Running head PTSD ANNOTATED BIBLIOGRAPHY 1PTSD ANNOTATED .docx
Justice for All - A look at returning veterans
1. Roger Williams University
Justice for All:A look at returning veterans living with PTSD and media involvement
Luke Branchaud
Dr. Scott
Justice Studies Capstone
February 25, 2014
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Introduction
Carrying out justice in returning military and the invisible wound these soldiers
return with is a discussion that must be had. PTSD, an ailment of the mind is of vital
importance to heal along with any other physical injury. The effect PTSD has reaches all
returning military, family, and friends, whether directly or indirectly and combating this
effect is of grave importance. The difficulties of reintegration into society are hard
enough, along with a wound that cannot be seen to the naked eye only amplifies this
hardship to an unbearable level. Living in the land of the free because of the brave, it
seems only right veterans are cared for to the full extent due to the sacrifices they have
given.
Reintegration to civilian society is one of the most difficult parts for veterans
returning home (Moron, 2011; McMichael, 2012; Institute of Medicine, 2013; The
Mission Continues, 2014). The difficulties extend from returning with PTSD, economic
problems, lack of family support, and inability to find work. With the U.S. Department of
Affairs estimating that almost 21% of soldiers returning home from Iraq and Afghanistan
having PTSD symptoms, and many more that hide the symptoms for fear of scrutiny.
With not all soldiers being treated for PTSD this raises a problem with how to deal with
soldiers who fear the negative stigma attached to having a mental disorder. Civilian and
exMilitary run websites such as FacebookPTSD Anonymous, TwitterPTSD Education,
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Terminal Lance, Real Warriors, and Marine Corps Times, Veterans can get information
and talk about their issues.
This paper seeks to examine the concept of justice, within returning Military who
have PTSD, and how various social media sites can aid reintegration. This research will
deconstruct the previous mission statement and examine it piece by piece to display why
social media should be incorporated within the healing process of PTSD. The facts and
history of PTSD will first be presented to help further the understanding and underlying
problem of this topic. Ultimately a recommendation will be made that would be a helpful
assistant in healing our Military with this growing problem and carrying out justice, as
they have done across the world.
Justice is….?
Oxford dictionary defines justice as “The fair and just treatment, with law and
authority maintaining this” (2014). This is inarguably a correct literal definition of
justice, but the use of the word justice has a much greater meaning, a more philosophic
meaning than anything. Justice is a foundation of the Criminal Justice System and an
American Military value. But to how far do these values extend? American society is
infatuated with the concept of Justice and the stressing of its importance to maintain
integrity as a society. Throughout American history this simple word has been used to
describe and explain monumental occasions. The United States Constitution opens with
“We the people in order to form a more perfect union, establish justice…”, as well as
President Obama Giving his speech on Osama Bin Laden’s death claiming “We can say
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to the Families that have lost love ones, Justice, has been served”. Using the previously
described oxford dictionary definition lets expand on this notion of justice.
Justice in this context is considered a virtue that is unveiled by the individual
through his or her actions. As well as the individual, Rawls (1971, pg. 64) explains
“Justice is the first virtue in social institutions” which implies justice is universally
encompassing, starting from the individual and expelling into society. So Justice begins
with the individual in their actions but is involved in society as a whole. In Plato’s
Republic (2006) He examines the true morality of justice and presents it as a moral state
rather than an adherence to law, or actions in a court of law. By this Plato means that
justice is involved with people making the moral and “Just” decision because its good
and virtues not because of fear of consequence. The Underlying principle is that justice in
Plato’s conclusion is a matter of morality in the individual’s choice. The definition of
Justice through research and theory of justice is as follows:
Branchaud, L. (2014), Justice: The fair and just treatment of individuals that
effects society as a whole, specifically in the context of A virtuous action which
demonstrates a true belief of doing good to others, and when failing to meet
certain universally agreed upon moral standards, law and authority maintaining
and judging those actions in a just manner.
