PTSD, Reading Comprehension and the Great American Love of Victimhood

Remember how Mad Duo Chris stirred everyone up with his post about PTSD, and how the fakers and bullshitters make it harder on those who really have it? Some people agreed, some disagreed, some engaged in intelligent discussion (a Good Thing), some acted like he’d wiped his ass with the American flag (many making cogent points in their outrage, others displaying a breathtaking lack of reading comprehension. Grunts: cogent. Well, he’s penned a response. Here it is. The original article is here if you want to brush up on it.

Do us a solid. If you want to comment or debate, and we hope you do, read and digest the entire article. Don’t just read the headline (which we intentionally named to be provocative) or skim the contents and weigh in. Those of you who did so last time – thank you. Mad Duo

PTSD, Jackassery, Heroism, Victimhood, Integrity, Courage & Strength

Mad Duo Chris

Not surprisingly, my essay PTSD: fakers and frauds and WTAF? generated hundreds of comments from angry, supportive, incredulous or head-nodding-in-agreement readers. Many veterans shared anecdotal evidence of other servicemembers who claimed PTSD for what appeared to be trivial things (for example, seeing a destroyed vehicle from a car bomb attack that happened a week earlier, or hearing a report of a possible sniper while on a convoy). In fact, if I recall correctly, of the many readers who agreed with me, only three weren’t veterans.

Of course, many people took exception to what I wrote. Quite a few thought my essay was insulting to non-combat troops. Some readers took my post to mean I don’t believe “fobbits” (a term I didn’t use in my essay) can get PTSD, or that people with PTSD shouldn’t get help. I objectively did not write those things, but the tone of my post apparently conveyed those messages to certain people.

One extremely angry reader commented, “What he said, and what people are hearing are two different things.” Well, a lot of people heard things very different from what I actually wrote. One reader, for no apparent reason, thought I claimed to be Special Forces and commented “Even regular Joe’s get PTSD too, not just you special forces assholes”. I got the distinct impression many readers skimmed through the essay, picked out whatever pissed them off the most, then furiously typed scathing comments. Those comments often seemed to have little connection to what I actually wrote.

I can’t help it if someone takes something totally off the wall from my essay. I can only write what I mean, as clearly as I can. People can take whatever meaning they want from it.

I got quite a few personal insults, from a variety of readers. I was called mentally ill, narcissistic, stupid, arrogant, and was even compared to Piers Morgan. One person hopes I have a stroke so I can’t write anymore. Several accused me of secretly having PTSD. One man furiously ranted about the harm I’m causing veterans, said it’s a good thing I left group therapy (which I was never in; reading comprehension was a bit of an issue here) before I “instigated someone to commit suicide”.  He then told me blow my brains out. I got a good laugh out of that one.

The many negative comments suggested, to me, that some veterans are fully invested in The Great American Love of Victimhood. I bet those veterans would have embraced me had I written an essay titled “I got PTSD from getting scared when a rocket landed five miles away in Afghanistan and don’t you dare judge me for it”. But for a combat vet to praise a friend who got help for a legitimate PTSD problem, while simultaneously criticizing the fakers and frauds who we all know exist?

Heresy. Treason. It’s as if I laid an explosive charge across the tracks of the VA Gravy Train.

However, at least one reasonable, well-spoken reader assumed I was infantry, and that I thought nobody but infantry could justify a PTSD claim. He initially had a problem with my essay, then read through the comments, and eventually we found ourselves in agreement. But this reader, who appeared to be a very intelligent man, felt I was exhibiting an “infantrymen are holier than thou” attitude.

I’ve written about my MOS elsewhere and didn’t mention it in this essay, but just to be clear: I am NOT an infantryman, and never have been. I was a support guy in the Marine Reserves, then a tanker and scout in the Army National Guard, and at the time of the combat action described in the essay I wasn’t even in a combat arms MOS. The VAST majority of my combat experience came from a deployment where I was a support soldier in a support unit. In previous writings I have been very open about my absolutely non-special, unremarkable military background. I have never written or said that I was infantry or that only combat arms troops engage in combat or get PTSD. However, if an intelligent, reasonable guy reads my essay and gets that impression, I should have been clearer. I thank the reader, former Marine Robert Voskoyan jr., for pointing out that flaw in my writing.

While many readers made substantive points, a few in particular stood out. One, “1AirCav69”, identified himself as a Vietnam veteran who worked with PTSD victims from the very first treatment efforts in 1980. He described a major problem they had when PTSD was recognized as a disability: “Well to go on, we had so many phony SF, LRRPS, SEALS, POW’S, RANGERS, RECON, it was unbelievable.” He then described the problem he saw with present-day PTSD treatment: “Well the problem today is the pendulum went from far right to far left, not in the middle. Now you have to prove nothing to get a PTSD claim, just know what to tell the doctors. No vetting, no ‘beyond the realm of normal trauma’, no ‘life threatening’, (I know a guy who knows a guy that died is good enough today), like little league today, everyone gets a trophy and the trophy is money. This is an insult and a slap in the face to every veteran that truly suffers from this God awful disorder.”

