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.

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

Saturday, August 25, 2012

Help4VetsPTSD Unfunded...Again


August 23rd, 2012 - Kansas City, MO: Retired Air Force Lieutenant Colonel Chris Sorrentino, President and Executive Director of Help4VetsPTSD, made an announcement at Help4VetsPTSD's semi-annual board meeting last night, commenting on the disappointment he felt upon hearing the bad news about another grant lost: "We have a great organization that is just starting out and in desperate need of funding. Our mission, to help military and veterans (and their families) with PTSD, is critical and can actually SAVE LIVES! I do not understand how 'quality of life' programs can be funded over such a noble cause as ours, a program that CAN SAVE LIVES!".
On average, one military member and 18 veterans commit suicide EACH AND EVERY DAY, and PTSD is a significant factor in many. Sorrentino added: "Every day we go unfunded, another 19 lives are lost and that is absolutely appalling! The military and VA cannot keep up with demand and there are a shortage of trained, qualified therapists in the private sector. Help4VetsPTSD can help alleviate some of the suffering and many senseless suicides committed by over 6,900 of our military and veterans EVERY year...senseless!"

We as a nation waste billions on political campaigns, needless spending, and luxuries each year while many of our nation's heroes go jobless, homeless, with no mental health treatment, and ALMOST 7,000 of them choose to end their lives...7,000 MILITARY AND VETERANS COMMIT SUICIDE EVERY YEAR!

Stop the insanity! Help end the negative mental health stigma in the military and among veterans, leading directly or indirectly to joblessness, homelessness, and suicide.

PLEASE DONATE TO Help4VetsPTSD TODAY...EVERY DAY YOU WAIT, 20 HEROES DIE!

Visit http://www.Help4VetsPTSD.org for details.

You can follow them on Twitter @Help4VetsPTSD or "LIKE" their Facebook page


Help4VetsPTSD is a 501(c)(3) non-profit (pending) and donations are tax deductible.

Help4VetsPTSD Not Selected for Newman's Own Grant for Second year in a Row

August 10th, 2012 - Kansas City, Missouri: Vicki Reeping of Newman's Own and Fisher House Foundation announced that Help4VetsPTSD was unsuccessful for the second year in a row, not being selected for a grant they so desperately need.

Ms. Reeping stated: "We received 164 eligible programs this year, displaying a broad range of ideas to improve the quality of life for service members, Veterans, and their families. The judges had a difficult time narrowing it down, but have made their selections. The 6 programs recognized in 2012 will be posted on the Fisher House website on September 20, 2012....We wish you all success in your current efforts to support our Nation's heroes.

According to their website, Newman's Own Grant winners are chosen based on" potential impact on their respective communities, creativity, and innovation" and ability to "improve the quality of life for service members, Veterans, and their families." Six "civilian" judges, four female and two male, made the final decisions, decisions reflected in the charities chosen for the grants: 

Tuesday, August 21, 2012

Two Great New Apps for Clients...and Therapists

For those with psychological "issues", there are a couple of great new apps out there for troops (and civilians) to use . LifeArmor and PE Coach (prolonged exposure) are available for Android and iPhones and each has a place in a therapeutic context.

LifeArmor is for more general issues, offering a lot if great information and tools for A VARIETY of problems, including anxiety, depression, substance abuse, stress and much more. It is easy to use and interactive, making psychoeducation portable, easy, and fun!

PE Coach is much more specific, focusing on prolonged exposure (hence the PE), the "empirically supported treatment" (EST - that's short for "supported by lots of research") for post-traumatic stress disorder (PTSD) developed by Foa, et al. PE Coach helps therapists and clients develop SUDS anchors, exposure hierarchies, homework assignments and even has an appointment tool and session recording/review option! This is a tool any therapist providing the EST of choice, PE, for PTSD should utilize! It's so simple and useful, I'm surprised nobody thought of it sooner.

Both apps are useful for INFORMATION PURPOSES, but are designed to augment, be used in conjunction with, therapy, conducted by A COMPETENT, LICENSED CLINICIAN.

LifeArmor and PE Coach are both available FOR FREE at Google's PlayStore, for those with Android phones. If you have an iPhone...you paid too much (and know where to go - I don't!).

c2


Saturday, June 9, 2012

Social Dystrophy™: Are Technology or Values to Blame?


