act - (Sec. 2) Requires the Secretary of Veterans Affairs (VA) to: (1) arrange for an independent third party evaluation, at least annually, of the VA's mental health care and suicide prevention programs; and (2) submit a report to Congress, by December 1 of each year, containing the most recent evaluations not yet submitted to Congress and any recommendations the Secretary considers appropriate. 
(Sec. 3) Directs the Secretary to survey the VA's existing Internet websites and information resources to publish an Internet website that serves as a centralized source to provide veterans with information, updated at least once every 90 days, regarding all of the VA's mental health care services.(Sec. 4) Requires the Secretary to carry out a three-year pilot program to repay the education loans relating to psychiatric medicine that are incurred by individuals who:

are eligible to practice psychiatric medicine in the Veterans Health Administration (VHA) or are enrolled in the final year of a residency program leading to a specialty qualification in psychiatric medicine; 
demonstrate a commitment to a long-term career as a psychiatrist in the VHA; and 
agree to a period of two or more years of obligated service with the VHA in the field of psychiatric medicine, as determined by the Secretary.
Limits the loan repayment to no more than $30,000 for each year an individual performs such obligated service.
The Clay Hunt SAV Act is a great start and long overdue, but shortsighted considering that over 8,000 Veterans commit suicide each year.  Psychiatrists, like all medical doctors (M.D.), are mostly concerned with prescribing pills, which is not the answer for post-traumatic stress disorder (PTSD) or many other psychological problems (anxiety and depression, the most common psychiatric conditions) for that matter. Pills only mask the symptoms of an underlying problem (disorder) and, in most cases, do little or nothing to help resolve the problem. After over 30 years in the field, I am not aware of a single medication that “cures” a psychological disorder. Psychotherapy by a trained, licensed professional is currently the most effective treatment for anxiety and depression and, by the American Psychiatric Association's (APA) own admission, the cognitive behavioral therapies (CBT) are the most effective treatments for most disorders.

The APA, a large and powerful special interest group, and proponent of the "medical model" (physicians/psychiatrists and pills/"Big Pharma" ... another massive and very powerful special interest group), has blocked Licensed Professional Counselor (LPC) access to many government programs because we (LPCs) are a threat to the status quo. If people (Veterans in this case) actually receive treatment (therapy) and resolve or reduce their psychological problems, what need would there be for psychiatrists and/or pills? There would be little or none ... big problem for psychiatrists and the big pharmaceutical companies that bring in tens of billions of dollars each year from psychotropic medication (antidepressants, antipsychotics, etc.) prescriptions.  So the APA does whatever they can to make sure LPCs are blocked from government jobs and contracts just as they are doing by controlling puppets like Paul Rieckhoff, IAVA, and Congress, ensuring that only psychiatry students receive financial support (and, eventually, jobs) under the Clay Hunt SAV Act.

Paul Rieckhoff, founder and CEO of Iraq and Afghanistan Veterans of America (IAVA), of which I am currently a member, possibly for not much longer, sits atop his throne at HQ/IAVA on Madison Avenue (another topic altogether - why does a non-profit need an office on Madison Avenue when that money could be going to help Veterans?) and makes decisions affecting millions of Veterans, apparently without proper counsel. When a longtime proponent of and advocate for effective mental health treatment for our Veterans, me, a retired military officer and Veteran of four combat operations as well as a clinician with decades of experience treating military and Veterans with PTSD, anxiety, and depression offered constructive criticism to Mr. Rieckhoff on Twitter:
Mr. Rieckhoff responded with this defensive and poorly conceived notion:
Beside being defensive when an expert in the field offered very accurate, factual, and compassionate advice with only the best interests of Vets in mind (I am not selling anything, do not have an office on Madison Avenue, nor do I have a massive ego to feed by getting face-time with Congress and the President of the United States), Mr. Rieckhoff is either completely ignorant and/or controlled by the powerful special interests (e.g. APA, big pharma) if he truly believes that, pardon my English, bullshit. 

Of course the APA disagrees with me because they have a very big dog in that hunt ... it is called money, a lot of it! In regard to "every veteran group in America", they would of course be remiss not to support such legislation to reduce Veteran suicides.  The problem being that, like Mr. Rieckhoff and IAVA, those groups also do not completely understand the issue.  Mr. Rieckhoff obviously also does not understand that Licensed Psychologists and LPCs are key to effective therapy and the long-term resolution of psychological problems, not just the symptoms, helping America's Veterans to heal, not just cope with their symptoms (e.g. taking antidepressant medications).

According to Roethel (2012), the National Center for Health Statistics reports that:

1. Americans are taking more antidepressant medications than ever before. When researchers compared the data from 1988 to 1994 with data from 2005 to 2008, they found that the rate of antidepressant use increased by almost 400 percent. 

