So it is reasonable that a returning veteran will be suffering effects from the entire trauma he was exposed to and also from his battle conditioning. Recall that proper training is all about conditioning. That is the only thing that will keep you alive.
What is clearly necessary is a combat exit training program, at least as long as boot camp in which the soldier is now conditioned with appropriate responses. While this is happening he is also trained to exhaustion so that he restores his center. It really does have to be as intense as boot camp.
It is wrong to let these men out to sort it out for themselves when they are conditioned to attack as a natural response to aggression.
Three months of such training that also sorts out theirs thought processes and reinforces good behavior allows that person to integrate back into civie street or possibly get back into the military in non combat. In short it is a necessary step that allows the pin to be put back in the grenade.
I have met my share of old soldiers and have had them share their stories. I guess I am good at listening. One chap did second war pre D day penetrations of France. One day they walked into an ambush which he survived without any issues. Except that back at base, his fingers refused to unclench his rifle. Another chap operated in Cambodia and walked though an ambush unscathed losing most of his group. That ended his career as the most gung ho of them all. Years later, I was told by a third party who had the right contacts that his career was the template for Kurtz in ‘Apocalypse Now’.
All these men never quite shook the experience and all needed some form of intense retraining to bring the issues under control which they never got. Lying awake is too easily solved with a flask of whisky. Most of these men are unable to scale the heights scaled as soldiers and stay directionless and impatient. They often chased other wars after they were no longer fit for duty.
I do not know if intense training can solve the problem but it is possibly a good beginning. That is how we made them.
The Tragedy of Our 'Disappeared' Veterans
How the justice system has been manipulated to put astonishing numbers of vets with PTSD and other psychiatric injuries behind bars.
Wayne McMahon was busted on gun charges six months after he got out of the Marines.
He was jumped by a gang of kids in his hometown of Albany, N.Y. , and he went for the assault rifle he kept in the back of his SUV.
He's serving "three flat, with two years of post-release" at Groveland Prison in upstate New York.
Maybe it's tempting to write McMahon off as just a screwed-up person who made the kinds of mistakes that should have landed him in jail, but maybe that's because his injuries don't show on the outside.
Unlike physical injuries, psychiatric injuries are invisible; the burden of proof lands on the soldier (or sailor or Marine), and such injuries are easy for the public to deny.
The diagnostic criteria for post-traumatic stress disorder include a preoccupation with danger.
According to Jonathan Shay, a Veterans Administration psychiatrist and author of Achilles in Vietnam, hypervigilance in soldiers and veterans is expressed as the persistent mobilization of both body and mind to protect against lethal danger -- they act as though they were still in combat, even when the danger is no longer present.
That preoccupation leads to a cluster of symptoms, including sleeplessness, exaggerated startle responses, violent outbursts and a reliance on combat skills that are inappropriate, and very often illegal, in the civilian world.
When I asked McMahon what he was doing with an assault rifle in his car, he told me that since he got back from Afghanistan, he didn't feel safe without guns around.
"There was almost always a gun," he said. "In the apartment, there was guns everywhere.
"I was just over in combat, and you guys gave me an M-16 and a 9mm and let me walk around for eight months straight. And now I get back, and I get jumped by a bunch of people, and I can't have a gun?"
McMahon sits across from me in his prison greens, elbows on his knees, leaning into his story about the kid he was and the man he is hoping to become. His eagerness and optimism make it clear that he believes his mistakes are behind him.
His parents were teenagers when he was born, and they separated shortly after. He bounced around on the streets of Albany, and, like so many other young Americans with dreams of escaping dysfunctional families and lousy neighborhoods, he saw the military as a get-out-of-jail-free card.
He enlisted in the Marines right out of high school.
For the first time in his life, McMahon found himself in a meritocracy. He was promoted regularly and quickly, making sergeant by the time he got to Afghanistan.
Then two days before his five-year contract was up, he was caught drinking on the job, busted down to lance corporal and administratively discharged. He lost all his benefits.
McMahon was in the Marine Corps from 2001 until 2006. He spent his last year working as an aircraft mechanic on a flight line in Afghanistan that was under near-constant attack. It was also a transshipment point for injured American soldiers who were being evacuated to Germany.
For eight months, his days and nights were spent up close and personal with the visceral evidence of what the rockets, mortars and rocket-propelled grenades do to human bodies.
