Markham's Behavioral Health

Suicidal soliders is not so much a mental health problem as a spiritual crisis

Reading about the increased incidence of sucides in the military and the huge numbers of soldiers with PTSD has gotten me interested in something which very few people in American society talk about and that is what Dr. Rachel MacNair calls "Perpetration-Induced Traumatic Stress", PITS.

PITS is the anguish and guilt which one human being feels when he/she kills another human being. This has been increasinly labeled as a mental health problem which it surely is, but even more, it is a spiritual problem in my view. All the mental health treatment in the world, and all the medications cannot absolve the guilt induced by the willful, deliberate killing of another human being.

There is a good article that attempts to describe this problem which was published in the Seattle Times 4 years ago on July 21, 2004. Here is a snippet:

Tucked behind a gleaming machine gun, Sgt. Joseph Hall grins at his two companions in the Humvee.

"I want to know if I killed that guy yesterday," Hall says. "I saw blood spurt from his leg, but I want to be sure I killed him."

The vehicle goes silent as the driver, Spc. Joshua Dubois, swerves around asphalt previously uprooted by a blast.

"I'm confused about how I should feel about killing," says Dubois, who has a toddler back home. "The first time I shot someone, it was the most exhilarating thing I'd ever felt."

Dubois turns back to the road. "We talk about killing all the time," he says. "I never used to talk this way. I'm not proud of it, but it's like I can't stop. I'm worried what I will be like when I get home."

The men aren't Special Forces soldiers. They're troops with the Army's 2nd Armored Cavalry Regiment serving their 14th month in Iraq, much of it in daily battles. In 20 minutes, they will come under attack again.

Many soldiers and Army psychiatrists say these constant conversations about death help troops come to grips with the trauma of combat. But mental-health professionals within and outside the military point to the chatter as evidence of preventable anguish.

It is very difficult for us as a nation to face up to the immoral and illegal war which we have perpetrated and are paying for which was based on lies and deceit by our government, let alone for our soldiers who have actually killed other human beings, civilians, women, children, for reasons that are not clear at behest of psychopathic and irresponsible leaders. What does this killing do to a person's soul other than lead to anguish, revulsion, self-recrimination, and too often self destruction in one form or another.

Families of these suffering souls have wanted to be proud of their relative's service and to believe it was for a good cause, but the truth does not match the delusion. The inability of people back home to "understand", let alone accept, the truth, leaves the suffering soldier even more isolated and tormented.

What is the answer to the spiritual suffering? The truth and repentence. Will McCain or Obama lead us there? I doubt it very much unless we as a country are willing to face our demons and admit that what has been done in our name is wrong. Witnessing the suicides and PTSD of our returning soldiers fortunately or unfortunately won't let us ignore or forget the heinous acts they have been asked and compelled to do in our name. The guilt belongs to us all not just to the perpetrators, but they are the more active participants while we just watch, cheer them on, and lie to them telling them they are doing grand, honroable, and glorious things when deep in their souls they know better.

I intend to write more on this topic so I am adding a new category to my blog today called Perpetration induced stress.

Nation & World | Soldiers trained to kill, not to cope | Seattle Times Newspaper.

 

Suicide of troops only one symptom of National spiritual dysfunction in the U.S.A.

I passed a car this morning that had a yellow ribbon on it which said "Support The Troops", and a decal on it which said, "Thank them for their service protecting our country." And I wondered to myself how do you thank people who are engaged in immoral and illegal activity of waging a pre-emptive war for a corrupt government than has waged war based on lies?

The Nurmeburg trials after World War II developed the principle that "just following orders" does not absolve a person from legal and moral guilt. The fact is that many of our troops are engaged in illegal and immoral activities, activities which they cannot justify to themselves or to others and so when they return home "from duty", from engaging in these activities they are killing themselves in greater and greater numbers.

Our chauvanistic and patriotic jingoism does not help these soldiers at all because they know what they did, and they are not proud, and they cannot say anything when they are being falsely adulated, and continued to be lied to that they have done brave and noble things.

What our soldiers and our country needs more than anything is the truth, because it is the truth that sets people free not lies in spite of what the current administration tells us.

When American soldiers choose suicide over life back in the U.S.A. that should tell us something. They know something we don't know and that is that our spirit is seriously broken and corrupted as a nation.

