Are We Telling Our Veterans They’re Broken?

One of the most important things I do, is work with veterans who have disabilities. So many of them suffer from Post-Traumatic Stress Disorder (PTSD) symptoms, some severe, some not. Most veterans with PTSD are high functioning and can do any job necessary with proper counseling, coping skills, and training. But so often the Veterans Affairs (VA) fails them by pushing psychotropic medications instead of counseling and training on how to enter the workforce with their PTSD properly managed. The VA offers counseling, but many veterans are re-traumatized by some of their methods, discouraging numerous veterans from seeking the treatment offered by the VA. Sean is one of those veterans who was let down by the VA. Sean is an intelligent, resourceful, and educated Army veteran with two tours in Iraq. Sean suffers from PTSD and refuses to utilize the VA to help control his PTSD. Sean had used the VA in the past and was given medication, which he now refuses to take. Sean’s PTSD is extreme, and he struggles daily just to attend his college classes. He continually question’s his ability to hold a job because of his PTSD and hopes college will help him gain the necessary confidence and skills to be successful. Part of what so many veterans, including Sean, must overcome are businesses fear of hiring veterans because they dread PTSD in the workplace. They don’t want to be responsible if someone “goes off” while at work.  

The VA is not helping because they're quick to give disability checks to those who have PTSD for the rest of their lives due to civilian pressure. Why should veterans work or find a job, when there’s no incentive to get better? The VA tells them they are broken because they are 100% disabled. In the VA’s defense, they do bring many veterans with PTSD back for re-evaluation every few years, but veterans have no reason to get better. After their PTSD diagnosis, many veterans are not required to complete therapy that can help them learn to manage their PTSD.

I understand this is quite controversial, everyone, including me, a 20-year combat veteran feel the VA needs to do their job and take care of our veterans. But what we know from so many of our WWII, Korean, and Vietnam veterans is, people with PTSD can live totally productive lives if they are not treated like they are broken and without purpose. Sean is one of those people who feels broken and without purpose. He believes he is going to struggle to get jobs because of his PTSD, he now has a defeatist, victim mentality.

What the VA needs to do is give effective personalized treatment for PTSD and continually monitor those who get disability checks for their PTSD. The VA is set up to reward veterans for maintaining their PTSD. The VA should educate veterans to find employment that will be better tolerated by vets with PTSD. Employers need to make a concerted effort to employ our veterans with good paying jobs and trust them, even those with managed PTSD. There are veterans who need to be 100% disabled because of their PTSD because they cannot function in society, but if a veteran can go to college and graduate, then they should be able to learn to manage their PTSD and re-enter the workforce, giving them back their sense of purpose.

For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro. 

The Battles Continue for Veterans

I met Frank at the Vet center where he is going to college. Frank is an operation Iraqi Freedom (OIF) veteran with two tours, he has seen more than any 27-year-old should ever have to. He is struggling to work through what happened while he was deployed and since his return to the “real world”. Since his return home he has been battling multiple fronts and having to fight different fights. Frank was married and has a six-year-old daughter, now he is divorced and lives alone. He has been battling with the Veterans Administration (VA) over his disability, causing frustration and anger. He has been going to college but struggles dealing with the younger generation. He has recently added a battle within himself, the battle over how he feels about his time in Iraq. His emotional issues have taken over his life. Not only is he battling what he saw and had to do in Iraq, he is having to deal with emotional issues that followed him home.

Those issues have played a huge part in his families struggles. He and his wife have divorced like so many other veterans’ whose relationships have suffered the same fate. When Frank left for the first deployment he was not married. He did not want to get married to his girlfriend because he worried he would not make it back. The first deployment affected him a little, but he felt it was nothing he could not handle. After his first deployment he and his girlfriend got married and had a daughter. They had been married about 3 years and he was again called to deploy. This time he had a wife and daughter to be concerned about. Like all good troops he went and did his duty. Frank explained how he remembers the first time his problem with PTSD was noticed. After about 8 months in theatre Frank’s Non-Commissioned Officer in Charge (NCOIC) started to get concerned, he noticed Frank had become careless and would lose his temper more often. He finished his deployment and returned home to his wife and daughter. When Frank returned, he was happy, but it was not long before the return honeymoon period ended. About a year later his wife left with his daughter because of his drinking.  Frank was not the same guy she fell in love with. Up until this point Frank had been reluctant to get help from the VA. He finally took that step for help, but it was too late for his relationship.     

