November 16, 2009
GOD, COUNTRY, AND PTSD.... Tara McKelvey has a fascinating item in Boston Review on diagnoses of post-traumatic stress disorder among veterans of the wars in Iraq and Afghanistan. Of particular interest was an anecdote from Paul Sullivan, an analyst in the VA's Veterans Benefits Administration.
Sullivan was working as an analyst at the Veterans Benefits Administration in Washington in early 2005 when he was called to a meeting with a top political appointee at the VA, Deputy Assistant Secretary for Policy Michael McLendon. McLendon, an intensely focused man in a neatly pressed suit, kept a Bible on his desk at the office. Sullivan explained to McLendon and the other attendees that the rise in benefits claims the VA was noticing was caused partly by Iraq and Afghanistan veterans who were suffering from PTSD. "That's too many," McLendon said, then hit his hand on the table. "They are too young" to be filing claims, and they are doing it "too soon." He hit the table again. The claims, he said, are "costing us too much money," and if the veterans "believed in God and country . . . they would not come home with PTSD." At that point, he slammed his palm against the table a final time, making a loud smack. Everyone in the room fell silent.
"I was a little bit surprised," Sullivan said, recalling the incident. "In that one comment, he appeared to be a religious fundamentalist." For Sullivan, McLendon's remarks reflected the views of many political appointees in the VA and revealed what was behind their efforts to reduce costs by restricting claims. The backlog of claims was immense, and veterans, often suffering extreme psychological stress, had to wait an average of five months for decisions on their requests.
McLendon denied the incident took place, but nevertheless told McKelvey that he believes PTSD is "a made-up term," which has "taken on a life of its own." She added that McLendon, in talking about the issue, "pounded the table with the side of his hand more than ten times, hitting it so hard that the wooden surface shook."
As Atrios put it, "It's like the job recruitment process [in the Bush administration] involved advertising for 'the worst people ever born in the history of the universe.'"
It's disheartening to think that the Bush administration put some of these people in key positions of authority and responsibility in the first place.
—Steve Benen 4:15 PM
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Sure is amazing that a guy who literally believes in an unprovable Superman can't seem to wrap his head around the idea that people can irreparably harmed by living through unimaginable traumas.
Posted by: Jay B. on November 16, 2009 at 4:22 PM | PERMALINK
McLendon denied the incident took place, but nevertheless told McKelvey that he believes PTSD is "a made-up term," which has "taken on a life of its own." She added that McKelvey, in talking about the issue, "pounded the table with the side of his hand more than ten times, hitting it so hard that the wooden surface shook."
McLendon is the VA appointee and is a man.
McKelvey is the reporter and is a woman.
Come on, Steve. This stuff is getting out of control and it's in almost every post. Slow down and proofread.
Posted by: shortstop on November 16, 2009 at 4:30 PM | PERMALINK
I assume that's a typo in the second sentence of the 3rd lastparagraph where you say "She added that McKelvey, in talking". The only she is McKelvey and I expect whe was referring to
McLendon pounding the table and not herself.
Posted by: Me on November 16, 2009 at 4:31 PM | PERMALINK
It's disheartening to think that the Bush administration put some of these people in key positions of authority and responsibility in the first place.
Disheartening?
Posted by: Econobuzz on November 16, 2009 at 4:31 PM | PERMALINK
Ah, faith-based governance... making policy bsed on what you believe to be true, rather than what is actually true. The Charismatics and faith healers are very fond of the Bible verse that reads, "Faith is the substance of things hoped for, the evidence of things not seen."
Apply this to politics: if you believe something to be true, it shall be true -- if only you believe hard enough, and never let doubt or contradictory evidence sully your faith. The Iraq War will lead to a flowering of democracy in the Middle East... tax cuts increase revenues... free markets will solve all problems... global warming is caused by trees... and, there's no such thing as PTSD.
Only believe, and it will be true. And if it doesn't come true, then the infidels prevented it from happening because of the poison of their unbelief.
Posted by: jvwalt on November 16, 2009 at 4:36 PM | PERMALINK
"It's disheartening to think that the Bush administration put some of these people in key positions of authority and responsibility in the first place."
In fact, it shows a great deal of foresight and advanced planning on the part of the Bush administration. How else would they be able to argue later (like now) that any "gummint-run health care" is inferior to "for profit health care"?
Posted by: Ian on November 16, 2009 at 4:39 PM | PERMALINK
"It's disheartening to think that the Bush administration put some of these people in key positions of authority and responsibility in the first place."
It's also to be expected, when the nation elects men who are simultaneously war-mongers and draft-dodgers to high office.
