A Difficult Veteren’s Day…

November 11, 2009

This is a re-post of my interview with The Gezzette about the Ft. Hood Massacre:

Drawing a straight line between secondhand trauma and a military base shooting is easy but could be misguided.
Although Maj. Nidal Hasan, who allegedly killed 13 people and wounded 30 more Thursday afternoon at Fort Hood in Killeen, Texas, worked with combat veterans at Walter Reed Army Medical Center in Washington, D.C., his secondhand exposure to the horrors of war should not yet be treated as a decisive answer to questions surrounding his potential motivations in the shooting, according to mental health experts with military backgrounds.
Terms such as Vicarious Stress Disorder and Compassion Fatigue are used by mental health professionals when discussing their own reactions to patients with Post Traumatic Stress Disorder (PTSD). But their usefulness in explaining the violence allegedly committed by Hasan is unclear.

“It’s a hazard of working in the profession,” said Glenn Schiraldi, a former professor at the University of Maryland who worked at the Defense Department on stress management issues and wrote a book on World War II survivors with strong psychological profiles. “But again, it doesn’t seem to account for this fellow’s behavior.”

“I think it just muddies the water more than clarifies anything,” said Dr. Joseph Molea, a former surgeon in the Army who spent time at Walter Reed and now practices psychotherapy in Florida.

Some psychiatrists report being overwhelmed when dealing with a large caseload of traumatized people such as victims of the Sept. 11, 2001 terrorist attacks, according to Dr. Robert Heinssen, a director at the National Institute of Mental Health in Bethesda and behavioral health officer for the Maryland Army National Guard for the past five years.

“This phenomenon is not uncommon, that people could experience some trauma…hearing these stories retold time and time again,” Heinssen said.

Heinssen and Molea also said they were unaware any research on the topic of how mental health workers in the military deal with the constant exposure to trauma. Such studies have taken place on emergency first responders in civilian settings.
But the same support system for civilian psychologists, who talk to each other about issues facing their patients and how they as professionals can cope, exists for military mental health workers to use.

“A good social support network is really critical in maintaining your resilience for this kind of work,” Heinssen said.

Failure to use that network and not discussing personal issues with ones work, on the other hand, can lead to dangerous consequences.

“If you hold all that stuff in, you’re only taking your own counsel, and when you take that to an extreme, that’s what psychosis is,” Molea said. “Once that line is crossed, anything can make sense.”

Despite reports about how Hasan’s personal background, his state of mind and his beliefs may have influenced his actions, Schiraldi said trying to understand the doctor’s actions based on hindsight and red flags was not necessarily helpful. Molea said Hasan’s work may have merely “fueled the fire” of Hasan’s other problems.

“I don’t know how you could prevent something like this from happening,” said Schiraldi, adding that prevention and equipping military personnel with proper coping skills should be the military’s ultimate objective in such situations.

Soldiers who served overseas and may have previously felt secure at military bases could have that confidence shaken in the short term because of the Fort Hood incident. Heinssen cited the case of people in the Louisiana National Guard who returned home from tours overseas before Hurricane Katrina struck in 2005.

“Hardship, suffering, all that was something that they could handle in Iraq, they understood that was war,” Heinssen said. “…out of nowhere, there was this natural disaster.”

Molea worried about policies that may aim to protect soldiers more carefully after the Fort Hood shootings, such as screening Muslim soldiers or creating a “bunker mentality,” but instead just represent an overreaction and could destabilize military cohesiveness.
He also worried about the lack of a strong psychological screening process for soldiers returning from combat.

“They’re going to have to do some work with troops to regain the sense of safety and stability,” he said.

Still, mental health workers and researchers said they were confident soldiers would not suffer long-term doubts about their safety with comrades and on military installations.

“They’ll get better,” Schiraldi said. “They’ll get over it.”

Mental health experts say reason behind Ft. Hood attack unclear

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