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Excerpts from:
Posted 2/28/05
Trauma of Iraq war haunting thousands returning home
By William M. Welch, USA TODAY

MORGANTOWN, W.Va. — Jeremy Harrison sees the warning signs in the Iraq war veterans who walk through his
office door every day — flashbacks, inability to relax or relate, restless nights and more. He recognizes them as
symptoms of combat stress because he's trained to, as a counselor at the small storefront Vet Center here run by the
U.S. Department of Veterans Affairs. He recognizes them as well because he, too, has faced readjustment in the year
since he returned from Iraq, where he served as a sergeant in an engineering company that helped capture Baghdad
in 2003.

These injured and disabled men and women
(returning from Iraq) represent the most grievously wounded group of
returning combat veterans since the Vietnam War, which officially ended in 1975. Of more than 5 million veterans
treated at VA facilities last year, from counseling centers like this one to big hospitals, 48,733 were from the fighting in
Iraq and Afghanistan.

Of the 244,054 veterans of Iraq and Afghanistan already discharged from service, 12,422 have been in VA counseling
centers for readjustment problems and symptoms associated with PTSD.

A recent Defense Department study of combat troops returning from Iraq found that soldiers and Marines who need
counseling the most are least likely to seek it because of the stigma of mental health care in the military.

as it anticipates "greater numbers of veterans with PTSD seeking VA services."
as it anticipates "greater numbers of veterans with PTSD seeking VA services."

Harrison, who was a school counselor and Army Reservist from Wheeling, W.Va., before being called to active duty in
January 2003, thinks cases of PTSD may be even more common than the military's one-in-six estimate

Vet Centers provide help for broader issues of readjustment back to civilian life, including finding a job, alcohol and
drug abuse counseling, sexual trauma counseling, spouse and family counseling, and mental or emotional problems
that fall short of PTSD.

More than 80% of the staff are veterans, and 60% served in combat zones, says Al Batres, head of the VA's
readjustment counseling service. "We're oriented toward peer counseling, and we provide a safe environment for
soldiers who have been traumatized," he says.

"A Vietnam veteran myself, it would have been so great if we'd had this kind of outreach," says Johnny Bragg, director
of the Vet Center where Harrison works. "If you can get with the guys who come back fresh ... and actually work with
their trauma and issues, hopefully over the years you won't see the long-term PTSD."
to Military Families
Submitted by: American Forces Press Service
Story Identification #: 200531565426
Story by Ms. Donna Miles

WASHINGTON (March 2, 2005) -- In an unprecedented expansion of its traditional client base, the Department of
Veterans Affairs is offering grief counseling to families of servicemembers who die while on active duty.

VA's Office of Readjustment Counseling offers the
counseling services at its 206 community-based Vet
throughout the United States, including Guam, Puerto Rico and the Virgin Islands.

Greg Harms, program analyst for the counseling program, said 412 military family members - from spouses to
children to siblings, parents and even grandparents - have taken advantage of the program as they struggle to
cope with the loss of their 276 servicemembers. Most were killed during deployments in Iraq and Afghanistan.

Expanding its services to serve veterans' families represents "quite a leap and a real innovation" for VA,
acknowledged Charles Flora, associate program director. But he calls the offering of bereavement counseling to
family members "a natural extension of what we already do for veterans."

Who, Flora asked, is more deserving of VA assistance than families who have sacrificed their husbands, wives,
children, brothers, sisters or grandchildren in support of their country?

The program also serves families of reservists and National Guardsmen who die while activated for federal duty.

Some families seek the VA's counseling services immediately after learning of their loved ones' loss, while others
wait until later, often after an important milestone such as a birthday, holiday or the one-year anniversary of the
death has passed, Harms said.

"Everyone grieves differently. It runs the full gamut," he said. "There are no standard operating procedures for grief."

As a result, services offered run the full range, from one- or two-time visits to weekly sessions, depending on the
family member's needs.

Regardless of the level of help needed, the VA service offers all its clients a common variable: a safe, caring
environment where a professional bereavement counselor helps them work through the emotional and psychological
issues associated with their loss.

"They're looking for support, looking for someone they can talk to who will listen and understand," Harms said. "A lot
of what people need," added Flora, "is a place where they can sit down, take a breath and tell their story in a calm
place where they can put things into perspective."

While all grief counselors are able to provide that service, the Vet Centers provide something many clients call a big
plus: More than half the staff at the Vet Centers are veterans themselves who understand the military lifestyle as
well as the tremendous sacrifice the families have made.

Counselors go out of their way to respond to families' needs, often meeting with them the same day they're
contacted. They keep clinics open late to accommodate families' schedules and network with other service
organizations to reach families in need. And in some cases, they even make home visits for families who might
otherwise not be able to tap into their services.

"We've made a science of overcoming every obstacle to care," Flora said.

No medical diagnosis is required to seek help, and services are completely confidential. The only way a counselor
can share information on a case is with written permission of the family member. "There's guaranteed clinical
confidentiality," Harms said.

