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  #21  
Old 7 May 2015, 10:28
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It is incredibly frustrating when people won't take this kind of advice, you know exactly where they're going and you're powerless to help.
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"The real problem was being able to stick it out, to sit in an office under the orders of a wee man in a dark gray suit and look out of the window and recall the bush country, the waving palms, the smell of sweat and cordite, the grunts of the men hauling jeeps over the river crossings, the copper-tasting fears just before the attack, and the wild, cruel joy of being alive afterward. To remember, and then go back to the ledgers and the commuter train, that was impossible. He knew he would eat his heart out if it ever came to that."

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  #22  
Old 7 May 2015, 10:45
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I'm not a shining example of someone who listens either. I've let things run a course that have helped further impact something that was special.

Luckily I have now learned how real some of this is by exposure to providers and vets who have used them.

I came up in a generation of Marines where anything not strong or aggressive was automatically labeled weak or pussy. While limp dick is a term of endearment btwn SOTB and TFG, we all know that it's used to signify someone we knew couldn't hack it or hang with the gunslingers. It's exactly the fear of falling into those catagorys that drives many to just bury it away or try to self heal.
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  #23  
Old 7 May 2015, 10:56
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Quote:
Originally Posted by mdavid View Post
SB your advice is amazingly good. It's tough to transition to the civilian world and easy to be way too hard on ourselves.

After ETS my wife and I went to counseling, which meant sitting down with some fat cow who had no fucking clue what was going on in my mind, no idea how to connect to me or why I was emotionally "intense". Her advice was counterproductive, totally off target and didn't help one bit.

I wish there was some way to direct vets to therapists that were "SB Certified" or had an SOF background....I'll bet they are somewhat rare though.
A few years ago my wife was asked to chair a Blue Ribbon panel assessing the VA's compensation for PTSD.

When she first met with the panel she asked for a show of hands of all those who had been in combat, 3 hands were raised. She then gave them a little of my background, and asked how many of them I would consider as combat vet's. All hands went down, these were M.D.'s who were in VN serving as M.D.s in a field hospital environment.

She told the IOM that she needed a combat vet to advise her committee, they offered Alfred Rascon MOH.
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Old 7 May 2015, 12:18
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Great thread. I just had a co-worker enrolled in a 4 week inpatient course at the VA. We had to go get him out of the parking lot of the VA center where the staff sent him to wait 5-6 hours to talk to a social worker. Fortunately he picked up the phone and called us instead of his weapon.

For those that enjoy their rights guaranteed by the 2nd amendment, the VA is ensuring it alienates them by turning over names to the ATF without the Veteran being given a "day in court".
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  #25  
Old 7 May 2015, 12:49
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Whenever I have a combat vet come into my office for a visit, I try to take extra time just to talk shit with him. Far and away the most common response I get is that they feel better after talking about war and memories that are hard to dredge up.

A number of my vet patients have some form of depression and/or PTSD. They tend to dwell on the bad memories and forget the good aspects of their service. It is the good bits that I try to coax out of them during our visits. Getting them to laugh about the stupid shit you can only see in war brings out a different side of these patients. And it helps get them out of the dark places. Honest laughter truly solves many problems and provides a ladder for guys to climb out of the mental basement.

I understand there are aspects of war that cause deep mental scars, but leaving them to fester rarely, if ever, helps. I don't know a whole lot about psychiatry, and for sure these guys coming in are only in my office for some surgical or weight-related issue. But I recognize when someone needs to talk, which really is the best therapy around. It is especially true when the two people talking have something in common.

The best part of my job is getting an email or text from one of these guys, succinctly saying "thanks", or "that was some funny shit", etc.
Thanks for sharing your thoughts, SB.