Posted by: Alan on November 16, 2009 at 4:49 PM | PERMALINK
It's disheartening to think that the Bush administration put some of these people in key positions of authority and responsibility in the first place.
sh*t, look at the human excrement you had at the top, and not just bush, but the whole top tier - the worst of the worst. It was never possible but to get the same thing filling out the ranks. This should not be a surprise that the extent and longevity of the bush damage is far ranging.
.
Posted by: pluege on November 16, 2009 at 4:51 PM | PERMALINK
Right! Obama has barely begun to de-Bushify our government...and has no excuse for the hold up. Start with putting new USAs in place and replacing the corrupted ones involved in the Don Siegleman case...you got an assistant USA blowing the whistle on these guys and she was fired by them for doing so.
Every department of gov. needs to be reevaluated for the personnel Bush managed to get installed as bribery.
Posted by: bjobotts on November 16, 2009 at 4:55 PM | PERMALINK
Ah, faith-based governance... making policy based on what you believe to be true, rather than what is actually true. The Charismatics and faith healers are very fond of the Bible verse that reads, "Faith is the substance of things hoped for, the evidence of things not seen."
A great verse [and I say that as a mainline Presbyterian, not a charismatic or a faith healer]--but a dreadful reading of it. I've never heard this verse applied to policymaking; it's about the hope of Grace. The problem with McLendon isn't that he puts too much faith in Hebrews 1:1; the problem with McLendon is he clothes his right-wing prejudices in the garb of faith.
Posted by: David in Nashville on November 16, 2009 at 4:56 PM | PERMALINK
If you go back and look, one of the issues veterans were concerned about at that time was that the Bush administration was deliberately avoiding the PTSD question. The person hired by them to deal with PTSD in the VA system (a woman physician whose name I forgot) openly denied the existence of PTSD claiming that most of the veterans who suffered from it were malingering. They knew that the cost to them, i.e. bad publicity about the effects of war, was too high and they avoided it by making sure that VA officials toed the party line.
So it is not surprising to hear another anecdote about PTSD and the Bush administration. I am too lazy to look all of this up, but I am sure that the Washington Monthly blog reported this story.
Posted by: mikeyes on November 16, 2009 at 5:02 PM | PERMALINK
Every now and then, I really understand where the killer in the "Saw" movies is coming from...
Posted by: Ken on November 16, 2009 at 5:06 PM | PERMALINK
If there is such thing as Karma, please let this man be transported to a combat zone, witness a friend get blown in half and be sprayed by their guts.
We'll see what he has to say about PTSD.
Posted by: citizen_pain on November 16, 2009 at 5:07 PM | PERMALINK
"it's disheartening to think that the Bush administration put some of these people in key positions of authority and responsibility in the first place."
It is indeed disheartening. But anyone who was paying attention (for instance, reading this blog...) knew that little Bushie was placing people in roles they were unsuited for purely based on their religious and political beliefs. And since they are Republicans they will never take any responsibility for the sh*tstorm they created. To them, it's the fault of either the guy that came before him or the one that came after.
Posted by: Limbaughs Diabetes on November 16, 2009 at 5:13 PM | PERMALINK
This "man" needs to have his Bible shoved up his anus and told it is the Presence of God blessing him. That this person still holds a position of responsibility is criminal. People's lives are being destroyed and he is allowed to collect a salary for doing so. I'd love to have him tell this to some person, like the good Major from Ft. Hood, and receive his just reward. If God judges him, he may do so through one of his own creations. No need to wait for Judgment Day. Today is Judgment Day.
Posted by: st john on November 16, 2009 at 5:19 PM | PERMALINK
If there's a concern to be had here, it strikes me less about the religiosity, or the bad quality of Bush appointees... and the sense that making progress on mental health is an entirely uphill battle, where merely getting people to understand basic notions around mental health is barely the starting point. "Who pays for PTSD treatment" is an issue because - and this is kind of crucial - PTSD does not just go away. There's not a pill, not a time period for treating it; there's treating it, seeing what happens... and probably continuing to treat it... for a long time.
I get the incredulousness at the table pounding, clueless born again who can't understand that PTSD is real, and serious... but the point, I think, is larger and worse: The Army has been doing a not so great job treating PTSD, people with mental health problems are going without proper treatment... and experts generally think the Army is doing a better job at mental health than everybody else is. I think there's a notion that, somewhere, someone is doing PTSD - and other mentak healtb treatment - right; the reality is, I think, the Army's doing something, much of the civilian world is doing nothing, and what's being done by the Army is time consuming and costly (and, as Dr. Nidal Hasan indicates, the Army is having trouble staffing up strongly enough to provide enough services). McLendon is an interesting detail... the problems around mental health, in and out of the Army, are far bigger, and much worse than we'd like to admit.
Posted by: weboy on November 16, 2009 at 5:30 PM | PERMALINK
Two points, if I may.
