Group Therapy

In 1977, after suffering a Vietnam flashback psychotic break and a mandatory ten day stay at the Sepulveda VA Hospital, my husband found himself attending a group therapy session at a storefront in Canoga Park, California.

His first impression, as he entered the hall to sign up and introduce himself to the shrink, a young graduate student who volunteered to work at the VA in order to gain extra credits for school, was concern that this guy would not allow him into the meeting because it already seemed to be full.  As usual, my husband’s instincts were right.  The young man in his early twenties referring to himself as a Physician’s Helper, at least according to the plaque he had placed on his desk, told my husband he could not participate, until my husband gave him the VA doctor’s name that had told him to attend.

There were 15 other men in that meeting; all of them were Special Forces combat veterans with two to four tours under their belts.  That is, all except one.  He had served less than three months in country until a very minor ‘million dollar’ thigh wound sent him home.   Most of the other men in the room, including my husband, had been wounded, far worse than that, multiple times, and still continued to serve.  None of them wished to cash in the ticket to go home, even though it was offered to each of them.  The young PA conducting the meeting had never been in the military, never been through basic training, and never been in combat.  He had absolutely no point of reference to the life experiences of the men he believed he was in charge of.  To most of them, he was a child without manners.

Most group therapy sessions have the room set up with the chairs in a circle, so that everyone feels equally invited to participate.  The PA decided to break from this format and moved the chairs so that everyone sat as if they were in a classroom and he was the teacher.  This was not appreciated by his class.  In addition, he allowed the meeting to be dominated by the ‘million dollar wound’ man, who spent most of the meeting whining about the horror of his three months in country, and of being shot.

My husband, sensing the growing irritation in the room, finally could take it no longer.  He told the guy to ‘shut up, and let someone else talk’, and was immediately applauded by every other man in that room.  The PA, taking offense to someone interfering with his authority, began to lecture the room, telling them that although he, himself, was not a ‘killer’ he believed he understood the men that had the mindset of a killer.   Everyone in the room bristled at the offensive nature of his speech.  He spoke a few more sentences, with several references to the men in the room as killers, before he sensed the mood change of the soldiers he thought he was counseling.  My husband called him on the offensive nature of his speech, explaining that they were soldiers, not killers, and their job was to stop the enemy, and if that meant killing, then that is what they did.  It had become obvious to all that the PA was not qualified to work with these men, and had lost any chance of gaining their trust, or respect.  The meeting ended within minutes, with the veterans walking out.  That young PA never returned to the VA; neither did my husband, nor his best friend, who had served three tours with him and committed suicide, within three years, and probably several other men who had attended that particular group therapy session.  Their session with this so called Mental Health Care Professional, who behaved with such an air of superiority towards the ‘killers’ he treated with such insult and disdain, had poisoned them all for the group therapy process and the VA, and did more damage to them, than good.

Thirty seven years and a couple of wars later, with a veteran suicide rate of 22 per day (that’s only the deaths that are listed as suicides.  If you include the deaths that are listed as ‘accidents’ for the sake of the relatives, it’s probably a great deal higher), there are two separate bills in the Senate that deal with veteran suicide prevention.  The first bill, the Suicide Prevention for America’s Veterans Act (SAV), introduced in March 2014 by Senator John Walsh of Montana (a combat veteran himself) is collaboration between Walsh and the Iraq and Afghanistan Veterans of America (IAVA).  SAV extends special combat eligibility from five to fifteen years, reviews wrongful discharges, establishes a common drug formulary between DOD and the VA, creates greater collaboration between the VA and DOD by putting a timeline on the MDAA mandate to make the VA and DOD records electronic, increases health care professionals in the VA by repaying medical school loans for psychiatrists who commit to long term service in the VA, and requires the VA and DOD to ensure mental health care providers have special training to identify veterans at risk for suicide.  This bill was written by combat veterans who understand the devastating effects of PTSD, and have lost friends to suicide.  They take the issue very personally, and have written a very important bill.

In May, the Jacob Sexton Military Suicide Prevention Act of 2014 was introduced by Senator Joe Donnelly and Senator Roger Wicker.  This bill appears to deal mostly with bureaucracy and logistics, than veteran’s problems.  It sets uniform standards and mandatory annual mental health assessments for all branches of service, improves DOD accountability by requiring a report analyzing the annual screenings and follow up care rates, establishes an inter-agency between the DOD and HHS (the Department of Health and Human Services) for the National Guard and Reserves, and requires the DOD to submit reports to Congress with evaluations and recommendations regarding specific tools, processes and best practices to improve the military’s identification, intervention and treatment policies and programs in relation to mental health conditions and traumatic brain injury.  Why not work with Senator Walsh to add these issues to SAV?  Why a separate and possibly competing bill?  SAV seems to be concerned with helping veterans, while the Donnelly / Wicker bill seems to be more concerned with giving Congress control over the process, jumping on a political bandwagon, and creating more bureaucracy, than actually helping veterans.

The major difference between the two bills is one was written by men that actually experienced combat, and one was written by politicians.  It is unclear whether or not either bill will actually become law, since that requires cooperation between the two parties, and given the past performance and gridlocked position of Congress, I don’t have much faith in their good intentions.  They seem to be more interested in winning elections, than taking care of the veterans they sent to fight wars and die for them, seemingly without a second thought.  God help our veteran’s.  America seems to have abandoned them.

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