Would "Social Dystrophy" be an appropriate term for the lack of social skills endemic in today's population? I came up with the term “social dystrophy” while exercising at the YMCA last week, having experienced more then the usual number of rude and obnoxious people that day. I cannot take credit for coining it because somebody already created a website, http://nyrixxblog.socialdystrophy.com, having apparently had similar experiences with humans.

According to Dictionary.com, “dystrophy” can be defined as “faulty or inadequate development” faulty or inadequate nutrition or development”. Dystrophy would then imply that there were some social skills in the first place, which may not necessarily be the case and may eliminate the term as an appropriate label for what we are experiencing. I may be generalizing, and I know there are many pitfalls in that and there are many socially adept people out there, young and old, but the problem seems to be getting worse and worse with the advent of new communication technologies (being invented almost daily). Let me elaborate and provide some poignant examples as well as potential solutions.

I was at the market the other day looking for my rewards card before placing my items on the conveyor (there was no line when I arrived and few customers in sight). Before I had a chance to hand my card to the cashier, some middle aged guy rushes up and starts putting his shopping items on the conveyor. As they whizzed past me on their way to the cashier, I looked back and politely asked "would it be OK if I continued to put my items on the conveyor and finish checkout?" while the cashier looked on in dismay. The man, who was accompanied by his teenage son, glared at me defiantly and stated "I didn't turn the conveyor on!" Really? Is that an answer or any kind of excuse for being rude and in such a hurry that you cannot wait until I complete a simple task? Dumbfounded by his ridiculous answer, I politely asked if he would remove his things so I could continue with my shopping, but his reply cannot can be repeated here, cursing and insisting that I was being rude simply because I wanted to continue my shopping without having to move his out of the way. Let me just say that the situation deteriorated from there with the man using profanity and insulting my character…what an excellent role model for his teenage son!

Then there are the people at the gym who turn the fans around the cardiovascular equipment on without bothering to ask the people who have been there for some time, and do not like the fan blowing on us, if we would mind if they “turned the fan on”. How difficult would it be to say, “excuse me, can I turn this on? Too difficult, obviously, for a social misfit who does not care about anybody but him or herself or does not have the social skills or training to communicate with other humans.

Still at the gym, there are the people, usually young, who barge past us in the locker room on their way to a locker they just cannot live without. Many times there are areas of the locker room totally empty and available, but they NEED THAT locker, cannot wait a few minutes until we are done, or do not have the skills or inclination to say "excuse me". Is that really so difficult?

Then there is the guy in his BMW that lays on his horn when I have the nerve to continue in the lane that I was traveling in after leaving a stop light. If he had not been too busy talking on his cellphone, he would have been cognizant of which lane was his and where he should have been driving. Instead, he thinks I am the moron when in fact he should have been ticketed for an illegal lane change, aggressive driving, and disturbing the peace.

I could go on and on and experience numerous instances like those above DAILY! Really? Daily? Yes, DAILY! Well, why is this happening daily and why does it seem to be getting worse as time goes on? In this reporter’s opinion, technology and a lack of clear core values are at the root of the problem.

Technology has grown so quickly and become so engrained in our culture, our lives, that we “think” we cannot live without it. How many times have you seen a car swerving all over the road, only to catch up to the driver and find them chatting or texting on their cellphone? If you live in any metropolitan area, or anywhere else for that matter, you see it all the time. Everywhere you go people young and old are talking on the phone or texting their friends about some inane subject, completely oblivious to what is happening around them or considering what affect their behavior may have on others. They simply do not care! It has gotten to such an extreme that people are texting the person standing next to them or in the same room! C’mon folks, is it really that demanding or difficult to look someone in the eye, open your mouth, and emit the words it takes so long to “thumb” on your smartphone (a misnomer).

The ability of humans to communicate is slowly deteriorating because of technology. Whether it is cellphones or computers, the internet or email, laptops or iPads – you name it – technology has made us (yes, I am not immune) not only more productive, but lazy! Before cellphones, computers, and the internet became commonplace, which was not all that long ago, people waited until they returned home to call a friend or even write a letter which may have taken several days to arrive once posted, and everybody seemed to be a lot happier, a lot less stressed than we are today. If technology and human behavior continue at this pace, the ability to communicate verbally, face to face, making eye contact and the whole shebang, is going to become a thing of the past. It is quickly becoming clear, particularly in the younger generations who have grown up with these technologies, that human communication is deteriorating rapidly and we should all be very concerned about that dilemma.