2. Antidepressants rank among the top prescription drugs among U.S. adults up to age 44, they are the most common prescription medication for Americans between the ages of 18 and 44, and the third most commonly prescribed drug across all age groups.

3. 60 percent of Americans taking antidepressant medications have used them for two years or more and 14 percent have taken them for more than 10 years.

4. 11 percent of Americans over age 12 take antidepressants.

According to Cohen (2007), the "U.S. Centers for Disease Control and Prevention looked at 2.4 billion drugs prescribed in visits to doctors and hospitals in 2005. Of those, 118 million were for antidepressants" alone.

Big Pharma has long been tied (financially) to the APA in general and psychiatrists in particular:
In March 2009, the American Psychiatric Association announced that it would phase out pharmaceutical funding of continuing medical education seminars and meals at its conventions.  However, the decision came only after years of controversial exposure of its conflict of interest with the pharmaceutical industry and the U.S. Senate Finance Committee requesting in July 2008 that the APA provide accounts for all of its pharmaceutical funding.  Despite its announcement, within two months, the APA accepted more than $1.7 million in pharmaceutical company funds for its annual conference, held in San Francisco. 
With the U.S. prescribing antipsychotics to children and adolescents at a rate six times greater than the U.K., and with 30 million Americans having taken antidepressants for a “chemical imbalance” that psychiatrists admit is a pharmaceutical marketing campaign, not scientific fact, it is no wonder that the conflict of interest between psychiatry and Big Pharma is under congressional investigation. (CCHR International, No Date)
New Yorker Magazine reported (Greenberg, 2013) that “It’s been just over twenty-five years since Prozac came to market, and more than twenty per cent of Americans now regularly take mind-altering drugs prescribed by their doctors. Almost as familiar as brands like Zoloft and Lexapro is the worry about what it means that the daily routine in many households, for parents and children alike, includes a dose of medications that are poorly understood and whose long-term effects on the body are unknown. Despite our ambivalence, sales of psychiatric drugs amounted to more than seventy billion dollars in 2010. They have become yet another commodity that consumers have learned to live with or even enjoy, like S.U.V.s or Cheetos.”

Unfortunately, there are also many uninformed or ignorant people in the world who do not understand the difference between psychiatrists, psychologists, counselors, and social workers, much less all of the unlicensed frauds out there taking advantage of people and the system, lumping all psychotherapists under the label "psychiatrist". FYI folks ... a psychiatrist is a medical doctor (M.D.) and normally prescribes pills, being much different than psychologists, counselors, and social workers who are trained primarily in psychotherapy and do not prescribe medications. You can read more about the differences here.

I recently asked you to please show your support for the Clay Hunt SAV Act by writing to your representatives and let them know that something must be done to help reduce the number of Veteran suicides (22) each day and that the answer is not more psychiatrists in the Veterans Affairs (VA) system or subsidizing their education. As I stated, the best answer is effective, empirically supported treatment by well-trained, licensed, professional psychotherapists (psychologists, LPCs, and social workers), insisting that the Clay Hunt Suicide Prevention for Veterans Act MUST BE AMENDED to also include the subsidizing of LPCs, social workers, and psychologists in-training, not just psychiatrists. 

Unfortunately, Mr. Reickhoff apparently does not like to listen to Veterans or experts in the field before proposing legislation that affects millions of Veterans and reduces the number of suicides as the Clay Hunt SAV Act has now passed both Houses of Congress with no changes.  What a shame! Maybe if Paul Rieckhoff cared about Veterans as much as his massive ego, he would have consulted with real experts instead of only the large special interest groups before drafting such a critical piece of legislation affecting our brothers and sisters-in-arms.

Do not get me wrong, the Clay Hunt SAV Act is a start and I am extremely pleased that our government has finally recognized that there is a problem as well as a need for a solution. I am only saddened by the fact that such a poorly conceived notion, that more psychiatrists are the answer to the Veteran suicide problem, was put before Congress and ultimately the President for signature in this landmark legislation.


You can read more about my views on mental health treatment, and the associated stigmas, among military and Veterans as well as the implications in regard to PTSD and suicide in my article: The Stigma Killing American Heroes on my blog and as published in De Oppresso Liber magazine.

