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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
Dr. Schwartz's Weblog

Veterans and PTSD: The Invisible Disorder

Allan N. Schwartz, LCSW, Ph.D. Updated: Jun 3rd 2008

 I have the privilege of working with some very special people thanks to my wife and her involvement with an organization called Puppies Behind Bars and the Psychiatric Service Dogs that she provides to Iraq and Afghani war veterans with PTSD. Puppies Behind Bars does the primary training and my wife, through her organization, Golden Kimba Service Dogs, finishes the training for and with the veterans.

These special people are the veterans who have served their this nation in Iraq and Afghanistan and return home severely traumatized from their experiences. In many cases, they have serious physical injuries along with PTSD. For example, some of them have traumatic brain injuries (TBI) also known as closed brain injuries, due to having been too close to the suicide car bombings in Iraq. Others have loss of limbs and back and neck injuries.

What has impressed me about these veterans is that they are extremely courageous people who seem to have no anger or bitterness about the enemy they faced in the Middle East or about the army and United States. Many of them witnessed the deaths of army friends and were forced to kill enemy soldiers, about which they feel awful.

All of them experience the typical symptoms of PTSD such as:

1. Nightmares
2. Irritability with family and friends
3. Flashbacks
4. Startle response to sudden noises or crowds of people
5. Depression
6. Anxiety
7. Panic attacks
8. Inability to concentrate and keep a job.
9. And any other symptoms I may have failed to mention.

One of the greatest obstacles these individuals face is the response of family when they return from the war. As all of the veterans I have seen thus far are men I will be referring to their wives. It is important to stress the fact that many veterans are women who are returning home with PTSD and facing the same obstacles as their male counterparts but with husbands.

What are those obstacles?

Wives and Family:

Over and over again, their wives seem to have little or no understanding of PTSD. In many respects, PTSD is an invisible disorder. By an "invisible disorder" is meant that other people are unaware that anything is wrong with the veteran. It is common for wives to dismiss symptoms of irritability and anger as their husband being intolerant or impatient. Also, there are wives who cannot adjust to the return of their spouse after several years, particularly if he is in a change condition. In at least one case I know of (and I have heard of more) the wife opted for divorce.

In other circumstances, the wife, not understanding the meaning and implications of PTSD, insist that their husband return immediately to work. In one situation, the wife, worried about money, wanted her veteran husband to take a job as a policeman in a neighboring town. With nightmares about guns and shootings, this was the last type of job he ever should have considered.

Veterans Themselves:

However, wives are not the only obstacle. In fact, one of the greatest difficulties faced by these veterans is their own refusal to admit that they have a problem. Brave soldiers who repeatedly faced combat situations and value themselves for having been strong in the most difficult of circumstances, experience facing the need for psychiatric help as stigmatizing. This is one reason why some of them wait too long before seeking help. Physical injuries are real and undeniable. Psychiatric injuries such as PTSD are not visible or obvious. There is a tendency for these men to turn to alcohol to help with sleep and depression problems. Of course, alcohol only serves to worsen the situation. It is even difficult, at times, to recognize and diagnose TBI's or traumatic brain injuries. In one case I know of it took the veteran a long time at work to realize that he remembered nothing of his graduate studies. The brain injury wiped out the memory of everything he had studied. Army neurologists finally diagnosed him with TBI, reporting that important neurons holding important memories, were permanently damaged.

Veterans Administration:

The army and the VA are part of the difficulty in getting these people the help they need in a way that is speedy and efficient. A recent essay by Dr. Dombeck, "Why the VA does not want to diagnose Iraq war veterans PTSD," can be found at the following URL:
/poc/view_doc.php?type=doc&id=15324&cn=109
explains part of the difficulty involved.

One of the veterans I met finally went to a private psychiatrist to get himself diagnosed and treated. After that, he went back to the VA who agreed with the private psychiatrist's diagnosis and started to treat him. Of course, there is no expense to the veteran involved when the VA provides the treatment and medication.

However, no one person or institution is at fault for these difficulties and obstacles. For example the veteran who started with a private psychiatrist did so because he did not want to run the risk of any of the other army men he knew finding out about his problems. This is another example of the issue of stigma being alive and well.

I even heard of a case where a veteran with PTSD refused a psychiatric service dog because having one would let people know about his disability.

There will be another article about Veterans, PTSD and Psychiatric Service dogs and how they help our veterans.

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at dransphd@aol.com for details.

    Reader Comments
    Discuss this issue below or in our forums.

    Updated Info - Tammie Rogers - Jun 19th 2011

    At Committed Canine, Inc. (www.committedcanine.org) we specialize in assisting disabled veterans with PTSD partner with a Service Dog to mitigate their disability.  We have had a number of veterans come through the T.E.A.C.H. (Train & Educate A Canine Handler) course that report many of the symptoms of their PTSD can be relieved through the use of a specially trained dog.

    We are a not for profit corporation that fund raises to secure tuition for veterans who choose to use a SD for their disability.