Flora said he considers the services the Vet Centers provides grieving military families "a sacred trust" that reflects
the VA's commitment to veterans and their families. "We're meeting these families at one of the most traumatic
points in their lives and helping to assist the family as it rebuilds itself," he said. "This is sacred business."

Referrals for grief counseling come through military casualty assistance offices, the VA and veterans service
organizations. The largest number of referrals comes from TAPS, the nonprofit Tragedy Assistance Program for
Survivors, which offers what Harms calls "incredible peer-to-peer support" but no professional bereavement
counseling services.

Families requesting more information or services can also contact the VA's Readjustment
Counseling Service directly at (202) 273-9116 or by email at
The Second War
begin to talk about post-traumatic stress,
coping and hoping
By T. Trent Gegax
Updated: 7:35 p.m. ET March 12, 2004

March 12, 2005 - The war on their minds wasn’t the Iraq war or the Persian Gulf War or the Vietnam War. At a
symposium last weekend at the University of Colorado in Boulder, it was “the second war,” the one that starts when
vets return home. It’s what a soldier faces when she has to prove that she hasn’t invented her mystery illness. It’s
what a National Guardsman faces when some acquaintance at work asks him how many “rag-heads” he wasted. It’s
what injured vets face when they try to get the disability payment they believe they deserve. The Army does “a
better job with the dead than with the wounded,” Lt. Col. (Ret.) Ralf Zimmermann, a decorated Desert Storm tank
battalion commander, told the audience of 135. From the sounds of it, too many service members are left to feel like
they’re begging for something they deserve in exchange for serving their country, or losing a buddy, or their hand,
or, temporarily, their mind.
...Mary Tendall, a psychotherapist contracted by the Dept. of Veterans Affairs to treat combat vets, said that post-
traumatic stress disorder (PTSD)—the mother of all second wars—wrongfully stigmatizes people. “PTSD is a normal
response to an abnormal life event,” Tendall said before making a point of contradicting some doctors who say
there is no cure. “Healing is an inevitable response to the right kind of treatment.” Yet the message was clear from
the handful of experts and witnesses: A significant number of psychologically wounded soldiers are returning from
...To be sure, the Pentagon is concerned about PTSD. It commissioned the Mental Health Assessment Survey of
soldiers serving in Operation Iraqi Freedom. But the study hasn’t been made public since it was finished three
months ago.
...The paradox is that seeking the sort of psychological treatment that can keep a soldier healthy can also
undermine unit cohesion. The Fort Bragg study showed that many soldiers who wanted help were hesitant. They
worried that fellow soldiers would see them as weak and lose confidence in them. They worried that they might lose
their security clearance. They worried that it could harm their career. But what “Unseen Costs of War” showed was
that ignoring the psychological trauma of combat on vets presents its own set of risks. It’s immoral, for starters. But it
could also hurt recruiting down the road. Ultimately, it’s too many if even a handful of soldiers, marines, airmen and
sailors come home to treatment that makes them long for the first war.

Feb. 9, 2005 issue -   Are soldiers fighting in Iraq more likely than other soldiers to take their own
lives? According to a long-awaited Army report, due next week, 19 soldiers serving in Operation
Iraqi Freedom committed suicide in 2003—a number that officials acknowledge is "above average."
Typically, military suicide rates drop during deployments.
The report, which also looks at the prevalence of combat stress and posttraumatic stress disorder
in Iraq, was produced by the Army's 12-member Mental Health Advisory Team, sent to Iraq in
September. The report blames the self-induced deaths on a combination of factors, including
depression (a common side effect of PTSD) and easy access to guns. Ironically, the military had
designated 2003 as its suicide education and prevention year.

But the problem may be more serious than the report shows. Last week some veterans criticized
the military for narrowing the scope of its study to only those incidents that occurred in Iraq, and
to those where the cause of death was definitive. "By my estimation, there are another 10 to 15
suspicious noncombatant deaths in Iraq that are still under investigation," said Steve Robinson,
executive director the National Gulf War Resource Center. "And there are reportedly 67 stateside
suicides, none of which have been attributed to wartime service. I want to know how many of
those involved people who served in Iraq." Among those under investigation: two recent deaths at
Walter Reed Army Medical Center. Military mental-health experts echoed some of those views,
saying that many soldiers often don't show the psychic wounds of battle until after they're sent
—Pat Wingert and T. Trent Gegax
© 2005 Newsweek, Inc.
Excerpts from:
Miami Herald:
Posted on Sat, Dec. 11, 2004
Iraq war vets struggle to fit back into family life
as well as adjust to lost limbs and flashbacks

