Thursday, November 19, 2009
What assistance does the Marine Corps offer to deploying and returning Marines and their families with issues such as PTSD, domestic violence, anger management and financial stress?
MAUREEN CAVANAUGH (Host) : I'm Maureen Cavanaugh, and you're listening to These Days on KPBS. You can find it in the headlines, and unfortunately among the homeless population in San Diego. It's the toll of unresolved emotional distress carried by members of the U.S. military. Post-traumatic stress disorder and other psychological problems that arise from military service have a long trail of consequences for individuals, families and society. Marine and Family Services at Camp Pendleton is offering support and counseling to troubled Marines, everything from new parent support groups to treatment for combat stress. Joining us is my guest, Dawn Herring, a counselor with Marine and Family Services at Camp Pendleton. And, Dawn, welcome to These Days.
DAWN HERRING (Counselor, Marine and Family Services): Thank you. Good morning.
CAVANAUGH: Now call us if you’d like to join the conversation, if you have questions about post-deployment issues, how to related to family members, how to communicate, or if you’re a family member of a Marine back from Iraq or Afghanistan, give us a call with your questions or your comments. The number, 1-888-895-5727, that’s 1-888-895-KPBS. Well, Dawn, we’ve been hearing a lot lately about the psychological and personal difficulties that some returning Marines and GIs encounter when they come home after a deployment. Can you tell us some of the problems that you’ve seen in your counseling service?
HERRING: Sure, I’d be happy to. You know, deployments are stressful in and of themselves for anybody and when you add to that a service member returning and attempting to sort of get back to normal with his or her spouse, partner, and children, it just complicates things that much more. While they’ve been away, the spouses and the partners and the children have been doing their own thing and so often there is a transition period necessary to just reallocate, if you will, the responsibilities.
CAVANAUGH: Right. Indeed. And how does the stress of combat show itself after a service member comes home, after a Marine comes home? Is it – Not only have the roles changed but there’s been a lot of stuff that’s happened during that time and are there anger issues?
HERRING: Correct. You know, one of the things that I hear quite frequently is if the service member comes in requesting some counseling, he or she will say that they were often sent by their spouse.
HERRING: And they will say, you know, I feel like I’m doing okay but my spouse says I’m a little more grumpy and, you know, I have noticed that my sleep isn’t as it used to be. Maybe I’m more short tempered. So sometimes it’s as general as that but the spouse is expressing concern, and so they come in really on behalf of that partner to say, you know, I’m not sure but I’d like to get some help just in case. So sometimes it’s just a sleep disturbance and they’ll say some irritability. Yes, sometimes they’ll say they’re very quick to anger and they never used to be that way, or they don’t feel as patient with just a number of things, whether it’s their children or just fixing the car in the garage. They just feel more irritable, more grumpy, more agitated.
CAVANAUGH: So what services are available at Camp Pendleton when those Marines do come in, whether they’re sent by their spouses or not, and they say that they have maybe issues of anger or maybe some depression?
CAVANAUGH: What do you guys do for them?
HERRING: You know, there’s a entire continuum of services available. At the high end of the continuum, if somebody’s truly diagnosed with post-traumatic stress disorder, that’s a medical condition and we would certainly see them at counseling services to do a screening and refer them to medical. So to the extent that there may be a true medical diagnosis, we’re going to refer them to the appropriate medical provider. And to a lesser extent, as you mentioned, we have the combat stress and that is certainly treated in-house. We can do that treatment ourselves. In addition, there are a variety of services available to families, whether it’s a new parents program, you also mentioned, to provide just some skill building and support to these families as they make their transition.
CAVANAUGH: So it’s not just the service member, it is actually the entire family involved?
HERRING: Absolutely, because it’s a system that’s experiencing the change and the transition and we want to support that system to the best of our ability. And I could actually go for an hour and not stop just discussing all of the resources available. There are so many things available. The chaplains have programs available. They have weekend retreats for couples to assist in that transition. They have family retreats. We have military One Source that we use that is really an extension of the Marine Corps installation and they provide education as well as counseling to both the active duty person and the spouse, whether it’s in couples counseling or individual. So there’s a significant variety of things that are available to the families.
CAVANAUGH: I’m speaking with Dawn Herring. She is a counselor with Marine and Family Services at Camp Pendleton. And we’re inviting you to join the conversation with your questions and comments. 1-888-895-5727 is our number. Dawn, and yet with all of the counseling and all of the outreach available, I, in preparing for this conversation, there’s a report from the North County Times recently, excuse me, that the Marine Corps suicides are on a record pace this year. Now, it’s not necessarily at Camp Pendleton. We’re talking about the entire Marine Corps. But why do you – There seems to be a disconnect between the amount of outreach, excuse me, the Marine Corps is doing and the fact that the depression, attempted suicides and suicide rate is increasing.
