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Wednesday, Oct. 14, 2009

From Warrior to Civilian

Veterans helping veterans transition from war to peace

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Milwaukee’s community of veterans is proving to be adept at healing soldiers from the current wars as well as those who left the battlefield decades ago.

Many veterans are reaching out to their peers who are having difficulty transitioning from being warriors in a threat-filled combat zone to resuming their lives as workers, students, spouses, partners or parents.

The transition from warrior to civilian isn’t easy, and can be made more difficult by financial stresses, unemployment, relationship crises, physical wounds such as traumatic brain injury (TBI) and untreated mental health issues such as post-traumatic stress disorder (PTSD)—a cluster of anxiety-related flashbacks, anger, sleeplessness and depression that can be triggered long after the soldier leaves the battlefield.

How long can PTSD linger? About half of the veterans currently seeking help for mental health are those who served in Vietnam, while about 20% served in Iraq and Afghanistan. The rest served in other battles—the first Gulf War, Bosnia, Korea, even World War II.

Their PTSD is often triggered by current events, such as news coverage of the war, or sounds or smells or tastes that take veterans back to the battlefield.

“You don't lose it 100%,” said veteran advocate Paul Fine, a resident of Brown Deer who served in the Korean War in the early 1950s.

Dr. Michael McBride, a psychiatrist at the Zablocki VA Medical Center and a major in the Army Reserves who has served four tours in Iraq and Afghanistan, said PTSD is a normal reaction to the abnormal situation of war.

“Every warrior who’s been to combat is significantly changed,” McBride said.

But he noted that about a third of recently returned veterans experience more severe PTSD, which interferes with their lives, their work or their relationships.

“Veterans have the training to be in the combat zone, but they don’t have the training to be a civilian again,” he said.

And that’s where other veterans can help.

Vets Helping Vets

Veteran peer healers play an important role in the community as more mental health experts are needed to serve the increased number of veterans who are struggling with civilian life. Since psychologists and social workers don’t always have military experience, sometimes they don’t link a veteran’s emotional issues to his or her time in the combat zone.

“They see the end result,” said Vietnam veteran Robert Curry. “They see the drinking, the suicides and the abuse in relationships, but they don’t link it back to PTSD.”

But veterans are more likely to do so, since they’ve shared the same experiences. They know which questions to ask. They don’t judge. They’ve been there.

Many of our local veterans are going to extraordinary lengths to help their fellow veterans. One example is the veteran-led nonprofit organization Dryhootch, which offers peer-to-peer PTSD counseling, referrals to other resources, weekend retreats, community outreach and support for families. They’ve organized the Wisconsin Warrior Summit on Oct. 22 for veterans, their families and the mental health community to learn more about helping the warrior transition to civilian life. (See “Wisconsin Warrior Summit.”)

Curry, one of the Dryhootch organizers, said peer groups offer a safe place to vets who feel they won’t be understood by their families and friends.

“The fear of a lot of veterans is that if I tell you what I really did over there, you’re going to judge me,” Curry said. “If I tell you the brutal truth, you wouldn’t understand, so I can’t say what I really feel. But I can tell it to another brother or sister who’s been there. Maybe I can’t finish a sentence but they can finish it for me.”

Joe Mitchell, an Army veteran who has served in Iraq and Afghanistan, has been doing community outreach with Dryhootch, trying to get recently returned veterans with signs of PTSD to get help.

“Everybody’s got problems, but to know that there are people you can talk to and who can relate to your concerns is half of the battle,” Mitchell said. It isn’t always easy, he noted. “There are places you can go, but you have to be willing to accept that help and do something about it.”

Greater Awareness of the Warrior’s Experience

The current outreach for veterans stands in stark contrast to the return of Vietnam veterans and the mental health community’s previous understanding of PTSD.

Although combat-related trauma was identified during ancient times, it hadn’t been well understood until recent years—and that knowledge is still evolving.

While 20th-century soldiers experienced PTSD, the American Psychiatric Association and the military didn’t acknowledge it until 1980. When Vietnam veterans reported having hallucinations and smelling odors or tasting things that reminded them of the battlefield, those experiences were written off as schizophrenia or drug or alcohol abuse, said Dr. Murray Bernstein, a Vietnam veteran who’s worked with other veterans and prisoners of war since 1970.

Bernstein said veterans began raising awareness of PTSD simply by sharing their experiences with each other.

“It began with veterans talking about it among themselves,” Dr. Bernstein said. “They were saying things like, ‘I feel like I’m ‘in country’ again.’”

Bernstein said treating PTSD has changed over the years as well. He advocates helping a veteran recondition his or her brain “to get the person to balance the past and the present.” As a result, the vet will be less likely to sense constant threats during sleep, in crowds, or in tense situations.

Families should also be involved in a veteran’s treatment, Bernstein said, because they need to know how to deal with their relative’s transition, and also acknowledge that they’ve been changed by the soldier’s deployment.

Bernstein said American-Indian healing strategies can also help, because they involve multiple generations of veterans sharing their experiences. He leads Warrior Quest retreats for veterans of all wars—including World War II veterans in their 80s who want to tell their stories.

“They need to have an elder, a role model,” Bernstein said of younger veterans. “It gives them more stability.”