The disease metaphor for mental health problems has been around for a long time. It began in the 1940s with Jellinek’s efforts to help people with alcohol addiction. It is seductive and since that time – with the encouragement of the drug industry - it has gained widespread popularity to cover nearly all other manifestations of distress; we have been convinced that these people must be suffering from unknown or unexplained disease processes. This metaphor for human problems, however, comes with much baggage. It scares the rest of us into thinking that problems are beyond our offers of support and help. It leaves out the central role of life circumstances and it diminishes the power of human relationships. We move away, we look at our friends and family members differently; we stop listening. These other human beings suddenly become strangers to us - we stop trusting what we see.
Almost always, these “diseases” are nothing less than very human reactions to the things that cannot be said – the secrets that erode people’s faith in themselves and other people. When a person begins to show signs of distress; start by listening and resist the temptation to turn them into strangers. Other things like professional help may be needed but don’t start by isolating them further. Getting well or deciding to keep going often comes down to having one relationship that the person can count on, no matter what comes.
Report critical of Veterans Affairs buried as ombudsmen investigate Add to ...
OTTAWA — The Canadian Press
Published Monday, Jan. 18, 2016 4:02PM EST
Veterans ombudsman Guy Parent says he’s not seen the draft, let alone a final version of the report on Veterans Affairs, but wants one. (Adrian Wyld/THE CANADIAN PRESS)
They just don't get it. Just taking off the uniform does not bring a military veteran any closer to navigating the hurtles of adapting to and finding meaning in civilian life. This is especially true for men and women who are released medically. In fact, the ability to make the mental transition to civilian life may require the same level of training that it took to teach us how to reject civvie life in the first place. If the feds are interested in developing programs, how about one called "Adapting to Civilian Life" that is run similar to any other military qualification course. I think that we have to be taught how to say good-bye to the uniform, including having our say, before walking out the gate for the last time. The assumption that we remember the values and the mindset of civilian life is not true for most of us. In fact, it can take years to figure this out and to find a new place on the outside. We need to figure out what we are leaving behind before finding a new normal.... there is no going back.
The stories over the past week about military veterans living on the streets do not surprise
me but these stories sadden and anger me. It is something we could have predicted
years ago. The fact that these stories highlight issues around substance abuse
and mental health problems stemming from military service and transitional shock
should also come as a surprise to no one. But various spokespersons seem to be
The issues among homeless veterans are related to military identity and stove-piped mental health services within the military and in the civilian world, they are
related to the policy of universality of service, and they are related to an outdated
understanding and response to substance abuse. Substance abuse continues to be
understood as a combination of behavioural/personality problems, childhood abuse, or
sometimes as a result of operational stress injuries. Even here, under the present
organization of federal health services divorced from the operational end of
the system, there are only so many things that can be offered to serving personnel
before recommendations are made for medical release. These men and women
then become someone else’s problem.
“For a moment, envision something similar to a large interpersonal GPS where every military member knows precisely
where they are located—by service element, unit, trade, past deployments, rank, section, specific duties, unit NCOs and
buddies. Where one fits, specific job duties, who they are accountable to, who matters and who does not are all known.
There is a predictability to life based in a complex web of experiences and relationships that defines one’s military identity
and personal expectations. Military members are first and foremost identified by these things, and when these are lost or
taken away, there are no replacements to be found for many.” [Excerpt from Going Crazy ...]
Next, come the battles with veterans affairs to convince bureaucrats and quasi-judicial
bodies that struggles are service-related. Even when veteran issues are deemed
to be service-related and despite the efforts of individual case managers, as a benefits
oriented organization, VAC as it is presently constructed, can offer only limited support
to veterans beyond financial compensation. There are no places for veterans and their
families to go through a process of transitioning (a terribly misleading term by the way) to
civilian life. Family strains, disorientation and re-adjustment anxiety, economic
disruptions, and lingering mental distress become someone else’s problem to manage.
Various advocacy groups and community organizations (usually comprised of ex-military people) have stepped into the fray to highlight and to help solve some of the
issues but they are on their own. Federal bureaucracies seem perplexed so they
will want more studies.
So, I am sad and angry this week and I know other people who are upset by the stories.
I hope you will do something constructive about your reactions.
Shrouded under darkness, it travels on the breeze, steady on its deadly journey towards unsuspecting soldiers huddled
in their trenches. An unseen enemy invades their world, blanketing them, choking out life. These statements offer a
description of the first chlorine gas attacks on Canadian soldiers during the First World War. This invisible enemy, this
deadly poltergeist, is also a fitting description of our modern day enemy - mental illness. It too, threatens to invade our
Canadian military, having already ended the careers and the lives of soldiers and veterans prematurely forcing the
leadership to take it seriously. This new enemy comes by various names – depression, panic, addiction and suicide –
but it is PTSD that stirs the same fear and confusion created by that other 100 year-old foe. Many members sneer in
feigned bravado to ward off this invader, even as it moves through steel walls and body armour to infect their senses
directly. It has been called insidious; leaving no trace of its approach as it settles in the brains of unsuspecting victims.
It may lay dormant for years, growing, festering, infecting thoughts and perceptions of reality and then erupting without
warning. It requires members to become vigilant of themselves and others for any signs of affliction. Its origins tantalize
observers; maybe this germ, this infection was there all along to be activated on the battlefield or maybe it crept in during
the time away from home only to be fertilized on familiar soil. It is a foe to be taken on and the CAF has done exactly this
in the form of overlapping programs and a complex mental health network to shed light on this intruder and to root it out.
Like a wielded cutlass, operational stress injuries have sliced across the heart of our military institution, cutting into men
and women of all ranks across the three service elements. The past 25 years has seen the CAF on the ground, on the
oceans, and in the air over many troubled places. It has navigated the eras of downsizing, right sizing, realizing
efficiencies, and the preoccupation with information control demanded by its civil leaders. But in the background, many
of these foreign spots have produced pockets of quietly suffering members. Our recent decade of war has produced
many more of them, ranging from privates to generals who also quietly seek out help. We have preoccupied ourselves
with efforts to solve individual cases but absent from discussion are meaningful conversations to understand this newly
recognized phenomenon. Alongside the many efforts to address concerns about mental health within the military, there
is also a deafening silence. There are no venues, either in the public sphere or privately for the institution to understand
how it has been changed by the full impact of recent wars. Many veterans tell me that the institution has become tougher
and more bureaucratic even as it labours to be more accepting of mental health concerns. It can be confusing to
unravel their concerns and the challenges they face as mentally wounded military veterans.
John J. Whelan
John J. Whelan, Ph.D., is the author of Going Crazy in the Green Machine, available now on FriesenPress.