POST TRAUMATIC STRESS DISORDER (PTSD): WHAT'S WRONG WITH DADDY?

Article I

I hate my Daddy.  He doesn't care about us.  All he ever does is drink, yell and beat us.  You can't do anything right for him.  He never does anything with us.  I wish mamma would just make him go away. I don’t know what makes him hate us so. We never did anything to him.  I don’t understand why he acts like he does.   

The above statements and questions seem to echo the sentiments of many children and spouses of combat veterans. What's wrong with Daddy?  Daddy is suffering from Post Traumatic Stress Disorder, or better known as PTSD for short.  What is PTSD?  Post indicates that it comes after something and in this case a trauma.  Trauma is defined as a bodily injury, wound or shock. Psychiatry further defines it as a painful emotional experience or shock. It might be a natural disaster or an accident. Some examples are: flood, fire, earthquake, tornado, car crash, bombing, shooting, torture, kidnapping, assault, rape, or child abuse.  Victims may witness serious violence, suffer the destruction of their homes and communities, or face a threat to their own lives and the lives of family and friends.  They are terrified, helpless, fear for their lives and often under extreme physical stress.  The trauma creates stress that affects the entire body. When the above conditions exist for longer than 30 days, according to the Diagnostic and Statistical Manual for Psychiatry Fourth Edition, the condition becomes a disorder. 

In the post-traumatic reaction, which can occur days, weeks, months, or even years later, there are several things which occur. First, the victims involuntarily reexperience the traumatic event in the form of intrusive memories (often referred to as subconscious tapes which play without warning), nightmares, and flashbacks during which they feel or even act as though the event were recurring.  Often they recall these episodes poorly or not at all.  They also suffer when exposed to anything that resembles, causes them to recall, or symbolizes some aspect of the trauma.  The veteran may undergo physiological and emotional reactions typical of combat when they hear taped battle sounds, watch filmed battle scenes, or even read war stories.   

The questions posed at the beginning of the article are asked time and time again without adequate answers being found.  To the families and spouses who live with the veteran it's a living hell. It's no picnic for the veteran either. He is also in pain and being tormented by some unseen monster.  It is a struggle for him, in many cases, just to survive, let alone maintain some semblance of a stable family life.  

Where do you go to find the answers to "What's wrong with Daddy?" For many minority veterans, the answers don't come easy and in most cases, they don't come at all or too late.  The Veteran's Administration Hospital and outreach clinics do offer help and answers. The degree of help is dependent upon the expertise and cultural competency of the VA staff, particularly the first person in the system that the veteran sees.  PTSD programs can run the entire gamut from excellent to not so hot.  Depending on their first encounter with the system, the veteran may or may not seek further assistance.  However, for many “nam” vets, the system is out of their reach.  Vietnam veterans, as a group, do not have any faith in the system and minorities even less. Their distrust stems from the reception and subsequent treatment they received upon their return to the states. Consequently, many Vietnam Veterans become the ones that seem to fall through the cracks.  The African-American veteran has an additional set of challenges to overcome. First and foremost, as a people, we tend to view any psychological problem as a curse. “I ain’ t crazy.”  Second, we have many issues that we consider “shameful” and we don’t want to tell anyone about them let alone get treated for them.  They become our “hidden secrets”. They are threats to our “manhood” and we try to cover them up at all costs. Third, for many of us, our first experience with “the system” was not pleasant. Consequently, we tend to shy away from anything that looks or smells like the “government”. When we attempt to access the system again, we do so with a chip on our shoulders. This in itself creates a new set of problems.  Fourth, we rely on someone else to tell us what is going on. We are an oral people. To look something up or verify information is unheard of. It would be a crime to ask someone where he or she heard something or to have him or her show it to you in “black and white”.  Lastly, we have to tell our story. It doesn’t matter whether the story is true or has anything to do with what is going on with us. Hence, many African-Americans become the ones that seem to fall through the cracks. 

