Military Presentation
James Martin, LMSW, MAC, SAP,
EMDR, CISD
The Casualties of War
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History Americans at War
Military Culture
Deployment/Redeployment
Reintegration
PTSD Causes
Symptoms
Suicide
Treatment
The Veterans Commission Reported
• America has 23.5 million veterans in 2007
• WWII Vets dying off
• Average of 500,000 per year are dying off
about 1400 per day.
• By the end of 2006 Vietnam Veterans were
the largest group in the veteran population.
• Curently over 2 million war veterans .
The Veterans Commission Reported
• The effects of the current war are beginning to
show
• 2 million had service related disabilities at the
end of 2007 and this number is rising.
• The VA is not geared up to handle these
numbers so vets needing help sometimes
don’t receive it
Who are our Military Personnel
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Active Duty
1.4 Million (48%)
Reserves
1.1 million (31%)
DoD Civilian Personnel
800,000 (23%)
Who Are Our Military
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Regular Army
Regular Navy
Regular Air force
Regular Marines National Guard
Reserves
Who Are Our Military Personnel
Age:
• Active Duty (general)
56% are under 26 years old
• Active Duty (Married)
Average age 31.8 years
 Reserves:
40% are 36 + years old
Who are our Military Personnel
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Married
Active Duty : 56%
Reservists : 44%
Active duty with dependents: 56.8 %
Reservists with dependents: 56.3%
1.2 Million dependent children of active duty
service members
Dual Income Families
• Require Second Income
77%
• Spouses of active duty personnel employed/
seeking employment
59%
The Vary Nature Of Military
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Trained to Kill
Trained to kill almost without hesitation
Make life and death decisions under stress
Do things that are horrible and upsetting for
any human being
• Their training and war experience can have a
life altering impact on their lives (young)
Battle Conditions
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Fear .
Guilt
Extreme weather conditions, hot or cold
Under constant enemy fire
Extreme fatigue
Perhaps four hours sleep a night
Extended time
Battle Conditions
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One third of 10 to 21 year olds killed.
Beginning 2006 weapons of choice I.E.Ds.
140,000 suffered brain injury.
Almost 10,000 have accrued in 2011.
June, 2011 deadliest month since 2008 - 14
attacks per day.
Deployment
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Deployed
Home
Redeployed up to 5 times and more
Reintegration
Problems adjusting.
Deployed again
Deployment Family
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Difficulty adjusting
Made decisions
Finances
Children (behavioral problems)
Social support
High rate of divorce (young)
Deployed Military Personnel
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Separated from family and friends
Disrupted career
Stress of combat
Lonely, scared, angry, sad
Expanded world experience and possible
changes in world view
Experience of Deployment Spouse at
Home
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Expanded responsibilities
Single parenting
Handling finances
Anxiety, anger, stress
Loneliness
Growth, change, self confidence
Reintegration
• Once over and leaves his/ her combat unit,
those who served will inevitably rethink their
experience.
• That’s when they and their families will begin
to experience the long term consequences of
the psychological damage of the war.
Reintegration
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Home coming party or quiet time
Children react in different ways to return
Mixed emotions
Problems connecting
Life again becomes disrupted
Return parent has to be updated
Family has to adjust to a new normal
Reintegration
• Stability for the family, roles and
responsibilities
• Discipline now goes back to both parents
• Non deployed parent may have changed
• Tension and anger can increase (marital )
• Commitment to two families
• Physical and psychological needs (PTSD)
• CAN BE DEPLOYED AGAIN
History of PTSD and TBI
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History of Wars , PTSD and TBI
Civil War Melancholy
WW I Shell Shock
WW II and Korea Combat Fatigue
Vietnam War PTSD
State of Denial
• I don’t have a problem - I can handle it
• A cultural thing , supposed to be tough
• Don’t want to admit their fear so they repress
it
• Bond with members of unit, don’t want to
leave them
• Paying job don’t - want to lose it
Combat-Related Stress Reactions
In Denial
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Isolation from friends and loved ones
Major psychiatric problems
Marital and family discord
Work and career problems
Alcohol and drug problems
Suicide
PTSD
• Personality Disorder,
• Discharged Under Chapter 11
• 1980 Vietnam PTSD
PTSD Combat Reaction to A Civilian
Provocation
• 1981 - 1,000 Vietnam Vets, one quarter
arrested since returning home .
• VA reports 150,000 or more homeless.
• January, 2008 N.Y. Times investigation came
up with 121 cases in which combat vets
committed a killing or were charged with
one after returning from war in Iraq or
Afghanistan .
Symptoms Of Combat PTSD and TBI
Dealing With the Unseen Scars Of War
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Military culture - mental toughness
Life time occurrence 10%-30%
Currently the cases have jumped 50%
Studies estimate that one in every five
military returning from combat has PTSD
PTSD
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DoD stated on the rise from 40 to 50 present
PTSD is a cumulative disorder
Worsens with increased exposure to combat
Many troops have been deployed numerous
times and their times have been involuntarily
extended.
• Conducting combat 10 to 12 hours per day for
months on end.
PTSD - I
• Why PTSD REGONIZED MORE TODAY
• Better medical records,
• Lives saved Due to better technology
Modern technology - live longer
• Better medical response teams
• Body armor, armored Humvees, can’t protect arms and legs, amputation increased
dramatically
• TBI increased from impact
PTSDII
• World War I and WW II – fewer that 2 soldiers
wounded for each killed
• Korea, Vietnam up slightly – 3 wounded for each
fatality
• PTSD rate in Vietnam was artificially low – little
knowledge 40 yrs. Ago
• Unpopular coming home, homelessness, spit on,
baby killers – didn’t want attention
• Counselors stated that Vietnam vets were
traumatized by news media – current vets
starting to seek treatment
PTSDIII
• More women in combat for first time in a major combat
• Higher for women than men, more sensitive
• Nationally there are about 1.7 million female vets,
235,000 receiving help - expect numbers to double in next
4 years
• Some hit with a double whammy with sexual abuse, won’t
tell due to nature of culture
• Condition called personality disorder discharged under
chapter 11 saved government up to 8 billion in medical
benefits
• Over 3,000 vets sought help in 2008 - Tri Care not accepted
by some providers
Suicide
• Veterans Association reports seeing 18
suicides per day among 25 million veterans
• DoD taking action
• Reported 150,000 homeless veterans, most
from the Vietnam War
• Expect numbers to increase
Suicide
• Higher rate than any other War where records
were kept
• More died from suicide than military action
• Rate before 9/11 - 9.1 per 1,000,000, by 2007
twice that - 24 per Per 1,000,000
• Reported that 1,000 attempts per month seen
in medical facilities
Suicide
• First seven months of 2011 - 109 suicides
• July, 2011 - suicides hit a record
• Staff Sergeant shot himself to avoid his ninth
deployment
• A full scale crisis
• Trained peers
• DoD investigating
Treatment Modalities
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Get solider to talk
Reality Therapy
Flooding
Debriefing
Virtual Reality
EMDR
Other Treatment Modalities
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MHN, Military One 12 sessions
Mental Health on base
Met plan
Blue ribbon/weekendworkshops/reintegration/families/children/
Dear John 9 (letters)