"We had a lot of explosions. Almost every day. And I seen guys coming out from convoy missions where their Humvees would have exploded," he told me matter-of-factly. "The first two months were pretty terrible. "
After that, even though "a lot of other people found it hard to deal with, it wasn't really too rough for me." A bit of Marine bravado, perhaps, but reinforced with a bit of liquid courage:
"We Marines, we're smart," he explained. "There was no alcohol provided, but I was making my own from fruit juice I got from the chow hall and yeast they gave us at the pizza shop. It was horrible, really horrible -- but two little 20-ounce water bottles, and you were good for the night. " It was the only way he got any sleep.
Jonathan Shay also notes the almost-universal reliance on alcohol or drugs by psychically injured veterans. They afford some temporary relief from intolerable memories and from the emotional and physical exhaustion of maintaining a constant state of vigilance.
McMahon came home from Afghanistan with a serious drinking problem, a hair-trigger temper and conditioned to rely on his combat skills for survival.
Both his marriage and his military career quickly unraveled, and then he was arrested. Nobody diagnosed his PTSD until he got to Groveland.
McMahon's obsession with safety and guns, and his compulsive drinking are both typical of a post-traumatic stress injury, but instead of diagnosis and treatment, he was left to his own compromised resources and promptly landed in jail.
it's a trifecta for the military when that happens. A damaged soldier is disappeared, the cost of treatment avoided and the evidence that would prove how often veterans find it impossible to readjust when they come home is erased.
In terms of the bottom line,
Traumatized soldiers are not a military asset. They are unreliable, and can be dangerous to their fellow soldiers and to themselves. Their care can take years and be quite expensive. But because the macho culture of the military stigmatizes mental health issues, most soldiers won't ask for the help they need.
When they try to manage on their own and fail, when the entirely predictable symptoms of their injuries get them into trouble, their behavior is used to justify kicking them out of the service.
They lose all their health and disability benefits, and in the absence of treatment and support, the same behaviors that got them kicked out of the military land them in jail.
Once they enter the criminal justice system, their military service is irrelevant. Soldiers and veterans with psychiatric injuries who, like McMahon, end up in jail, are handed -- and in fact often accept -- the full burden of responsibility for their actions. And when that happens, the system gets off free.
That's what happened to McMahon, and though it's still too soon for meaningful statistics about incarceration rates among this new generation of veterans, the anecdotal evidence suggesting a predictive relationship between military experience, PTSD and trouble with the criminal justice system continues to mount .
And this is not a new phenomenon. The National Vietnam Veterans Readjustment Study, published in 1990, found that more than a decade after the Vietnam conflict ended, 15 percent of male veterans still suffered from PTSD, and half of them had been arrested or in jail at least once.
Most Vietnam War veterans deployed for exactly one year. Veterans of Iraq and Afghanistan have experienced longer and repeated deployments, and top military psychiatrists acknowledge that veterans of these new wars may have an even harder time coming home.
And instead of improving, the situation is getting worse. In 2008, the Rand Corp. estimated that 300,000 soldiers returning from Iraq and Afghanistan will suffer from post-traumatic stress issues, and 320,000 others will suffer traumatic brain injuries that express many of the same symptoms as PTSD.
And although most of them will not seek treatment, even when they try the VA has made such care extremely difficult to access.
For years, the Pentagon has chosen to ignore congressional directives to screen soldiers both pre- and post-deployment.
In May, the Hartford Courant reported that such screenings are still being administered in haphazard fashion. Only 1 percent of at-risk soldiers were referred to a mental health professional prior to deployment, and post-deployment screenings continue to be a laughably inadequate box to be checked on a form.
The Courant noted that the situation has remained unchanged since the paper reported on the issue in 2007.
And for veterans, the VA's claims backlog in May was approaching 1 million, a 14 percent rise since January.
By now, the anecdotal evidence associating combat-related PTSD with crime and incarceration ought to be part of the conventional wisdom. Its accumulation over the past century should have engendered enough concern to provoke some serious attention and study.
But the reality is that nobody knows the precise number of veterans who have ended up behind bars in the aftermath of America's wars.
There are more than a few reasons why military and government officials might want those numbers to remain hidden, but certainly among the most compelling is cost.
Large numbers of veterans in prison suggest a pattern, perhaps even a causal relationship between military service and behaviors that lead to incarceration, lending support to those who argue that such behaviors should be seen as possible symptoms of a service-connected injury deserving of treatment and support rather than punishment.
