Fort Hood: A Harbinger of Things to Come?
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The Army knew that Fort Hood shooter Major Nidal Malik Hasan was shouting political and religious harangues to patients during his therapy sessions at Walter Reed Army Hospital.
When that happens in a psychiatric setting, it is time to radio Houston that we have a problem.
Instead of admitting the serious break down in Army quality control, each day the Army provides a new explanation of why blame for the Fort Hood shootings should be laid at the feet of Muslim terrorists and not the US military.
This problem the military has in confronting psychiatric problems is longstanding.
Unless there is a dramatic change in the military’s use of mental health expertise there will be more Fort Hoods as our troops return from Iraq and Afghanistan with serious psychiatric disorders.
Unfortunately, instead of making the needed changes to improve quality, the military has recently announced plans to paper over the problem by providing our troops with superficial new mental health treatments that could prove very harmful, especially when applied to the severe psychiatric disturbances caused by military duty.
Historically, sensitivity to mental health needs in the military was absent. In more recent times, the sight of homeless veterans on our nation’s streets coupled with news stories of veterans’ erupting into inexplicably violent behavior made it hard for the military to continue to deny the problem of obviously unmet mental health needs.
The military has not necessarily used its new allocation for mental health resources to provide high quality mental health care, however. Instead, it has tried to downplay serious mental health issues and co-opted mental health resources for other military objectives.
During the first Persian Gulf War, for example, there were seven thousand children who had both parents deployed in harm’s way. Then-Congresswoman Barbara Boxer chaired a subcommittee of the House Armed Services Committee and held hearings on the psychological implications of this for the children involved. Three military psychiatrists and I were asked to testify.
At this time, I had been in the forefront of the many turf battles that have characterized the competitive relationship between American Psychiatry and American Psychology. I was relieved to be in a setting where accord seemed guaranteed. Having both parents in harm’s way obviously was psychologically traumatic for children. We would not disagree on that one.
I was the first to testify. After I described the psychological trauma this kind of separation could cause for young children and made recommendations how to minimize that trauma, I quickly realized that my assumption of professional concurrence on the matter was ill-founded.
The testimony from the military psychiatrists was all to this effect: “Kids are tough.” “Kids are resilient.” “Adversity makes kids stronger.” And then there was my personal favorite: “Mozart’s greatness as an adult was caused by his father’s death when Mozart was still a little boy.” These were verbatim statements from the military psychiatrists.
In the subcommittee hearing, trained psychiatrists spouting pseudo-psychiatric nonsense were literally trying to convince the panel to ignore the psychological trauma that war causes for children who have both parents in harm’s way. Themes of toughness, resilience, and growth through adversity were bastardized and taken to extreme degrees. The military wanted to neglect the psychological trauma suffered by military children, and it used these three psychiatrists to achieve that objective.
The most extreme example of this exploitation of mental health expertise occurred when military mental health resources were used in the service of torture. As I reported <http://www.huffingtonpost.com/bryant-welch/torture-psychology-and-da_b_215612.html> last June in the Huffington Post when it came time to develop and implement instruments of torture, psychologists with close ties to Senator Daniel Inouye’s office were very useful handmaidens to the CIA and the military.
Dr. Martin Seligman, for example, a recent past president of the American Psychological Association, provided training to a group of CIA psychologists, including those psychologists now known to have developed the torture techniques used by the Bush Administration in its “enhanced interrogation program.”
Dr. Seligman is a nationally known psychologist who gained his reputation from experiments applying electrical shocks to dogs. He discovered that when electric shocks are applied to a dog over periods of time the dog begins to act helpless. He coined the phrase “learned helplessness” to describe the post-torture condition of the animals. One can, of course, see why the architects of the US torture techniques felt this body of knowledge might be useful for their objectives.
Dr. Seligman reports that he asked the CIA officials whether the training was being used for torture, but they reportedly replied that his lack of security clearance made it impossible for them to tell him. Apparently reassured by this answer, Dr. Seligman went ahead with his instruction on learned helplessness and what he learned from applying electric shocks to dogs.
With the current number of suicides and cases of post traumatic stress disorder reaching all time highs the pressure has increased on the military to address the mental health needs of the troops. One would expect that to help address that problem the military would turn to experts in the treatment of post traumatic stress disorder, the primary severe mental health problem requiring treatment. Instead, the military has once again turned to Dr. Seligman.
In August of 2009, in an announcement carried by the New York Times, Dr. Seligman reported that the military has developed a $119 million program to train 1.1 million American troops in the techniques of “Positive Psychology” aka the Psychology of Optimism. “Positive Psychology” was developed by Dr. Seligman. While Positive Psychology has developed some following in the mental health field, personally, I have not been able to find a meaningful distinction between it and Norman Vincent Peale’s Power of Positive Thinking. Both emphasize substituting positive thoughts for unhappy or negative ones.
In announcing the new military program, Dr. Seligman explained his view <> of the connection between Positive Psychology and military trauma.
”Psychology has given us this whole language of pathology, so that a soldier in tears after seeing someone killed thinks, ‘Something’s wrong with me; I have post-traumatic stress,’ or P.T.S.D.. The idea here is to give people a new vocabulary, to speak in terms of resilience. Most people who experience trauma don’t end up with P.T.S.D.; many experience post-traumatic growth.”