V/R,
Danny
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  #26  
Old 7 May 2015, 13:15
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Originally Posted by mdavid
I wish there was some way to direct vets to therapists that were "SB Certified" or had an SOF background....I'll bet they are somewhat rare though.
IMO -- YOU (we) are the best therapist there is. Yeah, a combat vet (LOL, in today's world -- WTF is that anymore?) could go to college, get his/her psych degree, and then turn around and offer counseling. Or -- and I think this is prob better (although still not necessary) that same vet goes and gets some focused counseling trg and starts assisting and then chairing sessions.

Here's what I think. If you know of someone who needs help (look in the mirror, too), get that person out of the stressful environment he/she is in, even if only walking down the hall with you. Better would be to get him to go fishing, the type where you're sitting on the bank and could care less if something bites, and talk. When I write talk, I really mean, get them to -- not always easy, and that is why I think we are better suited, we can look over and gauge what needs to be said to begin the conversation, some kid in a bright, pastel colored office, won't be able to.

Anyway, get them to talk, and you listen. IMO that is what we of this century are losing. We don't talk. We write on the internet. We post some stupid, trivial shit on FB. We send SMS messages. We occasionally write/read an email (the absolute WORST form of commo, BTW). In the end, we miss out on talking.

I have been on the receiving end of some support, recently. And I admit I pushed back/rejected it at first. It hurt my being to admit to a man I respected that I was weak. But the old bastard wouldn't let up, and kept at it, and forced me to hang out with him and when that was not feasible, he made me Skype (video-conference) him. Long story short, well, I'm still here pissing off half of the readership of this board -- so there's some evidence that it works.

What I am trying to write is that I don't believe in psychology. I have a degree in it (a BS in BS). I believe that what we need are friends. Not sympathy. Not patronizing, coddling. But friends who won't judge you for your moment of faltering under the ruck, and will simply quietly shoulder some of your weight for you, and the unspoken agreement is that everyone knows that when you have the chance to do so, you'll step in to shoulder someone's ruck too.

Those of you who've been under the ruck know of what I refer to. I don't need to explain. As such, fuck a bunch of therapists. Go help a friend....
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  #27  
Old 7 May 2015, 13:30
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Just found that report.



Committee on Veterans' Compensation for Post Traumatic Stress Disorder

Nancy C. Andreasen, M.D., Ph.D. (chair)
Andrew H. Woods Chair of Psychiatry, and Director
Neuroimaging Research Center
Carver College of Medicine
University of Iowa
Iowa City

Jacquelyn C. Campbell, Ph.D., R.N.
Anna D. Wolf Chair
School of Nursing
The Johns Hopkins University
Baltimore

Judith A. Cook, Ph.D.
Professor of Psychiatry, and Director
Center on Mental Health Services Research and Policy
University of Illinois
Chicago

John A. Fairbank, Ph.D.
Associate Professor of Medical Psychology
Duke University Medical Center, and Co-director National Center for Child Traumatic Stress
Durham, N.C.

Bonnie L. Green, Ph.D.
Professor of Psychiatry, and Director of Research
Department of Psychiatry
Georgetown University Medical School
Washington, D.C.

Dean G. Kilpatrick, Ph.D.
Distinguished University Professor
Department of Psychiatry and Behavioral Sciences, and Director
National Crime Victims Research and Treatment Center
Medical University of South Carolina
Charleston

Kurt Kroenke, M.D.
Professor of Medicine
Division of General Internal Medicine and Geriatrics Indiana University, and Senior Research Scientist and Director of Fellowship Training Regenstrief Institute Inc.
Indianapolis

Richard A. Kulka, Ph.D.
Senior Vice President of Strategic Business Development Abt Associates Inc., and Senior Research Scientist Center for Demographic Studies
Duke University
Durham, N.C.

Patricia M. Owens, M.P.A.
Independent Consultant
Minisink Hills, Pa.

Robert T. Reville, Ph.D.
Director
RAND Institute of Civil Justice
Santa Monica, Calif.

David S. Salkever, Ph.D.
Professor
Department of Public Policy University of Maryland, Baltimore County, and Research Associate National Bureau of Economic Research
Cambridge, Mass.

