TRAUMA CAN COME from so many sources. It can be delivered by a physical or sexual assault; from a relative or a stranger; it can arrive with the shriek and crash of a vehicle collision. It can arrive at the point of a gun being aimed at you, or by watching too many friends or strangers die in combat. It can arrive in the bang and bloodshed of an explosion. Trauma can come from repeated, chronic exposure to emotional or physical abuse, or from one terrible moment in your life.
Whatever its source, it can disrupt and corrupt an individual’s life, work, sleep and personal relationships, profoundly interfering with one’s emotional, psychological and physical health.
That’s be why mental health professionals call post-traumatic stress disorder, an ailment that wasn’t even labeled 20 years ago and which now applies to millions of Americans, one of the nation’s most significant psychological disorders. It’s most often, but far from exclusively, associated with veterans exposed to combat. It was once known as shell-shock or battle fatigue.
Johnathan Abbinett served two years as an Army infantryman through some of the worst fighting of the Vietnam War. He says he arrived in Southeast Asia as a boy, without fully realizing what he was doing or where he was going. He says he carried the psychological and emotional scars of that war with him for decades.
“I wasn’t mature enough at 18 or 19 years of age to really have formed a worldview and a philosophy, so war, for me, was very, very traumatic,” Abbinett says. “I’m a good example of a guy that secretly struggled for decades.”
Abbinett’s experience is not unusual. Many people with PTSD and associated problems take decades to seek and receive treatment. Kurt Vonnegut, for example, as a prisoner of war personally witnessed the catastrophic Allied fire-bombing of Dresden in Germany, but it took 23 years before he was ready to speak and write about that trauma.
Abbinett is a die-hard progressive today, supporting the Democratic Party and most of its issues. Another PTSD survivor and veteran we talked to for this story is as conservative as Abbinett is liberal.
Craig Leonard also served during the Vietnam War, aboard the U.S.S. Conserver and other ships of the Navy. He served in the Navy for four years, and in Vietnam for 12 months. He says that he was exposed to both fighting and Agent Orange during the period, and he lost his best friend.
Like a lot of veterans, PTSD is not Leonard’s only medical issue. He contracted hepatitis C while in the Navy, probably through a shared vaccination gun, and lost one kidney and has a chronic disease in the other. He says he was diagnosed with bipolar disorder in 1980.
Leonard says he had a pretty good life, at least financially, in the state of Washington until the recession hit. Then he lost everything, blaming his losses and the recession on President Obama, and Leonard eventually ended up living out of his truck in a dog park in East Las Vegas.
He’s on a host of medications for his medical and psychological issues. He’s worried about his kidneys and fears that he’s just a hair away from having to undergo difficult kidney dialysis several times a week — a prospect that Leonard says he fears more than death.
He shows me around his neat apartment in one of three complexes run by U.S. Vets in Las Vegas. U.S. Vets is a national nonprofit that helps veterans beat drug and alcohol addiction, find jobs and housing. On one wall of his bedroom, Leonard keeps a paper shrine to his friend, Ron Manca, who died in Vietnam on Feb. 25, 1975. Leonard leaves the television in his bedroom on all the time.
Leonard says employees with U.S. Vets helped him confront his PTSD, based on the anger issues he had in 2011. He says they told him that often in group classes with other veterans, they noticed he would say “kill, kill, kill” a lot.
The effort to understand and control his anger landed him in a Veterans Affairs hospital, and then in other VA PTSD programs, which he completed: more than 24 weeks of individual and group therapy.
Leonard still has some anger, mostly directed at the animal-rescue organization that eventually acquired, then sold, his two beloved basset hounds, Jessie and Tessie, which he brought down with him from Washington.
He fans out a stack of documents showing his ownership of the dogs, the fact that the animal-rescue group doesn’t have a Las Vegas business license, that the animals were service dogs important to his mental and physical health. Leonard hopes to find a lawyer to take the rescue group to court one day.
Leonard also is very angry with the Obama administration, which he believes is trying to impose sharia law on America. But fundamentally, he’s doing a lot better than he was three years ago, when he arrived in Las Vegas.
“I haven’t killed myself. I haven’t killed anyone else.”
People who are diagnosed with PTSD, or even those who have some but not all of the symptoms, can have huge problems maintaining relationships with family or friends. They may not sleep well. They often turn to drugs and alcohol to numb the worst effects.
