E
Ex_2_PPCLI
Guest
Indeed. The medical community in the CF-at least as it was when I was in-was not so much unprepared or incapable of dealing with the Post-Op issues as much as they refused to look elsewhere.
For example, after the 1993 Yugo tour some soldiers were identified as suffering from PTSD. After looking into (then) the symtpoms for PTSD (see the DSM IV for more information) it became readily apparent that PTSD was not, at least in many cases, the proper diagnosis. I tried discussing this with the Med-Psych people and they basically refused to acknowledge the shortcomings in using this diagnosis. In Israel a more appropriate diagnosis, known as Combat Stress Reaction (CSR), seems applicable. And the Israeli's ought to know given the conditions they send their troops into (whatever your opinion of ths situation).
The thing with CSR that differs from PTSD (and its variants) is twofold. On the one hand, PTSD requires there to be a 'traumatic' incident that acts as a catalyst or precursor to the Post Traumatic condition (These criteria are well explained in the DSM). However, the DSM also notes that the trauma occurs very differently, if at all, in and among certain high risk occupations-i.e. police, fire fighters, medical personnel (It does not include the military most likely because it is a civilian organisation) Back to the point. The reason why these groups are effected differently (warranting a different diagnosis) is simple: for trauma to evolve into a PTSD diagnosis and condition the initial event must be traumatic. In this case a traumatic environment is not the one that these high risk occupations are trained and experienced to exist in. For example, a paramedic. Although a paramedic may be 'shocked' by what he or she sees at a bad crash site they wont (normally) suffer PTSD from what they have seen. Why? Because this environment is not a 'traumatic' one to them. Another example closer to home: a Clerk may suffer PTSD from witnessing or taking part in the grave's registration duties we had to deal with in Yugo or the fighting in Medak. However, it is highly unlikely that an infanteer will because we are trained to exist and live in these very circumstances. This is NOT to say PTSD cannot occur only that it is highly, highly, unlikely.
On the other hand, CSR speaks directly to anger. And, for those who served with either 2 PPCLI up north in Yugo or 2 RCR down south (c.1993) they'll know, upon return, how the experiences overseas were manifest in the soldiers when they returned: anger. And lots of it. As the distance from the events widens the ability to cope with and locate the anger is limited and deepens in regards to CSR. In PTSD, which is a rare diagnosis in reality, the condition tends to sort itself out. In fact, many experts (real and experienced experts-i.e. those who dealt with Columbine) are saying that immediate intervention (often called Critical Incident Stress Debriefing or CISD) may worsen the problem. Why? BECAUSE we humans are a tough lot in the end and traumatic incidents are often, more or less, satisfactorily dealt with on their own. That is to say, it tends to deal with itself. Furthermore, as the person moves away from the events and environment the stress tends to decline as well. These experiences are COMPLETELY the opposite of CSR and in contrast to my experiences and those of my peers after Yugo (having been a facilitator).
But, and again, the military Med-Psych world did not want to discuss this. I went even as far as discussing it with the Ombudsmen and a member of the SCONDVA commision (the latter called once in regards to that tour and our opinions of the 'follow-up' actions. To which my response was: What follow-up?).
Sending troops to a happy middle ground before they return from a tour IS a great idea (that's why the long boat home from Europe allowed WW II soldier's to deal with alot of their grief). However, one of the major failures of the Medical branch was in MIS-diagnosiing soldiers. Soldiers who, by their very soldierly nature, will try and fit the diagnosis, a diagnosis given by a superior, and a superior supposedly only interested in that soldiers best intersts!
Many soldiers tried very hard to understand why their lives were falling apart and, especially here, the medical system (specifically the Med-Psych people) failed by virtue of conscious ignorance.
Add this to our leadership problem and soldiers are now left with very few avenues of support...
...I have ranted again it would seem... :-\
For example, after the 1993 Yugo tour some soldiers were identified as suffering from PTSD. After looking into (then) the symtpoms for PTSD (see the DSM IV for more information) it became readily apparent that PTSD was not, at least in many cases, the proper diagnosis. I tried discussing this with the Med-Psych people and they basically refused to acknowledge the shortcomings in using this diagnosis. In Israel a more appropriate diagnosis, known as Combat Stress Reaction (CSR), seems applicable. And the Israeli's ought to know given the conditions they send their troops into (whatever your opinion of ths situation).
The thing with CSR that differs from PTSD (and its variants) is twofold. On the one hand, PTSD requires there to be a 'traumatic' incident that acts as a catalyst or precursor to the Post Traumatic condition (These criteria are well explained in the DSM). However, the DSM also notes that the trauma occurs very differently, if at all, in and among certain high risk occupations-i.e. police, fire fighters, medical personnel (It does not include the military most likely because it is a civilian organisation) Back to the point. The reason why these groups are effected differently (warranting a different diagnosis) is simple: for trauma to evolve into a PTSD diagnosis and condition the initial event must be traumatic. In this case a traumatic environment is not the one that these high risk occupations are trained and experienced to exist in. For example, a paramedic. Although a paramedic may be 'shocked' by what he or she sees at a bad crash site they wont (normally) suffer PTSD from what they have seen. Why? Because this environment is not a 'traumatic' one to them. Another example closer to home: a Clerk may suffer PTSD from witnessing or taking part in the grave's registration duties we had to deal with in Yugo or the fighting in Medak. However, it is highly unlikely that an infanteer will because we are trained to exist and live in these very circumstances. This is NOT to say PTSD cannot occur only that it is highly, highly, unlikely.
On the other hand, CSR speaks directly to anger. And, for those who served with either 2 PPCLI up north in Yugo or 2 RCR down south (c.1993) they'll know, upon return, how the experiences overseas were manifest in the soldiers when they returned: anger. And lots of it. As the distance from the events widens the ability to cope with and locate the anger is limited and deepens in regards to CSR. In PTSD, which is a rare diagnosis in reality, the condition tends to sort itself out. In fact, many experts (real and experienced experts-i.e. those who dealt with Columbine) are saying that immediate intervention (often called Critical Incident Stress Debriefing or CISD) may worsen the problem. Why? BECAUSE we humans are a tough lot in the end and traumatic incidents are often, more or less, satisfactorily dealt with on their own. That is to say, it tends to deal with itself. Furthermore, as the person moves away from the events and environment the stress tends to decline as well. These experiences are COMPLETELY the opposite of CSR and in contrast to my experiences and those of my peers after Yugo (having been a facilitator).
But, and again, the military Med-Psych world did not want to discuss this. I went even as far as discussing it with the Ombudsmen and a member of the SCONDVA commision (the latter called once in regards to that tour and our opinions of the 'follow-up' actions. To which my response was: What follow-up?).
Sending troops to a happy middle ground before they return from a tour IS a great idea (that's why the long boat home from Europe allowed WW II soldier's to deal with alot of their grief). However, one of the major failures of the Medical branch was in MIS-diagnosiing soldiers. Soldiers who, by their very soldierly nature, will try and fit the diagnosis, a diagnosis given by a superior, and a superior supposedly only interested in that soldiers best intersts!
Many soldiers tried very hard to understand why their lives were falling apart and, especially here, the medical system (specifically the Med-Psych people) failed by virtue of conscious ignorance.
Add this to our leadership problem and soldiers are now left with very few avenues of support...
...I have ranted again it would seem... :-\
) the anger can become debilitating and dangerous.