Once in the system, the veteran has to overcome a couple of obstacles.  First, if the vet has a substance abuse problem in addition to the PTSD, they are likely to be treated for the substance abuse and the PTSD is overlooked.  Vietnam Veterans are portrayed negatively or viewed as substance abusers.  As the substance abuse problem is addressed, the vet finds that the PTSD problem gets worse.  A characteristic of all PTSD suffers is the self-medication aspect.  The inability to self medicate allows the mind to work, overtime.  At some point, the veteran’s PTSD is treated or they leave the treatment program to self medicate. Second, the helping professional, in some cases, is not skilled in handling PTSD victims and/or cannot relate to the veteran.  The inability to relate to the veteran will turn the veteran off and cause them to exit the system.  The VA, on occasion, has not been sensitive to the needs of the Vietnam Veteran and has allowed third world personnel to treat them.  The lack of adequate command of the English language has caused many “nam vets” to react negatively. This phenomenon is not unique to the Vietnam veterans. May other combat veterans from other wars are also affected. 

Even if the veteran is adequately helped by the system, they will find that the children and spouses are without a place to turn for assistance.  They are left to fend for themselves.  If family psychological problems become too severe, they are most often treated as a separated issue rather than in relationship with “daddy’s problem”.  The veteran returns to an unstable family unit as a new challenge.  The “old daddy” was predictable whereas the new one is foreign.   

What can the veteran do to deal with PTSD and its impact on the family?  PTSD is a family problem.  In order to address it properly, it is handled best in a family type seminar.  Select a speaker who understands PTSD and can explain it in terms that everyone can understand.  Time is allocated for questions after the seminar.  It is during this time that the veteran and family members begin to express their feelings and get some answers to questions that have plagued them for years.  A basic outline might be: The definition of PTSD; PTSD as it relates to the family; causes for the veteran’s behavior; things that can be done to lessen the impact of PTSD on spouses and children; coping skills; and the development of an informational repository.  After the session, the organization may have enough support to formalize a program.  

PTSD has been with us for many years and we have seen it in various settings. There are several challenges that we as combat veterans face. First, we must reach out to our brothers who have fallen through the cracks in the system and get them the care that they need.  Second, we must educate our families and ourselves. Third, we must teach those non-veterans that we interact with.  We are combat veterans who have served our country. We are human beings, productive citizens and not a bunch of crazed animals. PTSD is manageable. We just need to understand it and learn how to cope with it.  

We, the staff, at the paper are working to put together a program that will address several issues surrounding PTSD and the family. As we progress, you will be notified in this column.  This article is the first in a series of articles that will appear in this paper. Questions and letters can be directed to the editor of this section.

I hate my Daddy.  He doesn't care about us.  All he ever does is drink, yell and beat us.  You can't do anything right for him.  He never does anything with us.  I wish mamma would just make him go away. I don’t know what makes him hate us so. We never did anything to him.  I don’t understand why he acts like he does.   

The above statements and questions seem to echo the sentiments of many children and spouses of combat veterans. What's wrong with Daddy?  Daddy is suffering from Post Traumatic Stress Disorder, or better known as PTSD for short.  What is PTSD?  Post indicates that it comes after something and in this case a trauma.  Trauma is defined as a bodily injury, wound or shock. Psychiatry further defines it as a painful emotional experience or shock. It might be a natural disaster or an accident. Some examples are: flood, fire, earthquake, tornado, car crash, bombing, shooting, torture, kidnapping, assault, rape, or child abuse.  Victims may witness serious violence, suffer the destruction of their homes and communities, or face a threat to their own lives and the lives of family and friends.  They are terrified, helpless, fear for their lives and often under extreme physical stress.  The trauma creates stress that affects the entire body. When the above conditions exist for longer than 30 days, according to the Diagnostic and Statistical Manual for Psychiatry Fourth Edition, the condition becomes a disorder. 