Another reader, “Katie”, identified herself as a Physician’s Assistant who works with PTSD patients. She made this very interesting comment (abbreviated here): “I am a physician assistant and army veteran. I have seen this at the VA, when I rotated on a PTSD unit, when I worked in the CRC and even know someone who claims PTSD for my roommate being killed. The ‘fakers’ diminish the diagnosis and treatment and make it more difficult for people with real issues to want to get treatment…I believe this is an incredibly important topic and needs to be addressed. I feel some mental health providers are afraid to push people to talk about things in order to get an accurate diagnosis and giving a diagnosis of PTSD is a safe choice for them. Unfortunately, there will always be people that game the system while people who really need the help are not getting it.”

One reader named “Casey McLain” said he was retired after 20 years in the “specialized field of trauma” and offered this observation, part of a mu

ch longer comment: “Having worked with active duty and veterans, many times the military and the VA have misdiagnosed this disorder in the past. They have diagnosed it as some type of psychotic disorder. The reaction seen currently is two-fold: 1) a knee-jerk reaction – over diagnose and 2) make military and veterans appear incompetent or dangerous because of their profession.”

I don’t know about a conspiracy to make us veterans appear incompetent or dangerous, but the knee-jerk overdiagnosis part is certainly believable.

Of course, some intelligent people who seemed to know what they were talking about vehemently disagreed with me. One in particular, “Michael Parker”, is a veterans’ advocate (according to the internet). He disagreed with just about everything I said, although of course we both think outright liars and frauds need an asskicking (my words, not his). We had some interesting discussions, and while I don’t doubt his expertise on the subject, he did say something I find troubling: “The threshold is not what caused the PTSD, it is whether or not he has service connected PTSD and what are the impacts.”

This, in my opinion, is a problem. As 1AirCav69 said, there is no “beyond the realm of normal trauma” requirement. The attitude expressed by Mr. Parker, and by “PhD VA” who I think works with VA PTSD programs, is that “trauma” doesn’t have to be what I or anyone else reasonably thinks it is. It can be something that seems pretty mild to laypersons like me (for example, “I was traumatized because an IED went off a kilometer away from me and didn’t hit anyone”). Yes, there is a clinical definition of trauma: “(1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others (2) the person’s response involved intense fear, helplessness, or horror.” But that definition certainly seems flexible.

Consider these two real-life stories, and for the sake of argument let’s say I never experienced anything else.

One night I was at the Camp Victory truck yard waiting to leave on a convoy. Far in the distance, out in Baghdad, we saw the flash of an IED. A minute later we heard radio traffic that a Humvee had been hit. So I was “confronted with an event that threatened death”. If I go to a psychiatrist and claim I felt intense fear from seeing that distant IED strike, list the appropriate symptoms and claim they’ve lasted for the appropriate length of time, am I now disabled by PTSD?

In Afghanistan, two Afghan soldiers on our firebase perimeter shot each other one night. The survivor then fired over the camp to try to make everyone think the Taliban were attacking. We heard bursts of gunfire, and a while later an alarm sounded. We geared up and manned bunkers. Eventually word was passed that it was a green-on-green, and we stood down. No incoming fire, no coalition casualties, no American saw the dead Afghan. But we were still “confronted with an event that threatened death”. If I claim I was “horrified” by it, and self-report symptoms, am I now disabled?

As near as I can tell from Mr. Parker and PhD VA, the answer is yes. Nobody will judge the “trauma”. As PhD VA said in a comment, “If they experience the symptoms then they fit the bill.” This attitude reminds me of what I saw riding an ambulance during an EMT course. We had “frequent fliers”, repeat patients with minor medical problems who used ambulances as taxi rides to the hospital, never paid for medical services, and tied up critical EMS resources. Everyone knew they were abusing the system. But the official policy was, “If they say it’s an emergency, it’s an emergency.”

No, I don’t think you have to have hit the beach at Normandy to have PTSD. Yes, I understand we all have different levels of tolerance to trauma. But if trauma is basically whatever we feel like it is, and we follow an official policy amounting to “only god can judge”, we’re inviting abuse.

