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Mattis: You're not damaged goods

Combat experience makes vets stronger

May. 26, 2014 - 06:00AM   |  
Cpl. Darren D. Minder, a 23-year old team leader, from Savannah, Ga., orchestrates suppressive fire on a rooftop above Patrol Base Steelers, Iraq, on Oct. 18, 2006. That year was considered among the worst in the rise of the Anbar province insurgency.
Cpl. Darren D. Minder, a 23-year old team leader, from Savannah, Ga., orchestrates suppressive fire on a rooftop above Patrol Base Steelers, Iraq, on Oct. 18, 2006. That year was considered among the worst in the rise of the Anbar province insurgency. (Lance Cpl. Ray Lewis / Marine Corps)
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Marines of 1st Marine Regiment memorialized their fallen during a sunrise to trek up Camp Horno's 'Microwave Hill' in Camp Pendleton, Calif., Nov. 16, 2007. (Sgt. Ray Lewis / Marine Corps)

James Mattis wants Marines to know that though he's no longer wearing the uniform, he's still got their back.

James Mattis wants Marines to know that though he's no longer wearing the uniform, he's still got their back.

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James Mattis wants Marines to know that though he’s no longer wearing the uniform, he’s still got their back. The way the retired general sees it, there’s a narrative gaining traction in the media that portrays combat vets as ticking time bombs who present a danger to society and themselves, goods damaged by all they have seen and done in the war zones.

And that’s just wrong, says Mattis, a living legend among Marines who as head of U.S. Central Command oversaw the war in Afghanistan. With the call sign “Chaos,” he’s revered for his blunt talk and unapologetic embrace of fighting and winning and all-things-warrior.

“I just get so almost disgruntled about it,” Mattis told Marine Corps Times, “I keep reading that we’re all somehow screwed up.”

Worse yet, he fears, some Marines are buying into it.

“If you keep paying people to say we’re screwed up, and tell us we’re screwed up, Marines are going to believe it,” Mattis said. “I have trouble believing we're all so fragile. I just don't buy it.”

He and other military leaders are starting to push back against the equation that holds that veteran = PTSD = mental instability and violence. They’re giving voice to an alternate portrait of the modern veteran, those who raised their hands to serve their country in a time of war — call them the New Greatest Generation.

Gen. John Kelly, commander of Southern Command whose son was killed in combat in Afghanistan, criticized portrayals of today’s military members as “victims and weary.”

In a recent speech, he lauded today’s vets who “like their fathers and grandfathers before them, have a religious faith in self-reliance, hard work and making it on their own.”

That’s hardly the image that captures the popular imagination. After recent deadly shootings at Fort Hood, Texas, the online Huffington Post briefly posted an interactive map noting locations across the country where veterans had committed violent crimes. A postdoctoral fellow sparked complaints with an April New York Times opinion piece following a deadly shooting by a veteran outside a Kansas Jewish Center. The op-ed attempted to draw links between vets and white supremacist groups.

In 2009, Penn State University was forced to apologize after producing a video directing instructors on how to handle students who are veterans and threatening. In the video, a professor worries about a veteran in her class who is “always on the verge of losing his temper.” She is advised, if feeling threatened, to “call the police right away” and “get out quickly.”

Intimate combat

An estimated 20 to 30 percent of the veterans of the wars in Iraq and Afghanistan show some symptoms of post-traumatic stress, yet only about 1 percent saw serious combat, experts tell Marine Corps Times.

Mattis is quick to acknowledge that some service members who were in the fighting, especially those who may have experienced more “intimate” combat, as he calls it, are genuinely hurt mentally, and often get overlooked.

“There are guys who don’t have the shock absorber, or who had enough of the close-in stuff at a very young age, and some of them truly need help,” Mattis said.

The problem of demand is a serious issue, Mattis said, “the ones who really need help are diluted by a system that’s got a lot of money behind it to tell them that they’re damaged.”

Former President George Bush and others contend that referring to post-traumatic stress as a disorder places an unfair stigma on those grappling with the symptoms. They are pushing to have the condition redesignated PTS. But because “disorder” is part of an official diagnostic term, dropping that one word faces huge hurdles because it’s inclusion affects everything from care and diagnosis to research and treatment funding.