It is difficult for me to understand how anyone familiar with post traumatic stress disorder in the military could make such a statement. PTSD, once referred to as “shell shock,” occurs in veterans who have experienced the horrors of war to such intensity that they psychologically crack. PTSD is the illness depicted in the movies when crazed ex-veterans go on shooting rampages. Unfortunately, these movies are accurate depictions of many very real tragedies for military veterans.
In PTSD, victims are subjected to such overwhelming and horrible emotional trauma that they are unable to regain stability with typical psychological coping mechanisms. Instead, the rattled mind is driven into uncontrollable and rapidly changing, emotionally painful states. The mind oscillates from a full blown, emotional re-experiencing of the trauma to a complete numbing of all emotions, as if the mind were trying to protect itself from being re-traumatized by holding all feelings at bay. Night terrors, panic attacks, depression, and cognitive confusion occur in chaotic fashion to helpless victims.
When one understands and fully appreciates this inner world of the post traumatic stress victim, it is easier to understand why a veteran can go “berserk” killing his family and then taking his own life. It is not a mental state that can be treated by suggesting to the patient that he or she simply re-frame how they think about the situation, as Dr. Seligman suggests.
And yet the US military has bought into this untested notion to the tune of $119 million. This money, of course, could have been used to provide real mental health care to our troops. Instead, it is being used to tell military personnel that they can (and, thus, presumably should) overcome whatever happens to them on the battlefield with the dubious tools of Positive Psychology.
Once again the military is returning to the same pattern I saw in the panel presentation at the time of the first Persian Gulf War. As Seligman’s comments indicate, the military is developing a program for our veterans that are based on the same “kids are tough,” “they can do it,” and “through adversity to the stars just like Wolfgang Mozart” that the Armed Services subcommittee heard during the first Persian Gulf War.
Few who know the military culture think, as Dr. Seligman implies, that the problem with PTSD is that there are too many military personnel diagnosing themselves with PTSD. The problem is just the opposite. Too many members of our armed services are going through traumas that are undiagnosed by themselves or anybody else.
Telling trauma victims that they need to learn to “cope” with these traumas or, as the Positive Psychology approach suggests, find opportunities for “growth” in them, is effective for a military commander trying to drag one last drop of blood out of a soldier. It is not good, however, for the soldier or the society to which the soldier returns. In fact, it simply adds to the already excessive emotional burden the soldiers are carrying.
Our troops have been through enough.
While most Americans have contributed very little to the war effort, other than to adorn our cars with decals of a flag that smugly proclaims our support for the troops, we have subjected them to multiple deployments which none anticipated when they enlisted.
They have gone into battle with inadequate armor. They have watched their comrades die.
We have left the families of the troops without adequate support. We have caused their civilian careers to evaporate and let their businesses fail.
We have done this at a time when others have gotten wealthy and even enjoyed special tax cuts with money that rightfully should have gone to support the troops.
When the troops have returned home injured and in many cases with broken families, we slashed their health care.
Now, when they seek mental health care because their minds are like terrifying roller coaster rides, because of what they have seen in combat, we are going to respond to their PTSD by telling them to be resilient and turn their trauma into a Mozart concerto.
Can anyone see how that might make an already shaky mind crack and grab a gun?
If we can identify the real problem that caused the tragedy at Ford Hood we can possibly prevent such episodes in the future. Alternatively, we can continue to deny the real problem, provide sham treatments for serious psychiatric casualties, and just whoop up more resentment toward Muslims. That’s the current plan.
Author’s Bio: Bryant L. Welch, J.D., Ph.D is a clinical psychologist and attorney and author of State of Confusion: Political Manipulation and the Assault on the American Mind. (Thomas Dunne Books, St. Martin’s Press, June, 2008.) Dr. Welch graduated from Harvard College and received a juris doctorate from Harvard Law School and a Ph.D. from the University of North Carolina at Chapel Hill. After completing his education Dr. Welch joined the UNC medical school faculty and practiced clinical psychology for ten years . In 1986 Dr. Welch moved to Washington, DC to build the American Psychological Association’s Practice Directorate.. He was the first Executive Director for Professional Practice of the American Psychological Association and had overall responsibility for all APA programs relating to the practice of psychology including government relations, legal and regulatory affairs, marketing, state psychological associations, and public relations. During his tenure, Dr. Welch guided the APA through one of psychology’s most successful advocacy eras. He filed a successful class action anti-trust suit against the medically dominated American Psychoanalytic Association opening the field of psychoanalyis to non-MD mental health professionals and helping to revitalize American psychoanalytic thought. (Dr. Welch is himself a research associate graduate of the Washington Psychoanalytic Institute.) He successfully secured passage of legislation to make psychological services available to seniors and to persons with disabilities through the Medicare program, and he expanded access to psychological services into a number of new venues. He was also one of the first and most outspoken healthcare professionals to warn of the impending new problems created by HMO’s and corporate managed health care. Upon leaving the APA, Dr. Welch represented the American Psychological Association in the ill-fated Clinton Health Plan, and established a boutique law firm specializing in litigation against managed health care companies on behalf of suicide victims and their families. For over twenty years Dr. Welch has written regular monthly columns on psychology and political issues for the mental health trade press including the Psychiatric TImes and the American Psychological Association Monitor. He has appeared on all major media networks and been quoted in over two hundred newspapers across the country. He is board certified in clinical psychology, a Distinguished Practitioner Member of the National Academy of Practice and in 2005 was awarded the American Psychological Association Presidential Citation for “seminal contributions to professional psychology.” He has held academic appointments at the University of North Carolina in Chapel Hill, George Washington University, and the University of South Carolina-Beaufort.