Trauma and the damage (un)done

Posted by admin@ramblingsontrauma on May 1, 2012 No comments

My grad school is running a piece about me in the upcoming edition of their magazine, the Flame. Here’s the link to a preview of the story, Trauma and the damage undone.

Trauma and the damage (un)done

This story will appear in the Summer 2012 edition of the Flame magazine.

School of Community and Global Health student Mark Dust knows about trauma first-hand. After serving four years in the US infantry, with one year in Iraq, he returned home with post-traumatic stress disorder. He is not only managing his affliction, but is working to help others manage—even prevent—theirs.

Dust was stationed in Baghdad, where he spent 12 hours a day manning the gun turret as his Humvee patrolled the city and its environs. For those 12 hours he was both hunter and hunted: on the lookout for enemy activity while he and his platoon simultaneously made themselves a prominent target for attack.

“You have to keep vehicles away from you, you can’t let people walk up to you, you literally have life and death in your hands,” he said. “And you never know what is going to happen. You can go a week, a month, two months, with no incidents. But then there will be a whole week where you’re shot at everyday.”

Not to mention blown up. One day while on patrol, an IED (improvised explosive device) was detonated by cell phone just as Dust’s truck was about to drive over it. Thankfully, the shell exploded a second too early, and Dust considers himself lucky to have only received a face full of hot oil and scratched corneas.

In 2006, he safely returned home to his family in California in one piece, though his years of service left a mental toll. Like approximately 30 percent of America’s Iraqi and Afghanistan War veterans, Dust returned with post-traumatic stress disorder (PTSD).

PTSD is an anxiety disorder caused by witnessing or experiencing a life-threatening traumatic event, which then overwhelms the victim’s ability to cope with everyday life.

In Baghdad, Dust’s hyper-vigilance was a necessity for a job where he could be killed at any moment—or might have to kill someone else. After returning home, turning off that heightened awareness proved impossible.

“One of the most troubling experiences I had when I first got back happened while I was driving my family to Disneyland,” he said. “I saw some trash on the side of the road and it looked very similar to the trash pile that was hiding the IED that blew me up in Iraq. And I responded just like I would have if I were in Baghdad. I stomped on the gas pedal and swerved to get out of the kill zone. I couldn’t comprehend that I was back in California.”

In the midst of Dust’s struggles to acclimate himself to civilian life, he enrolled in the Executive MBA program at CGU’s Peter F. Drucker and Masatoshi Ito Graduate School of Management. In Professor Jeremy Hunter’s “Executive Mind” class, Dust would be sure to seat himself where he could scan the entire room and check for any threats. But it was also in that room that he found relief from his condition.

Hunter’s “Executive Mind” courses are designed to teach executives how to better regulate their mind—through managing their central nervous systems—so that their decisions are based on facts, logic, and reason, and not on anger or stress. Dust found that those same mindfulness techniques Hunter taught his students also helped combat PTSD symptoms.

“When I started feeling dysregulated, coming into an unfamiliar situation or seeing trash on the side of the road, I learned to recognize my body’s physiological response faster and realize how to intercede to stop myself,” he said.

After receiving his EMBA, Dust learned about CGU’s School of Community and Global Health (SCGH) and realized continuing his studies there would perfectly compliment his new business skills.

“I know someone with a business degree doesn’t usually pursue a PhD in public health,” he said. “But I think it’s a unique combination that will help me look at the business aspects of research and how it can be best applied—not necessarily for profit, but for the most good.”

But Dust is not waiting to receive his degree to do good. Through Hunter, he was introduced to the Trauma Resource Institute (TRI) in Claremont, a nonprofit organization that helps people whose resiliency has been damaged by exposure to trauma. He joined the staff and is currently project manager on an extension to an innovation grant TRI received, from the San Bernardino County Department of Mental Health, to teach its Community Resiliency Model (CRM) to 30 war veterans and 20 of their family members.

CRM is a mind-body intervention that focuses on the biological basis of trauma and lists three steps for overcoming the rush of activation resulting from PTSD. Dust never takes off a silicone bracelet inscribed with CRM’s recipe: “Grounding + Resourcing + Shift & Stay = Resilience.” Those steps lead the sufferer away from anxiety and towards increased physical awareness and positivity that, if maintained, can bring the parts of the brain affected by PTSD back under control.

Dust has also been trained in TRI’s Trauma Resiliency Model (TRM), which is designed for use by therapists to treat PTSD. While TRM has shown to be effective in treating those with PTSD, Dust is also interested in seeing if it also helps prevent people from developing the affliction. Both the mindfulness techniques Dust learned in Hunter’s class and those in TRM exercise the body’s parasympathetic nervous system (PNS). It is the PNS that can bring the fight-or-flight response associated with PTSD under control. And maybe exercising the PNS before experiencing trauma will create a resistance to acquiring PTSD symptoms in the future.