Here are a few more articles from my blog that are related to the information detailed above if you want to do some more reading:







References

CCHR International (No Date): Shrinks for Sale: Psychiatry’s Conflicted Alliance - The Corrupt Alliance of the Psychiatric-Pharmaceutical Industry
http://www.cchrint.org/issues/the-corrupt-alliance-of-the-psychiatric-pharmaceutical-industry/

Cohen, Elizabeth: CDC: Antidepressants Most Prescribed Drugs in U.S., July 9, 2007, CNN: 

Greenberg, Gary: The Psychiatric Drug Crisis. New Yorker Magazine, September 3, 2013 Issue – Elements: http://www.newyorker.com/tech/elements/the-psychiatric-drug-crisis

Roethel, Kathryn: Antidepressants - Nation's Top Prescription, Published 4:49 pm, Tuesday, November 13, 2012, SFGate: 


Title: Clay Hunt Suicide Prevention for Veterans Act ... Great Idea, Poor Execution

Key Words: Clay Hunt Suicide Prevention Act, SAV, ACT, Afghanistan, America, anxiety, Clay, Clay Hunt, depression, Hunt, IAVA, Iraq, legislation, Paul Rieckhoff, prevention, suicide, veterans, PTSD


Tuesday, November 18, 2014

Reduce Defense Spending ... Are You Serious?

According to Money Magazine (October 2012, p. 85), 68% of those polled (Republicans AND Democrats) think the United States should cut defense (military) spending. Military Times has reported on numerous occasions that the Department of Defense (DoD), Congress, and President Obama all want to cut personnel and retiree benefits, that is a fact. What are these geniuses thinking? What is 68% of the population, supposedly, thinking? You got me friends!

We have been at war with Al Qaeda, and others, for 13 years and our military, if not dead already, are worn out, exhausted, and not really appreciated, even though "thank you for your service" has become the "catch" phrase since 9/11. Our heroes in uniform, past, present, and future, put their families, health, and lives on the line every day ... for your freedom folks.

So now that Osama Bin Laden is dead, we are out of Iraq (for the time being, in mass anyway), and things are winding down in Afghanistan, we have nothing to worry about ... right? Military retention rates are at all time highs thanks to patriotism and a weak economy, so why not cut their (active duty, Guard, Reserves, and retiree) pay and benefits or, better yet, drum them out of the service altogether so we can save a few bucks? Forget those promises we (the government, recruiters) made about job security, lifetime healthcare, pensions, and other "retention" tools ... the threat is gone, over, history, so why not cut defense spending (that is shorthand for personnel and benefits? Do you really think the military (DoD) is going to give up any planes, tanks, ships, or helicopters?

I don't know about you, but I have a couple problems with that kind of thinking:

First, we, as a nation, made promises to our men and women in uniform and cannot change course now. That is immoral! Can you say integrity? Apparently not. Politicians and others can "talk the talk", but when it comes to keeping promises made to recruits, they DO NOT "walk the walk"! KEEP the promises you made (integrity) to those serving and those who have served. If you want to make changes, make them effective BEFORE future enlistees enlist, not after we obligated to and/or faithfully served our country.

Second, the president, Congress, and DoD ARE NOT focusing on fighting a few terrorists here and there, they are focusing on two very real, very large, very lethal threats ... CHINA (and their redheaded stepchild North Korea), IRAN, and Russia (again) thanks to their nutjob president, Vladimir Putin.

China is a military and nuclear superpower with BILLIONS of potential troops and Iran is on the verge of becoming a nuclear threat (beside having one of the most potent militaries in the Middle East), and is threatening one of the most unstable and economically critical regions in the world today ... ON A DAILY BASIS! Can you say OIL? How about nuclear holocaust? Israel? Are you people out if your freakin' minds?

So why not cut porkbarrel spending, pet projects, a bloated government full of useless programs and lazy workers (that is a generalization, there are many worthwhile programs and civil servants), or even cushy pensions for serving in Congress for a couple of years? Or why does the government not target the BILLION$ that goes down the drain every year due to FRAUD, WASTE? Because they do not care, memories are very short, and if there is not an immediate threat, citizens are selfish and want all the money to come to their way. That is human nature and means the politicians need to keep those voters happy so they can be reelected and receive those cushy pensions ... right?

In conclusion, our shortsighted predecessors cut defense spending after World Wars I and II, Korea, Vietnam, and even Gulf War I, but guess what? That's right, we got caught with our pants down when the next conflict came along. Do you have any idea how much we waste as a nation drawing down and building up our military as a reaction to world events , or worse, elections? BILLIONS ... JUST LIKE THOSE BILLIONS OF CHINESE just a stones throw from the United States of America ... can you say Alaska (Sarah Palin can see Russia from her house after all)? What about Hawaii? There is a place in Hawaii called Pearl Harbor ... have you heard of it?

China recently launched their first aircraft carrier and their defense budget has been increasing by at least 12% annually for decades. Who do you think they are preparing for? Al Qaeda? North Korea? No, they are preparing to take on the largest superpower in the world ... U.S. ... and we are going to be caught with our pants down once again. Why? For a few more votes ... for a few more self-centered, shortsighted, ignorant morons ... that's right, we call them POLITICIANS (lawyers mostly and we all know what Shakespeare said about lawyers).

