CombatCounselor

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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.

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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

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!

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

Copyright 2011-2014 - 3rd Wave Publishing and CombatCounselor - All Rights Reserved

Wednesday, June 18, 2014

Thank You For Your Service?

The following Letter To The Editor of Military (Air Force) Times was written after having witnessed more of the same foolishness I have seen repeated time after time in the nearly 30 years since I swore an oath "to protect and defend the Constitution of the United States of America against all enemies, foreign and domestic". 

Decisions such as these are not made to save money, the are made to promote people to the next higher position and beyond. Decisions such as the one I reference are made to effect short-term savings, without concern for long-term outcomes, so that the responsible individual can claim saving $XXX,XXX,XXX on their performance report and/or award citation, not because it is THE RIGHT THING TO DO.

In this case, the Pentagon apparently believed that the threat in the Middle East and Russia have wained to the point of eliminating Hazardous Duty Pay and Rest and Recuperation Leave in several countries where our men and women in uniform serve and are put in harms way every day. As we have all witnessed since last winter's Olympic games, Russia and Iraq are anything but stable and the regions are more volatile than any time since the mid-1980s. So the geniuses at the Pentagon decided to save some money at the expense of service members, once again, as has been the case over and over again for as long as I can remember.

I think my letter speaks for itself ...

I understand that the "imminent threat to personnel has been significantly reduced" in numerous countries adjacent to Iraq and Russia in order to save money (June 23, 2014, page 2). My only question to the JCS is: Did you get an INTEL brief before making that ignorant decision? If so, have those individuals been relieved?
Things in Russia and Iraq have been on a steady decline for months, so where is the surprise? Maybe our leaders could have saved money by not closing bases in the region and reducing forces only to have to ramp-up again. Knee jerk "money saving" (wasting is more like it) initiatives have been going on in one form or another for the last 30 years (as I have witnessed) and it needs to stop!
Instead of focusing on military active duty, retired, and veteran benefits/entitlements as the "go to" deficit reduction strategy, try looking past your noses and focus on the big picture. And don't bother thanking us for our service until you can start treating us with dignity and respect rather than the contempt you and our government leaders have displayed for 13 years of wartime service to our country, protecting YOUR FREEDOM!
CombatCounselor ... OUT!

Wednesday, April 30, 2014

Arlington National Cemetary (ANC) Could Do A MUCH Better Job When It Comes To America's Heroes

Arlington National Cemetary has a hallowed and illustrious past and is the final resting place of thousands of American heroes, including John F. Kennedy and his brother Bobby, Chappie James, George Patton, and John Pershing among many others. 

When a family loses a loved one, the very least that can be expected is for the people making the funeral arrangements to treat the mourners with dignity, respect, and compassion ... AT THE VERY LEAST. A recent experience with Arlington, while making funeral arrangements for my father, a World War II Veteran and my hero, leaves me extremely concerned that the loved ones of American heroes are being ignored, neglected, and instead of making a very difficult period easier and more stress free, Arlington is only contributing to their stress.

It is not as if Arlington does not have enough data available, having existed since 1860 with over 300,000 inhabitants, so how is it that they can virtually ignore us when we contact them to make funeral arrangements, stating "we can neither tell you when a funeral can be scheduled nor when we will even contact you to schedule it"?

We had a funeral scheduled for my father last August, but had to postpone it when our house sitter backed-out just two weeks before the service. Rather than wait until the last minute to let Arlington know, we decided that we would cancel two weeks out and reschedule at a later date so that some other grieving family could utilize the time and resources allotted for my father. It seemed like the right thing to do.

But when I contacted Arlington by email on March 20th, 2014, two months before our proposed funeral date and my father's 89th birthday (May 22nd, 2014), I did not hear a word for five days, so I called their toll free number. 


I was told that my request had in-fact been received and that we were in the "scheduling que". I asked the woman when we might expect to be contacted, telling her that we and other family members needed to make travel arrangements and that the date of the funeral would affect when my wife could travel to Italy to visit her ailing parents, but she told me "you'll just have to wait". Asking her how it was possible that they could have no idea how long it would take to contact us, she told me that all I could do is "call back and inquire from time to time".