Jessica Hamblen is the deputy director for education at the Veterans Affairs National Center for PTSD and a clinical psychologist. She emphasizes that although having some of the effects of PTSD are common for just about everybody who has been through trauma, the clinical diagnosis depends on four criteria:
• The victim has persistent, unwanted recollections or reminders of the trauma.
• The victim seeks to numb or avoid thoughts, recollections, places and people that may remind him of the trauma. That can include disengaging from family and friends.
• A person with PTSD will have problems with hyper-arousal, which can include brutal insomnia, “hyper-vigilence,” a quickness to anger and an exaggerated startle response.
• The victim’s symptoms last longer than a month and have a significant impact on his or her quality of life.
“About 50 percent of men and 60 percent of women experience a traumatic event in their lifetime,” Hamblen says. “Most people experience some symptoms, and most of them are resolved. A small portion develop PTSD.”
She says that if you have symptoms that aren’t resolved after three months, get some assistance. There is good news in a couple of ways for people who have those symptoms. The stigma once associated with PTSD or combat fatigue — and with seeking help for those symptoms — has largely evaporated, as modern medicine has come to understand the very real neurological and emotional toll that trauma takes on people.
The other good news is that, for those who sign onto and complete treatment programs, whether through the VA system or privately, the improvement rate is close to 100 percent.
But not everyone signs onto those treatment programs or takes their symptoms seriously. “Some people do very well,” despite what would be a diagnosis of full-blown PTSD, Hamblen says. “They sort of white-knuckle it. They force themselves to do things.
“For others, it really is too severe to continue,” she says. Work, everyday activities and social interaction are so compromised that they cannot function.
Abbinett followed up his Vietnam service with two decades in the Army Reserve and National Guard. He says that in his experience, most of those who have spent time in combat have PTSD issues.
“Not everybody gets affected,” he says. “Those who don’t directly participate in combat, such as support troops, many of them don’t have any PTSD at all. When it comes to combat troops, the argument is that if you participated in combat and killed another human being, unless you’re a total sociopath, you’re going to be affected. … Everyone is susceptible. The vast majority [of soldiers] are affected by PTSD if they’ve been in combat.”
And with tours that were extended and extended again for many soldiers in Iraq and Afghanistan, the numbers of soldiers affected by the disorder are increasing and will continue to increase, Abbinett predicts. He notes that draftees during the Vietnam War could expect a year or so of actually combat. Now, with the all-volunteer modern military, some veterans have spent the better part of a decade in active combat.
“People who haven’t experienced trauma are becoming rare,” he says. “We’ve never had a generation of veterans do this much time in combat.”
Hamblen says that some of the newest research shows that 2 percent of all men and 4 percent of all women in America have PTSD. The number of those who will meet the clinical standard for the disorder some time in their lives is about double that.
And for those returning from combat tours of Iraq and Afghanistan, the percentage is 12-15 percent, she says.
Fortunately, there are resources available to support those returning veterans. Dr. Andrew DiSavino, a psychologist, is the PTSD program director for the Las Vegas Veterans Affairs Department. He says treatment for veterans with PTSD symptoms usually includes two primary parts: individualized treatment and group therapy.
Psychotropic medications such as anti-depressants are often used, but an essential element of modern treatment involves cognitive behavioral therapy, in which patients are taught to guide their own coping strategies.
“Many of the treatment principles apply regardless of the specific trauma,” he says. “Even for people whose trauma is not related to combat, the symptoms are very similar to each other.” Failure to take trauma’s impacts seriously can be devastating, he warns. For those with significant trauma, “it affects every part of their lives, often in a negative way.”
Even those with lesser impacts “don’t have to put up” with symptoms that are degrading the quality of their lives, says DiSavino, who has been treating people with PTSD-related symptoms for 23 years. His work included treating crime victims who have suffered violent or sexual assaults.
What people should not expect is a rapid and total cure.
“A lot of people come in asking, ‘How long before I’m cured?’” he says. “That’s not realistic. The goal is to become in expert in symptom-management.”
In Las Vegas, there are four local clinics where veterans can access VA benefits and get help for PTSD issues. For information, call the VA at 251-7873 or (877) 927-8387.