This Researched and amplified definition of justice will be the foundation of this paper
when examining different sociological concepts of returning military.
PTSD The Facts…
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Post Traumatic Stress Disorder has a multilayered history from when it happened
to people, when it was recognized, and when it was viewed as a disorder. PTSD has more
likely been around since our species evolved; the U.S. Department of Veterans affairs
points out that attacks from Saber tooth tigers probably generated similar traumatic
experiences like that of a twentyfirst century terrorist attack. Human’s have known that
exposure to overwhelming terror can lead to troubling memories and social problems, but
not fully understood why. The Greek poet Homer was even known to write about these
symptoms in some of his epics when telling stories of war (Alford, 1992). The breaking
point of realizing that a real situation can permanently alter human’s psychology was met
with much resistance. Questions such as, is PTSD organic or psychological? Is trauma
subjective to interpretation? Does the trauma cause the disorder or preexisting
vulnerabilities? The amount of questions revolving around the topic of PTSD as a
psychological disorder is enough to dizzy anyone. So Lets take a further look.
Post Traumatic Stress Disorder is, as it name suggests, triggered by a past
traumatic, horrific, or injury/life threating event (APA, 1994). To be diagnosed with
PTSD, a traumatic event must have occurred and 3 of the listed qualifications (Appendix,
A) must persist for at least a month. Symptoms include “hyper arousal referred to
physiological manifestations, such as insomnia, irritability, impaired concentration, hyper
vigilance, and increased startle reactions” (North CS, Nixon SJ, Shariat S. 1999). PTSD
has been a persisting problem but came to fruition in World War I when, as
AudoinRouzeau, S & Becker, A (2000) explain “one tenth of mobilized American men
were hospitalized for mental disturbances, and, after thirtyfive days of uninterrupted
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combat, 98% of them manifested psychiatric disturbances in varying degrees”. The US
Department of Veteran affairs estimates that PTSD effects Almost 31 percent of Vietnam
veterans, As many as 10 percent of Gulf War veterans, 11 percent of veterans of the war
in Afghanistan, 20 percent of Iraqi war veterans. Soldiers are found to have some of the
highest risk to receive PTSD due to the violent nature of their job (see Table 1). This is
an ongoing problem that effects entire lives of returning military and deserves more
attention than received.
Table 1. Exposure to PTSD
Branchaud, L. (2014) Resources used: Girolamo, G; McFarlane, A. (1981). The Nature
of Traumatic Stressors and the Epidemiology of Posttraumatic Reactions. The Guilford
Press, NY. Pg. 129147
Learning from conflict…
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PTSD was first truly examined by Sigmund Freud and many others helped build
off of the foundation he laid. This is mostly applicable after WWI came to an end and
psychiatrists tried to start early interventions, however unsuccessfully (Merskey, 1991).
In 1923 was the first time psychiatrists tried to create a theory of war disorders which
when put to the test were also unsuccessful. But this was a major step in the history of
PTSD for the sole reason that people finally understood that traumatic events caused a
significant problem. And although it wasn’t universally accepted, psychiatrists were
beginning to create theories and put them to the test.
When World Way II was beginning to break out Abram Kardiner published The
Traumatic Neuroses of War (1941) (Appendix B). This was a major step in a positive
direction because Kardiner arguably defined PTSD for the remainder of the 20th
century.
One such excerpt defines war PTSD by stating:
The nucleus of the neurosis is a physioneurosis. This is present on the battlefield
and during the entire process of organization; it outlives every intermediary
accommodative device, and persists in the chronic forms. The traumatic syndrome
is ever present and unchanged…. And from a psychological point of view a state
of readiness for fright reactions. (p. 95, Kardiner)
Although this work made great strides, many of the lessons and applications
learned from WWI were forgotten and essentially, had to be rediscovered (McFlarne, A;
Van der Kolk, B; Weisaeth, L. 1996). The United States played a major role in finding
therapeutic methods in helping PTSD victims towards the end of WWII. This time period
is when research became fully examined and progressed to the level of helping victims.