Finally, I believe it is a loss of focus on or undefined core values that can account for much of the self-centered behavior we see daily. The world in general and our country specifically, politically, corporately and personally, has lost touch with what is important to us – our values. I see it day in and day out in my practice, when I ask a client to tell me what they value, they look at me like I have a penis growing out of my forehead. “My values? What do you mean exactly?” When I explain what values are, they routinely come up with “my family” or “my job”, still not quite grasping the concept.

Values, according to Encarta Dictionary, are “the accepted principles or standards of a person or group”. They define what we are about and, if clear and well defined, help us act in a moral, ethical, or legal way when presented with novel or familiar situations. That sounds pretty important! But few people can tell me what their values are and that is pretty scary. It is no wonder that people are running around thinking of little but themselves when they have no moral, ethical, or legal map to help get where they are going. That is why the world and our nation are in crisis, financial and otherwise, at this moment and it is also why people do not care about anybody but themselves.

Put down the phone, clarify your values (what is important to you), look people in the eye when you speak to them, treat people with dignity and respect, and act on your values...even if you are having a bad day, or are anxious or depressed...be selfless, not selfish and the world will be a better place to live.


More on values in a future post…


Key Words: social, dystrophy, values, value, core, inept, incompetent, CombatCounselor, combat, counselor, psychology, therapy, CBT, ignorant, ignorance, SocialDystrophy, technology, phone, text

Sunday, June 3, 2012

Letter to The Greatest All-Time Golfer and Man - Jack Nicklaus - Honor, Integrity, Sportsmanship, Legend

Dear Jack,

I am 55 year old, a retired Air Force lieutenant colonel, and combat-disabled veteran. 

I followed you for many years on the West Coast swing (LA and San Diego Open, Tournament of Champions, etc) in the late 70s and early 80s. Because "Mr. Nicklaus" was so accessible, friendly, and warm, you became known to me simply as "Jack". Please excuse my familiarity and casual tone, but after having spent decades of weekends together, on the course or on TV, you are like family.

You were always personable, treating me like an equal as you made your way to your next shot, sometimes smiling and other times chatting, even when the stakes were high and pressure from Trevino, Crenshaw, Kite, Watson and others intense.

Because of who you are as a man and legend, I took the liberty of naming my second son after you, Nicklaus A. Sorrentino, who will turn 25 on July 1st. I may be just a bit biased and believe both my boys have embraced the honor, integrity, and strength of character, which you possess and I have tried to emulate, on and off the golf course.

Others, who do not deserve to be mentioned in the same paragraph as you, may surpasses your feats on the golf course, but none will be known as the Greatest Golfer of All Time because YOU, Jack, have earned that title as a result of your outstanding golf acumen and victories, and your indisputable and immaculate character, which all golfers and non-golfers would do well to emulate.

These days, I occupy my time counseling military and veterans coming back from combat with PTSD as well as starting a non-profit called Help4VetsPTSD, Inc., an outreach, education, research, transition and residential treatment program for military, Veterans, and their families affected by PTSD.

Thank you for taking the time to read my note. I hope that I may have the opportunity to meet you again in the future and wish you and your family the very best in life.

Respectfully,


Chris Sorrentino, LtCol, USAF (Ret)
CombatCounselor


Visit:
http://www.CombatCounselor.com and http://www.Help4VetsPTSD.org

Follow on:
Twitter: @CombatCounselor and @Help4VetsPTSD
YouTube and Blogger: CombatCounselor and Help4VetsPTSD

Sunday, May 20, 2012

Checklist for Hiring a True Cognitive Behavioral Therapist (CBT)

As executive director of Kansas City Cognitive-Behavioral Therapy (KCCBT) and an expert in cognitive behavioral therapy (CBT), I receive many calls from people looking specifically for a therapist specializing in CBT. Because I rarely have any openings, I make a lot of referrals. Unfortunately, there ARE FEW TRUE COGNITIVE BEHAVIORAL THERAPISTS, at least in my area.

When I say "TRUE COGNITIVE BEHAVIORAL THERAPIST", I mean somebody who is an expert in CBT (which requires advanced knowledge of learning theory; e.g. classical and operant conditioning, relational frame theory, etc.) and practices using "primarily" cognitive and/or behavioral techniques. Easier said than done!