When Frank finally took the step to get help from the VA, another battle started. The VA is a huge bureaucratic nightmare and can be frustrating. His first step was behavioral health, he was placed on a waitlist. He soon became frustrated and came to see me while waiting for his spot to open up. About 2 months later he was called and given an appointment. Once it was all said and done, he received an 80% disability rating for Post-Traumatic Stress Disorder (PTSD). During this time working through the VA bureaucracy he decided to start college.

Frank explained how he was nervous about going to college. No one in his family had taken that step. He started using his post-911 education benefits. He soon found that there were battles he had to fight in college too. The college is a state-run institution and the education program is a federal program. Frank had to deal with two different bureaucracies, as a rule bureaucracies do not play well with each other. Once he was done with battling dueling bureaucracies he had to deal with immature students.  These students don’t understand him and asked, “stupid questions” like “did you kill someone?” or “was the war worth it?” This became a battle he had to deal with, he had to maintain his composure and keep calm. They did appear to affect him, because he started to have another battle within himself, was the war worth it since ISIS had taken large chunks of Iraq?    

Frank, like some other veterans now question what they were fighting for. He was glued to the TV for a while when ISIS invaded Iraq and the Iraqi Army lost control of the land they had fought so hard, shed blood, and died for. He has stopped watching the news because it brings up the negative emotions he has been trying to suppress. Even before ISIS took over parts of Iraq he was struggling to deal with the cost of the war. Frank tells very few about how he feels about the wars. He converses with other veterans who have spoken up, but he keeps his comments to a minimum. He is caught in a battle with himself and his feelings, he does not know how to feel. Frank feels if he does not care about what is going on in Iraq then he is disloyal to those who we lost. If he feels anger all his emotions he has worked hard to suppress will arise. Frank feels he should want to go back and recover what he had fought so hard for.

I am seeing more and more veterans struggling with the situation in IRAQ and I don’t see an end to it. I have talked to several in the Army, Navy, Air Force, and Marines who, like Frank don’t know how to feel. They mourn the loss and casualties of their brothers, while questioning whether it was all worth it. This is a hard place to be, it is difficult to feel your brothers died in vain, it’s a hard pill to swallow but many are starting to fight the battle. These are the same feelings the Vietnam veterans have been feeling for years, was it worth it. Only the individual veterans can answer that question.

For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro.

Leaving Money on the Table

I am constantly amazed at how many veterans don’t know they have benefits through the Veterans Administration (VA) or feel they don’t deserve benefits for one reason or another. One of the major benefits veteran’s overlook is disability compensation. It is shocking how little veterans and their families understand about VA medical disability compensation. I was at a store last week and ran into John, an Iraq war veteran. John struggles financially because he can’t keep a good paying job due to his war disabilities. John has been out of the Marines for 3 years and thought he had waited too long to apply for benefits, this is a misconception. John will always be eligible for service connected disability benefits. John also was not told he was covered for medical benefits by the VA for 5 years after his separation from the Marine Corps. John has been paying for medical insurance when he did not have to. I asked if he had been told about his benefits at the Transitional Assistance Program or TAPS seminar and he said he hadn’t. If John receives a 30% disability rating or higher, as a combat veteran he has medical benefits for life through the VA. Some veterans struggle to make ends meet when they don’t have to. There are benefits for veterans, they just need to apply. Even though applying for benefits is easy, working through the bureaucracy of the VA moves slowly, and is not so easy.

Applying for disability is not a difficult task, working through the VA disability process is challenging. Every US President has said they will improve the VA system, but the VA ship is hard to turn around. Filing a disability claim through the VA can be a long, arduous process. Once a claim is filed veterans needs to be prepared for the wait. The disability process has gotten better lately but it is still painstakingly slow. The key for the veteran is managing expectations and understanding their benefits claim will take time. Some veterans don’t feel applying for disability benefits is worth the effort and some veterans feel they don’t deserve the benefits and refuse to apply.   

