Counseling in Chicago with Bill Martin, LCSW

WAR’s PSYCHIC TOLL
By BOB HERBERT
Published: May 18, 2009 - N.Y.Times

I couldn´t have been less surprised to read last week that an American G.I. had been charged with gunning down five of his fellow service members in Iraq. The fact that this occurred at a mental health counseling center in the war zone just served to add an extra layer of poignancy and a chilling ironic element to the fundamental tragedy.

The psychic toll of this foolish and apparently endless war has been profound since day one. And the nation´s willful denial of that toll has been just as profound.

According to authorities, John Russell, a 44-year-old Army sergeant who had been recognized as deeply troubled and was on his third tour in Iraq, went into the counseling center on the afternoon of May 11 and opened fire - killing an Army officer, a Navy officer and three enlisted soldiers. The three enlistees were 19, 20 and 25 years old.

This is what happens in wars. Wars are about killing, and once the killing is unleashed it takes many, many forms. Which is why it´s so sick to fight unnecessary wars, and so immoral to send other people´s children off to wars - psychic as well as physical - from which one´s own children are carefully protected.

The fallout from the psychic stress of the wars in Iraq and Afghanistan has been vast, but there was no reason for its destructive effects to have surprised anyone. There was plenty of evidence that this would be an enormous problem. Speaking of Iraq back in 2004, Dr. Stephen C. Joseph, who had been an assistant secretary of defense during the Clinton administration, said, “I have a very strong sense that the mental health consequences are going to be the medical story of this war.”

I remember writing a column about Jeffrey Lucey, a 23-year-old Marine who was deeply depressed and suffering from post-traumatic stress disorder, or P.T.S.D., when he returned from Iraq after serving in the earliest months of the war. He described gruesome events that he had encountered and was harshly critical of himself. He drank to excess, had nightmares, withdrew from friends and wrecked the family car.

On the afternoon of June 22, 2004, he wrote a note that said, “It´s 4:35 p.m. and I am near completing my death.” He then hanged himself with a garden hose in the basement of his parents´ home.

Because we have chosen not to share the sacrifices of the wars in Iraq and Afghanistan, the terrible burden of these conflicts is being shouldered by an obscenely small portion of the population. Since this warrior class is so small, the same troops have to be sent into the war zones for tour after harrowing tour.

As the tours mount up, so do the mental health problems. Combat is crazy-making to start with. Multiple tours are recipes for complete meltdowns.

As the RAND Corporation reported in a study released last year:

“Not only is a higher proportion of the armed forces being deployed, but deployments have been longer, redeployment to combat has been common, and breaks between deployments have been infrequent.”

Recent attempts by the military to deal with some of the most egregious aspects of its deployment policies have amounted to much too little, much too late. The RAND study found that approximately 300,000 men and women who had served in Iraq and Afghanistan were already suffering from P.T.S.D. or major depression. That´s nearly one in every five returning veterans.

The mass-produced tragedies of war go far beyond combat deaths. Behind the abstract wall of RAND´s statistics is the immense real-life suffering of very real people. The toll includes the victims of violence and drunkenness and broken homes and suicides. Most of the stories never make their way into print. The public that professes such admiration and support for our fighting men and women are not interested.

Other studies have paralleled RAND´s in spotlighting the psychic toll of these wars. A CBS News survey found that veterans aged 20 to 24 were two to four times as likely to commit suicide as nonveterans the same age. A Time magazine cover story last year disclosed that “for the first time in history, a sizable and growing number of U.S. combat troops are taking daily doses of antidepressants to calm nerves strained by repeated and lengthy tours in Iraq and Afghanistan.”

We´re brutally and cold-bloodedly sacrificing the psychological well-being of these men and women, which should be a scandal. If these wars are so important to our national security, we should all be engaging in some form of serious sacrifice, and many more of us should be serving.

But the country soothes its conscience and tamps down its guilt with the cowardly invocation: “Oh, they´re volunteers. They knew what they were getting into.”

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Telephone/email therapy and other types of non-office communication with clients raises many ethical and legal questions.

The questions include:

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There are many psychologists and other behavioral health professionals concerned about the use of torture by the United States during the last decade. For a 10 minute video by Roy Eidelson, PhD., President-Elect, Psychologists for Social Responsibility, summarizing these concerns, click here.