Many therapists call themselves "COGNITIVE BEHAVIORAL" even though they may know little, if anything, about CBT. Why? Because most therapists (licensed professional counselors, clinical social workers, psychologists, and psychiatrists) depend on health insurance as reimbursement for their services AND insurance companies ONLY reimburse for empirically supported treatments (EST), with CBT being the primary (sometimes only) EST for the vast majority of anxiety and mood disorders (which make up the vast majority of disorders being treated).

Many of my clinical colleagues will probably not be happy with what I'm telling you and to them, as the character Gilly on Saturday Night Live would say: "uh huh"..."sorry!". We ALL owe it to our clients to be honest and provide the MOST EFFECTIVE TREATMENT available for our client's particular condition, which in many cases means CBT (the most researched and scientifically proven treatments available for many, not all, conditions).

When looking for a cognitive behavioral therapist, I suggest doing an advanced search on Psychology Today's Therapist Finder, screening for therapists in your zip code specializing in CBT for YOUR CONDITION. Once you have narrowed the list, start calling them and ask the following questions:

1. Are you a cognitive behavioral therapist and, if so, what technique(s) do you use for people with my kind of problem?

Answer: Yes. Answers could include exposure, exposure and response prevention (OCD), prolonged exposure (PTSD), activity scheduling (depression), cognitive restructuring, behavioral activation or rehearsal, and contingency management among others. Exposure, in vivo, imaginal, and prolonged, just to name a few is the treatment of choice for most anxiety-based disorders (e.g. generalized anxiety disorder, OCD, PTSD, agoraphobia, panic disorder, social anxiety disorder, simple phobias)

2. Which CBT therapy do you adhere to and who is the person (theorist) influencing your practice the most?

Answers: Cognitive Therapy (Primary Theorists: Beck, Ellis); Cognitive Behavioral Therapy or Stress Inoculation Training (Primary Theorists: Meichenbaum); Acceptance and Commitment Therapy - ACT (Primary Theorists: Hayes, Strosahl, Blackledge); Dialectical Behavior Therapy - DBT (Primary Theorists: Linehan); Mindfulness-Based Cognitive Therapy - MBCT (Primary Theorists: Williams, Teasdale, and Segal); Mindfulness-Based Stress Reduction - MBSR (Kabat-Zinn)

3. Estimate the percentage of techniques you use in therapy that are STRICTLY cognitive behavioral.

Answer: AT LEAST 60 - 70% is acceptable, preferably more.

4. Can you tell me the difference between positive reinforcement, negative reinforcement and punishment?

Answer: Positive reinforcement involves increasing the likelihood of a behavior occurring in the future by rewarding the organism immediately following the desired behavior. Negative reinforcement involves increasing the likelihood of a behavior occurring in the future by removing an aversive stimulus immediately following the desired behavior. Punishment involves introducing an aversive stimulus immediately following a behavior you are trying to eliminate and may work for a short time, but research indicates that it is ineffective in the long-term for changing behavior.
If they cannot answer this question, they know little if anything about the most important aspects of CBT and should probably be eliminated).

5. Do you offer FREE initial consultations (preferably in person, over the phone by exception)?

Answer: Yes. In-office consultations are preferred. If a therapist wants to charge you, keep looking unless they are obviously VERY SKILLED in CBT and you have no alternatives.

6. Are you licensed in your state (LPC, LCSW, licensed psychologist/psychiatrist, etc) AND certified (by whom)? What is your license/certification number?

Answer: Yes. Not all licensed therapists are also certified by a recognized national certifying body (requires passing a national exam and paying annual dues), but those who are indicates additional credibility and professionalism. Ask for the certifying body and certification number, then look up the licensing and certifying organizations on the internet and check to see if they actually exist, are current, and free of complaints or violations.

Unfortunately, there are many unqualified, unlicensed people out there calling themselves therapists, life/executive coaches, spiritual healers, etc. and probably do not have the necessary education, experience, licensing, and certification required to help you solve problems of the mind. Read my post "Client Beware" for more details about therapist credentials and picking a therapist.


In conclusion, CBT is one of the most researched, proven, effective, time-limited and cost effective (many problems can be treated effectively in 3 months or less - one one-hour session per week)  therapies available today and the treatment of choice for many psychological problems. So if you are looking specifically for a therapist specializing in CBT, as many educated consumers are, the preceding information should be helpful.

