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Measuring the psychic pain of war

posted Wednesday, 30 August 2006

[T]here is an even more pressing matter facing the Department of Veterans Affairs: preventing the development of long-term impairment in acutely disturbed veterans who seek care. I am referring specifically to the kind of chronic dysfunction that can be caused, paradoxically, by psychiatric treatment itself. I speak from my experience as a psychiatrist at the West Haven Veterans Affairs Medical Center in Connecticut from 1988 to 1992, a time of blossoming interest in PTSD within both the VA and the mental-health establishment. Good intentions were abundant, but, in retrospect, much of our treatment philosophy was misguided. For example, we spent too much time urging veterans to relive their war experiences in group therapy, individual therapy, and art therapy. Groups of 16 veterans were admitted to the hospital and stayed together, platoonlike, for four months. This practice took them out of their communities and away from their families. I remember some of the men coming back from a day pass with new war-themed tattoos and combat fatigues. Not exactly readjustment! Instead of enabling regression, we should have emphasized resolution of everyday problems in living, such as family chaos, employment difficulties, and substance abuse.

The good news is that most of these inpatient programs are now shuttered.

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© 2006 Washington Post. Newsweek Interactive Co. LLC

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