    Tammie Rogers

    service dogs - ak - Jan 4th 2009
    There is a stigma with ptsd. That is the person is dangerous and the american people fear them and will destroy them at any chance they get. It is important to make sure that the vets get the help they need without the stigma and other bad things that happen. Dogs are the greatest creatures and far better than humans. The VA will not pay for them yet but consider this, how much does each plastic container for medicine cost? Half filled then thrown away with mailing costs. This in itself will save a bunch of money especially of the vet is off of medication and their skills for coping improve. If most vets look at the medications they are on they can find on the web a place to see the interaction of the drugs together and they will find that most of them have a toxic coctail. My dogs help me and that is something one cannot put a price on. ptsd vets are slaughtered every year by police who percieve them dangerous and some are locked away for no reason because the system doesn't know how to think outside the box. Ptsd vets have skill and special talents that many don't know of yet. This country will nedd them again soon and the vets will not run like most of the civilian populace. As you can see the stigma that has been forced upon me now I hate more than ever people and have bonded with my dogs and trust only my dogs. Help the other before they get to this point of no return. There is only one cure for ptsd and that is death, otherwise you must develop the skills to deal with the everyday problems associated with this injury that changes on a daily basis. Don't lock them up and throw away the key and don't force them to isolate. There is nothing wrong with leaving them alone. a problem in this country where people have to meddle all the time and cannot leave anyone alone. Silence is golden. This is my two cents from experience. Most private counselors cannot be trusted and most shrinks don't know how to think outside the box only what they read in books. Counselors are truly fiends for rent and nothing more but the vet centers have people who can help. You have to start by going to the center first. It starts with one small step and educating the people and law enforcement on how to deal with these people all thoug it is my experience that law enforcement only like to kill people anytime anywhere but they put that into me and once in it will never leave. lessons learned the bad experience stay forever. Good ones last a short time and have to be reinforced. Once has to stop the stigma, the attacks in order to help if you cannot stop this then there is no help but dogs. I would give my life for my dogs but not anymore for a person.

    PTSD service dogs can help victims of violent crime too - Jan - Dec 9th 2008
    Today marks 25 years since I was abducted, held hostage and assaulted by a serial killer. For ten years I suffered in darkness even thoughI was in therapy. Then, I got a dog and 6 years later, trained her to be my service dog.  What a miracle, the healing, she brought to me.  The therapist I switched to in 2000 encouraged me to utilize her as much as possible, which ended up necessitating a law suit with my employer to allow for accomodation of my disability. I have deep respect for all fellow humans with PTSD. Victims of random acts of violent crime, suffer in isolation, as they are rarely part of a group who have witnessed the horrors of the particular event or events. But for many of us with PTSD, service dogs are a great resource. I highly recommend them for all folks with PTSD. My beloved first service dog, Haley, died suddenly on 26 Nov 2008 and now I have a new 16 week old puppy I will be training. The dark moments of PTSD, are comforted by the spirit and presence of another and often a dog is the best help.  Thanks with all my heart for saving my life and renewing my hope, to my hero Haley. 

    mydog4vets? - Debbie Rose - Nov 19th 2008

    Tonights' news on PTSD veterans and dog programs, inspired me to respond.  My Rottweiler, Buddy, and I would like  offer  compassion and friendship to any veteran.  Buddy may be the world's smartest and most loving dog, willing and thrilled to accompany people.  Maybe someone can suggest how we can be of use to our wonderful veterans.

    Thank you,

    Debbie and Buddy

    Train Your Own Service Dog for PTSD - Tammie Rogers - Oct 17th 2008

    My husband (a former US Marine) and I are professional dog trainers.  We operate DarnFar Ranch in central IL.  Because so many of the Service Dog organizations either have a long waiting list or do not provide PSD (Psychiatric Service Dogs) and because many of the dogs available have a $10,000 or higher price tag, we offer a program called "Professionally Guided - Owner Trained Assistance Dogs".  It allows people to learn how to train their own Service Dog under our professional guidance.  PSDs are particularly well suited to this sort of training program, as are Mobility dogs.  Because the dog is provided by the owner (or we can help find an appropriate dog) and because the owner participates in much of the training, the cost is significantly less than acquiring a dog from a big organization.  We also offer a discount to veterans.

    You can read more about our program at

    www.darnfar.com/SERVICE_DOG

    Tammie Rogers

    PTSD and service dogs..looking for recipients - Heidi - Sep 28th 2008

    Hi!  I am the Founder and ED of Paws 4 Liberty .  We are a young non-profit breeding, raising and training service dogs for a variety of physical and psychological disabilities for teens and adults and veterans. I am an Occupational therapist and started this org. 7 years ago..but..finally pulled it all together a few years ago!  Long road!  I'm very interested in working with veterans and placing some of my dogs (8, two year old German Shepherds and labs, available within the next 6-8 months) with veterans that have so bravely given up so much.  The PTSD and assistance with having a service dog to me is...just so incredible.  I have great respect for Puppies behind Bars and know a few people involved there.  I would welcome any input, conversations and/or any veteran that may wish to discuss receiving a dog from us.  I am in Palm Beach County.  I have a wonderful trainer and it is a great match..myself as an OT and the trainers ability to make a great "handler/dog team". 

    Feel free to mail me via my website.  I look forward to hearing from any.  I am thrilled to be able to offer dogs in a small "mom and pop" org. that I have but I know that it will benefit and be appreciated. 

    Thanks!

    Heidi 

    - - Jun 6th 2008

    Thanks for comment and info.  am surfing info. 

    Psychiatric Service Dogs - Allan N. Schwartz, PhD - Jun 5th 2008

    The V.A will NOT pay for these service dogs. However, if you are a veteran from either Iraq or Afghanistan and you have a physical disability due to the war and/or PTSD due to the war Puppies Behind Bars might pay for and provide you with such a dog. Their web site is: http://www.puppiesbehindbars.org

    Dr. Schwartz

    Perhaps - Chris - Jun 5th 2008

    Perhaps you can help-

    I would invite to see the website of this for ptsd- which what I am for this -

    http://chrisa4animals.vets.yuku.com/

    trying to get the VA to pay for the service dogs.

    any info or help would be appreciated- thanks

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