Truth, honesty, repentence, forgiveness, exoneration, reconciliation are badly needed in our national soul and the prophetic leadership is sadly lacking. Until it emerges our returning troops will continue to suffer and kill themselves.

It is a mistake to view the suicide and psychiatric crises in our returning veterans as mental health problems alone. At the core they are spiritual problems, and Americans as a whole share a spiritual responsibility for the state of our nation's soul. The suicide of our soldiers is only one symptom of serious spiritual dysfunction of our country.

James Jenkins was a Marine who served two rotations in Iraq. He became increasingly agitated and dispairing over the 212 people he states he killed and he told his mother he didn't understand why he was there. It seems that a very promising, bright, hard working, intelligent young man joined the service "for college money" and "to serve his country" only to find out that the "service" involved unspeakable activities that he would rather kill himself for than have to live with. It is a very sad commentary on how the current administration and our country has exploited its youth and their potential for very dishonorable , deceiftul, and destructive policies.

The blood of James Jenkins, the 212 people he killed, and the thousands and millions who have suffered because of this tragic policy falls on George Bush and his ilk and all the idiots in this country who voted for them.

Video lasts 7: 16

Pennsylvania Injuries Rise After Repeal of Helmet Law

I have argued this point with various people over the last few years that motorcyle helmets and bicycle helmets save lives and traumatic brain injuries. Only 20 states require motorcyle helmets, New York where I live, being one of them. Two years ago, Pennsylvania stupidly rescinded its helmet law and guess what? Right. Head injuries and deaths have gone up dramatically. Here is a snippet from the June 11, 2008 Reuters HealthDay article based on an article which will appear in the August issue of the American Journal of Public Health:

In the two years after Pennsylvania repealed its universal motorcycle helmet law, there was a 32 percent increase in motorcyclist head injury deaths and a 42 percent increase in head injury-related hospitalizations, a University of Pittsburgh study says.

The state's universal helmet law was repealed in 2003. Currently, only riders under age 21 and those with less than two years' experience who haven't taken a safety course are required to wear helmets.

The researchers analyzed data from the state's health and transportation departments for the years 2001-02 and 2004-05 and found helmet use by motorcyclists involved in reported crashes decreased from 82 percent to 58 percent in the two years after the helmet law was repealed.

While the head injury death rate increased by 32 percent, there was no increase in the non-head injury death rate.

Along with the 42 percent increase in head injury-related hospitalizations after the repeal of the helmet law, there was an 87 percent increase in the number of head-injured, hospitalized motorcyclists who required further care at facilities specializing in rehabilitation and long-term care.

Total acute care hospital charges for motorcycle-related head injuries increased 132 percent in the two years after repeal of the law, the study found.

I was talking to a young 16 year old client of mine who is a true libertarian and who advocates for goverment to stay out of people's lives and let people to do as many stupid things as they like such as drink alcohol, drug, have promiscuous sex, ride motorcyles helmet free, etc. His point is that it would be an exercise in social darwinism, that is, the stupid will die young and not reproduce. In a way I think he has a point. It could be that New Yorkers are a little smarter when it comes to public health than Pennsylvanians. Certainly our auto insurance and health insurance companies prosper while Pennsylvanian insurance companies are paying the price of stupidity as well as individuals and their families.

MedlinePlus: Pennsylvania Injuries Rise After Repeal of Helmet Law.

Psychologists engage in torture and war crimes

On Friday, July 18, 2008, Amy Goodman, host of Democracy Now, interviewed Jane Mayer, the author of the new book, The Dark Side, about the role that psychologists, and the APA played in torturing prisoners in the so-called "War On Terror".

It seems that America has lost its way under the Bush administration and has engaged in war crimes. Americans have lost their ideals under this administration as they have watched their leaders justify and engage in policies and behaviors that  disregard human rights, dignity, and justice.

It seems ironic that a President who engaged in illicit sex in the White House is impeached, while a President who is an international war criminal is ignored. What has happened to the American people?

Amy Goodman's interview is well worth listening to or watching. You can do so by clicking on the link below which will take you to the show on the Democracy Now web site.

Here is part of the interview. It lasts 8:29

Democracy Now! | July 18, 2008.