The next major conflict in American history was the Vietnam War, which many
veterans are still suffering from the effects of PTSD. One particular research study that
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was conducted examined 326 Vietnam Veterans. Findings showed that war stress are
consistent predictors of PTSD symptoms. For this paper, the most notable findings were
“The most consistent relationship was between denial of war stress and subsequent
intrusive imagery and numbing symptoms” (FreyWouters, E; Gallops, M; Laufer, R.
1985, p. 73). This is a particularly disturbing finding, if soldiers deny there is a problem,
than how can they be helped? Unfortunately this denial of PTSD did not stop with
Vietnam veterans. Moving forward on the time line to the war in Iraq and Afghanistan,
Veterans are still facing the same problems. Soldiers are instructed to be tough in nature,
unbreakable in character, and unshakeable in the hardest of situations. This training is
what makes our Military one of the strongest in the world and has undoubtedly saved
lives, but it also may have a negative impact. Soldiers have admitted anonymously that
they fear seeking help for PTSD for numerous reasons; and many of these reasons seem
to have a direct correlation to the mental training they receive. Along with this training,
negative stigmas of having a mental disorder, and media representation of loose cannon
soldiers has only amplified the problem.
A Synonym for Veterans? Prisoners…
A major issue with all returning Veterans is reintegration into society, and best
results for proper assimilation is to be involved with social institutions. This can be
difficult for returning military without stable families to become fully involved in society.
Getting a job is not only a necessity, but a great option to become involved in these
institutions; however with returning military who are specifically trained in combat,
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finding a job is not that easy. In fact, returning veterans are becoming unemployed at an
unprecedented rate and this number is only expected to grow. A reason for this is
“There’s been an upsurge in young people going into the military and not staying for a
full 20year career,” says Jane Oates, the Assistant Secretary for Employment; another
reason is the pulling out of Iraq.
This next statement may seem a bit drastic but the comparison of inmates reentry
seems scarily similar to war veterans trying to reintegrate. Problems with reentry of
prisoners are: Employment, Substance Use, Programs and Services, Health, Family,
Community, and Expectations (LaVigne, N. Travis, J. Visher, C. 2004). Problems with
veteran integration in civilian society include: Employment, Health (PTSD), Substance
Use (Stemming from PTSD), Family, Community (Negative Stigmas), and availability of
Programs and Services (Moron, R. 2011). The fact this comparison can even be made
demonstrates the incompetence of society and lack of efforts from the government.
Which leads to the underlying notion of, is justice done to those who served our country
upon returning, or are they merely lost in forgotten?
Where sickness thrives, bad things follow…
With reintegration being a key component in a successful transition from Military
to civilian life it is curious how wide spread the effect of PTSD has on society. There are
several obvious categories of people who are directly or indirectly affected by this
disorder. These include Military in general (through attached stigmas), the family and
friends of those diagnosed with PTSD, as well as those undiagnosed (see Table 2).
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Postdeployment screening questionnaires conducted by the Army brigade combat team
found disturbing statistics involving those undiagnosed with PTSD. Being allowed to
complete the form anonymously, it showed suicide and depression rates were four times
hire than those who were required to put their names on the survey. Physicians in
Uniformed Services University of Health Sciences stated, “Current postdeployment
mental health screening tools are dependent on soldiers honestly reporting their
symptoms. This study indicates that postdeployment health assessment screening
process misses most soldiers with significant mental health problems”. Reversing the
feeling of soldiers being afraid to be honest about their mental state is of dire importance
in helping to move forward in in living with this disorder.
Table 2.
