Lucie Lewis, Contributing Writer…
We have been sending soldiers off to war down through history, and through the years, many have returned with unseen wounds. We have long acknowledged the struggles of solders and veterans who experienced mental and emotional crises both during and aft er the conflicts they fought in. Historically, the symptoms they displayed were referred to by names such as combat exhaustion or battle fatigue. After World War I, with the trench-fought battles, it became known as shell shock.
According to an article by Steve Bentley (January 1991) entitled A Short History of PTSD: From Thermopylae to Hue–Soldiers Have Always Had A Disturbing Reaction To War republished in the VVA Veteran in March 2005, “…war has always had a severe psychological impact on people in immediate and lasting ways.” Bentley reported that, in prior wars, the ailments shared by so many were believed to be caused by a lack of courage, weak character or by malingering. He cited the 1864 comments of the Surgeon General that reflected the attitudes of the times when he was quoted to say, “It is by lack of discipline, confidence, and respect that many a young soldier has become discouraged and made to feel the bitter pangs of homesickness, which is usually the precursor of more serious ailments.”
According to Paul Chubbuck, author of Releasing The Past — Four Keys to Healing from Trauma, Abuse and Loss, (2004) the numbers of affected soldiers visibly increased after the Korean and Vietnam wars. In agreement, Bentley asserted that the emotional crises experienced by our soldiers and veterans persisted beyond World War II with little more understanding of the cause. Bentley also concurred that the symptoms of those who were serving or had served were identical to those experienced down through history by the soldiers who had been diagnosed with combat exhaustion, battle fatigue or shell shock.
While they still had no means to help alleviate the suffering, at least during World War II, these symptoms were finally recognized as not being the result of weak character, and in 1980, these common conditions were given a new name—PTSD.
According to the National Coalition for Homeless Veterans (NCHV) as cited in the white paper entitled Homeless Female Veterans, PTSD is one of the largest mental health challenges facing returning veterans. Based on their research, “From 2004-2008, the number of veterans seeking help for PTSD in the VA system increased from 274,000 to 442,000.” This represents an increase of more than 60 percent. According to the National Center for PTSD, a department within the US Department of Veterans Affairs, the symptoms of PTSD include hyper-arousal, re-experiencing, avoidance and numbing.
Numbing is most easily explained through the popular danger response concept of fight or flight. When faced with danger, it is a survival mechanism to choose between fight or flight. However, according to Paul Chubbuck, to understand numbing, there is a third response that must also be understood. Chubbuck explained that when the circumstances or events become too big, come too fast or become repetitive with no way to fight or any means of flight, the final response is to freeze. He offered the picture of a cornered rabbit such as the one in your yard happily chewing at the grass until you begin to approach, coming to close for him to escape. The rabbit becomes motionless until you move to a safe distance and then he recovers and makes his getaway.
Chubbuck explained that, in animals, this momentary reaction will oft en discourage a predator, allowing the animal to survive. This behavior occurs in people as well, Chubbuck added. In people, the freeze looks like the shutting down of their alertness resulting in a loss of the special spark. They appear depressed. Chubbuck equated this response to a circuit breaker being tripped. The freeze allows individuals to survive the experience by pushing down the feelings and going numb. While they continue to function, their emotional response to life is less joyful and they are a little less alive. Unlike the animal kingdom that recovers naturally when the threat is gone, many people are rarely able to recover from the freeze without support.
Although it was only recently that women were allowed into combat, they have been a part of our military action as far back as the Civil War. From disguising themselves as men to serving as cooks, nurses and non-combat personnel, women have found a way to serve. In fact, according to Women in Military Service for American Memorial Foundation
The first women to fall in combat occurred on Dec. 11, 1775 when Jemima Warner was felled by an enemy bullet. Since that time, women have been recorded as part of every conflict, experiencing the trauma and terror of war alongside their brothers in arms. As a result of their shared experience, as veterans, men and women share something else— the risk of PTSD. According to the Veterans Administration, “almost half of all female Vietnam veterans have experienced “clinically serious stress reaction symptoms.” (http://www.ptsd.ne.gov/what-is-ptsd.html)
The symptoms of PTSD as they present in women may differ from those of men, however. According to the National Center for PTSD, women with PTSD are more likely to feel jumpy and have more trouble feeling emotions than men, whereas men are more likely to feel angry and to have trouble controlling their anger. While women experience depression and anxiety more frequently, men are more likely to have problems with drugs and alcohol. The Center also reported that women in the military are twice as likely to develop PTSD as men. They reported that women may also take longer to recover from PTSD and are four times more likely to experience long-lasting symptoms.
Recognizing the need for support for women veterans with PTSD, the Department of Veteran Affairs began offering treatment tailored to their special needs in 1992 when they opened the Women’s Trauma Recovery Program, a 60-day residential recovery program, located in Menlo Park, CA. According the program description, the Program supports residents from 26 to 62 with the average age of 46. Residents include veterans from the Vietnam era (15%), diverse peace keeping missions (15%), Desert Storm (15%), Operation Enduring Freedom (22%), and Operation Iraqi Freedom (30%). Twelve percent of the residents were still on active duty at the time of their dismissal from the Program and 56 percent reported having served in a war zone. However, one program demographic highlighted another critical issue when discussing PTSD.
PTSD is not just experienced by soldiers involved in wars and conflicts. PTSD is a response to trauma—all trauma. Women that have been the victim of sexual assault/abuse or child abuse, suffered a loss, or experienced (or witnessed) a life threatening event are also at risk of experiencing PTSD. Consequently, the incidence of sexual abuse in the military heightens the PTSD risk for women veterans.
Ninety-seven percent of the residents of the Women’s Trauma Recovery Program reported experiencing military sexual trauma (MST) (http://www.paloalto.va.gov/services/wtrp/). It was also reported in Homeless Female Veterans that, “A study done by Kelly et. al found that women who experience Military Sexual Trauma (MST) were nine times more at risk for PTSD.” (http://www.nchv.org/images/uploads/HFV%20paper%281%29.pdf)
According to a study led by Shira Maguen, PhD, a psychologist at the San Francisco VA Medical Center as reported by Steve Tokar– NCIRE – The Veterans Health Research Institute (September 14, 2011)
“Thirty-one percent of women veterans of Iraq and Afghanistan who were diagnosed with post-traumatic stress disorder reported military sexual trauma (MST), in contrast to one percent of men with PTSD.”
Almost One Third of Iraq/Afghanistan Women Veterans with PTSD Report Military Sexual Trauma, Researchers Find (http://www.coe.ucsf.edu/coe/research/ptsd-sexualtrauma.html).
However, Chubbuck leaves us with the affirming thought that recovery comes. He says that, “We all need someone to look us in the eye and say we will be okay.” This human reassurance that allows us to tell the story and unlock the freeze helps us on the road to healing.
For more information on Women’s Trauma Recovery Program call the Admissions Coordinator at (650) 614-9997 ext. 22843. (http://www.paloalto.va.gov/services/ wtrp/contact.asp)