When the patterns are hidden -- the numbers unavailable -- it is easier for the military to pretend that the problem is with a given individual and not systemic.
In January 2008, when the New York Times reported that it had identified 121 cases in which veterans of Iraq and Afghanistan had been charged with murder, the Pentagon declined to comment because it could not duplicate the newspaper's research.
A year later, the Army finally admitted that there might in fact be a connection between the violent behaviors of some returning service members and their combat experience. Pete Geren, Secretary of the Army, announced that in response to a spate of homicides at the Fort Carson Army base, he was “considering” conducting an Army-wide review of all soldiers involved in violent crimes since returning from Iraq and Afghanistan.
The report, which was finally published last week, does in fact “suggest a possible association between increasing levels of combat exposure and risk for negative behavioral outcomes."
And though it accuses the Army of denying necessary care to soldiers, and specifically blames commanders for proscribing access, Eric Schoomaker, the Army's surgeon general, calls it “preliminary,” and insists that no causality can be inferred from the findings.
Without causality, there is of course limited accountability.
Shoomaker pointed out that soldiers themselves should bear some responsibility for failing to seek help, ignoring the fact that half of the surveyed soldiers accused of violent behaviors had been sent back to Iraq “early,” and that many of them had documented suicide issues. Schoomaker also stressed that though many soldiers claimed to have witnessed war crimes, an Army probe did not substantiate those claims.
The results of this report might have been an invaluable contribution to the public conversation about what war does to soldiers and who should be responsible for their readjustment into society. Instead, once again, soldiers are blamed for violent behaviors that are clearly symptomatic of their injuries. When individuals take the rap, there is no interrogation of the pattern. Officials remain free to dismiss and deny how many ex-service members are ending up in jail. And as long as the bodies remain hidden, they get away with it.
Vets Demonized; the System Gets Off the Hook
Ed Hart has a hard time accepting official denial of a connection that to him seems more than obvious.
Hart is an 87-year-old Marine, a veteran of World War II. He is also a former president of Veterans for Peace, a retired attorney and a deeply concerned citizen.
"People like me are upset about what they did to us -- and what they continue to do to the fuzzy-faced kids they haul off to boot camp," Hart said. "Too many of those kids never made it back into reality; they were found guilty of terrible crimes and sent off to spend years in prison -- maybe all the years left to them -- and we can't figure out what happened to them?"
Hart did in fact try to figure out what was happening in the late ‘80s, when Vietnam veterans began showing up in large numbers in the criminal justice system. Along with his pro bono legal work, he began interviewing large numbers of vets in prison.
What he discovered has been corroborated by every Bureau of Justice Statistics survey since: incarcerated veterans are better educated than their non-veteran counterparts; they are more likely to have been employed at the time of their arrest; and they are more likely to be in jail for a first offense -- all of which should be factors in their favor at sentencing.
But instead, they are more likely to get longer sentences than non-veterans -- on average, more than two years longer -- for the same crime.
Guy Gambill, director of research and policy at the Veterans Initiatives Center and Research Institute (VICTRI), attributes this to a "know better" syndrome.
"Judges and juries, ironically, place veterans in a higher category, one with heavy moral undertones. The thinking goes that they should know better and therefore should be held to a higher standard of conduct," he said.
Hart also recognized that moral judgment, but in his days as a practicing attorney, he saw an element of demonization in the dynamic as well.
"I've seen prosecuting attorneys in their final statements point to the bewildered man at the defense table and tell the jury, ‘Look at him! He's a trained killer! We need to get him off the streets and make them safe for our women and children.' "
Mike Thomas has experienced that prejudice firsthand. Thomas did three tours in Vietnam, was wounded twice, and earned all kinds of medals, but he's doing 25-to-life at Mule Creek Prison in Ione, Calif., for spewing some racist bile at an Asian man over the phone.
The day he got home from Vietnam, he beat up an Asian man in a bar, and he did it again the day they let him out of jail. He was sent to a military hospital for two years with a diagnosis of Adult Situational Reaction, a diagnostic precursor to PTSD.
The military declared him "fully recovered." For 25 years, he held down a job as a sales manager.
Then, one morning, in the midst of a flashback, Thomas lost his balance. Aside from hypervigilance, the symptoms of PTSD also include flashbacks. Flashbacks can be so convincingly real that the sufferer behaves as though he or she were actually in the remembered moment.