Why don’t veterans want to apply for disability benefits? When I pose that question to veterans they feel they are not disabled enough, there are veterans missing limbs and have visual wounds, while theirs may be internal and psychological. They feel their disabilities are not severe enough to warrant a claim. Another answer I get is, I am taking benefits from someone who needs them worse than I do. VA funding is based on the number of veterans served at their facilities. Sitting out the disability process is not helping anyone, by not applying for benefits you could cause a cut in funding to your local VA facility.

Sometimes, those who receive benefits are called “moochers” by some in our society, usually those who never served. Because of this attitude some veterans feel they are working the system and getting charity, the reason it takes months or years to get a disability claim through, is that the VA spends the time to weed out the “moochers”.  While in your 20’s, jumping off a 5 ton or duce and half with an 80 to 100-pound rucksack in full battle rattle, being tossed around on an aircraft carrier deck or, jumping off of aircraft and equipment is hard on the knees, ankles, and back. I truly believe no one gets out of the military physically unharmed. If you have a legitimate issue caused by your military service, file a claim. The health issues from your service in your 20’s might not be seen instantly but they do catch up to you as you age.  You earned these benefits, it’s not a gift.

The bottom line is you need to apply for the benefits you have earned. There’s no reason for veterans and their families to struggle financially or have medical bills when you don’t have to. I talked to John for about an hour and finally convinced him to apply for compensation for his medical problems.  Many veterans are going to have back, knee, ankle, or various other physical and mental issues because veterans are trained to feel indestructible while serving. Apply for the disability benefits you earned, the military forced you to abuse your body when you were young. Don’t struggle financially in retirement or pay for medical insurance because you abused your body or are suffering with PTSD. Why leave money you have earned on the table?

For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro.

Veterans and their Spouses Need to Understand the VA System

Even though I served 20 years in the Air Force and have been retired for 12 years I still did not understand exactly how the Veterans Administration (VA) works. After 32 years I am now on a mission to learn the VA system. I thought I would share some of what I have learned. Being retired I have Tri-care medical insurance and felt I didn’t need the VA medical system. I tried to not use the VA system believing I was taking appointments from veterans who needed them.   I had gotten my disability rating when I retired and believed did not have to set foot in a VA hospital or clinic because I have Tri-care. The one time I went to the VA was about 6 months after I retired and was not happy with the way I was treated, I waited 10 years to go back into the VA. I did not want to deal with the headaches of the VA, so I didn’t go, that was a big mistake on my part. My thought process changed when I filed to increase of my disability claim about 2 years ago. I found I had to start playing their game.

My claim was denied for lack of documentation because I had chosen to not use the VA system. I retrieved my civilian medical records and took them to the VA believing that would give the VA the needed documentation for my claim. After waiting about 2 hours at the VA records department I was unable to add my personal medical records to my VA medical records.  I needed permission from a VA primary care physician, which I did not have. I was required to sign up for a primary care provider at the VA, taking an appointment from another veteran who only has medical insurance through the VA. I received an appointment in a shockingly quick time. I now have 2 primary care physicians one from the VA and a civilian doctor from Tri-Care. I quickly found I did not understand the system. As I have learned the hard way the VA has 3 separate sections and they don’t talk to each other. The VA’s 3 sections are Veterans Healthcare Administration (VHA), Veterans Benefits Administration (VBA) and National Cemetery Administration.

The VHA healthcare system is the largest integrated health care system in the United States. What many do not know is each VA healthcare facility is managed as a separate entity. Every VA facility is different and offer different services. Often one of the biggest issues is the different VA facilities or entities not talking to each other. The VA runs more than 1,700 hospitals, clinics, and other facilities spread throughout the country. I have heard of several instances where a veteran goes to a different VA facility than their normal one and the visiting VA facility has no access to their medical records. Veterans need to be aware their VA medical records are not available when they travel unless the veteran registers to share them.  