Branchaud. L (2014) The reach of PTSD
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There are several means on which someone diagnosed with PTSD can receive
help; this however is useless if those suffering do not admit to living with it. According to
the National Institute of Mental Health, depression is a symptom that comes frequently
with PTSD. When depression is left untreated and the individual suffering from that
continues without any help the risk of suicide is significantly increased. In 2012 more
soldiers committed suicide than were killed in combat operations (U.S. Department
of Defense). Preventing this at all costs should be top priority for returning soldiers. Not
reporting this due to fear of judgment or a harmful effect on their career are issues that
must seriously be examined. Reversing a stigma or complete thought process that
Military has is extremely difficult and could take countless years, if ever.
To the victors go no spoils…
Throughout the history of the world when soldiers would go off to battle and be
compensated for the victories they achieved. Land would be given up to soldiers who
served long, or in times of peace so they can farm, work, and overall contribute to
society. Today our returning hero’s are finding it harder to become employed due to
negative stigmas and the perceived notion of military returning with mental issues
(Moron, 2011). All though most veterans return without PTSD, the ones that do have it
find it immensely difficult to find work. Since this problem has been realized there have
been efforts to diminish this statistic, and although it is in the infant stage, it is a start.
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Spike TV, which is known for being a mainly male demographic television
channel has launched a campaign to help hire veterans. This campaign will launch a
website entitled Hire a Veteran which will seek to get jobs for veterans from main street
to wall street (Potts, 2011). Spike TV President Kevin Kay explains "These young men
and women who have bravely served their country are now making the often difficult
transition from military service to the general workforce. Hire A Veteran is designed to
help in that process." The website is extremely easy to navigate and has a variety of
different services for a truly effective media tool. There are tabs for Veterans to click on
for jobs, as well as companies who look to get involved, as well as blogs about resume
building and interviewing skills.
Other corporations have stepped up to the plate such as JPMorgan, Chase, and
Verizon pledging to hire 100,000 veterans by 2020. Along with this, the updated GI Bill
has helped with paying for some education, a living allowance, and ability to transfer
unused benefits to spouse or children. But with 220,000 soldiers out of work from Iraq
and Afghanistan these efforts will still not be enough (Appendix C). Barker, S. (2013)
explains a vital key to success in Veterans returning is community connectives. This also
goes along with what other scholars deem to be a viable solution in effective reintegration
(Cotton, D; Jackson, J; Sessums, L; Taichman, D; Williams, S; 2013). The reason for
drilling this point in is a simple one; to effectively assimilate with a community having a
job is one of the best social institutions to be involved with. The New York Times article
As wars end, young Veterans are returning to scant jobs, which Veterans explain that
employers are hesitant to hire soldiers, grouping soldiers with the possibility of having
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PTSD. This article interviews Veterans and allows them to describe their hardships upon
return. Jobs seem hard to find without a college degree and employers appear hesitant to
higher veterans, grouping all those returning with the possibility of having PTSD. With
Joblessness being a major issue for Veterans it begs the question what is the government
doing to help them? The Obama Administration has pledged to create “Career ready
veterans” and has hired 85,000 veterans to payroll since 2008. This is a great step
forward not only hiring, but putting into action a plan to prevent soldiers from being
unqualified to begin a career separate from the Military.
Military Benefits, most notably the VA clinic do not fully offer health care to
returning veterans and many times PTSD medication is too expensive. Certain programs
such as the Wounded Warrior Project help raise money to aid these Veterans, but not
enough to combat this issue. Two solutions to help truly battle PTSD have been found,
Cognitive Behavioral Therapy and Movement Desensitization Reprocessing, but many
times these come with a high price tag. Depending on the particular healthcare, it may
only cover some of this cost and with veterans having a hard time finding a stable job this
is a vicious cycle of a problem. One way to combat this is to reverse the stigma attached
with returning military, which is arguably the hardest task when seeking to help PTSD
victims. Universally, A major way to reach the masses and have a profound impact on a
specific topic, whether positively or negatively, is through media outlets.
Media Backtracking….
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Media has had a profound effect on labeling and stereotyping veterans and has
been part of the problem that is now at hand. Negative stigmas have been attached to
people with mental health issues, and when reporting PTSD in media this stereotyping
latched on to returning veterans as a whole. Former President Clinton said, “Mental
illness is nothing to be ashamed of, but stigma and bias shame us all” this holds truer
today than when he first said it.
