Understanding the Stigma

I realized that before I could really comment on the media’s coverage of PTSD and mental trauma among military men and women, I needed to know more about PTSD and also understand the stigma surrounding it.

To that end, the following were extremely helpful:

Veteran’s at the Breaking Point – MSNBC.com

The Army Denies Combat Stress Causes Homicide

Coming Home: The Army’s Fatal Neglect

As was the investigation of homicides at Fort Carson, Colorado from November 2008 – May 2009, which was published by the US Army Center for Health Promotion and Preventive Medicine.

In February 2009 Salon, a news site that has extensively covered issues in the military, ran an in-depth investigative series in February 2009,  “Coming Home: The Army’s Fatal Neglect.” The series highlighted “25 suicides, prescription overdoses and murders among soldiers at Colorado’s Fort Carson since 2004,” and behind the failures in treating and diagnosing mental health issues is “an Army culture that punishes problematic soldiers instead of aiding them.”

The investigation found:

The soldiers seemed to be suffering classic symptoms of post-traumatic stress disorder: explosions of anger, suicidal and homicidal ideation, flashbacks, nightmares and insomnia. The Army was responding, for the most part, with disciplinary action rather than treatment, evincing little concern for possible underlying problems.

Finally, I interviewed Jim MacMillan, a journalist and photojournalist who has spent the last several years focusing and seriously studying trauma.

MacMillan on the stigma of mental health in the military: “There are two stigmas associated with the military and mental health,” said MacMillan, who started looking at trauma critically in 2006. “The first is the stigma within the military that if you have PTSD or trauma then you’re weak and not capable of performing.”  The other stigma is that people with PTSD or other mental health issues are unstable – they “might go postal and kill everybody.”

MacMillan pointed me to a major problem about the misrepresentation and misunderstandings of PTSD: While “diagnosing and acknowledging [PTSD] helps clarify things, it also makes it difficult because there are differences among cases – a person can have only one or two of the following manifestations and be diagnosed with PTSD,” said MacMillan. Those manifestations are intrusion (dreams, flashbacks etc…), avoidance and arousal (elevated startle response).

MacMillan’s reaction to the coverage of Sgt. Bales: “It’s shallow, simplistic reporting,” says MacMillan, and “at a glance, I think it’s been disastrous.”  Because “the number of soldiers with PTSD who become violent is a very small percentage and the percentage that are violent in such a public way is even smaller – usually the violence is limited to themselves and those closest to them, which is devastating in its own way.” One of MacMillan’s biggest critiques of the coverage of the Bales case was that “in all the coverage, I never head about the context of how rare it is to go ‘postal.’ Before we had an under-abundance of reporting on PTSD, now we have a misunderstanding of PTSD.”

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