"Everybody who's lived at the brink of terror for some time has stored that place in his memory," Hart explains with empathy. "There's always the possibility that something will take him back sometime, give him that little push that will take his balance away.
"But there ain't much more you can do to a guy on the phone worse than yell at him."
Nonetheless, the prosecutor, noting Thomas's two priors, decided to interpret his phone rant as a terrorist threat -- hence the draconian sentence.
Some might argue that Thomas's antagonism towards Asians made him an accident waiting to happen, and they're not wrong. But dehumanization of the enemy is central to how military training enables soldiers to overcome their inherent resistance to killing other human beings.
Author Jonathan Shay describes how images of the enemy were drilled into his Vietnam-era patients as a "demonized adversary … evil, loathsome, deserving to be killed as the enemy of God, and as God-hated vermin, so inhuman as not really to care if he lives or dies."
It seems a distortion of justice to send a man to prison for life because in the course of his military training a switch got flipped, making him temporarily more useful to his government.
The practice continues. Bob Herbert, writing in the New York Times, described "the growing rage among coalition troops against all Iraqis (known derisively as 'hajis,' just as the Vietnamese were known as 'gooks')."
He quotes Sgt. Camilo Mejía, an Iraq war veteran, who explained, "You just sort of try to block out the fact that they are human beings and see them as enemies. You call them hajis, you know? You do all the things that make it easier to deal with killing them and mistreating them."
"The sacrifice that citizens make when they serve in their country's military," Shay reminds us, "is not simply the risk of death, dismemberment, disfigurement and paralysis -- as terrible as these realities are. They risk their peace of mind."
"When I went to boot camp," Thomas said, "I was a good Catholic boy who'd never shot so much as a squirrel. But I turned 20, 21 and 22 in Vietnam, and that became my identity. I tried to filter life through that prism of horror, pain and loss. Not good. A recipe for disaster."
Thomas once tried suicide to escape "the despair, grief, survivor guilt, nightmares, depression, the pain of hearing my mother say she wished I had died in Vietnam so her memories wouldn't be tainted."
More recently, he asked Veterans for Peace -- by mail -- to sponsor a nationwide program for incarcerated vets. His proposal was accepted and in May, VFP Incarcerated Chapter 001 was officially incorporated at Mule Creek Prison.
Wayne McMahon was luckier in that New York state still maintains residential therapeutic programs for veterans at three of its prisons. (In 1999, there were 19, boasting a recidivism rate of 9 percent after five years compared to 52 percent for non-veterans. Unfortunately for taxpayers, those programs were consolidated for the sake of "efficiency and effectiveness.") He has taken advantage of courses in anger and aggression management, interpersonal dynamics, and substance abuse, and he has completed his training as a group facilitator.
McMahon has a job waiting for him when he gets out; he wants to go back to school; and he is going to try for a discharge upgrade from the military based on his PTSD diagnosis.
The Hidden Numbers
Since its first study of the issue in 1979, the Bureau of Justice Statistics has been the best source of information on the number of vets who have ended up behind bars.
According to the bureau's most recent survey, in 2004, there were 140,000 veterans in the nation's prisons -- or about 10 percent of the total prison population. By 2007, that number had risen to156,100, but the prison population overall had increased, so the relative share of vets in the population remained unchanged.
But as Baruch College's Aaron Levenstein once said, "Statistics are like bikinis. What they reveal is suggestive, but what they conceal is vital. "
For example, the numbers above don't include veterans held in the nation's jails, or those on probation or parole. When those groups are included, according to BJS estimates, the number of veterans who were under correctional supervision in 2007 jumps to 703,000. In addition, just under 1.2 million vets were arrested in 2007.
At least some of those on parole or probation at a given point will be arrested later in the year, skewing the estimated total. But Christopher Mumola, author of the last two BJS surveys of incarcerated veterans, said "if 703,000 veterans are supervised in some fashion on a given day, and 1,159,500 arrests in 2007 involved veterans as well, that gives you a rough approximation of the maximum number of vets who are touched by the criminal justice system in a year of about 1.8 million to 1.9 million veterans."
Still, in all probability, that number under-represents the number of veterans behind bars for several reasons.
For one, Mumola points out, an inmate's military history is irrelevant to prison administrators. "(They) measure the things they operationally use or are bureaucratically accountable for. Whether someone is a veteran or not doesn't change how that inmate is handled, the privileges they have or anything like that." So prison administrators don't ask. And, Mumola added, "the federal government doesn't require them to keep those statistics."