Media’s influence can touch almost everyone’s aspect of life, and unfortunately
not always in the greatest of ways. News sources use titles such as “Shooting by
Troubled Veteran” or CNN’s “Wartime Stress: A defense for murder?” they do nothing
but damage an already fragile matter at hand. With titles such as these that stand out to
the reader it reverses progress made to detach the stigma of a loose cannon Veteran. But
not all news sources are throwing Veterans under the bus; some seek to bring light to the
issue. For example, Fox news backtracked from a previous article and posted another
about the negative effects of these shooters (besides the obvious).
One article posted was Linking Fort Hill shooter to PTSD hurts vets trying to
heal. Fox interviewed Medal of Honor recipient Dakota Meyer who was diagnosed with
PTSD and asked him to shed some light on the subject. Meyer stated “It’s putting a label
on all veterans, that veterans are psychotic or mentally unstable and they’re going to
shoot up places. And they’re not”. Meyer who suffers from PTSD is the first living
Marine to be given the Medal of Honor since 1973. He earned it by extracting for of his
deceased comrades bodies from a firefight, during this time he killed eight Taliban, saved
thirteen American lives, and twentythree Afghans. Meyer later wrote a book about the
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incident in which he told the world a dark secret. Days after the year anniversary of the
firefight, he tried to commit suicide. Meyer later sought help for PTSD and is currently in
the Marine Reserves and CEO of a construction company. Meyer stated that he believes
the Government is doing what they can, but America needs to do more Stop labeling
Veterans with PTSD as dangerous. If they are afraid to come forward then they will not
receive the help desperately needed.
Social Media, an Anonymous Hero…
With Military personnel sometimes unwilling to admit their difficulties when
dealing with PTSD, this brings a difficult challenge in trying to help. Soldiers who were
allowed to remain anonymous in surveys admitting much more than those required to
submit their personal information; anonymity is a subject that should be examined. PTSD
United is a nonprofit organization that explains connecting, learning, healing, growing,
and inspiring are important steps in dealing with PTSD. With connecting being the first
step, this should be a piece that a majority of resources and focus should be given.
On PTSD United’s website, they have started an online community called
“Huddl” that is an anonymous online community. The goal is to connect with others, be
heard in your struggles, and inspire and grow with others being affected. Its requirements
are simple, an anonymous screen name and a password to join the group. Other groups
like this exist; Facebook has a PTSD group that is also completely anonymous. The way
it works is individuals send a message to the group, who in turn posts the message in its
entirety to the page for others to view. The level of disturbance when reading the posts is
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a tragedy and is a great example of why this topic deserves a significant amount of
attention. Almost every post discussed the problems the individual was dealing with and
they involved fear of not being anonymous and thoughts of suicide or severe depression.
It was not only individuals suffering from PTSD posting, but family members and
significant others as well. The online community in this group was very supportive and
every post has comments on it giving advice or words of encouragement. In addition to
emotional support there are other sites that give advice and educational support. For
instance, a Twitter account of PTSD has informative tips, and answers questions
anonymously and refers followers to other sites that may help.
In the twenty first century this is a prime example of a bridge solution, with
roughly 500 million people using Facebook, it’s a universally encompassing way to get
people involved. Social Media addresses the problem that individuals are afraid to admit
having symptoms or even already being diagnosed with PTSD. These sites are an
anonymous outlet for people to receive, support, advice and information. Although this
paper’s focus is narrowed to Military PTSD, these sites have posts ranging from sexual
abuse to a traumatic event that may have happened to an average citizen.
Conclusion/Recommendations
Throughout this research it should be determined that justice is not fully served to
our returning military. When an inarguably strong comparison can be made to returning
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military and prisoner reentry into society, it seems obvious that justice is not fulfilled.