In the post-traumatic reaction, which can occur days, weeks, months, or even years later, there are several things which occur. First, the victims involuntarily reexperience the traumatic event in the form of intrusive memories (often referred to as subconscious tapes which play without warning), nightmares, and flashbacks during which they feel or even act as though the event were recurring.  Often they recall these episodes poorly or not at all.  They also suffer when exposed to anything that resembles, causes them to recall, or symbolizes some aspect of the trauma.  The veteran may undergo physiological and emotional reactions typical of combat when they hear taped battle sounds, watch filmed battle scenes, or even read war stories.   

The questions posed at the beginning of the article are asked time and time again without adequate answers being found.  To the families and spouses who live with the veteran it's a living hell. It's no picnic for the veteran either. He is also in pain and being tormented by some unseen monster.  It is a struggle for him, in many cases, just to survive, let alone maintain some semblance of a stable family life.  

Where do you go to find the answers to "What's wrong with Daddy?" For many minority veterans, the answers don't come easy and in most cases, they don't come at all or too late.  The Veteran's Administration Hospital and outreach clinics do offer help and answers. The degree of help is dependent upon the expertise and cultural competency of the VA staff, particularly the first person in the system that the veteran sees.  PTSD programs can run the entire gamut from excellent to not so hot.  Depending on their first encounter with the system, the veteran may or may not seek further assistance.  However, for many “nam” vets, the system is out of their reach.  Vietnam veterans, as a group, do not have any faith in the system and minorities even less. Their distrust stems from the reception and subsequent treatment they received upon their return to the states. Consequently, many Vietnam Veterans become the ones that seem to fall through the cracks.  The African-American veteran has an additional set of challenges to overcome. First and foremost, as a people, we tend to view any psychological problem as a curse. “I ain’ t crazy.”  Second, we have many issues that we consider “shameful” and we don’t want to tell anyone about them let alone get treated for them.  They become our “hidden secrets”. They are threats to our “manhood” and we try to cover them up at all costs. Third, for many of us, our first experience with “the system” was not pleasant. Consequently, we tend to shy away from anything that looks or smells like the “government”. When we attempt to access the system again, we do so with a chip on our shoulders. This in itself creates a new set of problems.  Fourth, we rely on someone else to tell us what is going on. We are an oral people. To look something up or verify information is unheard of. It would be a crime to ask someone where he or she heard something or to have him or her show it to you in “black and white”.  Lastly, we have to tell our story. It doesn’t matter whether the story is true or has anything to do with what is going on with us. Hence, many African-Americans become the ones that seem to fall through the cracks. 

Once in the system, the veteran has to overcome a couple of obstacles.  First, if the vet has a substance abuse problem in addition to the PTSD, they are likely to be treated for the substance abuse and the PTSD is overlooked.  Vietnam Veterans are portrayed negatively or viewed as substance abusers.  As the substance abuse problem is addressed, the vet finds that the PTSD problem gets worse.  A characteristic of all PTSD suffers is the self-medication aspect.  The inability to self medicate allows the mind to work, overtime.  At some point, the veteran’s PTSD is treated or they leave the treatment program to self medicate. Second, the helping professional, in some cases, is not skilled in handling PTSD victims and/or cannot relate to the veteran.  The inability to relate to the veteran will turn the veteran off and cause them to exit the system.  The VA, on occasion, has not been sensitive to the needs of the Vietnam Veteran and has allowed third world personnel to treat them.  The lack of adequate command of the English language has caused many “nam vets” to react negatively. This phenomenon is not unique to the Vietnam veterans. May other combat veterans from other wars are also affected. 

Even if the veteran is adequately helped by the system, they will find that the children and spouses are without a place to turn for assistance.  They are left to fend for themselves.  If family psychological problems become too severe, they are most often treated as a separated issue rather than in relationship with “daddy’s problem”.  The veteran returns to an unstable family unit as a new challenge.  The “old daddy” was predictable whereas the new one is foreign.   