The benefits section of the VA the VBA covers a multitude of items for service members, veterans, their dependents and survivors. The benefits section of the VA covers disability claims, education, training, home loans, and life insurance for qualifying members. The important thing to remember is the benefits section might not talk to your VA primary care provider for information about your claim. While talking to my VA primary care provider I found the information from my VA benefits claim, filed by a VA benefits contract doctor was not added to my permanent VA medical records. I had to tell my VA primary care doctor my diagnosis from a VA contract doctor. You have to stay on top of your information and claim. The people reading your compensation claim utilize all documentation, but you need to make sure all documentation is there. If you went to your VA primary care or civilian physician after the claims section has pulled your records for review they do not have your most recent information. If you have been diagnosed with a medical issue by a VA contract doctor do not assume it is in your VA medical records for your VA primary care doctor to see.   

The third section of the VA is the National Cemetery Administration. Many veterans and their families do not know that veterans and spouses can be buried at any of the 134 National cemeteries if they qualify, and most veterans do. Your local Veteran Service Organization (VSO’s) Should be able to help you. Your Funeral home should also be aware of the requirements for VA death benefits.   

In the end, you as the veteran or family member must stay on top of your documentation and claim. If you understand that the VA sections do not talk to each other it makes it easier for you to work through the system. It is in your best interest that you not assume the VA benefits section has all of the needed information for your claim. Make sure you understand how you can control the speed that claims get handled by understanding how the system works. For your health don’t assume your VA primary care physician has all of your needed information. Follow up to make sure the right section has the documentation needed to file a successful disability claim and your VA primary care doctor has the needed information to save your life.

For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro.

Women Are In Combat

At a veteran’s event I was talking to a Lara a female employee of the Veterans Administration (VA). We spent a lot of time talking about issues within the system. She had served 10 years in the Army before she was medically retired due to her Post Traumatic Stress Disorder (PTSD). Like most people I assumed her PTSD was from a sexual assault. I was wrong, she had combat PTSD. She explained that my assumption was a major reason many female veterans will not reach out for mental health services or file a claim for PTSD because of the shame associated with sexual assault. I assumed that any female who has PTSD must have gotten it from sexual assault not combat, I assumed incorrectly.

I have said in past columns that I have yet to meet a female veteran who had not at a minimum been sexually harassed. Lara continued to educate me and said I was the third person that she had heard the sexual assault assumption from.  Lara informed me she had not been sexually harassed or assaulted during her time in the Army. We continued to talk and she told me that most people still struggle to believe that female veterans served in combat, let alone getting PTSD from a combat experience. Lara explained how a struggling a female veteran she knew could have gotten a 100% disability rating if she included her combat PTSD. She refused to include PTSD in her claim for fear people would assume her PTSD was from a sexual assault not combat, she did not want to deal with the shame associated with people assuming she was sexually assaulted. She did not want to be seen by society or other veterans as a victim.  

Lara continued educating me on her experiences and discussed how she had been struggling for quite a while because there are no groups for female veterans with combat PTSD. She tried to go to a combat PTSD group and an older veteran asked what was she doing there, women can’t have combat PTSD, women don’t serve in combat! That is a huge misnomer. There has been over 800 women wounded and 130 who gave the ultimate sacrifice since the wars started in 2001.

Recently women have been ok’d for combat, even some who have made it through Ranger school. Female veterans see combat whether society likes to admit it or not. In the past women were not trained for combat but they continued to take on rolls that place them in the line of fire during support missions. Women have been in convoys since day one of our recent wars. On today’s battlefield women receive and return fire. One of the most effective ways for our enemy to do damage to our psyche is road side bombs or Improvised Explosive Devices (IED). These tactics focus on convoys, and females are a part of them, leaving them susceptible to combat just like their male counterparts.