Jobs are scarce, and employers are hesitant to hire Veterans due to lack of “work
experience” and of course, the fear they may have PTSD. The stigma of Veterans with
PTSD being loose cannons that has been previously painted by news media has yet to be
reversed. The consequence of this is soldiers are hesitant, even afraid to admit or seek
help for their issues with PTSD. This started with the Vietnam War study when research
found denial of war stress produced the most serious symptoms. Moving forward to our
current soldiers, in 2012 more soldiers committed suicide than were killed in combat
operations. As previously described, depression, especially left untreated has a much
increased risk of suicide. The main problem can be simplified to the fact soldiers are
hesitant to admit or open up about PTSD, for fear of being negatively labeled, and the
adverse affects on their career and personal life.
What then can be done about this issue? The answer seems clear to a certain
extent, soldiers must not be afraid to admit having PTSD, so for this to happen peoples
perceptions must change. Changing the mindset of a nation is no easy task, but it is
possible. Learning from the past it can be concluded that changing the way an individual
thinks and views a topic needs two of the most valuable resources, Education and Time.
As it stands now, there seems to be a viscous cycle that is spinning and keeping
Veterans prisoner to an unsuccessful life after service (see Table 3). Using the research
previously described in this paper, the cycle goes as follows: When reintegrating into
society it has been shown that getting a job is the best social institution to properly
assimilate within a community. Soldiers are having a difficult time finding jobs due to
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negative stigmas attached with returning military. These stigmas are: “returning soldiers
have PTSD and are loose cannons” which have been elegantly created by various news
sources. For Fear of gaining these stigmas those soldiers who might have symptoms of
PTSD may not get help for fear of being labeled. Those who truly have PTSD are not
receiving the help that they need.
Table 3. Cycle of failed military integration
Branchaud, L. (2014)
As discussed, It will take time and education to reverse these ideas attached to
returning military, thinking that all of them have PTSD; As well as even those diagnosed
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with PTSD, understanding it does not make them psychopaths. Until these stereotypes are
detached and soldiers can freely discuss their issues without fear of consequence, than
there is little that can be done. One recommendation that is small, but potentially highly
effective could be a greater implementation of social media sites. If the problem is the
need to remain anonymous because of the listed fears, then social media is a perfect
outlet. What social media does is give individuals the option to talk and express their
problems and in return they receive support and advice. The sites are free to use so lack
of healthcare or finance won’t be an issue and they’re relatively easy to navigate for all
levels of Internet users. All of the problems that stem from military returning can’t be
solved with the use of social media, but they can be addressed. This in essence can divert
the cycle shown in table 3 and produce some positive results until the issue as a whole is
examined and solved.
When speaking with professionals, the tests can’t be confidential to access if an
individual is showing signs of PTSD. But if the soldier agrees to the test and it does
show that he has PTSD there are several outlets that are given. These include different
doctors to visit for medications, or psychiatrists to talk to, and support groups (similar
AA meetings) to attend. These anonymous websites however are not mentioned,
presumably due to the fact that social media sites have never been used as a medical
resource.
The implementation I would recommend would quite literally use social media as
a medical resource, as a therapeutic exercise, similar to seeing a psychiatrist. Although
you don’t receive the professionalism as someone with a PhD, you get to discuss your
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problems and emotions, which individuals are facing with no charge and complete
anonymity. In fact these sites are in essence their own social institution in which a soldier
or anyone for that matter, dealing with issues of PTSD can feel a sense of community.
How this should be implemented is simple, when all soldiers return home after service
they are given a piece of paper, or a broacher in their departing package. All this needs to
have is information that can be used to help aid individuals who may be suffering. This
should include a list of symptoms of PTSD, different medical treatments one can receive,
and lastly different websites of anonymous group chats. This way every soldier coming
home has the knowledge that If they want to remain anonymous for the time being, they
can still talk, as well as if they are ready to get help immediately, the information is all
there. This small step could help break the cycle of failed reintegration and possible save
lives of individuals who felt they had no one to talk to.
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