HERRING: Yes, and, you know, that is a significant concern to all of us and something that, you know, we’re learning about every day. And the outreach, of course, you know, it is what it is and we’re doing the best we can with it but it is still difficult to touch everybody. And the Marine Corps is extremely concerned about that, and as are all branches, certainly, of the military. And we have in-house as well as an education team that heads out and does trainings on suicide awareness just to continually educate the Marine Corps about the red flags and the risk factors for suicide so that we can at least even address that on a more general level. And the Marine Corps has always had that but that’s even gotten stepped up now as we do see the increase in the suicides.
CAVANAUGH: Now, getting back to when a Marine perhaps is dealing with issues from coming home from Iraq or Afghanistan or whatever is happening in his or her life, when other people are observing that there may be a problem, can a commanding officer refer them to counseling services?
HERRING: Absolutely. And, you know, we have tremendous command support and that’s one of the things that I’ve been very pleased with is that the tone and the support of the commanding officers and, really, up and down the chain of command is wonderful. And I’ve had many people referred by various leaders in their command and I think that that tone makes such a difference in whether or not somebody will be brave enough to even ask for help.
CAVANAUGH: We are speaking about counseling services at Camp Pendleton. My guest is Dawn Herring. We’re taking your calls at 1-888-895-5727 and Ace is on the line in Mira Mesa. Good morning, Ace. Welcome to These Days.
ACE (Caller, Mira Mesa): Good morning. My question is – Well, first of all, my grandfather and my father both commented on people that they knew that were in World War II and Vietnam that came back and they were completely different people and it wasn’t for the better. Do you think that the stigma regarding mental illness and mental problems is stopping the military or holding the military back from aggressively pursuing treatment for these type of people? And do you think that mental illness is also looked upon as a sign of weakness within the military environment as well?
CAVANAUGH: Thank you for that – those questions, Ace. And, Dawn, what is the Marine stance on seeking treatment for mental problems?
HERRING: You know, I would say that it is so much better today than, certainly, it was 30 years ago. And it is – Certainly, are we going to find people who still view that as a sign of weakness? Absolutely. And you know what I tell people when they come in is, there’s no such thing as courage without fear. And so by the time they are seeking treatment that, in fact, takes courage to do and it is not a sign of weakness and it is certainly done in spite of any fear. Is there still a stigma? Of course. Of course there is, and that’ll be something that we continue to, hopefully, dispel with further education. But the Marine Corps, the overall tone and atmosphere of the Marine Corps, in my experience as a clinician, working here every day with these people, is that it is positive and it is supportive. And the stigma has decreased or we wouldn’t even have the programs we have today. And, you know, we now have forms of treatment that are so much more effective than we really even had 30 years ago. Our understanding is so much better of the trauma, of the combat stress, than it was 30 years ago, and that’s one reason why I’m so delighted to have the opportunity to serve these men and women.
CAVANAUGH: Now when we say stigma, do we mean just pure stigma? I mean, there’s a certain feeling among Marines that perhaps seeking services is not the most Marine type thing to do? Or are we talking about an actual stigma that would – in someone’s record that would hurt their ability for advancement within the Corps?
HERRING: I think it depends upon the individual. I think that both stigmas exist and you can add to that the layer of the stigma of just being a man asking for counseling. You know, that’s not socially something that historically and probably even currently on some level is really even encouraged. You know, you don’t go talk about your feelings with somebody; you suck it up and you deal. So while that is changing, you know, there are going to be multiple levels to that stigma and we have to acknowledge that in order to even move past it.
CAVANAUGH: Dawn, do you have a profile? I don’t even know if something like this exists but is there sort of a profile of a typical Marine who will come in seeking counseling? Maybe a certain age or deployment status?
HERRING: You know, no, only because we see people of all ages and all ranks with a number of different issues. So I would say, you know, the majority of our Marines are younger because that’s just our population.
HERRING: So that’s probably the only consistent variable or factor is that, you know, they do tend to be in their twenties, but not all of them, and married, and some with kids and some without. But barring that, I would say that then there’s a wide variety of issues that bring them to us.
CAVANAUGH: Do multiple deployments make it more likely a Marine will need help?
HERRING: Yes, I think so.
CAVANAUGH: Well, that’s a straightforward answer. Thank you for that.
CAVANAUGH: I’m speaking with Dawn Herring. She’s a counselor with Marine and Family Services at Camp Pendleton. Our number if you’d like to join the conversation is 1-888-895-5727. Let me ask a follow-up to that question and that is why? What kinds of problems do Marines who have had multiple deployments come in with?