To see my interview on narcissism on Fox32 TV, click here.

Lefever here tells us that he, a member of the task force was “officially requested” by a military official and was officially sanctioned by the Navy. This puts the lie to any claim that APA leaders selected the task force. Rather, they merely ratified choices “officially requested” by military officials. They thus surrendered the association’s ethics decision-making to the military.

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(This the second part of the Soldz article on psychologist involvement in torture and contains the open letter written by Bryce Lefevre, a military psychologist, to his colleagues who criticized him for his radio interview on National Public Radio.)

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by Stephen Soldz

Stephen Soldz is psychoanalyst, psychologist, public health researcher, and faculty member at the Boston Graduate School of Psychoanalysis. He is co-founder of the Coalition for an Ethical Psychology(I am reprinting this 3 post article on the role of psychologists in the use of torture with permission from Stephen Soldz.)
The recently public posting on the Propublica web site of the listserv from the American Psychological Association’s secretive 2005 PENS [Psychological Ethics and National Security] task force has again focused attention on the nature of this task force and on potential collusion between the APA and the Pentagon to provide “ethical” cover for psychologists aiding Bush administration interrogations at Guantanamo, the CIA’s “black sites,” and  in in Iraq and Afghanistan.

One piece of evidence supporting a claim of collusion is that, in a highly unusual step, the task force membership was kept confidential from both the APA membership and the press and public. Salon reporter Mark Benjamin had to go to Congressional sources to get the names a year later, though it turned out that they had been available on an obscure website, if one had known to look there. APA members learned from Benjamin that a majority of members were from the military-intelligence establishment. Five of these members had aided Bush-era interrogations, with four from chains of command accused of abuses; among other ethical problems with the task force composition, these members were giving themselves get-out-of-jail-free cards by pronouncing these interrogations “ethical.”

Not long after the listserv release psychologist and PENS member Bryce Lefever was featured on NPR’s All Things Considered, defending CIA torture psychologists Mitchell and Jessen and the reverse-engineering of the military’s Survival, Evasion, Resistance, and Escape [SERE] techniques. Lefever revealed in that interview that he saw no ethical problems with Bush administration interrogation tactics, based as they were on the techniques used on US service members in the SERE school where Lefever had served as a psychologist monitoring trainees for possible harm.

The Lefever NPR interview created quite a stir among psychologists, including members of the APA’s Council of Representatives, as it revealed the questionable ethical reasoning of those chosen to form policy for the APA in this critical area. Reportedly, a major figure in the APA military psychology division wrote a letter distancing the division from Lefever’s extreme views, as depicted on NPR. In response to the criticism, Lefever has issued an Open Letter to military psychologists in which he taken exception to this criticism, and to the NPR interview, claiming major distortions of his views by NPR. In addition to clarifying and defending his views, in this Open Letter Lefever incidentally provides additional evidence of APA-Pentagon collusion in forming the PENS task force.

Before examining his Open Letter, it is useful to understand that this NPR interview was not the first time Lefever made the arguments supporting US interrogation tactics. In an article on the NPR interview, I quoted material from the PENS listserv indicating that he made many of the same arguments to the task force, and was largely ignored, but met with no objection from other members. Further, in August 2007, Lefever defended the SERE-based abuse [torture] of Jose Padilla to a Christian Science Monitor reporter:

” ‘There’s something to be said for sending the message that the gloves are coming off,’ says Capt. Bryce Lefever, a Navy psychologist and former SERE school instructor. ‘You don’t take a knife to a gunfight.’

Captain Lefever says it is unfair to compare US antiterror interrogations with Soviet interrogation techniques. ‘Their abuse was a systematic practice to conceal the truth,’ he says. ‘If Padilla was abused, then it was for a righteous purpose – to reveal the truth.’

Lefever opposes the use of torture because in most instances it is ineffective. But sometimes, harsh and brutal tactics can produce results, he adds. The key is that interrogators must be careful in their questions not to telegraph an agenda to the subject, because if the technique is coercive enough, the subject will say anything to make it stop.’ “

When I do an initial assessment, I ask many questions about family history. Although it is always an ongoing process, after a few sessions, I will usually understand how long parents were married, any divorces or major illnesses, parenting styles, length and quality of clients relationships, educational and career history, and importantly any experience of abuse and/or neglect. Why is this important?

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