DO NOT FORGET TO VOTE! I am not going to tell you WHOM to vote for, but vote with your conscience, and, ABOVE ALL, vote for a strong military and hold your elected officials accountable for protecting the FREEDOM we in the military have worked so hard TO EARN and DEFEND. Vote for president in 2016 or you might just be voting for a Chinese Premier in 2020.

That's the end of that tune ... CombatCounselor...OUT!


Chris Sorrentino, LtCol, USAF (Ret)
aka CombatCounselor


This article can be published in its entirety with the permission of C.T. Sorrentino, aka CombatCounselor, 3rd Wave Media Group, and 3rd Wave Publications

Key Words: benefits, budget, China, cuts, defense, election, government, Iran, Korea, military, Obama, pension, personnel, politics, spending, Vietnam, voters, war, Osama bin Laden, 


Copyright 2012-2014 - 3rd Wave Publications - All Rights Reserved

Watch Inspirational Videos, including BMB Basic Training, on The CombatCounselor Channel on YouTube

Friday, September 26, 2014

CNN Says Obama's "Latte" Salute Is "Not An Issue" ... THIS PATRIOT DISAGREES!

On September 25, 2014, several CNN reporters alluded that President Obama's "latte" salute released by the White House a day earlier was not an issue deserving much attention. I watched initial footage of the "salute" (and I use that term loosely), was appalled (not surprised) and still am. If you have not seen it, here it is ...



The President of the United States is Commander-In-Chief of the United States Armed Forces and we in the military swear allegiance to the Constitution of the United States of America and, ultimately, our commander-in-chief when we enlist for service. Those two United States Marines you saw smartly and professionally saluting our president as he disembarked Marine One are the "best of the best", likely highly decorated combat veterans and deserving much more respect than President Obama was apparently willing to provide that day.

I have seen Obama's half-assed attempts at saluting my comrades in arms on numerous occasions, but the latte salute was a new low, even for him. If he truly respected our men and women in uniform, he would take his obligation more seriously and dispose of garbage before boarding or departing Air Force One or Marine One. 

How difficult would it be to remember his duty to salute his brave and dedicated subordinates every time he gets on or off the plane or, in this case, the helicopter dedicated to his safe transport. Could one of those in his massive entourage not hold his coffee for two minutes while he performs his official duties and pays respect to these young men and women whom risk their lives every day to ensure his protection? The very least he could do is give them the smart, professional salute they so richly deserve.

Key Words: Obama, CNN, Don Lemon, Don, lemon, president, commander-in-chief, commander, Marine, one, Air Force, TV, United States, Marines, President Obama, salute, latte, coffee

Wednesday, August 27, 2014

Reply To The VA Regarding The Hiring (Or Not) of Licensed Professional Counselors

I posted a tweet on Twitter (see below) about the sad state of affairs at the VA and their unwillingness to hire Licensed Professional Counselors (LPC) even though OVER 8,000 VETS COMMIT SUICIDE EACH YEAR AND THE VA DOES NOT HAVE ENOUGH CLINICIANS TO HELP PREVENT THOSE UNNECESSARY DEATHS.

I received a response from the VA, finally, and am posting my response sent to them via email today ...
In reference to my tweet and your reply:

CombatCounselor@CombatCounselor
@vacareers Retired military officer, combat/disabled #Vet, expert in#CBT for #PTSD, 30+ years experience ... UNQUALIFIED TO WORK FOR VA? - 26 Aug
VA Careers@vacareers
@CombatCounselor Thank you for your service. Send your CV Re:Twitter toVHAAdvertising@va.gov and we can take a look.
08:03 PM - 26 Aug 14
I am not currently looking for full-time work due to an upcoming commitment (October 2014-February 2015), but am providing my resume as requested. 
The issue seems more to be the fact that, even though the VA has been mandated by Congress to hire Licensed Professional Counselor’s (LPC) and has reportedly had great difficulty hiring the many clinicians required to serve the many Vets unable to access care for several years, LPCs have been ignored. I have searched USA Jobs on numerous occasions, but have yet to see more than a handful of LPC slots a VA facilities nationwide and none in my area. The VA is missing out on hiring well trained, experienced, professionals by bowing to the demands of the professional associations protecting the “status quo” and the careers of psychologists and Licensed Clinical Social Workers, many of whom have inferior clinical skills to many LPCs. 
Veterans in the VA system and elsewhere need well trained, professional help with their depression, anxiety, and other mental health issues AND THEY ARE NOT CURRENTLY RECIEIVING THAT CARE! 22 Vets a day commit suicide and the VA cannot stand by and let another 8,030 Veterans die in the next year because you refuse to hire LPCs, particularly those with military backgrounds. 
I don’t expect the VA to ever hire me, even if I were looking for work currently, because it has been proven that retaliation against whistleblowers and others who tell the truth about the sad state of affairs at the VA is the norm, not the exception. I hope and pray that changes soon and that the VA puts the welfare of Veterans above those of the shortsighted gatekeepers insistent on maintaining the status quo instead of giving Vets the care the so desperately need and deserve after serving their country and PROTECTING YOUR FREEDOMS. 
You can read my article, The Stigma Killing American Heroes, published last year in De Oppresso Liber magazine on my blog, http://www.combatcounselor.com/2014/07/the-stigma-killing-american-heroes.html, where this email will also be posted. A copy will also be sent to my Congresswoman and Senator. 
Thank you for getting back to me. 
Sincerely, 
Chris Sorrentino 
LtCol, USAF (Ret) 
a.k.a. CombatCounselor 
MS, LPC, NCC
Do Vets and the VA a favor and CONTACT YOUR REPRESENTATIVE, telling them to "insist that the VA hire Licensed Professional Counselors and curtail the thousands of needless Veteran suicides each and every year!"