HERRING: Umm. You know, sometimes a Marine can have or a sailor can have, you know, two or three deployments and they’ll say, you know, that first one was nothing and the second one was nothing but that third one really got me. So sometimes some deployments are going to be less stressful to them than others. And when you add onto that – Let’s say that each deployment is just seven months long. So if you add on to that just the amount of time they’ve been gone, if they’ve had three deployments, from a family, from children, from a spouse, when I do the math sometimes I reel from the amount of time these spouses have actually been away from their service member and I’m always amazed at how strong these marriages are in spite of that. But they do then end up having different challenges just with that significant time apart from one another.
CAVANAUGH: Can you tell us about maybe a few cases where your counseling and the counseling services have been able to make a difference for a Marine? Someone comes in with a problem and after going through treatment that problem is resolved.
HERRING: You know, I would be happy to and, in fact, you know, it’s difficult to speak to specifics because of confidentiality…
HERRING: …and their right to privacy but I had a Marine who sought treatment for his combat stress and he asked me afterward if he could write up, for whomever, in whatever capacity it would help, a brief letter detailing his experience with his treatment. And he went through a specific treatment that we refer to as EMDR and I can talk about that…
HERRING: …a little bit later if you’d like.
HERRING: But what I’d like to do is be able to just read to you parts of what he said in his letter because it was so profound. And I read this at a training at one point and people were in tears, I think, with just his honesty. So if you’d like that…
CAVANAUGH: Yes, please…
HERRING: …I could do a piece of that.
CAVANAUGH: Please do, Dawn, yes.
HERRING: Okay. And this also gives sort of a snapshot of, if there is a typical, what our typical client might look like coming for combat stress. And he wrote: My name is irrelevant. I am a 24-year-old husband, a father of two dogs, an older brother to 4 siblings, an uncle to 10 nieces and nephews, a brother and a best friend. It took me nine months and my wife leaving me to realize I had a problem. I tried to fight it all by myself. I figured I’d be all right. It would just take some time to adjust. But nine months of fighting is too long. Not only was my life irritating me, I couldn’t sleep. I would constantly have nightmares and flashbacks of Iraq. My attentiveness to everything that was going on around me made me unable to focus on my life with my wife. I was smoking more, losing my health, getting in fights. My level of reasoning had dropped and my brain was having trouble adjusting to the changes. My brother just told me to fight it. My wife just didn’t understand. So that’s one piece, and then he goes on and talks about his treatment and I’d be happy to read that part a bit.
CAVANAUGH: Okay. Yes, please.
HERRING: Okay. He says: I began EMDR and it only started with talking initially. I was a little apprehensive about opening up my personal issues to a complete stranger. My wife and I had gotten separated at this time. We figured that getting help for me was the only way to fix my marriage. I spent all my days at work and then came home to an empty house. I began focusing on my health, running, weights, eating right, not smoking so much. I began EMDR addressing the events in Iraq that brought the most damage to me. The stress of the convoys, the IEDs, the body bags, the stresses within the platoon, and the drama at home. Every time I dug within myself, I could feel the stress relief like lifting a weight off my body. Crying and sporadic breathing were common while feeling the pain rising out of me. Every day was a progression. More smiles, less cries, whiter eyes, and a new outlook on the way things affected me and how I chose to let them affect me. My temperament became better, more tolerating of stupid incidents that normally set me off. I can’t believe how much better I’ve gotten at handling life and I’m grateful for having been exposed to such a remarkable treatment. It saved me in more ways than one.
CAVANAUGH: Well, that’s quite a remarkable letter that you got from the Marine. It seems like the counseling turned his life around.
HERRING: Yes, and that is often what we hear from the service members who come in and receive some EMDR, is they will say that almost immediately, within one or two sessions of their EMDR that their sleep is at least returning to normal, and that’s a big problem for many of them. And then they will also say they’re less irritable.
CAVANAUGH: Let me stop you there. We’ve been using that term EMDR. This is a sort of a therapy, physical therapy for post-traumatic stress disorder. It’s eye movement. Tell us about it.
HERRING: Yes. EMDR stands for Eye Movement Desensitization Reprocessing. And I always tell people there won’t be a test, you don’t have to remember all that.
HERRING: You can find it on their website, which is just EMDR.com if they want more information. And it is an integrative psychotherapy approach and while it works for post-traumatic stress disorder, it also works for a number of other things including the combat stress that may not meet criteria for post-traumatic stress disorder. It works beautifully with anything that creates anxiety, irritability. And it is aimed at reprocessing what we call stuck memories and images in the brain, the idea being that sometimes certain things happen and they don’t quite get filed by the brain as most information does and EMDR assists the brain in really filing that, giving it its sense of history and, therefore, giving one a sense of distance from it. It takes the anxiety out of it. And what people will then report afterward is it never bugs them the same way again.
CAVANAUGH: That’s interesting. Let’s take a call right now. John is on the phone from San Diego. Good morning, John. Welcome to These Days.