Robert J. Ursano, M.D.
Professor of Psychiatry and Neuroscience; Chair Department of Psychiatry; and Director Center for the Study of Traumatic Stress
Uniformed Services University of the Health Sciences
Bethesda, Md.

STAFF

David A. Butler, Ph.D.
Study Director


AP story here...


May 8, 2007, 10:55AM
Better veterans stress testing urged


By RANDOLPH E. SCHMID Associated Press Writer
2007 The Associated Press

WASHINGTON The surge in the number of veterans suffering post-traumatic stress disorder requires development of better tests to evaluate affected personnel and determine how best to compensate them, a panel of medical experts said Tuesday.

"As the increasing number of claims to the VA shows, PTSD has become a very significant public health problem," said Nancy Andreasen, chair of the committee that prepared the report.

"Our review of the current methods for evaluating PTSD disability claims and determining compensation indicates that a comprehensive revision is needed," said Andreasen, head of the psychiatry department at Carver College of Medicine, University of Iowa.

Claims increased from 120,265 in 1999 to 215,871 in 2004 and payments jumped from $1.72 billion to $4.28 billion in the same period, a combined committee from the Institute of Medicine and National Research Council said.

While the largest share of claims is still coming from Vietnam War veterans, there are expected to be many more claims in future from personnel who served in the first Gulf War and in the current conflicts in Iraq and Afghanistan, the panel said.

But the Veterans Affairs Department uses only crude criteria for rating disabilities due to mental illness and is not consistent for relapsing conditions, according to the report, which had been requested by the VA.

The panel urged the VA to develop new criteria based on the diagnostic standards of the American Psychiatric Association and to establish certification programs for workers who deal with PTSD claims.

The panel said the VA should base compensation decisions on how greatly PTSD affects all aspects of a veteran's daily life, not just his or her ability to be gainfully employed.

Andreasen noted that in the case of a paraplegic, compensation is based on both ability to work and quality of life, while in the case of mental illness, currently the ratings are tightly linked to the ability to be employed.

The report also noted that PTSD can be triggered by trauma other than combat, such as sexual assault. Female veterans are less likely to receive compensation for PTSD, which may in part be due to the difficulty of substantiating exposure to traumatic events unrelated to combat, including sexual harassment or assaults that occurred during service, the report said.

It urged the VA to gather data and provide reference materials to help disability raters better address the management of PTSD claims related to sexual assault during military service.

Dr. Robert J. Ursano, chairman of the department of psychiatry at the Uniformed Services University of the Health Sciences in Bethesda, Md., a member of the committee, said the recommendations are complex and the VA will have to study how to implement them over time.

The Institute of Medicine and National Research Council are branches of the National Academy of Sciences, an independent organization chartered by Congress to advise the government on scientific matters.
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  #28  
Old 7 May 2015, 13:49
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Originally Posted by Forestboy View Post
For those that enjoy their rights guaranteed by the 2nd amendment, the VA is ensuring it alienates them by turning over names to the ATF without the Veteran being given a "day in court".
I have long sought evidence that this actually happens, real proof, and I have come up snake eyes. There is a ton of anecdotal gossip that the VA is referring veterans to the ATF, but no evidence of it.

This pisses me off. For veterans to say, "I am not going to the VA because they will take my guns" is sheer stupidity. Never have I been asked, "any guns at home?"

If that ever did happen, I would politely ask, "why do you ask?"

And they would tell me. They would probably say. "I have to follow this checklist."

Upon which I would say, "please make a copy of that check list for me." And then I would smile.

They would either give me a copy or not, but my next move would be to the Patient Advocate's office, where I would file a written complaint to the administrator of the hospital, cc'ing every goddamned legislator in the state.

I have received treatment at the VA since 1991, then after a long pause, since 2001, without interruption. Never have I been asked about firearms. I would refuse to answer such a question, and I strongly advise that no one ever answer such a question. It is none of their damned business.