Key Words: VA, veterans, administration, affairs, department, government, whistleblower, retaliation, suicide, veterans, vet, vets, death, depression, PTSD, anxiety, die, dead, mental, health, stigma, CombatCounselor

Friday, July 18, 2014

The Stigma Killing American Heroes by C.T. Sorrentino, LtCol, USAF (Ret)

This article was originally published in De Oppresso Liber Magazine in January 2013 and is being republished here after the recent VA scandal and resignation of General Eric Shinseki to highlight the dilemma still facing our military and veterans ...

Abstract 

On average, one military member and 18 Veterans commit suicide each day, and post-traumatic stress disorder (PTSD) is a significant factor in many of those deaths. The negative stigma surrounding PTSD and military mental health treatment exist partly because the brave men and women who make up our military are hesitant to seek mental health treatment from military practitioners. Our young men and women in the military are returning from deployments having experienced horrifying events, either directly or as an observer. PTSD incidence is reported to be as high as 20 to 30 percent of our military returning from recent combat. Until military and civilian leaders understand the connection and impact the negative military mental health stigma has on our force's mental health and morale, these needless deaths will continue. The negative stigmas regarding PTSD and Veterans are perpetuated by the media. As long as these stigmas are perpetuated in the media, young heroes, our military and veteran men and women, will continue to die. We need a positive dialogue started in this country, educating the public, our elected officials, and military leaders, about the problems in military and Veteran mental health treatment and figure out a way to fix them soon! We also need leaders willing to give our men and women in uniform the confidentiality they need when seeking treatment for their problems, be it PTSD, depressions or anxiety. We need leaders who are going to do the right thing and end the negative stigmas against PTSD and seeking mental health treatment in the military … now, today, before one more American hero dies by their own hand!

By C.T. Sorrentino, LtCol, USAF (Ret) 
On average, one military member and 18 Veterans commit suicide each day, and post-traumatic stress disorder (PTSD) is a significant factor in many of those deaths. We as a nation waste billions on political campaigns, needless government spending, and personal luxuries each year, while many of our nation's heroes go jobless, homeless, and with inadequate mental health treatment, while almost 7,000 of them choose to end their lives ... that is correct, nearly 7,000 MILITARY AND VETERANS COMMIT SUICIDE EVERY YEAR!
Being a Veteran of multiple combat operations over my 20-year career in the Air Force and a licensed professional counselor, practicing psychotherapy and treating military, Veterans, and “civilians” (everybody else) with anxiety disorders, including PTSD, and depression for nearly 30 years, I have a unique insight into the military, combat, and the effects both can have on the human psyche. 
PTSD has been around as long as humans have been exposed to trauma, and as long as there has been war, having been called many things over the centuries, including exhaustion, railway spine, stress syndrome,  shell shock, battle fatigue, combat  fatigue, traumatic war neurosis, and, most recently, post-traumatic stress disorder or PTSD for short.  
Combat stress reactions appeared as early as the 6th century BC when the Greek historian Herodotus reported one of the first descriptions of a PTSD-like incident:
During the Battle of Marathon in 490 B.C., an Athenian soldier who had suffered no combat injuries, became permanently blind after witnessing the death of a fellow soldier.  
A more accurate diagnosis of this reaction would be “conversion disorder” rather than PTSD, but it is an indication of the dramatic impact a traumatic event can have on a human being nonetheless. 
  