Michael Parker also gave me valuable insight into something I hadn’t considered, although I’ve heard bits and pieces about it. According to him, the Army recruited many substandard soldiers during the height of the Iraq War. Many were psychologically unsuited for military service and prone to PTSD due to preexisting issues. They developed PTSD after experiencing what most of us would consider benign wartime experiences. In his opinion, if we recruited them, and “broke them”, then it’s our responsibility to take care of them. Fair enough. But I have serious questions about how to determine who had those preexisting conditions, versus having another preexisting condition called “lack of integrity”. Nonetheless, he brought up an important point and I thank him for enlightening me on it.

Michael Parker’s information wasn’t all puppies and kittens and chocolate rivers though. To prove the VA catches veterans who make false PTSD claims, he provided a links to VA cases where veterans were denied compensation. I found #1338751extremely interesting (see below for link).

I’d suggest you read through it (it’s in convoluted legal format, so it helps to “copy all” and paste it into a word document). In this incident, a Vietnam-era veteran was initially denied a PTSD diagnosis, and the VA noted he “expressed disappointment” at not being diagnosed. He came back a few months later with a different story, citing two accidents on his ship where friends were killed, and was then diagnosed with PTSD despite lack of any verification of his claimed trauma. Two years later the VA determined the veteran’s story wasn’t true; but he was still diagnosed with PTSD by multiple doctors for 6 more years. By the time the veteran’s service-connected PTSD diagnosis was removed and his request for disability denied, more than 8 years had passed since his first PTSD claim. The veteran didn’t ever receive money for his PTSD diagnosis, but he still used plenty of VA resources and saw multiple VA psychiatrists in pursuit of his false claim. That doesn’t sound like a success story to me, and it illustrates one of my points: fakers are taking limited resources from veterans who truly need help.

No matter how judgmental anyone thinks I am, no matter how angry a reader is at me for writing that essay, the evidence seems to bear out my claim: some veterans are making false PTSD claims to scam the system for free money. Maybe my “five fakers for every real victim” estimation is too high, and I sure as hell hope it is. But it’s happening, and doesn’t seem to be rare. Even most of the readers who were infuriated by my essay still agreed that some people are scamming the system. But some of them still insisted I shouldn’t have written it, because all I’m doing is “further stigmatizing veterans with PTSD”.

I don’t see it that way. My essay didn’t stigmatize veterans with PTSD who truly need help. Far from it. The truth is, liars and fakers are stigmatizing ALL of us, especially those suffering from service-connected psychological disorders.

But some readers wonder why I wrote the essay. So here’s the explanation, as plainly as I can put it. 

I wrote it because I’m proud as hell of being a veteran. I’m proud of the men and women I served with.

I didn’t join the military so that my country could give me a free ride for the rest of my life, I joined to defend it from its worst enemies. I expected pain, fear and hardship from war. I believe our job as soldiers is to endure that pain, fe

ar and hardship so our citizens don’t have to. We are the barrier between our people and foreign threats.

Being part of that barrier doesn’t require heroism. But it does require integrity, courage and strength. The same integrity, courage and strength my great uncle Leo undoubtedly showed before he marched to his death on Bataan, and my great uncle Jesse showed when he jumped into Sicily, Normandy and Holland, and my great uncle Richard showed as he fought his way through Korea. And by generations of other American warriors on battlegrounds from Lexington to the Korengal Valley.

Every time a veteran makes a false claim of PTSD, that barrier is weakened. Every time a veteran is exposed as a fraud, the barrier loses precious integrity. Every story that hints we’re all damaged by PTSD, that we’re all unstable, that we’re all victims, gouges chunks from the barrier’s foundation.

The time I spent as a soldier at war, forming a tiny part of that barrier, has been the proudest of my life. My writing is the only tool I possess that might keep that barrier standing. So I applied that tool, to defend something I treasure. And I don’t regret it for a second.

 – Chris Hernandez –

Note: the link to the case file mentioned earlier: http://www.va.gov/vetapp13/Files4/1338751.txt.

Chris Hernandez (Mad Duo Chris, seen below on patrol in Afghanistan) may just the crustiest old member of the eeeee-LIGHT writin’ team here at Breach-Bang-Clear. He is a veteran of both the Marine Corps and the Army National Guard who served in both Iraq and Afghanistan. He is also a veteran police officer of nearly two decades who spent a long (and eye-opening) deployment as part of a UN police mission in Kosovo. He is the author of White Flags & Dropped Rifles – the  Real Truth About Working With the French Army and The Military Within the Military as well as the modern military fiction novels Line in the Valley and Proof of Our Resolve. When he isn’t groaning about a change in the weather and snacking on Osteo Bi-Flex he writes on his own blog, Iron Mike Magazine, Kit Up! and Under the Radar. You can find his author page here on Tactical 16.

Mad Duo, Breach-Bang-CLEAR!