I called back a few weeks later, but was told the same thing, "you will have to wait" and "we cannot provide any more information". That was when I became not only insulted, but incensed about not only the way we were being treated, but the treatment everyone else in "the que" is also experiencing. So I sent the following email to Arlington:
Case #xxxx16 - RE: PFC J. SORRENTINO, USA 
We have been attempting to schedule my father's funeral for his birthday, May 22nd, this year, but your schedulers refuse to provide any information regarding when we might expect a burial. We have numerous obligations which cannot be finalized, totaling several thousands of dollars, until we have a funeral date, including travel plans for several people to attend the funeral, house sitting, my wife's travel plans to visit her elderly and ailing parents in Naples, Italy among others.  
ANC is not new to this endeavor and should have historical information which could provide an estimate of how long it will take to be contacted by a scheduler and how far out burials can be scheduled based on those currently in the system. Keeping loved-ones waiting unnecessarily, unable to make plans only because your employees refuse to take the needs of others into consideration is unprofessional.
I realize that it is an honor to be buried at ANC and that your staff are overburdened by the number of funerals they are required to schedule, but a small amount of dignity, consideration, and foresight could eliminate any additional hardship on families already affected by the loss of a loved one. 
Respectfully, 
Chris T. Sorrentino, LtCol, USAF (Ret) Next-of-Kin
Here is the reply I received:
From: <DoNotReply@us.army.mil>Date: Thursday, April 17, 2014 at 1:34 PMTo: Chris Sorrentino <rospo2356@gmail.com> 
Subject: Arlington National Cemetery - Feedback Confirmation 
We appreciate your feedback correspondence, which prompted this automatic e-mail response. Someone will be contacting you shortly with a tracking number.  Given the varying nature and types of inquiries we receive, we cannot comment on how long each specific type of inquiry should take. However, we are acting on your inquiry. Should you like to check its status, please feel free to call 1-877-907-8585 and provide your tracking number. 
Thank you for contacting Arlington National Cemetery.  Honor - Remember - Explore.
With over 300,000 data points, you would think that Arlington could extrapolate based on the number of requests, funerals in "the que", and employees available, and give mourners a rough idea when their loved ones might be buried OR at least when they might be contacted to make final arrangements. 

Three weeks out from our desired funeral date and 13 days since I was told I would be contacted with a "tracking number" regarding my email, I had still not been contacted. We had to cancel our plans for the May 22nd funeral because travel costs were skyrocketing and my wife needed to make plans to travel to Italy to see her ailing parents. We not only  wasted weeks of preparations for the event, we also had to pay an additional $400 in airfare due to waiting until the last minute to make airline reservations thanks to Arlington's lack of professionalism, concern, respect, and compassion.


The implications in terms of our lives are minimal compared to the grieving families of those who have recently lost a loved one and are stuck in the que waiting for a funeral date without hope for even a clue as to when they might be contacted. What happens to the remains of those waiting weeks or months while Arlington pencil pushers and bureaucrats sit on the paperwork, deciding when they might grace us with their presence and alleviate the suffering they have unduly caused to the grieving families of America's heroes? 

There is more than enough data for Arlington to figure out what their schedule looks like and how many requests they have in the que, providing at least a rough idea when families might be contacted and a ballpark figure as to how far out funerals are being scheduled so that loved ones can make appropriate plans, inviting family and friends to travel to Virginia and honor the deceased with the dignity and respect they deserve. Currently, they are failing miserably and whomever is in charge of our Nation's most respected military cemetery should be ashamed, very ashamed.

"Honor - Remember - Explore" ... Yeah, right!

