Though he didn’t notice it at first, U.S. Marine Corps veteran Bruce Bennett came home from Vietnam a changed man.
Wounded, but having survived combat, Bennett returned feeling “bulletproof” and ready to take on the world. Over time, however, problems surfaced. He found himself becoming quick to anger, anxious, and fearful of crowds. The older he got, the stronger the symptoms became.
“I didn’t know I had it, but it would come out,” he said. “Something inside would react, and I’d be running at the mouth, screaming and yelling, or I’d turn and go to another room and sit by myself.”
In the 1970s, medical professionals only had vague euphemisms for the “it” Bennett was experiencing, “battle fatigue” or “shell shock” among them. It wasn’t until 1985 that doctors diagnosed him with Post-Traumatic Stress Disorder (PTSD).
“It’s a defense mechanism that you could call a ‘flashback,’” Bennett explained. “I need to know that there’s an exit. I don’t like people behind me. When I go to a restaurant, I always sit with my back to the wall. I’m continually watching to see what is going on around me, and I always have a Plan B, whether it’s fight or flight.”
As a result of his symptoms, Bennett went through three marriages and 15 jobs over the course of 40 years. Like many combat veterans suffering similar fates, he dealt with his PTSD by self-medicating with drugs and alcohol, which addressed the problem the same way releasing some steam temporarily tones down a pressure cooker.
Then doctors put Bennett on medication, which significantly brought his anger level to a manageable level. Now on the path to recovery and living in Santa Barbara, he sees his experience mirrored in recently returned soldiers.
“If you talk to the spouse of someone who’s been deployed to Afghanistan or Iraq and they’ve come back, they’ve changed,” he said. “It’s across the board. They’re a changed person.”
The suicide epidemic
According to a 2008 study by the RAND Corporation, close to 30 percent of all veterans returning from conflicts in Iraq and Afghanistan show at least some signs of PTSD.
As in Bennett’s case, sufferers are often locked in the perception that they’re still in the combat zone. They may imagine dangers—such as snipers or roadside bombs—and experience inexplicable periods of intense rage or exaggerated startled responses. Sleep disturbances, nightmares, and insomnia are also common.
In a break from past actions, the military is now acknowledging PTSD as a major contributing factor to the startlingly high suicide rates seen in returning veterans. According to statistics available from the U.S. Department of Veterans Affairs, 18 veterans commit suicide every day, and the epidemic is growing; from 2005 to 2009, the suicide rate doubled for Army personnel returning from Iraq and Afghanistan.
According to a recently published report in The New York Times, more than 1,000 California veterans younger than 35 died after returning home from Iraq and Afghanistan between 2005 and 2008—three times more than the number of California military personnel killed in the two conflicts. The report also showed veterans were 2 1/2 times more likely to commit suicide than civilian Californians of the same age.
For Bennett, the numbers provide parallels to Vietnam, where, according to some estimates, up to 100,000 U.S. troops committed suicide after returning home, nearly twice the amount killed in combat.
“When you look at it and everything is gone, they give up. No one—even the doctors can’t help them anymore,” Bennett said. “You have someone who could be a very valuable asset to society, and they just didn’t, for whatever reason, follow the plan.”
The RAND study also found that only half of the veterans who need mental health care receive it. Upon leaving the service, soldiers report to the Department of Defense for an orientation program where their benefits are explained to them. From there, they’re under the care of the Department of Veterans Affairs (VA).
Michael Young, counselor and liaison for the VA, runs the Vet Center in San Luis Obispo, a brand new counseling center servicing Northern Santa Barbara County and southern SLO County. He works closely with the VA outpatient clinics in Santa Maria, providing readjustment counseling and helping recently returned veterans
find jobs.
Sometimes, the Vet Center’s therapists are the first to diagnose PTSD in returning soldiers. They look for “clusters” of symptoms, including avoidance of sights, sounds, or smells; disturbing thoughts; and anger problems.
Young said it’s difficult to quantify how many returning vets have PTSD because military members are reluctant to seek mental health services and may not be fully aware they’re even experiencing symptoms.
“In the folks that we have come in, it’s pretty common,” he said. “When you’re in a war zone, you’re exposed to extreme stress conditions. Military life and military culture, especially working in a hazardous area, can have all kinds of effects on someone emotionally and psychologically.”
The SLO Vets Center is currently temporarily housed in the county’s Veterans Services Office, awaiting a lease on permanent housing. Once up and running, Young said, the center will get an outreach coordinator, a veteran himself, who will be sent out to talk to returned soldiers about treatment options at places like the Allan Hancock College and Cal Poly campuses.
“We’ve seen people do very well, and we’ve seen others that we need to try a different approach with,” Young said. “What we do know is that folks that don’t get treatment definitely don’t get better—and usually get worse.”
According to Gary Erickson, co-founder of Ventura’s Gold Coast Veterans Foundation, which serves vets in the Tri-Counties, symptoms of PTSD are underreported out of the sufferer’s fear of showing weakness and the stigma of mental illness.
“Many of the soldiers are somewhat concerned about raising many of the issues because they’re afraid they won’t be released,” he said. “Their concern is, ‘I’d rather be home than be put into some kind of program.’”
Erickson said the VA doesn’t have enough programs to fill the needs of returning vets. However, acknowledging the pervasiveness of PTSD, the VA recently changed the criteria for diagnosing the disorder. Now, any combat-experienced vet is assumed to have PTSD and is automatically considered for treatment—a shift that lets therapists like Erickson speed up the process.
While there’s still more work to be done, Erickson said the spotlight on PTSD is helping therapists make inroads in curbing the epidemic of self-inflicted military deaths.