Many people think only of combat when they think of PTSD, but there are many causes, traumatic experiences, that can lead to PTSD symptoms, including accidents, physical and sexual assault/abuse, terrorism, as well as many others.  According to Department of Veteran Affairs (VA) estimates, seventy percent of the population will experience a trauma extreme enough to qualify for a PTSD diagnosis over the lifespan.  Oddly enough, also according to the VA, only 6.8% of all Americans will develop PTSD during their lifetimes, or roughly 10% of those experiencing a trauma.  Recent Veterans of the Iraq and Afghanistan Wars, on the other hand, suffer an incidence rate of 13.8%, nearly twice that of the general population.
PTSD is a medical diagnosis as defined by the Diagnostic and Statistical Manual, 4th Edition, Text Revision (DSM-IV-TR, APA, 2000) and the symptoms of PTSD include 1) hyper-arousal (exaggerated startle response, difficulty sleeping or staying asleep); 2) avoidance (avoiding things previously enjoyed or that remind the individual of the trauma); and 3) re-experiencing (flashbacks, nightmares or night terrors, daydreaming about the trauma).  An individual must experience a trauma so severe that the individual experienced extreme fear, helplessness or horror and the threat of death or serious injury in addition to all of the three symptom areas listed above (more than one symptom are required for diagnosis in two of those areas) in order to be officially diagnosed by a licensed clinician with “PTSD”.
Ignorance and bureaucratic processes, having needed changing for decades, if not centuries, are the cause of this stigma killing our young American heroes.  A stigma, because the brave men and women who make up our military are hesitant to seek mental health treatment from military practitioners.  They are hesitant and afraid, and rightly so, because their careers and/or security clearances could be at stake if they seek treatment from a military provider. 
I served in the Air Force for over 20 years, retiring in 2005 as a lieutenant colonel, and experienced the stigma firsthand. I would not and did not seek help for post-deployment anxiety and depression until AFTER I pinned-on my silver oak leaf and knew I would be retiring (meaning "they" could not hurt me). I spent four years in four different combat zones during my career, including "boots on the ground" in the Middle East one month before 9/11 and during the first year of Operation ENDURING FREEDOM, and the stresses of combat took their toll, although not enough to receive a PTSD diagnosis, thankfully.
I recently returned from Fort Riley, Kansas, home of the 1st Infantry Division, better known as "The Big Red One", where I provided counseling to soldiers returning from Afghanistan and Iraq. Two of the battalions I worked with suffered high numbers of casualties, with several killed in action (KIA) and many more wounded in action (WIA). Dozens of brave young men and women received purple hearts, having lost limbs and suffering other wounds, many invisible to the naked eye.
Not all wounds are visible, with traumatic brain injury (TBI) and Post-Traumatic Stress Disorder (PTSD) making up the majority of injuries to those returning home, many times caused or hastened by experiencing the effects of an improvised explosive device (IED), the current weapon of choice of Taliban and Al Qaeda terrorists. When a young man loses his leg, he is considered a hero, and rightly so. But when a man or woman "loses his or her mind", either through physical damage to the brain, as is the case in TBI, or emotional damage, as we see in those who have experienced severe trauma in combat, those coming home with PTSD, they are portrayed as weak or as malingerers by their comrades, or worse, the officers responsible for their health, safety, and well-being.
Looking down on or thinking less of those who seek help for mental health issues has been a problem in the military for centuries, but is also a problem in our modern, technologically advanced, contemporary culture here in the United States and elsewhere.  Ignorance in regard to psychotherapy and counseling is nothing new, and few people are enlightened enough to understand that it is a sign of strength, not weakness, to seek help or treatment from a qualified, licensed clinician, be it a psychologist, psychiatrist, licensed professional counselor, or licensed social worker. 
Unfortunately, there are many unqualified and unscrupulous individuals taking advantage of people weakened by emotional stress and the turmoil of modern life, and they have given psychotherapy a bad name. Therefore, it is no wonder that an uneducated and psychotherapy-ignorant public, so desperately in need of professional treatment, misunderstand and fear the many highly qualified, licensed, certified clinicians, helping and saving lives every day. 
Our young men and women in the military are returning from deployments having experienced horrifying events, either directly or as an observer. There are estimates that as many as 50 percent of those returning from combat come home suffering from a mental health issue of one kind or another. PTSD incidence is reported to be as high as 20 to 30 percent of our military returning from recent combat. Yet many, if not most, do not seek treatment because they are afraid that doing so will damage their careers.
I have seen it firsthand in my own career, in my private practice and non-profit, and with soldiers recently returning from Iraq and Afghanistan. Their leaders, who can be squad and platoon leaders (enlisted) or company, battalion, brigade, and division commanders (officers), do not understand the devastation TBI and PTSD can cause in a person's life. Many of these individuals, both the so-called leaders and the individual suffering from a mental health issue, simply refuse to acknowledge the pain and suffering, maintaining the ridiculous macho bravado and reputation of a "real soldier" or "real man" who does not ask for help. These young men and women may even have a caring and compassionate chain-of-command currently, but do not know whether the beliefs and attitudes of their "next" unit's leadership will be as flexible and understanding.  