1) jvwalt is on to something: "...if only you believe hard enough, and never let doubt or contradictory evidence sully your faith...." This is why it is off the mark to accuse conservatives of lying. They are telling stories. It is not the same thing.
2) A central tenet of conservative faith is that there is no such thing as mental illness. They regard it as a uniquely depraved form of self-indulgence and their bitterest contempt is reserved for it. Many who have become so blase about other forms of sin that they usually appear almost normal will still scream and pound the table when this topic comes up. They even apply it to stroke victims, etc.
Posted by: Frank Wilhoit on November 16, 2009 at 5:33 PM | PERMALINK
McLendon denied the incident took place, but nevertheless told McKelvey that he believes PTSD is "a made-up term," which has "taken on a life of its own." -- Steve Benen
Obviously, another "Muscular Christian", who believes that real men don't succumb to stress; probably also old enough to remember the older term: "hysterical". It's amazing how many people are uncomfortable with mental problems. And how many believe it's "all in your head", not real. No fever, no virus shows up in your bloodstream... It's not real.
Posted by: exlibra on November 16, 2009 at 5:35 PM | PERMALINK
And it's still going on under the Obama Administration. Go over to Salon and read about the psychiatrist who has warned the USMC about their PTSD problem at Camp Lejeune, who was summarily fired this past summer for bringing up the fact that the Marine Corps has an official position not to different from that of this fundamentalist whackadoodle.
Further proof that you can indeed always tell a Marine - you just can't tell him very much if anything.
Posted by: TCinLA on November 16, 2009 at 6:20 PM | PERMALINK
Further information from Ms. McKelvey:
http://bostonreview.net/BR34.6/mckelvey.php
In a 2004 study of approximately 1,400 Vietnam veterans, almost 90 percent Christian, researchers at Yale found that nearly one-third said the war had shaken their faith in God and that their religion no longer provided comfort for them. The Yale study found that these soldiers were more likely than others to seek mental health treatment through the Department of Veterans Affairs (VA) when they came home. It was not that these veterans had unusually high confidence in government or especially good information about services at VA hospitals. Instead, they had fallen into a spiritual abyss and were desperate to find a way out. The trauma of war seems to be especially acute for men and women whose faith in a benevolent God is challenged by the carnage they have witnessed.
...
During the Iraq war, however, the great difficulty veterans experienced in getting psychiatric care—greater than before—was not a product of cost-cutting, but of conviction: many Bush administration officials believed that soldiers who supported the war would not face psychological problems, and if they did, they would find comfort in faith. In a resigned tone, one prominent researcher who worked for the VA, and asked that he not be identified because he was not authorized to speak to the press, explained that high-ranking officials believed that “Jesus fixes everything.” Benimoff and the others who returned with devastating psychological injuries found a faith-based bureau within the VA. At veterans’ hospitals, chaplains were conducting spirituality assessments of patients.
...
Things had already begun to change dramatically at the VA by early 2005, shortly after Roger Benimoff left for his second deployment to Iraq. Many appointees at the agency were disturbed that so many Iraq veterans showed symptoms of post-traumatic stress disorder (PTSD). In part the concern grew from skepticism about the diagnosis itself, which some believed to be a legacy of the Vietnam-era anti-war movement. Whatever the merits of the diagnosis, it was clearly widespread and, moreover, staggeringly expensive to treat. In 2008 the RAND Corporation put a number on the problem, reporting that one in five veterans of the wars in Iraq and Afghanistan has suffered some form of mental illness, mostly PTSD and depression.
“God doesn’t like ugly,” one political appointee told Paul Sullivan, an analyst in the VA’s Veterans Benefits Administration, in a clumsy attempt to reduce the cost of caring for psychologically traumatized veterans. “You need to make the numbers lower.” Sullivan left the VA in 2006 and became head of Veterans for Common Sense, a group that filed a class-action lawsuit against the secretary of the VA for the shoddy treatment of veterans. It was dismissed in 2008 and is now being appealed.
...
Later, in an email about our conversation, he (McLendon)wrote:
[PTSD] is not a diagnosis based on empirical evidence, but rather . . . it is an artificial construct erected by a vote of selected psychiatrists. This does not mean that there are not problems that certain individuals do have [and] issues that need to be addressed. But rather, it means that we have created policies and programs that have not served veterans well.
...
McLendon and many of the other high-level officials at the VA shared political convictions that, along with doubts about the science of PTSD, made them less likely to push for additional psychiatric services for veterans. They believed in streamlined government and free markets, and they supported a prominent role for faith-based organizations. The secretary of the Department of Veterans Affairs, R. James Nicholson, had previously served as chairman of the Republican National Committee and as ambassador to the Vatican. McLendon’s politics closely mirror his boss’s, and under Nicholson’s watch, veterans had increasing difficulty in obtaining adequate psychological care.