Money trail

Dr. Cam Ritchie, a retired Army colonel and former top psychiatrist for the Army surgeon general, said there is a convoluted money trail built around the term, PTSD.

“Congress gave the military a lot of money for post-traumatic stress disorder and traumatic brain injury, and the whole disability [compensation] system is geared around post-traumatic stress disorder,” said Ritchie, now the chief medical officer for the department of mental health in Washington, D.C.

Facing intense public and political pressure, Veterans Affairs Secretary Eric Shinseki adjusted the qualifications for a PTSD diagnosis to include anyone who experienced “fear of hostile military or terrorist activity,” rather than actually experiencing hostile military or terrorist activity.

The cause behind the decision was the growing disparity between reports of PTSD and the number of veterans who had actually experienced combat. At the time, veterans needed witnesses and/or documents to prove they had experienced a traumatic event.

Shinseki’s course of action aimed to streamline an already sluggish benefits program. But, Dr. Chris Frueh, Director of Research at The Menninger Clinic in Texas, said, “the VA has left itself open for very well intentioned policies to be exploited and taken advantage of. And there are some people who are misunderstanding or abusing the system.”

So veterans with severe cases of trauma find themselves battling for benefits alongside everyone else.

Yet the public presentation of post-traumatic stress is largely one-dimensional, a mass of veterans all suffering the worst effects, when the truth is much more nuanced.

Frueh, who previously worked as a PTSD psychologist for the VA, wrote a paper arguing that the diagnosis for PTSD ought to be more heavily scrutinized, citing his own research and other findings that concluded “there may be distortions to the PTSD database due to exaggeration or malingering related to secondary gain incentives among veterans.”

Though many of his colleagues applauded his work, he found himself under intense pressure from various interests to shelve his work.

“It’s kind of the third rail for a lot of [politicians],” said Frueh.

The worst of it

One veteran with extensive experience on the ground with Marines during the invasion of Iraq, and then on direct action raids with SEAL teams in Baghdad, said he has been in treatment for psychological problems he deals with as a result of intense close-in combat. Marine Corps Times has agreed to keep his identity anonymous.

“I’m going to be honest, it was just the feeling of being a savage,” he said of the raids, “and baby screams still to this day infuriate me, it’s a type of flashback, it’s not like a feeling of guilt, it’s a feeling of anger and rage and confusion.”

He eventually was medically retired for various diagnoses, including PTSD. What followed was treatment at a VA medical clinic, and group therapy.

He said there was a noticeable difference in the number of vets who had experienced serious day-to-day combat and who had experienced one, or two, or a handful of moments.

“This is the therapy? This is the treatment? I have to hang out with these guys and they don’t feel the same as I do?” he said.

Mattis doesn’t so much as think PTSD needs to be replaced as a diagnosis, as it should be augmented with the reverse terminology: Post Traumatic Growth.

“I see a lot of guys who come back and they end up being great fathers and mothers, great leaders. Then someone tells them they’re damaged.”

He told the story of a Canadian vet who came back from the combat zone and felt almost pushed into claiming post traumatic stress. He started a campaign with the slogan, “It’s OK to be OK.”

During a speech last month at the Marine Memorial Theater in San Francisco, Mattis underscored that experience at war often makes vets “kinder” to their fellow man, more attuned to the human condition and the fragility of life, and more likely to succeed as leaders.

Aside from educating veterans about a more positive characterization of themselves, perhaps it would shift the narrative a bit.

“My concern is for the truth about our veterans and that they not be mischaracterized as damaged in some way,” wrote Mattis via email. “There was a hell of a lot of trauma on Iwo and those guys came back and ended up doing great.”

It’s simply not enough to provide a counter narrative to PTSD, though, Mattis says the community should rally around those combat vets too rarely in the news.

“We have to start highlighting these guys who are CEOs and successful business people,” he said. “And we’ve got to help vets become successful.”

Patricia Kime contributed to this report.

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