With that said, there are many reasons why CBT may not be appropriate for you or your particular problems. There are many good therapies and therapists available, so I recommend you do some research and know what you are looking for when selecting a therapist. In any event, to reinforce the importance of my earlier point, MAKE SURE THEY ARE LICENSED (PSYCHOTHERAPIST) IN YOUR STATE if nothing else.

Feel free to contact me if you have any questions or need additional assistance finding the right therapist for you. GOOD LUCK!

Wednesday, May 9, 2012

Timely Reply from Managing Editor, Air Force Times


From: Becky Iannotta
Sent: Tuesday, May 08, 2012 9:26 AM
To: combatcounselorchris@gmail.com
Subject: Letter to Air Force Times

Mr. Sorrentino,

Please allow me to introduce myself. I have been the editor at Air Force Times for about six months, yet I do not recall ever seeing a letter from you in my current role or in my previous position as news editor of Air Force Times. Your letter on accidents and redeploying troops makes it sound as if you have written on multiple occasions. I apologize if you have sent letters that went ignored.

I would like to publish your letter as it relates to the "thrill seeking behavior" and lack of qualified mental health providers, and your response to the suicide story. The letter will be edited for space and style, as is our policy.

Thank you for writing and for reading Air Force Times.
Sincerely,
Becky


Becky Iannotta
Managing Editor
Air Force Times

and my reply...

Ms. Ianotta,

Thank you for responding and for acknowledging the importance of these issues by publishing my letter. 

I have written on several occasions to Dr. Bret Moore (Kevlar for the Mind – psychotherapy related issues such as these), Ask the Lawyer (regarding being discriminated and retaliated against – as a male/disabled veteran – by the University of Missouri-Kansas City, a case that the US Department of Education is investigating and has found “cause” for mediation), as well as a few to airlet@airforcetimes.com where I sent these emails.

I would finally like to point out in Dr. Moore’s May 7th follow-up piece on the “stigma” of mental health in the military.  I believe he missed a tremendous opportunity to fix some things that have been broken in the DoD and VA for a long time and even hurt the cause by “recommending” that military members go the “chaplains” if they want 100% confidentiality.  Of course, chaplains provide wonderful services and there is a time, a place, and a person best suited for that experience. But the problem is that these wonderful people are not (normally) qualified to properly treat our military with PTSD and other mental health issues.  These young men and women (military and veterans) are committing suicide in record numbers, or are not seeking the treatment they so desperately need, because THEY ARE AFRAID TO SEEK TREATMENT because it WILL ruin their career and/or they WILL lose their security clearance.  That stigma and paranoia carries over into the VA system where they see the same bureaucracy and lack of a sense of urgency in helping them as they saw in the military.  I have seen it first hand in my role as a licensed clinician on military installations and experienced it myself upon return from a year in the desert (Aug 01 – Aug 02).  Even as a mental health provider myself, I would not and did not seek treatment UNTIL I knew I was retiring and could not be hurt by “the system”.

In any event, it is nice to have you on board as editor and am glad that you took the time to read my concerns and publish them.

Best wishes,

Chris

Chris Sorrentino
Chris Sorrentino, LtCol, USAF (Ret)
LPC, NCC


Tuesday, May 8, 2012

Letter to the Editor - Air Force Times


I'm not sure why I bother sending these emails because I have never even been acknowledged, but I feel compelled to speak out anyway. Maybe it is time to retire dinosaurs such as Bret Moore and Robert Dorr, hiring writers who are more in-tune with the realities of current military issues.

Regarding the subject article from your May 7th issue, Ms. Jowers omitted a critical cause of accidents for Redeploying troops, "thrill seeking behavior". After 8-15 months in a combat zone going 100 mph, figuratively, not literally, coming back home is a huge adjustment. It is widely known among anybody familiar with human behavior and the military that thrill seeking, such as speeding or driving while impaired, increases dramatically upon return to home post/base. If you've been in combat, and I have, you are on an adrenaline rush for months on end and crave that rush upon returning home. It should come as no surprise and, if records were kept during previous periods of combat operations (WWII, Korea, Vietnam), you would see exactly the same trends. How could your writer miss such an obvious variable?