Female veterans need and deserve the same treatment males get for their psychological issues. According to Lara female veterans do not like to attend combat groups because most of them are full of older veterans who have not seen or believe women should be in combat. These females have earned and deserve their own groups for PTSD. The numbers of female veterans speak for themselves. They were 1.9% of casualties and 2.4% of all deaths. More than 280,000 women have served in OIF/OEF and they now make up to 20% of new recruits. Females are 14.5% of the 1.4 million in the military and 18% of the 850,000 reservist. Many of these women have been directly exposed to combat and have earned the benefits.

The center for women veterans was established by congress in November 1994. There has been little done for women veterans until recently when they started to fight for their rights. I have had several conversations with the Women Veterans Program Coordinator at the Loma Linda VA about women’s issues. She is working hard to make the Loma Linda VA a safe place for female veterans to go. I have sent several of my female clients to the Loma Linda VA women’s clinic and they have been happy with the care and services they have received.

Our women veterans deserve to be treated just like male veterans and have the same benefits from the VA. If you are a female veteran or know one, please visit or support the women’s clinics at the VA. The VA Loma Linda Healthcare System offers a variety of health services to address the unique needs of female veterans. Look to see if your local VA has a female veteran’s clinic. Female veterans have earned the right to the same benefits male counterparts receive, take advantage of them. The more female veterans utilize their clinic the more the funding will increase. Don’t be scared to get what you have earned. Don’t let others assumptions stop you from getting what you deserve.

For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro.

Veterans Must Tell Their Story

I often wear my Desert Storm hat in public because I am proud to be a veteran. I love for other veterans to come up to me and tell me their story, and all veterans have them. Some stories are funny, some are serious and others are downright bothersome. On occasion, a civilian will come up and thank me, but usually it is a veteran who thanks me for my service. I was not prepared for what happened last week at a local restaurant. A young man who appeared to be about 10 years old came up to me, shook my hand and thanked me for my service. He was followed by his younger sister who did the same. Their dad had a huge smile on his face and said, “I am trying to raise them right” I shook his hand, and thanked him. I assumed he was a veteran or in the military because of his haircut. He told me he was a law enforcement officer. I can honestly say I was impressed. Of all the people that have thanked me these children moved me the most. At times, we write off the newer generations but they usually come through.

Since the most recent wars started in 2001 the country has seen a significant increase in patriotism that most veterans did not expect. Before the most recent wars it was unusual to see a Vietnam veteran hat anywhere, now you constantly see them. I believe our society feels some guilt for the way we treated the Vietnam veterans, as they should. Between the Vietnam Veterans and societal guilt our veterans are getting the recognition they deserve. Some struggle with their time in service and feel it is too much recognition. Most of them don’t wear the hats or shirts, they set quietly in their corner because they are struggling or feel they are boasting if they bring attention to themselves. For the most part if they are wearing a hat or shirt stating they are a veteran it is ok to thank them because they are opening the conversation by wearing their military veteran clothing. But veterans are disappearing. A 2014 survey indicated there were 19.3 million military veterans, of which 9.4 million are over 65 years old and only 1.7 million are younger than 35. With the estimated suicide rate of 20 veterans a day committing suicide more than 69% of veteran suicides are among those age 50 years and older.

We also have the least number of veterans serving in congress in our nation’s history. In the house of representatives 90 of 435 seats are filled with veterans, in the senate 26 of the 100 seats are veterans. Less than 22% of those serving in congress are veterans. This number will more than likely continue to decline because of the amount of money it takes to run for a seat, most military veterans do not come from wealthy families with the money needed to run for the Senate or House. If the younger generations do not understand what veterans have done in the past they will be lacking information for the future, we need to let them know the sacrifices veterans have made. 

I challenge every veteran to spend more time telling their stories to children in their family. If you get the opportunity go to a school and volunteer to tell your story to a history class. We don’t need to get into the details, just discuss what you have done for your country and how you fought for the freedoms they have. The younger generation will be playing a part in who will be controlling the conversation in the future. As they age we need them to continue to fight for our promised benefits. They will be the ones who drive the discussion in the future concerning the Veterans Administration and will be setting the funding. If they do not know what has been sacrificed they might feel the need to stand by because they don’t understand. It is our job to help them understand. Since only 7 % of the population has ever served, only 1% have served since 2001 it is imperative that we tell the younger generation our stories. Keep our history alive to help prevent history from repeating itself. It’s also important for future VA funding. Please get involved in telling your story. The library of Congress has a program called the Veterans History Project. Please consider it and tell your story, veterans future might depend on it. If there are more children like the ones that approached me last week we stand a chance to get the benefits we have earned.