Because mental (behavioral) health treatment in the military is not confidential and becomes a permanent part of an individual's medical record, any psychological treatment received, becomes a matter of record for future leaders to hold against an individual or a reason to deny a coveted security clearance. It is no wonder young soldiers, airmen, sailors, and Marines are afraid to step forward for treatment, and no wonder that suicide rates among military members has skyrocketed.
Until military and civilian leaders understand the connection and impact the negative military mental health stigma has on our force's mental health and morale, these needless deaths will continue. When you are anxious, depressed, sleep-deprived, and suicidal with nowhere to turn, the options are limited, particularly when you are a brave, skilled marksman with easy access to lethal weapons.
There is no reason military members cannot have the same rights and protections as the average citizen when it comes to confidentiality in psychotherapy. What does the military have to gain except complete, 100 percent control over their people, by allowing confidential communications between therapist and client in the military? The same restrictions which apply to confidentiality in the private sector could also apply in the military: danger to self or others; child, spouse, elder abuse; and criminal behavior would still need to be reported. Threats to National security and good order and discipline are two military-specific areas that may need to be added to those limits of confidentiality, and I do not believe anyone would argue against that.  Nevertheless, military members would then know that anything else they say would remain confidential, allowing them to open-up, develop a trusting relationship with their therapist, and get the help they so desperately need and deserve.
The Joint Chiefs of Staff (JCS), Service Secretaries, Secretary of Defense, and President of the United States are going to have to "do the right thing" and end the negative stigma associated with military mental health care by allowing the limited confidentiality described above to be implemented across the military. It will take several years for our military men and women to trust the system and routinely seek treatment for the problems caused by the rigors and stress of military service, but WE MUST START SOMEWHERE, WE MUST START TODAY! Our American heroes deserve no less!
The negative stigmas regarding PTSD and Veterans are perpetuated by the media. The film, television, and print (hardcopy and online) industries are at least partial contributors to Veteran joblessness, homelessness, and, ultimately, suicide. With unemployment rates for Veterans hovering at least five percent higher than non-Veterans, we must ask ourselves why.
Because non-Veterans, not having had the opportunity to serve in the military, do not understand the our culture, and rightfully so.  What they also do not understand is that the trash the media is spewing about Veterans and Veterans with PTSD or TBI is that we are dangerous!  Veterans, particularly those with PTSD, are regularly portrayed in films, television series, TV news, magazines, newspapers, and blogs as being aggressive and threatening at the very least and homicidal maniacs on the other end of the continuum.  Veterans “are nuts” and about to blow our corks at the drop of a hat and go off on innocent civilians, possibly whipping out an automatic weapon and killing dozens, as was the case in the spring of 2012 when an Army Staff Sergeant killed 17 Afghanis after multiple deployments, TBI, and PTSD, having seen his buddy’s leg blown off just the day before.
Recently having read an article entitled: "IS GETTING HELP A CAREER KILLER?" in a large weekly military magazine, I noticed that in a little more than one page, the author managed to hinder any progress we have made in recent years toward reducing the negative stigma.  The article highlighted why airmen and other military members need to be afraid, very afraid, of seeking mental health treatment, or even worse, talking about it! 
The article’s author wrote about an Air Force NCO (non-commissioned officer) who had sought help for alcohol abuse and depression, and educated other airmen, telling them about his battle with alcohol (which he is currently winning, by the way) and other mental health issues. His supervisor, an obvious Neanderthal, virtually ended this airman's career by making statements about his alcoholism in his enlisted performance report (EPR) and marked his rating down, both career-ending behaviors. The NCO in question, a master sergeant (E-7), appealed his "referral" EPR to his superiors and the Inspector General, but was unsuccessful. Not surprising and not promoted!
Most everyone in the Air Force, Army, Navy, and Marines have heard plenty of horror stories like the one described above and now have one more...a page and a half's worth in national weekly military publication.  As long as these stigmas are perpetuated in the media, young heroes, our military and veteran men and women, will continue to die. For the first time in recorded history, more people are dying by suicide in the military than are being killed in combat! 
The space taken up by that particular article could have been better utilized by providing accurate information about the PTSD and the associated stigma(s), identifying what the implications of the stigma(s) are (e.g. suicides), and analyzing realistic proposals regarding what we can do about them. We need a positive dialogue started in this country, educating the public, our elected officials, and military leaders, about the problems in military and Veteran mental health treatment and figure out a way to fix them...soon!
