Bob Reiter, Director of Veterans Services for Rensselaer County, was a helicopter door gunner during two tours in Vietnam, and served on active duty in the Marine Corps and the Armed Forces Police from 1960 to 1968. He had never talked about his military service, not even with his wife and children. But last September Reiter traveled from his office in Troy to Wheaton, Illinois, to address a gathering of veterans who had served in wars past and present. The gathering was a three-day Soldier’s Heart Healing Workshop for combat veterans suffering from post-traumatic stress disorder (PTSD). Filling out this 65-member gathering were mental health care providers, social workers, nurses, and vets’ family members.
Reiter knows what PTSD looks like and he knows that there is no statute of limitations on the number of years a vet’s pain can be buried deep before it unexpectedly erupts. This was the case when he shared his story in a segment of the workshop where other vets did likewise. Surrounded by so many others who carried similar burdens, Reiter found his nearly 40 years of bottled-up terror and grief suddenly beginning to flow. Through tears, he described the fear that engulfed him when his helicopter was shot down by enemy fire. “We were in firefights every day. We got shot at every single day,” said Reiter, as if in disbelief. Two other Vietnam vets in the group embraced Reiter while he sobbed.
The workshop’s leader was Dr. Ed Tick, a clinical psychotherapist with extensive experience treating veterans. Tick describes PTSD as “frozen war consciousness,” a psychological reaction to warfare that causes survivors to repeatedly replay the trauma, sometimes months and even years later. In 1980 the American Psychiatric Association (APA) added PTSD to its manual of diagnosis, in response to the flood of Vietnam vets seeking treatment for a host of physical and psychological symptoms.
While the APA categorizes PTSD as an “anxiety disorder,” those who work closely with vets know that the symptoms are much broader, encompassing physical, emotional, psychological, spiritual, and social dimensions. Hypervigilance, depression, anxiety, spousal abuse, sleeplessness, drug and alcohol addictions, and suicide attempts are familiar symptoms of PTSD sufferers. In his highly acclaimed book War and the Soul, Tick describes PTSD, first and foremost, as a spiritual disorder, a “soul wound.”
Tick began his psychotherapy practice in the 1970s, when, many of his first patients were combat veterans who had served in Vietnam. Now Tick encourages vets to tell their stories “in a safe and sacred space,” as he calls it, like that created during the experiential workshop that Reiter attended. There, vets’ family members, chaplains, social workers, and mental health care providers literally formed a circle around the veterans. “As witnesses, they share in carrying the burden of the warrior,” Tick explains. In another segment of the workshop, Reiter was among a roster of speakers—all veterans—who spoke to the numerous implications of PTSD and its prevalence among combat veterans.
Barriers to care
The Veterans Administration’s National Center for PTSD estimates that 30 percent of people who spend time in a war zone will develop PTSD. Many of them don’t get help for it. A 2004 study of Army and Marine troops returning from Iraq and Afghanistan, published in the New England Journal of Medicine, found that only 23 to 40 percent of those with PTSD sought treatment.
Reiter understands, first hand, that many factors contribute to these disturbing and, in his opinion, grossly underreported statistics. He names stigma within the military, fear of job loss, and a severe shortage of VA services as barriers to care. He believes that a frighteningly large proportion of servicemen and women returning from Iraq and Afghanistan who exhibit symptoms of PTSD will never be diagnosed, let alone provided with the necessary treatment. What’s more, in Reiter’s experience, it can take up to 120 days to get treatment for PTSD through the VA once a diagnosis has been made. “If you’re suicidal, this isn’t going to help you much,” he says.
Troy is headquarters for New York’s 42nd Infantry “Rainbow” Division of the Army National Guard, and for Reiter this place reflects the reality of cities and rural towns across the country. “The biggest problem in getting treatment for PTSD is getting the vet to admit they have a problem,” he says. Yet another disturbing aspect of the problem, according to Reiter, is a new VA rule stating that National Guard and Reserve service members must serve two years active duty before they are eligible for VA health care coverage over the two years following their service. “It’s criminal,” he says. “There should be no cap on this. Lots of times, PTSD doesn’t show up or isn’t reported until after that point.”