UPDATE: MAY 11, 2014

It has now been nearly two months since I contacted ANC to schedule a funeral for my father and over 3 weeks since I was promised contact and a "tracking number". It appears at this point that one of three things is happening:

  1. ANC leaders and staff, US Army employees, are incompetent
  2. ANC staff could care less about the grieving families of US military personnel
  3. ANC is actively retaliating against me, a retired Air Force lieutenant colonel and future ANC resident, for having to cancel my fathers funeral last August through no fault of our own
In either case, the result is unacceptable. Again, we have only been inconvenienced in terms of plans and money lost as my father's cremated remains have not deteriorated or putrefied during the two months we have been waiting for Arlington National Cemetary to contact us with a date for his funeral. Yes, my wife has to curtail her visit to Italy to see her family so we can possibly have his funeral in August before she returns to work at KU and maybe ANC staff will contact me in time ... MAYBE?

In any event, I have experienced enough indignity and disrespect from the people we, American taxpayers, pay to manage the final disposition of our Nation's heroes and will contact my US Senator, Pat Roberts (R - KS), asking him to intervene on our behalf and on behalf of other families whom may be experiencing much more than inconvenience as a result of Arlington National Cemetery's complete lack of competence and professionalism. 

Here is the email I sent to Arlington on May 11th, 2014:
As confirmed on March 25, 2014, you received my request for a funeral for my father, PFC Joseph Sorrentino, on May 22nd, 2014 (Case #150016). I have called and emailed several times since, but here it is nearly two months later and your staff refuses to contact me. We had to cancel plans for the funeral and have incurred added expenses because your employees refuse to let us know when we can expect to schedule my father's funeral. This is unacceptable! 
I was promised a response and case number after I contacted you on April 17, 2014: 
From: <DoNotReply@us.army.mil>Date: Thursday, April 17, 2014 at 1:34 PMTo: Chris Sorrentino <rospo2356@gmail.com> 
Subject: Arlington National Cemetery - Feedback Confirmation 
We appreciate your feedback correspondence, which prompted this automatic e-mail response. Someone will be contacting you shortly with a tracking number.  Given the varying nature and types of inquiries we receive, we cannot comment on how long each specific type of inquiry should take. However, we are acting on your inquiry. Should you like to check its status, please feel free to call 1-877-907-8585 and provide your tracking number. 
Thank you for contacting Arlington National Cemetery.  Honor - Remember - Explore 
If I do not hear from your staff by Monday, May 12th, 2014, I will file a Congressional Complaint with my US Senator, Pat Roberts (R-KS). You can read the whole story on my blog: http://www.combatcounselor.com/2014/04/arlington-national-cemetary-anc-could.html 
Sincerely, 
Chris Sorrentino, LtCol, USAF (Ret) - Next-Of-Kin
This is not the first problem experienced because of incompetence at Arlington as has been reported in the Washington Post, NBC News, and various blogs, with hundreds of remains being unaccounted for, misplaced, or otherwise disrespected. THIS IS UNACCEPTABLE AND SENATOR ROBERTS SHOULD ACT WITHOUT DELAY IN CORRECTING THESE GRAVE DEFICIENCIES AND THE LEADER RESPONSIBLE FOR ARLINGTON SHOULD BE ADMONISHED, REPRIMANDED, OR FIRED ... NOW!

Key Words: Air Force, Arlington, Arlington National Cemetary, Army, cemetery, combatcounselor, funeral, grave, military, national, Pat, Roberts, senator, Senator Pat Roberts, soldier, unknown, unknown soldier, veteran

Friday, April 4, 2014

Introduction to Body-Mind-Behavior Therapy (BMBT)

Many of us have suffer from anxiety or depression, yet are still looking for a solution. Whatever you have been doing must not be working or you would not still be looking for answers.

Maybe you have been looking in the wrong places! Maybe you have been focusing on changing the "content" of your life (words, thoughts, emotions) instead of the "context", the part you actually have control over when it comes to internal problems (e.g. cognition...your thoughts).

In my upcoming book, "Get Off Your Buts And Live A Value-Driven Life ... That's A Freakin' Order!", I explain my proprietary approach to psychotherapy, integrating traditional cognitive behavioral therapy (CBT) with mindfulness-based CBT, called Body-Mind-Behavior Therapy (BMBT).