Frank Dawson, a patient advocate at the Boston VA, has long been frustrated and dismayed by the lack of reliable numbers. Dawson says he believes veterans need support before their lives spin out of control, and, "as a national service provider, the VA can't target services unless it knows where its population is."
But Dawson, like everyone else, has been stymied in his efforts. "I keep on my desk a stack of 6,000 address labels that I got from the Department of Justice," he said. "Six thousand institutions, 6,000 egos, 6,000 systems, 6,000 sets of protocol. There is no standard intake anywhere. I keep that stack on my desk to remind me how complicated they have made it. "
In the absence of federal, state or local legislation requiring penal institutions to use standard intake procedures that include verification of an inmate's military history, veterans' advocates across the country are pressuring the courts to at least inquire about veteran status during the bail-screening process.
But Taylor Halloran, who recently retired as the VA's liaison to veterans in New York's downstate prisons and jails, said there are more than a few reasons why veterans might refuse to divulge their military background.
Halloran emphasizes that many veterans offer fake Social Security numbers or aliases at intake, or they fail to report their arrests to VA because they fear the loss of benefits -- which is at least partially true.
Health care benefits are suspended for the term of an inmate's incarceration and, after 60 days, disability benefits are reduced by about half, but those too should be reinstated when a veteran is released.
Lots of veterans don't know or understand the VA's policies, many have families that depend on those checks, and the VA has a reputation for taking its time reinstating benefits after an inmate is released.
So it's sort of a devil's bargain: identify themselves and lose half of their disability benefits, or take a chance they won't get caught. But if they do, they are royally screwed.
They have to pay the government back with interest and fines, but the far more serious consequence is that they lose all future benefits, including health care, disability and education.
To many, the risk seems worth taking. A 1999 Inspector General's report sharply criticized the VA's failure to "implement a systematic approach to identify incarcerated veterans and dependents, resulting in additional past and future overpayments exceeding $170 million dollars."
A 2004 VA Performance and Accountability Report found $5.7 million in benefit overpayments in a 20 percent sample of cases, and the report noted that "tracking 100 percent of these cases would not be cost beneficial."
Halloran said he had to work to get his potential clients to come forward voluntarily. And even then, he "couldn't touch the guys the VA doesn't consider veterans -- anyone with a dishonorable or bad-conduct discharge." One in six incarcerated veterans has been dishonorably discharged.
New Wars, Old Problems
Although the data are imperfect, one thing the BJS surveys do well is identify trends and patterns. For example, its last survey showed that at about 40 percent, Vietnam-era veterans still constitute the vast majority of vets in state and federal prisons.
The Gulf War involved far fewer soldiers and lasted for only six months, but at 15 percent of the veteran population in state and federal prisons, they constitute the newest wave. Veterans of the Gulf War are almost twice as likely to be incarcerated as demographically comparable non-veterans.
At 4 percent of the incarcerated veteran population, Iraq and Afghanistan veterans were only just beginning to show up in the 2004 BJS survey.
"It takes quite a while for these folks to show up in the criminal justice system," Chris Mumola explained. "They are out there in these conflicts, having these experiences, coming back, getting into trouble with the criminal justice system, being fully adjudicated, winding up in prison, and only then are they available to be interviewed in these surveys. It may take years and years to marinate before it really manifests itself. "
Unfortunately, the next BJS survey is not scheduled until 2012.
However difficult those populations might be to track, it would seem that if ever there was a population that should be easy to count, it's prisoners. Every one has a number. Files are kept. There are forms -- and now computerized records -- from which patterns might be gleaned.
And prisons aren't the only black holes into which our nation's damaged warriors are disappearing. They also end up in hospitals and mental institutions. They vanish beyond the margins of society when their lives, their marriages, their careers fall apart. They end up in boxes on the street, vilified, forsaken, and self-medicating. Far too many die too soon of disease, accidents, overdoses or suicide.
An honest accounting of their numbers would be ammunition for those who believe that soldiers and veterans are still not receiving the care and support they need.
It would help challenge the myth of the romantic warrior by better educating our children to the real dangers of military service. It would also contribute to a public better informed about the hidden costs of our military ventures, including the ongoing damage to our citizens and our treasury, and to our national character as well.