What can the veteran do to deal with PTSD and its impact on the family?  PTSD is a family problem.  In order to address it properly, it is handled best in a family type seminar.  Select a speaker who understands PTSD and can explain it in terms that everyone can understand.  Time is allocated for questions after the seminar.  It is during this time that the veteran and family members begin to express their feelings and get some answers to questions that have plagued them for years.  A basic outline might be: The definition of PTSD; PTSD as it relates to the family; causes for the veteran’s behavior; things that can be done to lessen the impact of PTSD on spouses and children; coping skills; and the development of an informational repository.  After the session, the organization may have enough support to formalize a program.  

PTSD has been with us for many years and we have seen it in various settings. There are several challenges that we as combat veterans face. First, we must reach out to our brothers who have fallen through the cracks in the system and get them the care that they need.  Second, we must educate our families and ourselves. Third, we must teach those non-veterans that we interact with.  We are combat veterans who have served our country. We are human beings, productive citizens and not a bunch of crazed animals. PTSD is manageable. We just need to understand it and learn how to cope with it.  

We, the staff, at the paper are working to put together a program that will address several issues surrounding PTSD and the family. As we progress, you will be notified in this column.  This article is the first in a series of articles that will appear in this paper. Questions and letters can be directed to the editor of this section.

I hate my Daddy.  He doesn't care about us.  All he ever does is drink, yell and beat us.  You can't do anything right for him.  He never does anything with us.  I wish mamma would just make him go away. I don’t know what makes him hate us so. We never did anything to him.  I don’t understand why he acts like he does.   

The above statements and questions seem to echo the sentiments of many children and spouses of combat veterans. What's wrong with Daddy?  Daddy is suffering from Post Traumatic Stress Disorder, or better known as PTSD for short.  What is PTSD?  Post indicates that it comes after something and in this case a trauma.  Trauma is defined as a bodily injury, wound or shock. Psychiatry further defines it as a painful emotional experience or shock. It might be a natural disaster or an accident. Some examples are: flood, fire, earthquake, tornado, car crash, bombing, shooting, torture, kidnapping, assault, rape, or child abuse.  Victims may witness serious violence, suffer the destruction of their homes and communities, or face a threat to their own lives and the lives of family and friends.  They are terrified, helpless, fear for their lives and often under extreme physical stress.  The trauma creates stress that affects the entire body. When the above conditions exist for longer than 30 days, according to the Diagnostic and Statistical Manual for Psychiatry Fourth Edition, the condition becomes a disorder. 

In the post-traumatic reaction, which can occur days, weeks, months, or even years later, there are several things which occur. First, the victims involuntarily reexperience the traumatic event in the form of intrusive memories (often referred to as subconscious tapes which play without warning), nightmares, and flashbacks during which they feel or even act as though the event were recurring.  Often they recall these episodes poorly or not at all.  They also suffer when exposed to anything that resembles, causes them to recall, or symbolizes some aspect of the trauma.  The veteran may undergo physiological and emotional reactions typical of combat when they hear taped battle sounds, watch filmed battle scenes, or even read war stories.   

The questions posed at the beginning of the article are asked time and time again without adequate answers being found.  To the families and spouses who live with the veteran it's a living hell. It's no picnic for the veteran either. He is also in pain and being tormented by some unseen monster.  It is a struggle for him, in many cases, just to survive, let alone maintain some semblance of a stable family life.  