In BMBT, we focus first on what your BODY is telling us in terms of proper exercise, diet, and sleep as well as those internal sensations that "set-off" your anxiety or depression. Next, we focus on the MIND, teaching you how to be mindful in the present moment, accepting thoughts and emotions, and changing the "context" of how you relate to your thoughts rather than changing the thoughts themselves. Finally, BEHAVIOR becomes the target by clarifying your values, setting achievable goals, and making a commitment to taking action toward achieving those goals.

The result of BMBT is not another "quick fix", but a new way of life where you are mindful of the moment and ACT based on your values, rather than avoiding the things that you fear or make you sad.

Visit and SUBSCRIBE to my POPULAR YouTube channel, The CombatCounselor Channel, and  send me a message, telling me about your problem, what you have tried to do to fix it, and what result you would like to achieve:


Or SUBSCRIBE to the CombatCounselor Channel on Spreecast:



You may be one of the lucky viewers who has their issue addressed personally by CombatCounselor.


Good luck!

acceptance, ACT, anxiety, are, avoidance, cognitive behavioral therapy, CBT, acceptance and commitment therapy, combatcounselor, DBT, depression, journey, ACT, mental health, ptsd, mindfulness

Monday, March 31, 2014

Is a Smaller Amygdala The Cause Or An Effect of PTSD?


PTSD Linked to Smaller Brain Area That Helps Regulate Fear

In an recent PsychCentral.com article by Janice Wood, researchers at Duke University and the Durham VA Medical Center discovered that combat veterans with post traumatic stress disorder (PTSD) are more likel to have a significantly smaller amygdala than those without PTSD. The amygdala is a small structure in the brain which regulates emotions, in this case fear and anxiety, with anxiety literally being  "the fear of fear".

Wood states that "their study provides evidence that smaller amygdala volume is associated with PTSD, regardless of the severity of trauma. But, they add, it’s not clear whether the physiological difference was caused by a traumatic event, or whether PTSD develops more readily in people who naturally have smaller amygdalas."

“Researchers found 20 years ago that there were changes in volume of the hippocampus associated with PTSD, but the amygdala is more relevant to the disorder,” said Rajendra A. Morey, M.D., M.S., assistant professor at Duke and lead author of the study.

Morey noted that studies in animals have established the amygdala’s role in regulating fear, anxiety and stress responses, but its effect on human behavior is less well known. “It’s associated with how fear is processed, especially abnormal fear processing,” he said. “So it makes sense to look at the structure of the amygdala.”

The researchers recruited 200 combat veterans who served in Iraq and Afghanistan after Sept. 11, 2001; half had PTSD and the other half had been exposed to trauma, but did not developed PTSD. Amygdala and hippocampus volumes were computed from MRI scans of all 200.

The researchers found significant evidence that PTSD was associated with smaller volume in both the left and right amygdala, and confirmed previous studies linking the disorder to a smaller left hippocampus. The researchers emphasize that the differences in brain volumes were not due to the extent of depression, substance abuse, trauma load or PTSD severity, factors they took into account in their statistical model.

PTSD strikes nearly 14 percent of combat veterans serving in Iraq and Afghanistan, according to the Department of Veterans Affairs. PTSD also is estimated to affect 6.8 percent of adults in the general population who have suffered abuse, crimes and other traumas.
“The next step is to try to figure out whether a smaller amygdala is the consequence of a trauma, or a vulnerability that makes people get PTSD,” Morey said.
He said the study showed that amygdala volume does not appear to be affected by the severity, frequency or duration of trauma, indicating that these factors do not cause the amygdala to shrink. It appears more likely, according to the researchers, that people with measurably smaller amygdala to begin with are susceptible to PTSD, but more studies are needed to make that determination.

Morey said he and colleagues are exploring that question, and are intrigued by evidence from their study that suggests people may have a propensity for developing PTSD based on inherently smaller amygdala volume.
“This is one piece in a bigger puzzle to understanding why some people develop PTSD and others do not,” Morey said. “We are getting closer to that answer.”
Funding for the study, which was published in the journal Archives of General Psychiatry, came from the U.S. Department of Veterans Affairs and the National Institutes of Health.