As far as your editorial and reporting on the "lack of qualified mental health providers" in the DoD and VA, excuses both have been making for years, your writers have omitted another critical fact. The federal government has refused to acknowledge and hire master's-level licensed counselors for years! How can you, and they, whine about shortages of qualified clinicians when there are literally tens of thousands of licensed clinicians around the country, many looking for work, including me. I, for example, am a retired Air Force lieutenant colonel, combat veteran, disabled veteran, and licensed professional counselor (LPC) specializing in cognitive behavioral therapy (CBT) for post-traumatic stress disorder (PTSD). I have 30 years of education and experience working with anxiety and mood disorders, 21 of those licensed and nationally certified, yet the government readily hires social workers or psychologists fresh out of school over an "unqualified" clinician such as myself. Get a clue! Granted, not all LPCs have the experience I have, but if just 10% had the qualifications, the VA could easily fill those 1,900 vacant positions. Stop the whining and reporting half truths.

As far as Mr. Dorr is concerned, I'm sure I'm not the first person to mention this, I am sick and tired of his slanted, archaic, self-promoting chatter. Who the hell is he to tell the Air Force Chief of Staff which planes to keep and which ones to get rid of? I think it's time for some fresh blood and a current perspective in such a powerful role as is his. By the way, I'm not a volunteer for the position should you decide to join the 21st Century.

One more thing. In regard to the article on "Suicides" in the same issue, please read my blog http://www.combatcounselor.blogspot.com and the post on The Stigma Killing Young American Heroes.
Capt Julie Hanover is quite right when see says "they believe it will hurt their careers", but quite wrong when McCarthy says "we need to educate airmen" about the 97% "adverseless" action rate. Do you really think Airmen will seek treatment when they have a 3% chance of ending their career? Are you serious? Airmen, soldiers, sailors, and Marines WILL NOT SEEK MENTAL HEALTH TREATMENT until there is 100% protection and limited confidentiality as is the right if every non-military citizen!  Do you and DoD leadership really think that it is better or safer to have people avoid treatment and keep their clearance? If you do, I have some oceanfront property here in Missouri you might be interested in!

This information will be posted on my blog, http://www.combatcounselor.blogspot.com, so it won't go to waste when you ignore me once again. I have plenty of followers eager to hear what I have to say.

Thank you.

Chris Sorrentino, LtCol, USAF (Ret)
CombatCounselor

Follow me on Twitter @CombatCounselor
and on YouTube http://www.YouTube.com/combatcounselor

Monday, April 23, 2012

THE STIGMA KILLING YOUNG AMERICAN HEROES

THE STIGMA KILLING YOUNG AMERICAN HEROES is based on ignorance and bureaucratic processes that have needed changing for decades, if not centuries. The brave men and women that make up our military are hesitant to seek mental health treatment from military practitioners because they are afraid, and rightly so, that their careers and/or security clearances could be at stake if they did. 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 I pinned-on my silver oak leaf and knew I would be retiring (meaning "they" couldn't hurt me). I spent four years in four different combat zones, including "boots on the ground" in the Middle East one month before 9/11 and the first year of Operation ENDURING FREEDOM.
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, the 2nd Battalion, 34th Armor Regiment (2-34) and the 4th Squadron, 4th U.S. Cavalry Regiment (4-4 CAV), 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 of those returning home, many times caused or hastened by experiencing the effects of an improvised explosive devices (IEDs), 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 person "loses their 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 les 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 US (and elsewhere). Post-Traumatic Stress Disorder (PTSD) has been around since the beginning of the human race and has been called many things over the centuries including exhaustion, railway spine, stress syndrome, shell shock, battle fatigue, combat  fatigue, and traumatic war neurosis. According to Wikipedia, "reports of battle-associated stress reactions appear as early as the 6th century BC. One of the first descriptions of PTSD was made by the Greek historian Herodotus. In 490 BC he described, during the Battle of Marathon, an Athenian soldier who "suffered no injury from war but became permanently blind after witnessing the death of a fellow soldier." Although this reaction would more accurately be diagnosed as conversion disorder rather than PTSD, it is an indication of the dramatic impact a traumatic event can have on a human being. Many people think of combat when they think of PTSD, but there are many causes, traumatic experiences, that can lead to symptoms, including accidents, physical and sexual assault/abuse, terrorism, as well as many others.
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 cliniician, be it a psychologist, psychiatrist, licensed professional counselor, or licensed social worker. 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. You can read more about these individuals elsewhere in this blog, so I will not elaborate here. However, it is no wonder that the many highly qualified, licensed, certified clinicians out there helping and saving lives every day are misunderstood, even feared by the uneducated and ignorant public so desperately in need of professional treatment.
Our young men and women in the military are returning from deployments having experienced horrifying events, either directly or as an observer. Estimates range from 20 to 50 percent of those returning from combat suffer from a mental health issue of one kind or another. The incidence of PTSD has been reported as high as 20 to 30 percent of military returning from recent combat. Yet many, if not most, do not seek treatment because they are afraid they will damage their career.
I have seen it firsthand in my own career, in my private practice and non-profit, and with soldiers recently returning from Afghanistan. Either 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. Or they 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 now, 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 TREATMENT 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 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 that apply to confidentiality in the private sector would also apply in the military: danger to self or others; child, spouse, elder abuse; and criminal behavior would still need to be reported. But military members would 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 the so richly and desperately deserve.
I challenge the Joint Chiefs of Staff (JCS), Service Secretaries, Secretary of Defense, and President of the United States 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 instituted across the military. It will literally take years for our military 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! They deserve no less.
Copyright 2012 - CombatCounselor and 3rd Wave Media Group - All Rights Reserved 