Where do you go to find the answers to "What's wrong with Daddy?" For many minority veterans, the answers don't come easy and in most cases, they don't come at all or too late.  The Veteran's Administration Hospital and outreach clinics do offer help and answers. The degree of help is dependent upon the expertise and cultural competency of the VA staff, particularly the first person in the system that the veteran sees.  PTSD programs can run the entire gamut from excellent to not so hot.  Depending on their first encounter with the system, the veteran may or may not seek further assistance.  However, for many “nam” vets, the system is out of their reach.  Vietnam veterans, as a group, do not have any faith in the system and minorities even less. Their distrust stems from the reception and subsequent treatment they received upon their return to the states. Consequently, many Vietnam Veterans become the ones that seem to fall through the cracks.  The African-American veteran has an additional set of challenges to overcome. First and foremost, as a people, we tend to view any psychological problem as a curse. “I ain’ t crazy.”  Second, we have many issues that we consider “shameful” and we don’t want to tell anyone about them let alone get treated for them.  They become our “hidden secrets”. They are threats to our “manhood” and we try to cover them up at all costs. Third, for many of us, our first experience with “the system” was not pleasant. Consequently, we tend to shy away from anything that looks or smells like the “government”. When we attempt to access the system again, we do so with a chip on our shoulders. This in itself creates a new set of problems.  Fourth, we rely on someone else to tell us what is going on. We are an oral people. To look something up or verify information is unheard of. It would be a crime to ask someone where he or she heard something or to have him or her show it to you in “black and white”.  Lastly, we have to tell our story. It doesn’t matter whether the story is true or has anything to do with what is going on with us. Hence, many African-Americans become the ones that seem to fall through the cracks. 

Once in the system, the veteran has to overcome a couple of obstacles.  First, if the vet has a substance abuse problem in addition to the PTSD, they are likely to be treated for the substance abuse and the PTSD is overlooked.  Vietnam Veterans are portrayed negatively or viewed as substance abusers.  As the substance abuse problem is addressed, the vet finds that the PTSD problem gets worse.  A characteristic of all PTSD suffers is the self-medication aspect.  The inability to self medicate allows the mind to work, overtime.  At some point, the veteran’s PTSD is treated or they leave the treatment program to self medicate. Second, the helping professional, in some cases, is not skilled in handling PTSD victims and/or cannot relate to the veteran.  The inability to relate to the veteran will turn the veteran off and cause them to exit the system.  The VA, on occasion, has not been sensitive to the needs of the Vietnam Veteran and has allowed third world personnel to treat them.  The lack of adequate command of the English language has caused many “nam vets” to react negatively. This phenomenon is not unique to the Vietnam veterans. May other combat veterans from other wars are also affected. 

Even if the veteran is adequately helped by the system, they will find that the children and spouses are without a place to turn for assistance.  They are left to fend for themselves.  If family psychological problems become too severe, they are most often treated as a separated issue rather than in relationship with “daddy’s problem”.  The veteran returns to an unstable family unit as a new challenge.  The “old daddy” was predictable whereas the new one is foreign.   

What can the veteran do to deal with PTSD and its impact on the family?  PTSD is a family problem.  In order to address it properly, it is handled best in a family type seminar.  Select a speaker who understands PTSD and can explain it in terms that everyone can understand.  Time is allocated for questions after the seminar.  It is during this time that the veteran and family members begin to express their feelings and get some answers to questions that have plagued them for years.  A basic outline might be: The definition of PTSD; PTSD as it relates to the family; causes for the veteran’s behavior; things that can be done to lessen the impact of PTSD on spouses and children; coping skills; and the development of an informational repository.  After the session, the organization may have enough support to formalize a program.  

PTSD has been with us for many years and we have seen it in various settings. There are several challenges that we as combat veterans face. First, we must reach out to our brothers who have fallen through the cracks in the system and get them the care that they need.  Second, we must educate our families and ourselves. Third, we must teach those non-veterans that we interact with.  We are combat veterans who have served our country. We are human beings, productive citizens and not a bunch of crazed animals. PTSD is manageable. We just need to understand it and learn how to cope with it.  

We, the staff, at the paper are working to put together a program that will address several issues surrounding PTSD and the family. As we progress, you will be notified in this column.  This article is the first in a series of articles that will appear in this paper. Questions and letters can be directed to the editor of this section.