For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro.

Things that Bug Veterans

A group of veterans were watching protesters burning flags on TV. Leonard went crazy, yelling it’s not right for anyone to burn the flag, who do they think they are. That made me think about what Leonard was feeling, and how other veterans felt about various issues in our society. I started talking to other veterans from different generations, as it turns out we don’t look at things the same way. Why do we let some things get to us?  Certain things drive some veterans crazy and some things don’t. I thought I would put a few of them together for everyone to mull over.  Let’s start with what set Leonard off.

The flag of the United states is sacred to most who served. Burning the flag angers most Americans especially veterans. To those of us who served under the flag it is disrespectful. We have fought, defended, and lost friends while serving under the flag. Our flag is special to us and it is demoralizing to see it desecrated in that manner. Another form of disrespect is displaying the flag upside down. We are taught that the flag being upside down is the sign of distress, and displaying the flag upside down is disrespectful unless used in an actual distress situation. Even though we don’t like it, this is what we fought for, the ability of our people to say or do what they want, it is what makes the US special. At times this includes putting up with people who want to burn our flag, or wear our flag upside down. Because we have fought to give them the right we don't feel it’s appropriate for them to be disrespectful to our values, but we have to accept it.

Being respectful is one of the core values of every military branch. Being on time is one of the key elements of that respect. When we were in the service were taught, if you’re not 15 minutes early you are late, this doesn’t hold true to many civilians and it drives allot veteran’s crazy.  Military member feels they respect others and should be respected in return, the problem is many civilians don't feel the same.

Some veterans who have worn the uniform proudly feel disrespected when civilians wear parts of the uniform if they never served. Often times I will walk up to someone wearing parts of the battle dress uniform (BDU) uniform. I usually ask what branch they served in and about 50% of the time they will tell me they never served. They may have gotten the clothes at the surplus store, or given them by family but it still bugs allot of veterans. I understand why they would want to wear the clothing, they are comfortable and great utility work clothing, but it still bugs me and a lot of veterans.

War is not a movie, and telling a veteran that you understand because you have seen a movie is disrespectful. Unless you have served in the military there is no way you can fully understand the culture and brotherhood. The closest a civilian can get is being a spouse or military brat. The media plays a part in the lack of understanding. Countless veterans believe the media does not cover the reality of war. From 1991 to 2009 the media was not allowed to show the flag draped coffins of our fallen. Many veterans and families felt the government was sanitizing the cost of war. The media did not protest loud, they just accepted it. Our fallen were flown in at night when they could not be seen and the media played along. The media did not protest and the cost of war was not seen by the general public. The rules have changed but many media outlets still fail to show the cost of war. Their perception is showing the cost of war, by not showing the coffins of our fallen, is too graphic, war is real and graphic, the media should report the truth. The government played it off as being respectful to the families, but some veterans felt it was to prevent civilians from seeing the true cost of war and eliminate protests against the war and for political gain.  

The military branches are not the same. Many times we don’t even understand each other’s rules and dress codes. Every branch is unique. The Air Force and the Marines are totally different, we share very few commonalities. But that’s ok were family. When outsiders disrespect one branch they are disrespecting all of the military and all branches will join the fight. It’s like a brother and sister relationship, I can do it but an outsider can’t.

Please don’t tell a veteran you were going to join the military. Our comment will be why didn’t you join. Just because you “wanted to join” don’t give a civilian the credit or respect they seek from the veteran, it shows veterans your insecurities and you didn’t think you could serve or had the will to do what it takes to become a member of the military. It’s better to not say anything, thank you might work.  