Excessive texting is a tell tale sign of infidelity

There was a brief article in the Telegraph, a newspaper in the United Kingdom, on 06/25/08 about how excessive text messaging can be a sign of infidelity. Here is part of what the article says:

Excessive texting and emailing is now the number one sign of infidelity, a leading law firm has said.

Family lawyers said an addiction to text messages or emails has replaced "working late" at the office as the main tell tale signs of an extra-marital affair.

Andrew Newbury, partner at specialist law firm Pannone said: "We see the same features in so many of the marital disputes that we deal with.

In the last 3 months I have had 5 couples where the spouse is objecting to the number and type of text messages being sent by his/her spouse. In one case, the wife objected that her spouse had sent 6,000 text messages to a female co-worker the preceding month. The husband claimed it was merely a friendship with a co-worker and there was nothing romantic going on.

Last night, I saw an upset husband who stated that his wife is getting all kinds of text messages from male co-workers at all times of the day and on weekends and when he asked what was going on, his wife became very defensive and denied any wrong doing. She was further defensive when he called the cell phone company wanting the phone records.

I have several other cases now where text messaging and setting up of accounts on MySpace has concerned spouses that their spouse is engaging in behavior that could lead to infidelity. In my experience, sometimes this has happened. In one case and unhappy wife of 26 years, left her husband to meet some man she had been corresponding with on the Internet who lived in another state. The wife knew nothing about this person other than from the emails.

It is interesting to learn how the new technology is being used in human relationships. Often the concern is for children and protecting them from predators and other questionable activities like taking and circulating nude photos of themselves (which I had one 13 year old client do). And yet, it seems that adults are getting into just as much, if not more, trouble.

Like any new technology, the technology itself is value free - in and of itself is amoral, but the use to which humans put it often raises all kinds of moral issues. With technology like text messaging, we are only being to learn how this new form of communication will affect human relationships.

Excessive texting is a tell tale sign of infidelity - Telegraph.

Praying for clients?

Continuing with the discussion of spirituality in therapy I was struck by Lorraine Wright's statement that she sometimes prays for her clients. Here is part of what she writes in her article, “Spirituality, Suffering, and Beliefs”,

“ Over the past few years, I have on occasion, independently adopted Dossey’s (1993) practice of praying for, although not with, clients and families with whom I work. As Dossey (1993) suggested, if a health professional believes that prayer works, not to use it is analogous to withholding a potent medication or surgical procedure: ‘Both prayer and belief are nonlocal manifestations of consciousness, because both can operate at a distance, sometimes outside the patient’s awareness. Both affirm that, “it’s not all physical”, and both can be used adjunctively with other forms of therapy.” (p.141) In praying for our clients, we perhaps also heighten our connection with them and our investment in their recovery and well-being.”

P. 64 in Spiritual Resources In Family Therapy edited by Froma Walsh

In further research, Dossey's claims have not been affirmed and it appears that there is no physical benefit to praying for someone who does not know they are being prayed for.

However, I wonder if praying for clients detracts from the psychotherapy? Is this a counter transference issue that would enhance the therapeutic alliance or interfere with it in some ways? If you had a student or supervisee who told you in clinical supervision that he/she was praying for his clients without the client's knowledge how would you handle it? Supposing it was with the client's knowledge?

Is praying for clients something that should be encouraged or discouraged? 

I, myself, sometimes pray for my clients and if wishing them well is considered praying, I pray for them all. I think that whether a therapist or a health care provider prays for clients would depend on the therapist's beliefs and spiritual practices. Certainly, clients pay a health care professional for a professional service and not for prayer, but I think that most clients would want their therapist to wish them well and care about their lives and the outcome of the therapy and not just be in it for the money.

Unfortunately, health care has turned into a business. It has become a commercial enterprise and is no longer a human service or a ministry in the broad sense of the word. I do not run my practice only as a business enterprise. I want to be of service to my clients and my community and take a number of clients pro bono and at reduced fees. I could make more money if I only served the more affluent who could pay me full fee, but that is not why I became a therapist and that is not what I believe God has called me to do with my professional skills.

Perhaps it is this desire to serve that is a prayer in and of itself.