Now, there is one state of affairs where I can understand the VA asking this question, and this is when the veteran is determined to be incapable of managing his own financial affairs. You have to be pretty jacked up for this to happen, and in every case where I witnessed this, it was for the benefit of the veteran. I saw guys getting paid on Monday, they were drunk till Friday, then on Saturday they were admitting themselves back into VA custody.

For psychiatric care providers, they must advise police in the event that they believe that a patient is a mortal threat to themselves or to anyone else. There is no grey area, no wiggle room. If you are suicidal, or homicidal, therapists must report it.

Other than these two circumstances, I have never seen hard evidence that the VA refers veteran gun owners to ATF.

Refusing to go to a VA facility to take care of yourself because you believe gossip is stupid. Plain stupid.
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  #29  
Old 7 May 2015, 14:15
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+100 on the Vet Centers. Also, the Vet Centers are well rounded and they'll hook them up with additional resources. In fact, the VA will probably refer them to the Vet Center. There is the vet2vet mentor program that many vet centers offer. You spend a minimum of 4 hours with a vet they partner you up (whom they can relate and talk to) with. I think some of the group talk therapy with other vets seemed to really help a lot of guys as well as the individual talk therapy. Seemed like all the counselors in the Vet Centers I know of were also vets.
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  #30  
Old 7 May 2015, 14:19
reddevil reddevil is offline
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SOTB nailed it. Talking to another combat vet helps tremendously. They will also call you out on your BS when your making excusing, being destructive, or avoiding something - as we saw in SB's initial post.
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  #31  
Old 7 May 2015, 14:30
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Quote:
Originally Posted by Silverbullet View Post
I'm not a shining example of someone who listens either. I've let things run a course that have helped further impact something that was special.

Luckily I have now learned how real some of this is by exposure to providers and vets who have used them.

I came up in a generation of Marines where anything not strong or aggressive was automatically labeled weak or pussy. While limp dick is a term of endearment btwn SOTB and TFG, we all know that it's used to signify someone we knew couldn't hack it or hang with the gunslingers. It's exactly the fear of falling into those catagorys that drives many to just bury it away or try to self heal.
My buddy had it all. PTSD/survivor's guilt (my opinion), head trauma that was probably never properly treated, bad substance abuse and eventually serious mental health problems. He adamantly refused to admit he had any problems, wouldn't go to the VA, and he had the money to keep running around and never getting trapped anywhere. He was a great guy, he outright rejected any attempts to help him by me and many others and he very predictably died.
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"The real problem was being able to stick it out, to sit in an office under the orders of a wee man in a dark gray suit and look out of the window and recall the bush country, the waving palms, the smell of sweat and cordite, the grunts of the men hauling jeeps over the river crossings, the copper-tasting fears just before the attack, and the wild, cruel joy of being alive afterward. To remember, and then go back to the ledgers and the commuter train, that was impossible. He knew he would eat his heart out if it ever came to that."

- "The Dogs of War" by Frederick Forsyth
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  #32  
Old 7 May 2015, 14:32
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Originally Posted by Massgrunt View Post
My buddy had it all. PTSD/survivor's guilt (my opinion), head trauma that was probably never properly treated, bad substance abuse and eventually serious mental health problems. He adamantly refused to admit he had any problems, wouldn't go to the VA, and he had the money to keep running around and never getting trapped anywhere. He was a great guy, he outright rejected any attempts to help him by me and many others and he very predictably died.
Mass:

I know you tried...He has to want, and accept proper help
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Old 7 May 2015, 14:35
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Oh and I've never seen anything credible about vets with PTSD being referred to the ATF or anything like that. Massive HIPPA violation for one thing.
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"The real problem was being able to stick it out, to sit in an office under the orders of a wee man in a dark gray suit and look out of the window and recall the bush country, the waving palms, the smell of sweat and cordite, the grunts of the men hauling jeeps over the river crossings, the copper-tasting fears just before the attack, and the wild, cruel joy of being alive afterward. To remember, and then go back to the ledgers and the commuter train, that was impossible. He knew he would eat his heart out if it ever came to that."