The last thing that bugs me is strings. Yes strings on your clothes. It’s crazy but strings on your uniform got you in trouble during inspection and it still drives me crazy to this day. All veterans are brainwashed to a point. We are taught what the military perceives as right and wrong. That sticks with us for most of our lives. This perception of right and wrong can be as small as strings, or as large as burning our flag. I understand why Leonard felt the way he does he, like all who fought under the flag, have differing views of how to look at it. I look at it as being wrong, but I understand that some have given their lives for their rite to burn the flag or protest. I always remind them of that when I get the chance to address protesters. Like everyone else in society veterans are different even though we are the same. We are veterans who have fought for your right to be wrong.

For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro.

The Trauma of Following Orders

A colleague and I were discussing one of his veteran clients.  My colleague is a Vietnam Era veteran and I am a Desert Storm veteran and we often consult with each other about our cases. His client William, is a Vietnam Veteran in failing health. I had met William through another veterans program and referred him to my colleague because I felt he would be a better fit. Due to his failing health William is starting to look back at his life and psychologically preparing for his passing. Like many Vietnam veterans William is struggling with what he had to do in Vietnam to survive. The Vietnam battlefield used civilians, women and children to carry out some of their attacks. As a Soldier, Sailor, Airman, or Marine you had no idea who your enemy was. All you could do is make instant life or death decisions, follow orders, and hope you are doing the right thing.  

When William’s unit entered a village in Vietnam, they were ordered to destroy the village and kill or capture anyone who was there, including women and children. Military intelligence had informed his commanding officer (CO) that the village was a haven for Viet-Cong and needed to be destroyed. Williams platoon completed their mission and proceeded to kill those who refused to surrender, and burned the village to the ground. What was ordered and accepted by his superior’s is something William would live with the rest of his life. Since the age of 19 he has spent most of his life self-medicating with drugs and alcohol trying to forget the action he had to take in that village. He wonders how he could go to heaven after killing so many people.

William is suffering from what is called moral injury. Moral injury is a relatively new term, but its pain is as old as war. It is a negative self-judgment based on having transgressed core moral beliefs, values or on feeling they possess. The term is described as “the psychological burden of killing and the betrayal of leaders”. Moral Injury appears to be a slow burn that takes time to sink in. The victim of moral injury needs to accept moral reasoning, evaluate behavior, experience empathy, and create a coherent memory narrative. Many times, soldiers are placed in no win situations by their leadership and told they must betray there since of “what’s right”. These actions cause confusion concerning one’s morality because they knew it was wrong, but were told by your superiors its ok. For some it takes minutes, for others it takes years to feel the sadness or sorrow of not following your moral beliefs. Veterans try to suppress their moral injury and some succeed through the use of drugs and alcohol. Others work hard to support their families and place their moral injury on the back burner, they are doing what is moral, providing for their family and working.  

A common theme is veterans feel nothing can prepare you for what war is really like. To some when they return home it feels like they have lost their soul. It is tough when society states, thou shall not kill, and military states thou better kill, be killed, or suffer the shame of not trying. Many have endured the moral pain of driving past wounded women and children and not stopping for help because of orders, having to shoot civilians because you don’t know who your enemies are, killing families because of one enemy sympathizer, or killing someone over anger because they killed or shot your comrade. There appears to be no end, the symptoms include shame, survivor guilt, depression, despair, addiction, distrust, anger, a need to make amends and the loss of a desire to live. In war military members have to follow orders without question, and at times those orders shake our moral beliefs.

Moral injury is not something that can be cured by medication. The restructuring of their moral identity and meaning is the key. Seeking help from clinicians and chaplains is the first step. What it takes is the support of a caring non-judgmental community who can find a way for veterans to forgive themselves. Our communities need to understand the war doesn’t end when our troops return home, it is just the beginning of their battles. Some Vietnam veterans are still dealing with this issue 40 plus years later. We now have a new generation of troops who will be facing the same issues. In the future moral injury is going to explain why some veterans suffer. Some feel moral injury is one of the primary factors in military suicide rates. The key is for friends and families to be on the lookout and get them the help they deserve. There is hope, the VA is funding a 4 year study on moral injury in Marines and there are numerous counseling options for veterans and their families.  

For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro.