It’s always good
to see public discussion about posttraumatic stress and elevated concern for the
health and welfare of our troops. But,
just between you and me, I don’t think the events at Fort Hood
had anything to do with posttraumatic stress. First, because the alleged shooter
didn’t have PTSD, And second, because it’s an insult to people with PTSD, most
of whom function very well in spite of their ugly symptoms, to compare them
with this alleged perp.
People with posttraumatic
stress rarely shoot anyone, period, and on the rare occasion that they do, it’s
more likely to be themselves. (V.A. Secretary Shinseki has already
reported that as many service people from Iraq and Afghanistan have committed
suicide as have been killed thus far in these wars – and that’s now over 4,000,
souls. Do the math and be horrified, people.)
Sure, those with PTSD can
get mean, bad-tempered and cranky; they can have nightmares where they punch and
kick at phantoms in their sleep; and they can drink too much and end up abusing
spouses and kids. But you know, that could be a lot of 22 year old,
hyper-adrenalized, post-deployment males, with or without PTSD. The truth is, most people with posttraumatic
stress should get an extra medal for being the good citizens that they are,
functioning at 75%-90% in spite of the toll their condition takes. It’s just
not a very interesting story and it’s not what gets the headlines.
Nor did this Dr. Hasan
have vicarious trauma. That’s the result of a caregiver’s or reporter’s or
bystander’s compassion. In fact, it’s actually been called “compassion
fatigue”. People loaded up on too much identification with the suffering
of others are the least likely bunch to go around shooting and maiming innocents.
Mostly, they suffer and smile less. (Besides, this guy barely worked at all –
saw maybe one patient a week on average, and barely listened to what they had
to say anyway. Vicarious trauma? I don’t think so.)
question, “Is the shooter crazy or a terrorist?” may be the wrong question. He
could be both or not quite either. It’s
always dumb to diagnose somebody from afar, without benefit of interaction, files
or history, but we mental health professionals kind of can’t help ourselves.
Before I learned
much about him, I was thinking this was probably yet another paranoid
schizophrenic – who would be impossible for terrorists to recruit, because of
being too disorganized and crazy.
But now I’m
leaning more toward a schizoid guy with lots of paranoid features, and a guy
like that could be recruited. Are these the fragile folk that the Bad Guys are
looking to proselytize? Perhaps. Could a guy like this have generated this
attack on his own, without being encouraged? Definitely.
I think the DoD
and the V.A. are asking the right questions now: how did this wildly
inappropriate MD get away with his weird, hostile, un-doctor-like, in-your-face
behavior for as long as he did? I trust
that Secretaries Gates and Shinseki – both extraordinarily smart, trustworthy
leaders – will get to the bottom of this.
And our national security and intelligence agencies will figure out the
degree of terrorist involvement.
But if we want to get rid
of PTSD, the first thing we need to do is stop the cruel, multiple
rotations. We’re sending some of our service people out on their 8th
rotation, people. Do you know what kind of havoc this wreaks on anyone’s psyche, let alone what
it does to their families’?
We have plenty of research
data to show that multiple exposures to traumatic events increase
exponentially the likelihood of acquiring PTSD.
Not that we needed studies to prove this – it’s just common sense.
I hate to say it, folks,
but reinstating the draft would put an end to this, for lots of reasons –
because we’d have more troops; and because we’d all be noticing with great intensity and discernment, how hard this
is on our own kids and families. And we’d be far more likely to question the
necessity of any war.
But enough about this for
Stay tuned: my next rant will be about what the military
is doing to address PTSD – the V.A.’s exclusive love affair with Prolonged
Exposure Therapy; the DoD’s madcap infatuation
with Positive Psychology; and the many creative, effective, if little known
therapies, popping up all over the place like mushrooms after a spring rain.