'When I saw the stumps, I thought, `Damn, both of them?' Then I looked at my leg and I was trying to figure how to
put a tourniquet on it because I didn't have any hands.'' The rocket-propelled grenade that ripped off James Eddie
Wright's hands and tore into his left leg ended the war for him and changed his life forever.
In a way, Wright, 29, personifies the new veteran coming home from Iraq. Many hundreds are amputees and,
according to The New England Journal of Medicine, one in six suffers from a stress-related disorder. More often than
not, today's veteran has that thousand-yard stare that soldiers have been carrying home for years -- a mask for the
gnawing confusion and anguish that can blow apart a smooth return to civilian life.
Unlike the young draftees of earlier wars, many of these men and women are older, with families. For them, this
morphing from a fighting machine ducking bullets into a mommy or daddy packing school lunches presents a special
challenge. This time the government tapped the National Guard and the Reserve to augment regular forces. Some
returnees -- proportionately many more than in Vietnam -- have left limbs and slices of sanity on an urban battlefield
as strange as the Iraq war itself. Improved body armor kept many troops out of body bags in Iraq after they were
ravaged by roadside bombs and shoulder-mounted rocket launchers.
A varied lot, these returnees. Among them: A freshly retired soldier struggling with anger and guilt as she
desperately tries to fit back into the lives of her husband and three kids. An ex-soldier who shuns humans in favor of
his dogs. A star basketball player who lost her shooting hand. A lifer from North Miami who can't spit out the smell of
death. A guy with a John Wayne fantasy. A seven-year Marine fighting to keep his shattered arm.


13 screws hold his arm together. No prosthesis for me, says John Dale, 29, of Coconut Creek. So far, his left arm is
still his. He's had eight surgeries to save it. The next one's due in three months.

''It felt like someone hit me with a baseball bat,'' he recalls. It was April 4, 2003. His unit, the 2nd Tank Battalion,
assigned to the 1st Marine Division, was taking heavy fire on the way to Baghdad on the first day of action during the
The battleground was surreal, like an arthouse war flick: oil burning in roadside ditches, smoke blotting out the sun
and screening the enemy, the Marines moving forward in their Humvees.
The Iraqis would pop up and shoot. Dale would machine-gun their hideout from his seagull view in the turret. Such a
sweet target. An AK-47 round shattered the humerus, the long bone of the upper arm.
His arm was left dangling, blood seeping through his chemical suit and flak jacket and racing down to his fingertips,
forming large claret pools on the Humvee floor. A corpsman lifted him into an ambulance. But he had to give up his
space to a Marine who had been shot in the face.
''I had to crouch behind a tank until a Humvee drove by. I hitched a ride with them,'' Dale says.
The firefight fanned out as he sank helplessly in the back of the vehicle. He didn't panic and he didn't pray.
Everything was gonna be all right, he thought, but it would be an hour and a half until a medevac chopper arrived.
Dale counted three friends among the severely wounded. Nearby, a corpsman was pushing to save a tank
commander. But the officer's body was already adapting to meet death.
Dale's arm is now held together by a metal plate that travels from shoulder to elbow and is attached to the bone by
13 metal screws.
He sleeps as if time is rationed. Nightmares mess with his mind. The doctors call it post-combat trauma. He and two
other Iraq war veterans meet weekly at Dale's home with Patrick Murphy, a team leader at the Vet Center, a
government counseling service.
Three weeks in combat changed him forever, the sergeant says. He no longer puts things off. Like furthering his
education. The South Broward High grad says he's going back to school. He likes the medical field.


Post-traumatic stress disorder (PTSD) is a psychiatric illness that can occur following life-threatening events such as
combat, natural disasters, terrorist incidents, serious accidents or personal assaults such as rape. Combat troops
who suffer from PTSD often relive some of their experiences through nightmares and flashbacks. They have difficulty
sleeping and feel detached or estranged from friends and family. Such symptoms can significantly impair the
person's life. Counseling, which could include group therapy, helps the patient cope.

''Most of the older veterans are coming home to spouses and children whom they haven't seen in a year or more,''
David says. ``They have to readjust to getting out of soldier mode to being home. And that's stressful, even for
combat-support troops, because they are constantly in harm's way, too.''
Unlike his counterparts from past wars, the Iraq veteran faces physical and psychological traumas that spring from
an urban battleground that combines international politics and guerrilla warfare.
Some 2.4 percent of the 9,700-plus wounded during combat in the 20-month Iraq war are amputees. Chuck Scoville,
amputee program manager at Walter Reed, told a congressional committee that the number is twice the rate of both
world wars. In addition, 350 psychiatric casualties have been admitted to Walter Reed; 20 percent have PTSD.
According to the New England Journal of Medicine, one in six Iraq war veterans suffers from a stress-related disorder.
In the Vietnam War, a 10-year venture, one-third of the 2.4 million troops were diagnosed with PTSD, but the
disorder was recognized seven years after U.S. troops withdrew in 1973. So proportionately, and factoring in the time
frame and troop strength, the Iraq war may be producing more amputees and psychiatric cases.

In the Vietnam War, a 10-year venture, one-third of the 2.4 million troops were diagnosed with PTSD, but the
disorder was recognized seven years after U.S. troops withdrew in 1973. So proportionately, and factoring in the time
frame and troop strength, the Iraq war may be producing more amputees and psychiatric cases.
Early psychiatric intervention...can prevent long-term consequences. So far... the Vet Center, has reached 2,015
veterans and signed up 515.

• Vet Center: Patrick Murphy305-859-8387 in Miami-Dade; Bobby White, 954-356-7926 in Broward.
• VA outreach program: Lillian Foley, 305-575-3528; Sherrill Valdez, 954-229-7650; Richard Mendez, 305-346-5725
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