JOHN (Caller, San Diego): Good morning. As a former submarine Navy person, I’ve worked with a lot of people that had mental health issues that never reported their issues due to the fact that they could’ve lost their security clearances due to not having a stable mental health background. And a lot of these issues, I think, were brought upon workload and what we were doing on the submarines.
JOHN: So is that an issue that the Marines are facing today then is it encouraged for them to report their mental health issues without risk of losing their security clearances?
HERRING: You know, I don’t want to speak to that 100%. First of all, I want to say I have some very close friends who are Navy submariners so that’s close to my heart. So, thank you.
HERRING: And, yes. Yes, I can say that, yes, in that people are now able to receive treatment still redeploy. And, you know, my guess is that it is going to depend upon, you know, what their MOS is, what their job is. What I often tell people when they come in to see me even just for screenings is, if you would like, if you feel more comfortable receiving some counseling off base, we’ve got referrals for that as well. Sometimes people just feel more comfortable getting their counseling off base.
CAVANAUGH: What would be the difference? Why would that make a difference to them?
HERRING: Well, it depends. Sometimes it doesn’t make a difference but sometimes just emotionally and in terms of their own safety disclosing, it is important for them to be able to be off base when they’re not having to be in uniform—not that they have to be in uniform here but often they are…
HERRING: …and it just – and they can see somebody on evenings or weekends. And so it just gives them a greater sense of, I think, privacy. Now the other thing is counseling services where I practice is not – because we don’t do medical fil – we don’t have medical files. We don’t do diagnoses. Sometimes people prefer to come to us because they know they will not have a medical file here and – whereas, if they’re truly in the mental health field, if they’re referred to a medical branch, then there’s going to be a medical file and that, to them, makes a difference. And so we try to be sensitive to that and assess whether or not that’s an issue for them so that we can give them as many referrals and resources as possible so that they can actually, you know, get the help they want.
HERRING: But I hear what he’s saying. It’s still a concern.
CAVANAUGH: Let’s take another call. Matt is calling from San Diego. Good morning, Matt. Welcome to These Days.
MATT (Caller, San Diego): Yes, hello?
CAVANAUGH: Yes, hi, Matt.
MATT: Hi. I just wanted to express that I’m actually a outreach coordinator. My name is Matthew Camp with Mental Health America San Diego County, and I’m actually a veterans’ and their families’ outreach coordinator. And I wanted to express how important it is for peer-to-peer outreach such as veterans outreaching to veterans because…
MATT: …we know where the person who is going through the problems is coming from. You know, so I just wanted to come on line and let you guys know that, you know, that how important that actually is whenever you’re dealing with a veteran who has post-traumatic stress disorder or is going through something else because we know what they’re – we know what they’ve been through.
MATT: You know, we’ve walked in their same shoes. And…
CAVANAUGH: Thank you. Matt, I have to stop you because we’re kind of running out of time and also because I think I understand the question. Is there any sort of like group counseling services that you have at the Marine Family and – and Services in Camp Pendleton?
HERRING: Yeah, actually here at Counseling Services we have a combat stress group and there are groups in various places and people are welcome to come in and visit us Monday through Friday. We have walk-in hours from one to four, Monday through Friday. And at that point, we talk with people about their needs and give them those kinds of resources. And I want to say to what Matt said, yes, you know, many of my referrals come from peers who’ve had treatment and found it to be useful, and I can’t really stress enough how important it is that they talk with one another and have had a good treatment experience so that they can then say, dude, I know this is difficult and you may not want to but, hey, it works.
CAVANAUGH: Exactly. Dawn I want to ask you just in closing, you know, you’re reading the same statistics that we all are about, as I say, the growing number of suicides and attempted suicides. Is there any movement at Camp Pendleton or in the Marine culture at all to maybe also increase outreach or do something a little bit different in response to what seems to be increasing stress put on our Marines?
HERRING: You know, yes, there certainly are the awareness of it and the conversations that are happening. And it is not my specialty, it is not the area in which I’m working now. I mean, we could certainly find more of those answers for you because I think that that is a crucial question and I know that the suicide rate has been staggering. So I would be happy to be able to get you more information on that and educate the community more on what is happening in terms of education and intervention with the suicide. And I think addressing that stigma is a big part of it and when people are fearful of losing their career, certainly they don’t ask for help and that can actually increase risk for suicide so it is so important that no matter what they get – what I call selfish enough to ask for the help.
CAVANAUGH: Well, I want to thank you. You’ve given us a lot of good information. Thank you, Dawn.
HERRING: Thank you so much, Maureen. I appreciate the time.
CAVANAUGH: I’ve been speaking with Dawn Herring. She is a counselor with Marine and Family Services at Camp Pendleton. If we couldn’t answer your question on the air, do post your comment online, KPBS.org/TheseDays. And stay with us because coming up we’ll talk about the growing problem of food insecurity. That’s next on These Days here on KPBS.