When a 2006 Government Accountability Office report raised questions about whether soldiers were getting the psychiatric help they needed, an assistant secretary of defense disputed the report’s findings, pointing to the fact that soldiers were being referred to chaplains. During this time contracts for veterans’ services were increasingly parceled out to leaders of faith-based organizations rather than to secular ones, even though veterans’ advocates opposed any bias toward faith-based treatment and argued that replacing empirically proven, nonsectarian programs with faith-based ones was a mistake.
The religious programs grew, despite concerns. At the VA Healthcare Network in upstate New York, chaplains compiled spirituality assessments of patients within twenty-four hours of their arrival. The VA Greater Los Angeles Healthcare System gave patients a questionnaire that stated one of the System’s goals as helping veterans “Maintain Optimal Spiritual Health.”
...
For spiritual uplift, many soldiers and veterans depend heavily on pop-Christian books, especially Rick Warren’s "The Purpose Driven Life," and themes of divine purpose and devotion to God.
...
Since Vietnam we have learned that PTSD tends to hit people especially hard when they fight in wars of choice. Bobby Muller, the head of Veterans for America, told me it was difficult for soldiers to talk about the war in Vietnam after they came home; years later, though:
I would get in touch with some of these guys, and they all had to come to the realization, ‘This is bullshit.’ It’s not just the horror of killing, but its context. . . . If you’re fighting a necessary war, it’s awful. But it’s kind of what you got to do. Let’s take a war that turns out to have been unnecessary. And in fact your leadership betrayed you. That willingness to serve was betrayed by a leadership that lied and squandered that trust. The very moral fabric of your life gets ripped apart.
Despite its limitations, "The Purpose Driven Life" is still used in the military to inspire soldiers and ease doubts about their mission. Nobody forces soldiers or veterans to read "The Purpose Driven Life," of course, but it is extremely popular. Paperback copies are passed around among soldiers, and one edition of the book was published with a camouflage cover, a savvy move by the publisher that helped tap into the military market.
Posted by: TCinLA on November 16, 2009 at 6:42 PM | PERMALINK
"Disheartening" is the one thing these appointments were not. They were promised quite openly. They were delivered quite methodically. They were celebrated quite lustily. And the evil empire they made is with us still, permeating the new regime as an acrid cloud of intimidation and the culture with nauseatingly incorrigible denial, delusion, and conditioned blood lust. But it's a little disgusting, still, to see a man like McLendon gazing so ungratefully on psychological masterpieces wrought by his own government.
Posted by: Carter Nicholas on November 16, 2009 at 7:25 PM | PERMALINK
But today on MSNBC two guests, sitting side-by-side, said that holding trials for KSM a few blocks from the WTC will cause massive PTSD.
Posted by: tomj on November 16, 2009 at 10:13 PM | PERMALINK
"It's like the job recruitment process [in the Bush administration] involved advertising for 'the worst people ever born in the history of the universe.'"
OK, they didn't hire Mao, or Stalin or Hitler or Mugabe or Hussein, so not the WORST people in the history of the universe.
Just the biggest %$#*holes, which, sadly, is actually more pathetic than hiring the truly worst people...
Posted by: Jason on November 17, 2009 at 8:27 AM | PERMALINK
Hm, interesting reaction by McLendon to the rise in claims. The *correct* response by a person in his position is to use it, and fight for *budget increases*.
Sheesh.
Posted by: ajw93 on November 17, 2009 at 9:35 AM | PERMALINK
Another good example of the fake christian party. Republicans are going to hell.
Posted by: Patrick on November 17, 2009 at 9:42 AM | PERMALINK
McLendon should read this piece from Rolling Stone on the so-called "Marlboro Marine", Blake Miller, and then see if he can deny PTSD with a straight face: http://www.rollingstone.com/politics/story/19733160/the_troubled_homecoming_of_the_marlboro_marine/print
Posted by: macleodcartoons on November 17, 2009 at 11:48 AM | PERMALINK
This man pounds the table repeatedly, year after year, harder and harder. Sounds like PTSD to me. Sounds like he needs to turn away from the temptations of power and Satan and return to God and country.
And, yes, more proofreading is in order, even for one so prolific as Steve Benen.
Posted by: Brownell on November 17, 2009 at 4:26 PM | PERMALINK
This man pounds the table repeatedly, year after year, harder and harder. Sounds like PTSD to me. Sounds like he needs to turn away from the temptations of power and Satan and turn back to God and country.
And, yes, more proofreading is in order, even for one so prolific.
Posted by: Brownell on November 17, 2009 at 4:27 PM | PERMALINK