“You do bicep curls to make your arms strong, maybe we can do exercises to make your nervous system strong. That’s what I came into the PhD program to do, to experiment with the idea of strengthening the parasympathetic nervous system to see if it has an effect on preventing the development of PTSD,” Dust said.

If Dust is able to demonstrate that PNS can be strengthened—and he has already designed experiments—he thinks it could be a breakthrough with almost limitless potential. This is because PTSD doesn’t just affect war veterans, but millions in the civilian population who have experienced traumatic events.

“I need to prove that prevention will work, and based on my experiences I think it will. If it does, we could give this training to soldiers in basic training or in the work up before they enter a war zone,” Dust said. “But this could be useful for anyone. Just imagine if we worked on building a resilient society. There would be less alcoholism, less drug abuse, less suicides—all of which are often the result of undiagnosed PTSD.”

More information on Dust’s experience with PTSD, and his efforts to combat and prevent it in others, can be found on his blog, Ramblings on Trauma: www.ramblingsontrauma.com.

Service branches need to improve mental health screening techniques, local veterans say

Service branches need to improve mental health screening techniques, local veterans say

Jim Steinberg, Staff Writer

Posted: 03/12/2012 08:15:43 PM PDT

Afghan soldiers, left, walk past a U.S. Army soldier outside of a military base in Panjwai, Kandahar province south of Kabul, Afghanistan on Sunday. (The Associated Press)

SAN BERNARDINO – The details have not yet emerged, but area veterans say an Army staff sergeant’s alleged rampage that killed 16 Afghan villagers as they slept pointed to the need for better mental health evaluations of combat troops.”Better screening is needed, especially of soldiers who have had multiple combat tours,” said Richard Valdez, commander of Disabled American Veterans San Bernardino chapter.

On Monday, the 38-year-old suspect, a father of two who has been in the military for 11 years, with three tours in Iraq, was being held in pretrial confinement in Kandahar by the U.S. military as Army officials reviews his deployment record and medical history. His name had not been released.

But observers who have seen combat were already focusing on the emotional health of troops within an American military that has endured a decade of war in Iraq and Afghanistan.

And that health – or the lack of it – has tragic consequences abroad and at home, they said.

Although the understanding of Post Traumatic Stress Disorder has improved dramatically since his service with the Marines in Vietnam, the armed forces still need to look deeper into the experiences a veteran encounters in war, Valdez said.

They are encounters like Mark Dust’s.

Dust, who served four years in the U.S infantry, with a year in Iraq, returned home with strong memories of how every day, for 12 hours a day as his Humvee patrolled Baghdad, he was both a hunter and among the hunted.

It’s the uncertainty of it, he said, never knowing what’s going to happen.

He still remembers upon his return, driving his family to Disneyland. He saw some trash on the side of the road that looked very similar to the trash pile he saw back in Iraq that was hiding an improvised explosive device (IED).

Just like he responded in Iraq, he stomped on the gas pedal and swerve to get away from the “kill zone.”

Part of the problem is a culture that still frowns on those who have PTSD.

Dust, a San Bernardino resident who is focusing on PTSD for his doctorate at Claremont Graduate University, said that combat veterans know how to respond to questionnaires seeking to pinpoint signs of mental stress.

In that culture, there’s a stigma for having PTSD or other mental health problems. Soldiers know how to answer questions to avoid seeming to appear weak, he said.

“Until that (the stigma) is taken care of, I don’t know how they are going to get the right screening questions,” said Dust, who runs a blog calledramblingsontrauma.com.

Dust would not have told Army officials he had symptoms of PTSD until he learned he was going to be medically discharged for foot injuries, he said.

While American foreign policy experts note that the shooting spree comes at a time of already strained relations between the U.S. and Afghanistan following the burning of Qurans, Valdez said that the Afghani fury in reaction to that event (the Quran burning) might have contributed to the sergeant’s actions.

Both men said that the fact that the sergeant’s alleged rampage was directed at women and children is not surprising.

In his first tour of Afghanistan, after three combat tours in Iraq, this sergeant likely had some significant physiological and psychological problems, Dust said.

In the combat environment it is easy to disassociate people as being human beings. Whenever someone falls into the classification of “enemy,” age and gender don’t matter.

That disassociation occurred in South Vietnamese village of My Lai, where U.S. army forces massacred more than 300 in 1968.

Most of the victims were women, children and elderly.

Prior to the massacre, soldiers were often attacked by snipers after they left the friendly people of My Lai – who never warned them of the snipers they surely knew about, Valdez said.

That was the trigger that resulted in a coordinated, group massacre.

Valdez, who had a relative serving with the unit that attacked My Lai, said there may have also been a trigger in the Afghani villages that tipped the sergeant over the edge for his alleged attack.

Or it might have been the general rise in hostilities toward Americans after the Quran burning incident that set him off, Valdez said.

Both Dust and Valdez also speculated that the sergeant’s breaking point might have been triggered by a flashback – a classic symptom of PTSD – to something that happened during one of his tours in Iraq.

The Associated Press contributed to this report.