First posted at http://www.psychologytoday.com/blog/science-isnt-golden/201405/the-rest-the-iceberg-exposing-secrets
Published on May 22, 2014 by Paula J. Caplan, Ph.D. in Science Isn't Golden 0
inShare Good it is that some Veterans Affairs cover-ups are now widely known, but the rest of the iceberg remains dangerously hidden. A primary reason for what remains hidden and for the extremely late exposure of the cover-ups now in the news is that American veterans are largely invisible to most other citizens.
We live in a nation that is not only war-illiterate but even military-illiterate,* because Americans don't like to think about war, veterans comprise less than 7% of the population, and war veterans are "the other 1%." It is rare for anyone who doesn't live with a veteran to choose to meet, get to know, or listen to a veteran. This leads to often soul-crushing isolation for veterans and their loved ones, and it creates in this country a dangerous divide, one whose disastrous consequences are still developing -- largely invisibly -- even as I write.
Most Americans go about their daily lives heedless of the needs and goals of veterans and their families, with the exception of the occasional Congressional Medal of Honor recipient's appearance on a talk show, a few commercials, knee-jerk "Thank you for your service" statements, and tear-jerker media stories about a deployed parent returning home and surprising their child at a major sporting event that is televised on the big screen, denying the child and parent privacy and the freedom to focus on what they each really need at that moment.
Small wonder that the current scandal about some VA officials' schemes to conceal the excruciatingly long periods of time many veterans were kept waiting comes as a surprise. Any nonveteran who had bothered listening to a veteran or two would at least have known about the wait times if not the purposeful concealment of their lengths.
I hope that every nonveteran who reads this will consider marking Memorial Day by listening -- just sitting and listening -- to a veteran from any era. Col. (Ret.) David Sutherland, founder and head of the important Dixon Center of Easter Seals** that helps communities come together to support veterans and their families, speaks often about the harm done when what happens on deployments become secrets back home. Veterans' loved ones already carry unfairly the lion's share of responsibility for providing support and understanding to veterans, and their wider communities need to offer to listen to both veterans and those close to them. That is what The Welcome Johnny and Jane Home Project is about, and it is as simple as it sounds -- just listening but doing so with respect and one's whole heart -- and is powerful and positively transformative for both veteran and listener, far beyond what most people would expect.*** The very simple information for prospective listeners and for veterans is at listen2veterans.org
Isolation and invisibility, as Col. Sutherland and I have written, are prime contributors to the high rate of veterans' suicides, which are estimated -- no doubt underestimated -- to be 22 a day, and the rates are highest among the older veterans.**** So when you decide to do a listening session, a great thing to do is to do it at one of to Veterans' Homes, other nursing homes, or hospice facilities, where you are likely to find those from World War II, the Korean War, and the Viet Nam War.
Getting back to the current VA exposé, let's look at what else is dangerous. Horrific problems in the delivery of high-quality healthcare to veterans -- like the horrific barriers to getting high-quality healthcare to most Americans -- deserves more than what Andy Warhol predicted would be every American's 15 minutes of fame. The media lose interest when there is "no more news," but the suffering of inadequately cared-for or uncared-for veterans will long continue. Let us hope that some responsible journalists will refuse to allow these concerns to disappear back under the rug.
There is the additional problem that in this country, too many of those who hold the power find easy ways to lift responsibility from their shoulders and place it on those of others. All morning, I have been looking for what I recalled -- perhaps imprecisely -- as a phrase from a T.S. Eliot poem I read in college. The phrase I have tried to find is "a committee to appoint a committee," which popped to mind yesterday when President Barack Obama announced that he has ordered "an investigation" into VA wrongdoings.^ The Eliot quotation I managed to find is this:
Cry cry what shall I cry?
The first thing to do is to form the committees:
The consultative councils, the standing committees, select committees and sub-committees.
One secretary will do for several committees. http://quotes.dictionary.com/Cry_cry_what_shall_I_cry_The_first
If not only President Obama but also his many predecessors truly had no idea until now about the VA's rampant mistreatment of veterans, there is no excuse for that ignorance. In July, 2007, Veterans for Common Sense filed a landmark lawsuit, Veterans for Common Sense v. Shinseki, aimed to end unconscionable delays and active mistreatment of veterans, especially for their emotional needs. In 2011, I wrote about what happened to that case, and I copy part of my essay here because it is sadly still relevant three years later:
the Ninth Circuit Court of Appeals ordered the Department of Veterans Affairs to overhaul its mental health system, calling it “shameful” and plagued by “egregious delays.” At last, veterans thought, they might receive prompt and effective support as they tried to heal from the emotional carnage wrought by war and by the almost unimaginable culture clash between being at war and trying to come home.
The court order gave the VA a chance to make a major turnaround; take a good, hard look at what it has been doing that has failed to help and even made many veterans worse; identify those in its system whom veterans described as caring and helpful; try to make the approaches of the latter into its standard; and consider what other, perhaps less traditional approaches they might implement. The Court of Appeals sent the case back to district court so that a plan for providing better care could be devised. This opportunity was especially important in light of the steadily-rising rates of suicide committed by veterans not just of current wars but of earlier ones as well.