Friday, March 21, 2014

LETTER TO THE EDITOR: Air Force Times

According to an article in your March 24, 2014 issue, George W, Bush and Army General Chiarelli, well respected  psychologists and scientists?, believe and profess that removing the word "disorder" from post-traumatic stress disorder (PTSD) is going to single-handedly end the military and veteran mental health and PTSD stigmas. Sorry boys, don't be ignorant ... ain't gonna happen!

President Bush's endorsement of this half-baked idea is as sound as my abilities in brain surgery and General Chiarelli's influence and support would be better utilized by focusing on the real causes of the stigmas, lack of confidentiality in military mental health, the macho bravado and ignorance endemic in the military, and the inaccurate portrayal of veterans and military members in the media.

PTS Without "Disorder" WILL NOT END THESE STIGMAS gentlemen. Use your clout to attack their real causes before more American heroes decide suicide is a better alternative than seeking treatment, risking security clearance and career, or being called a wimp. 

As a licensed professional counselor with 23+ years of experience treating military and veterans with anxiety (including PTSD) and depression, a retired military officer, and disabled veteran, I have written and advocated extensively on this topic. Specifically, my article THE STIGMAS KILLING AMERICAN HEROES.  http://www.combatcounselor.com/2012/12/article-stigmas-killing-american-heroes.html and two White House Petitions asking President Obama to address the stigmas, which garnered a whopping 70 signatures each out of the tens of thousands who heard my pleas, outlined clear, tangible courses of action. I have also written to Air Force Times on numerous occasions regarding this exact topic, but was ignored. But who can blame you when you have such authoritative experts in psychology and military/veteran mental health as President Bush and General Chiarelli?

C.T. Sorrentino, LtCol, USAF (Ret)
aka CombatCounselor
Lawrence, KS

Sunday, March 2, 2014

Psychology Today's "Dear Abby" Unethical in Advice to Reader

Letter to the Editor: T

In regard to her column in the April 2014 issue of Psychology Today, Hara Estroff Marano was out-of-line. The reader asked for help in getting "the spark" back in her relationship with a man she obviously loves. Ms. Marano was not only incompetent and unprofessional in her response, she was unethical. I'm not sure what her qualifications are, but based on previous columns and this, she apparently does not answer to a code of ethics.

Her judgmental "advice", something a licensed clinician who adheres to a code of ethics would never offer, was appalling. Take a six-month break, date other people, better qualities? This poor woman has the values and motivation most people should emulate, loyalty and respect toward the man she loves, and all the "fraud" you apparently allow to dole out advice in your magazine can do is recommend bailing on the relationship? 

Ms. Marano obviously does not know any better, but you as editor of such a popular and influential national publication should know better than to allow this type of garbage to be published. Shame on you.

C.T. Sorrentino, LtCol, USAF (Ret)

MS LPC NCC

aka CombatCounselor

www.CombatCounselor.com

Tuesday, February 18, 2014

"Thank You for Your Service"? Put Your Money Where Your Mouth Is!


A February 18, 2014 Facebook post by The Duffel Blog proves that a picture CAN in-fact be worth a thousand words:

As I have been saying for a long time, words are easy, actions are more challenging and appreciated. I have sponsored two White House Petitions in the last two years asking the public to sign and support action by Obama in reducing the staggering rates of PTSD and suicide in the military and among Veterans. The petitions needed 10,000+ signatures for POTUS to take action, BUT LESS THAN 70, that is SEVENTY, people took the time (5 minutes) to read and sign the petitions!

I've also been struggling to start a non-profit for Vets with PTSD, aptly named Help4VetsPTSD, but am considering throwing in the towel due to lack of support and funding. 

BOTTOM LINE: Please stop "thanking" us for our service. Instead, please PUT YOUR MONEY (OR SIGNATURE) WHERE YOUR MOUTH IS and support military and Veteran charities and non-profits.

Thank you,

CombatCounselor ... OUT!

Photo courtesy of The Duffel Blog, posted 2/18/2014 on Facebook