Wednesday, April 11, 2012

Lack of Integrity and Cutting Benefits Promised During Recruitment Hurts the All Volunteer Force


One huge barrier to voluntary service is making promises to enlistees, then not following through on your word. The Department of Defense (DoD) needs to stop attacking active duty, Guard, Reserve, and retired entitlements (e.g. Tricare fees, retirement benefits) and cut unnecessary programs and staff instead.

How many people cater to every whim of The JCS? 50? 100? 500? Maybe our top brass could cut back on some of the perks...huge staffs, private (government) planes, waste of resources (rock painting) during visits, among many others...and tighten their belts rather than taking aim on the benefits of those who have honorably served their country for 20+ years.

#Integrity means keeping ones' word, doing the right thing, even when nobody is watching...ACT WITH INTEGRITY Mr. Panetta and JCS...we are all watching! STOP CUTTING THE BENEFITS AND ENTITLEMENTS WE WERE PROMISED FOR RISKING OUR LIVES FOR OUR COUNTRY!


Friday, March 16, 2012

CombatCounselor Describes War-Induced Stress On Kansas City TV Station KMBC



An experienced combat veteran, retired Air Force lieutenant colonel, and expert in working with military and veterans with post-traumatic stress disorder (PTSD), Chris Sorrentino, a licensed professional counselor, Executive Director of Kansas City Cognitive-Behavioral Therapy, and President of Help4VetsPTSD, a non-profit dedicated to military and veterans with PTSD, discusses combat stress with ABC News affiliate:








Sorrentino went on to describe his sorrow for the families of the 16 Afghanis allegedly killed by a US solider and for the soldier's family.  "My heart and prayers go out to the families of the victims, the soldier, and the Afghani people for their unimaginable losses" Sorrentino told Maria Antonia via Skype this afternoon.  LtCol Sorrentino happened to be out of the area at the time, working with re-deploying soldiers at an undisclosed location.




"The military is a microcosm of American society", Sorrentino added, stating: "and the extremely unfortunate events that occurred in Panjwai district, a rural suburb of Kandahar and a traditional Taliban stronghold, are not at all indicative of the behavior of our brave, dedicated, selfless military personnel and should be considered an isolated event". Our deployed military are heroes and this incident should not reflect negatively on them in any way.  It is understandable and warranted for the Afghan people to be horrified and upset about the attack, just as many American are, and justice will be served as the soldier's fate is determined in a court of law.


The facts have yet to be determined, but Sorrentino concluded "the negative stigma attached to mental health treatment in the military has existed for decades and will not, unfortunately, end anytime soon".  "If the attacks were related to combat-related stress or other psychological issues, an environment more conducive to military members seeking treatment, rather than fearing reprisal or loss of a security clearance, could have potentially mitigated this threat ".  LtCol Sorrentino asked President Obama to "end the negative stigma associated with military mental health care" in a question and answer session after January's State of the Union Address.  Unfortunately, Obama ignored Colonel Sorrentino's pleas and failed to respond to his question.