Instead, according to a recent New York Times report, rather than working with the plaintiffs — the nonprofit groups Veterans United for Truth and Veterans for Common Sense — to come up with a better plan, the VA has chosen to appeal that ruling. This is all the more tragic and mystifying, given that the VA’s raison d’etre is surely to assist veterans and given that the court declared that the VA’s failure to address veterans’ needs constituted an infringement of their constitutional rights, i.e., to receive mental health care and to the timely adjudication of their emotional disability claims.
The court noted that the VA had no suicide prevention officers at any outpatient clinic and that at 70 percent of its locations there was no system to track potentially suicidal patients. Media coverage of veterans suffering from despondency has included alarming stories of those who contacted the VA, said outright — often on repeated occasions — that they wanted to kill themselves, and either received no appointments at all or only many weeks or months in the future or did not even receive a return phone call. Often, these stories are prompted by the fact that these veterans went on to kill themselves while waiting for VA staff to help.
Their ways of dealing with suicidal despair are far from the only major problems in the VA system.  For years, its senior officials have acknowledged in their press releases that they try one measure after another to stem the rising tides of substance abuse, family violence, and homelessness. But reports of successful programs are rare.  When writing my book about veterans, I was able to identify only two instances of specific programs that seemed to be meeting with success. Those involved the use of mindfulness work and meditation, and in one case, of explicit grappling with the intense and varied, moral conflicts that plague so many vets.  There are probably other effective VA programs, but what was striking was the way that, as I tracked the VA’s press releases since the start of the United States’ war in Afghanistan, those at the top of the VA hierarchy continued to report increases in the manifestations of emotional trauma and other psychological problems.
Recent months have brought reports of the ineffectiveness of psychiatric drugs in treating those with war-caused trauma and of deaths from drug interactions, sometimes interactions between psychiatric drugs and sometimes between those drugs and prescription drugs of other kinds. These reports are particularly disturbing in light of the heavy and increasing use of psychiatric drugs as the primary or only approach to emotional problems for VA patients.
It is hard not to wonder what the top brass at the VA are thinking. Surely they realize that at the very least, their decision to appeal the court order makes them appear unconcerned about providing help for those they are supposed to serve. Bending over backward to give them the benefit of the doubt, we could assume that they have been as taken in as many in the mental health system by the claims of pharmaceutical companies that their products are cure-alls and by the claims of the powers-that-be that psychotherapy is effective for people who have been traumatized by war. It is rare to hear veterans report that psychoactive drugs have been helpful to them, though some do. It is almost as rare to hear veterans say that psychotherapy was the only thing they needed in order to heal, although it is effective for some. Almost invariably, however, those who have moved toward healing have said that connecting with other veterans, connecting with others in the wider community, and becoming involved in activities in which they focus on helping others and/or in creative realms have been helpful.
The VA would far better serve veterans if they dropped their appeal of the court order and instead invested some of their considerable resources in what veterans, rather than Pharma and the traditional mental health community, say they have found salutary. Furthermore, the VA could recognize that it is worth implementing throughout its system the mindfulness, meditation, and moral conflict foci that have been shown to be effective but that few of their staff all ever use.
For now, as the Ninth Circuit Court panel declared, it is shameful that the VA is appealing the court order for it to reduce the suffering of those whom our government has sent to war.^^
In January, 2013, Veterans for Common Sense lost its bid for the United States Supreme Court to hear its appeal. Veterans for Common Sense is a non-profit based in Washington, DC.^^^
If reading about that brave and compassionate lawsuit makes you feel sad and powerless, this is the time to remember that you are not powerless and that just listening to any veteran is helpful to the veteran and the listener. Here are a typical comment from a veteran who had a listening session and from a listener:
Brock McIntosh, Afghanistan veteran (U.S. Army) (at listen2veterans.org) said: When I came back from Afghanistan, hearing the words “Thank You” from people who didn’t know what I did or saw was an empty gesture. More than anything, I wanted my community to listen to the stories of veterans like myself—to participate in that moral struggle, and gain a deeper awareness of the meaning of war. The Welcome Johnny and Jane Home Project understands the important role that civilians can perform simply by listening to veterans actively and without judgment, generating new opportunities for veterans to serve their communities by educating them about the nuanced reality of war.
A nonveteran who listened to a veteran's story in The Welcome Johnny and Jane Home Project said: I decided to do this to try to help a veteran, and the veteran I listened to said it did help. What I had not expected was the powerfully positive effect that the listening had on me. My politics are very different from the veteran's but that was irrelevant. This was about human connection. By listening to what this veteran had been through in the military and then after coming home, I learned about their humanity but also about my own. I was inspired by the person's integrity and honesty and the courage in speaking so openly to me.
For Memorial Day -- and every day -- let us work together to end the disconnection of veterans from the rest of us, to connect through our common humanity.
*Paula J. Caplan. 2011. When Johnny and Jane Come Marching Home: How All of Us Can Help Veterans. Cambridge, MA: MIT Press. listen2veterans.org
****Col.(Ret.) David Sutherland & Paula J. Caplan. 2013. Unseen wounds. Philadelphia Inquirer. February 10.
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