“So many veterans are falling through the cracks, and we’re losing more veterans now to suicide than we are to the war,” Erickson said. “That just can’t continue.”
Horses and heroes
According to the RAND study, in most cases, VA programs haven’t been as successful as community-based programs in treating PTSD and reintegrating returning soldiers.
One reason for the success of private sector treatment, Erickson explained, is the inclusion of the soldier’s family as part of the solution.
“The family has to understand what the veteran is going through because he or she is acting strangely, or they’re not the same person,” he said. “We hear this time and time again. This is not the son or daughter that left here two years ago. They’re different. Something’s wrong.”
Family is often neglected when it comes to PTSD treatment, according to Jennifer Bartel, associate director of Outdoor Adventures at Casa Colina, a nonprofit physical rehabilitation center in Pomona.
After 30 years of helping people with brain injuries reintegrate back into society, the center received a grant to treat vets with combat-acquired brain injuries, but quickly expanded into PTSD.
“What we’re finding is there really isn’t anyone coming back who doesn’t have some level of PTSD,” Bartel said. “We had to modify our treatment approach to include the effect of a brain injury and PTSD, which is kind of like 2+2=10 when you combine those two diagnostics.”
In November 2009, Casa Colina hosted “Survive and Thrive,” a five-day retreat at Solvang’s Alisal Guest Ranch and Resort, during which 12 veterans with PTSD, and their families, enjoyed horseback riding, swimming, boating, and archery at no cost. The event served as a pilot program for the center, a step toward developing a clinical model to treat PTSD at a broader level.
Bartel said the purpose of the retreat, which will return to Alisal Ranch in April 2011, is to provide families with an understanding of how PTSD affects them and an opportunity to be a family again, at least temporarily.
“So much gets fractured when you’re in that survival mode. A wife is no longer a wife, but a full-time caretaker,” she said. “They don’t have the chance to just relax and play and recreate and enjoy each other. For a few days, we can give them that, but ultimately we just want to offer them some hope through those processes.”
Just down the road, at Flag Is Up Farms in Solvang, a similar approach to PTSD therapy is underway, headed by Monty Roberts, the world-famous “horse whisperer” and author of New York Times bestseller The Man Who Listens to Horses.
Roberts recently brought three California veterans with PTSD to his ranch to learn how to connect with his horses using “Join Up,” a language of territorial gestures based on techniques he learned by studying the behavior of wild horses.
With Roberts looking on, the veterans used Join Up techniques to forge bonds with horses in a round pen over a period of four days. The experiences were filmed for the television special “Horse Sense and Soldiers,” which aired on the Military Channel in September.
According to Roberts’ eldest daughter, Debbie Loukas, the family spokesperson, the same communication techniques used to create trust and discipline within a herd of horses can be used to bring adrenaline down in humans. Through
Join Up, Loukas said, veterans learn to use language skills—rather than aggression—to communicate.
“When you’re taught to just react and to also be aggressive, you tend to shrink your communication skills,” Loukas said. “You put those people back in a social or domestic setting with the family, and the family says, ‘We don’t want to.’ Then they’ve got a shorter fuse.”
After the experience, Loukas said the veterans left the ranch calmer and happier.
“It was fun to see them just smile and relax and feel like they were in control again of a situation,” she said.
When Hearts Adaptive Riding Center’s Program Director Connie Weinsoff saw the TV special, she immediately noticed the similarity with the therapeutic horseback program she runs in Santa Barbara. She asked Roberts if she could bring her staff out to the ranch for a training session with Roberts to certify them in Join Up techniques. The session is scheduled for December. After training with Roberts, Weinsoff said she’s planning to develop a structured, eight-week course to teach veterans with PTSD communication skills to take back into society.
Hearts Adaptive, which specializes in riding lessons for people with physical and mental disabilities, started discussing the potential of holding lessons for vets with PTSD three years ago. Their “Horses and Heroes” program began in January, and has since allowed 14 combat veterans with PTSD the opportunity to ride for two hours each Saturday on a ranch with an ocean view and 30 miles of trails.
Not backed by VA, Hearts doesn’t require veterans to have a diagnosis to participate. Weinsoff said the experience enables the vets to develop relationships with the horses and encourages them to open up.
“It sounds so simple, but for people who are dealing with psychological issues, it can be very releasing,” she said. “Nobody’s going to jump out of the bushes and attack them. They finally get to relax and think some things through.”
With a lifelong passion for horses, PTSD sufferer Bennett heard about Hearts Adaptive and volunteered to help lead the program, crediting the experience with
giving him respite from his hypervigilance.
“It was a very calming, relaxing feeling,” Bennett said. “When I drove onto that property, that became the world. All those problems I was having no longer existed. They were gone.”
Bennett said building a rapport with a horse helps veterans calm down; they’re able to tell horses things they couldn’t tell anyone else, including their therapists.
“It’s like talking to another person,” he said. “They look at you, they pay attention, and you can get everything off your chest and know without a doubt it’s not going to get repeated.”
Bennett said there’s no pressure on veterans to ride. Some just sit and watch the ocean; others have gotten over their fears of horses and saddled up. After going through the program, Bennett said, one veteran called a son he hadn’t talked to in 20 years. Another credited it with saving his life.
“They’re doing something that they never thought about doing or didn’t think they could do. That control all of a sudden opens them up,” he said. “When you can take a horse that hasn’t been around people and you get that horse to trust you, that’s empowering. That’s what a lot of these guys need.”
Contact Staff Writer Jeremy Thomas at jthomas@santamariasun.com.
This article appears in Nov 11-18, 2010.