- "The Dogs of War" by Frederick Forsyth
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  #34  
Old 7 May 2015, 14:37
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Quote:
Originally Posted by CPTAUSRET View Post
Mass:

I know you tried...He has to want, and accept proper help
It was incredibly draining and frustrating and has made me more reluctant to get that involved with other guys that need help. I know that's not the proper response though. Thank you.
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"The real problem was being able to stick it out, to sit in an office under the orders of a wee man in a dark gray suit and look out of the window and recall the bush country, the waving palms, the smell of sweat and cordite, the grunts of the men hauling jeeps over the river crossings, the copper-tasting fears just before the attack, and the wild, cruel joy of being alive afterward. To remember, and then go back to the ledgers and the commuter train, that was impossible. He knew he would eat his heart out if it ever came to that."

- "The Dogs of War" by Frederick Forsyth
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  #35  
Old 7 May 2015, 14:39
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It was incredibly draining and frustrating and has made me more reluctant to get that involved with other guys that need help. I know that's not the proper response though. Thank you.
Brother, it is an honest response.

No one knows what they'll do until they have been put in that position.
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  #36  
Old 7 May 2015, 18:06
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Oh and I've never seen anything credible about vets with PTSD being referred to the ATF or anything like that. Massive HIPPA violation for one thing.
Mass, IIRC I did some research on this before the banning of Lanister, and I am pretty sure LE is exempt from HIPPA. But this was about 6 years ago. I am not sure where my post is.
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  #37  
Old 7 May 2015, 18:34
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Originally Posted by Expatmedic View Post
Mass, IIRC I did some research on this before the banning of Lanister, and I am pretty sure LE is exempt from HIPPA. But this was about 6 years ago. I am not sure where my post is.
I honestly don't know. I do maintain that I've never seen any credible evidence that this occurs and I believe it's a conspiracy theory.
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"The real problem was being able to stick it out, to sit in an office under the orders of a wee man in a dark gray suit and look out of the window and recall the bush country, the waving palms, the smell of sweat and cordite, the grunts of the men hauling jeeps over the river crossings, the copper-tasting fears just before the attack, and the wild, cruel joy of being alive afterward. To remember, and then go back to the ledgers and the commuter train, that was impossible. He knew he would eat his heart out if it ever came to that."

- "The Dogs of War" by Frederick Forsyth
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  #38  
Old 7 May 2015, 18:41
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I honestly don't know. I do maintain that I've never seen any credible evidence that this occurs and I believe it's a conspiracy theory.

http://www.hhs.gov/ocr/privacy/hipaa...poses/505.html


From the .GOV. Hope this helps clarify.
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We call this piece the Fecalator. One look at it and the target shits him or herself. Try it on.

Well, it's a lot more compact than the flaming sword, but it's not nearly as impressive. Just doesn't have that Wrath-of-the-Almighty edge to it. I mean, come on, how am I supposed to strike fear into the hearts of the wicked with this thing?

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  #39  
Old 7 May 2015, 18:50
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Originally Posted by SOTB View Post
I believe that what we need are friends. Not sympathy. Not patronizing, coddling. But friends who won't judge you for your moment of faltering under the ruck, and will simply quietly shoulder some of your weight for you, and the unspoken agreement is that everyone knows that when you have the chance to do so, you'll step in to shoulder someone's ruck too.
...
Exactly.
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  #40  
Old 7 May 2015, 19:11
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This seems to be a decent explanation of the issue. The issue in my mind is that a VA determination of "incompetent to handle your affairs" is not an "adjudication," which should require a judge, not a panel of doctors. I know the ATF has modified their language to include this, so it's a combined effort.

http://www.veteranstoday.com/2013/02...nked-somewhat/
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