The stigma surrounding Veterans has affected my own life as well. Having had a disappointing experience in the private sector, I returned to a local state university on the Post-9/11 GI Bill to become a school counselor. After 4 semesters and 27 units completed with a 4.0 GPA, being inducted into the Phi Kappa Phi National Honor Society in April 2011, I was called into a meeting with my advisor, a woman of color I had only met on three other occasions.  I thought that she was going to congratulate me on my honor, but that could not have been further from the truth.
When I entered the room for the meeting, my advisor was seated with another professor I had never seen before.  The mood in the room and the tone of the conversation quickly enlightened me that I was not there for a “pat on the back”.  My advisor stated that she felt that I was “aggressive and threatening” and that if it “didn’t stop”, my “status in the program would be in jeopardy”.  Having always treated fellow students, professors, and administrators with nothing but dignity and respect, I was flabbergasted!  I asked her for some concrete examples of my “aggressive and threatening behavior”, but all she could come-up with was “it’s a perception, that’s all, a perception”.
After the meeting, I filed a complaint with the university’s Office of Affirmative Action based on the fact that she threatened my status in the program based on a false “perception” of me being “aggressive and threatening”.  All Veterans, anyone who would fight for their country and sometimes have to kill our enemies, must be “aggressive and threatening”, right?  I filed the complaint in May 2011 and the Head of the Office of Affirmative Action only harassed and insulted me, accusing me of being bigoted and racist!  The Deputy Chancellor for Diversity then refused to investigate my complaint.  I filed an appeal with the President of the University of Missouri in August 2011 and was immediately promised a response from “general counsel”, but I still have not received that response.  Because of the aggressive, threatening, and intimidating environment that was created, I have not returned to complete the three courses required to complete my Educational Specialist (EdS) degree and become licensed as a school counselor.
When will all of this insanity stop?  When will the population, our elected officials, government agencies, even our very own Departments of Defense and Veterans Affairs and military comrades, end these negative stigmas?  Stigmas against Veterans in general, and those unfortunate enough to return with PTSD and other debilitating mental health conditions, must be addressed now!
The answer to many of our problems, including how we perceive and treat PTSD, is to clarify our core values, then act on them. It sounds extremely simple, and it is. The primary problem with our world, nation, military, and selves is an alienation from our core values or not having defined any in the first place.  It appears as though people, in general, have become extremely self-centered in recent time. It seems to be all about ME...ME...ME…how is this or that going to affect me?  Guess what folks, there are other people in the world and last time I checked, the world did not revolve around any single person or group.  
Values are signposts, directions, not something that can be attained like a goal. Without values, you cannot form goals and if you have neither values nor goals, how can you possibly act in any other way than impulsively...selfishly?  Therein lies the problem.  With no values, no direction, people will react emotionally when confronted with a situation, and because self-preservation is an innate human condition, that reaction will normally be of a selfish nature.
We must clearly define and understand our values if we are going to succeed as a human race. Our men and women in uniform must memorize their service’s Core Values, which, in the Air Force, are: 1) Integrity; 2) Excellence; and 3) Service before self, but do they really understand what they mean as they apply to behavior, to combat? If you clearly understand what your core values are, when confronted with a situation, difficult or otherwise, you can confidently act in accordance with those values, without even thinking...REACTION! Know your values cold, react appropriately and selflessly when required.  Values lie at the core of my therapy for PTSD and other mental health problems, and this is a cursory explanation at best, so I will go on to discuss the processes in-depth in future articles about my proprietary treatment to anxiety, including PTSD, depression, and other problems: Body-Mind-Behavior Therapy (BMBT).
Our world, our society, and our military are in the state they are in because we have no direction, no values, and no real leaders leading us, teaching us, or acting as role models, mentors, for positive core values. Our leaders are perpetuating the negative stigmas I have been discussing here because many continue to reinforce and condone them, doing nothing about them.  It should be rather obvious, but people comfortable seeking and receiving mental health care are far less likely to resort to suicide than those who are chastised and ridiculed for doing so. 
The Army recently threw $1.5 million at a study to determine how to reduce the suicide rate in the military.  We do not need to waste millions on research to know how to stop suicide or end these harmful stigmas, we need leaders who are going to stand-up and say “enough is enough!”  We need leaders who will give our men and women in uniform the confidentiality they need when seeking treatment for their problems.  We need leaders who will not condone the harassment and peer pressure keeping our men and women in uniform from seeking the mental health treatment they so desperately need and deserve.  We need leaders who are going to do the right thing and end the negative stigmas against PTSD and seeking mental health treatment in the military … now, today, before one more American hero dies by his or her own hand! 

Key Words: anxiety, depression, disorder, help4vetsptsd, hero, heroes, killing, leaders, media, military, post-traumatic, ptsd, stigma, stigmas, stress, suicide, values, veterans, vets


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