Title: CombatCounselor Describes War-Induced Stress On Kansas City TV Station KMBC

Key Words:  KMBC, TV, Kansas City, MO, MIsouri, combatcounselor, combat, counselor, war, induced, stress, PTSD. PTS, trauma, disorder, television, 

Tuesday, January 24, 2012

Submission to President Obama: State of the Union Q&A (January 24th, 2012)

As a retired Air Force officer, combat veteran, disabled veteran, and licensed professional counselor (since 1991) I am not surprised many of the hundreds of thousands of young men and women who have served in Iraq/Afghanistan came home with PTSD, TBI, and other disorders, but are EXTREMELY hesitant to seek help and treatment. 
Until the Commander-in-Chief, JCS, Service Secretaries, and chain of command (in all services) STOP THE RETALIATION and END THE NEGATIVE STIGMA associated with mental health treatment in the military, our young men and women ARE GOING TO CONTINUE TO AVOID TREATMENT, SUFFER, AND COMMIT SUICIDE!
TAKE OFF YOUR BLINDERS and give our airmen, soldiers, seamen, and Marines 100% confidentiality in mental health treatment and EDUCATE THE BROWNSHOES who keep this ridiculous schema alive. Follow CombatCounselor and @CombatCounselor on Twitter for more information and updates.
Mr. President, Will you work to put an end the negative stigma attached to military mental health care and the associated unprecedented SUICIDE rate among military members/veterans because they are afraid to ask for the help the so richly deserve?
combatcounselor - Kansas City, MO.
Watch the video on The CombatCounselor Channel...SUBSCRIBE!
White House Facebook Page

Saturday, January 21, 2012

You Think, You Are: Anxious...A Journey from Avoidance to Acceptance


You only THINK you are anxious. If the thought did not enter your mind, you could not feel anxiety. What I am saying is that YOU can control anxiety (or depression, etc.) by altering the way you react to and experience anxious thoughts, sensations, or even other emotions you may be interpreting to be anxiety (e.g. anger).
That is why I say "You Think, You Are" anxious. If you Think anxious thoughts, you will experience anxiety unless...
you decide to experience anxious thoughts, feelings, and memories simply for what they are: thoughts, feelings, and memories!
Anxiety is the fear of fear. When we were roaming the plains, prairies, and mountains as hunter-gatherers, it was adaptive to be anxious about things that could kill us (bears, lions, falls, lightening, etc.), otherwise our species would have died off long ago. Anxiety is still adaptive when it involves fear of things that can honestly harm us. The problem is that many of us are anxious about many arbitrary things in life that are not necessarily dangerous, we only PERCEIVE them to be dangerous.
For example, public speaking is the #1 fear around the world, yet nobody has ever died from public speaking (excluding Julius Ceasar and a few others who happened to be speaking when killed). Other common fears include fear of heights (acrophobia) and of spiders (arachnophobia) as well as some less common such as germs (OCD) and open spaces (agoraphobia). Some people even fear intense anxiety or panic (panic disorder).
So, when we fear things that are not necessarily inherently dangerous, we are limiting our ability to experience and enjoy the present moment because we are so enveloped in thoughts and sensations caused by the fear inducing event or thing.
In Body-Mimd-Behavior Therapy (BMBT), I teach my clients first to learn mindful meditation or the ability to focus on the present moment (StayPresent ©). Next, I teach them to expect and accept the  unexpected nonjudgmentally and with curiosity (BeResilient ©). Finally, we explore and identify the clients's core values (e.g. integrity, honor) and help them develop goals and commit to actions that are in accordance with those values, even though those actions may make them uncomfortable or even anxious (StayTheCourse ©). Because they are acting based on things that are important to them, they are more likely to act in the face of fear or other painful emotions.
Avoidance is the cause of anxiety, depression and many other inorganic disorders because it is very rewarding in the short-term. When you avoid something that frightens you, anxiety goes away for a while and that is very rewarding. The problem being that if you are avoiding life, it is rarely joyful and leads to more and more problems. The key is to accept and experience intense, uncomfortable emotions like anxiety, learning by approaching rather than avoiding, that anxiety goes away on its own given that you can withstand the situation long enough to prove it. That is the biggest problem, that most people avoid or escape the anxious situation BEFORE they get a chance to learn that 1) anxiety will not kill you; and 2) anxiety will NATURALLY diminish (disappear) on its own (that's called habituation). It is impossible to stay in a highly aroused state of fear or anxiety for long.
So, the next time you experience fear in a situation the is not inherently dangerous, take a deep breath, experience and accept the thoughts and sensations for what they are, and face whatever your particular demon happens to be, knowing that you are acting based on what is important to you...YOUR VALUES!