Happiness more or less constant over the course of life

An interesting study done in Germany and reported on the BBC found that happiness is more or less constant over the course of a person's life. Here is a snippet from the article:

Momentous events in your life such as having children, or getting married, may make you happier, but only temporarily, say researchers.

Our basic happiness level essentially stays the same throughout adult life, the Economic Journal reports.

Economists from the UK, US and France based their conclusions on a 20-year analysis of the life satisfaction of hundreds of people from Germany.

Even after traumatic events, overall mood dipped but then recovered.

BBC NEWS | Health | Happiness 'immune to life events'.

Pharmaceutical companies disease monger to detriment of society

Catherine Arnst had an interesting article published in the May 8, 2006 issue of Business Week entitled "Hey, You Don't Look So Good: As Diagnoses Of Once-Rare Illnesses Soar, Doctors Say Drugmakers Are 'Disease Mongering' To Boost Sales".

Here is a snippet from the article:

Click on article to enlage for easier reading.

 

Psychotherapy involves a sense of reverence

Lorraine Wright in her article, Spirituality, Suffering, and Beliefs writes about an incident that occurred when she was being observed working with a family behind a one way mirror. A team member who was observing said to Lorraine that

"...what he believed to be the most powerful aspect of my clinical work with families: the notion of 'reverencing' that occurred between families/clients and myself. In those moments of reverencing, there is a profound awe and respect for the individuals seated in front of you. It is not a linear phenomenon in these moments. I feel that same reverencing from family members being given back to me. In those moments of reverencing in clinical work something very special happens between the therapist and the family; it is something felt by all - a deep emotional connection. I know and have felt these moments in therapy, both in the therapy room and from behind the one-way mirror as a supervisor or team member."

Spiritual Resources in Family Therapy edited by Froma Walsh, p. 63

I am reminded of Jesus' statement that where two or three are gathered in my name, there I will be. There is something about psychotherapy that can be sacred not in a religious sense but in a spiritual sense.

Psychotherapy is a trust between the therapist and the client(s) where the psychotherapist is duty bound to put the clients needs ahead of his/her own. The psychotherapist is ethically bound to use his/her personality in a purposeful way to help the client get the clients' needs met. There is a deep listening that is empathically profound and an attentiveness that goes way beyond the ordinary. It is the conscientious attentiveness on the part of the therapist that makes psychotherapy hard work in the sense that it takes discipline to set aside one's own narcissistic preferences and desires in service of another. This "being there" for another is what begins to make the rapport sacred and the quality of reverencing begins to emerge.

Discussing clients spiritual beliefs as part of therapy

I have been reading Spiritual Resources In Family Therapy edited by Froma Walsh and there is an article in the book by Lorraine Wright entitled, "Spirituality, Suffering, and Beliefs: The Soul Of Healing With Families."

 

Lorraine describes herself as a family therapist/nurse educator who works predominantly with families experiencing illness. She says some interesting things like:

 

The influence of family members’ spiritual and religious beliefs on their illness experiences has been one of the most neglected areas in family work.” P. 62

 

I wonder why that would be? What is the fear or the constraining beliefs that therapists have that would make it nonconductive to discussing clients' spiritual beliefs as part of the therapy?

 

Part of the contraints probably have to do with the split between the secular and the sacred, between science and religion, between evidence based practice and the clinical arts, between the psychological helper and the ministry.

 

I have been trained as a psychotherapist not as a pastor and our roles are different and yet without understanding and taking into account my clients' spiritual and religious beliefs especially when they are suffering, I am not likely to be of much help.

 

Thankfully, there is increased interest in the health care professions in the role that spirituality and and religion play in a person's physical health and mental well being. To describe someone as "broken hearted" or as having "killed their spirit" is to describe a person who is in need of some sort of spiritual uplift. There is a difference between a physical cure and a healing of the spirit.

 

My friend and colleague, Ed, recently died on June 30, 2008 at age of 56 of Esophogeal cancer. I last had lunch with him on June 18,2008. Even though physically he was having difficulty his spirits, as always, were good. I am not sure what Ed's religious and spiritual beliefs were, but he loved life, he loved people, and he lived every day up to his last to the best of his ability and for this I am very grateful to Ed for inspiring me with a great example of how to die.

 

Paul Pearsall, the neuropsychoimmunologist, who had four near death experiences himself, said, that no therapist can hope to be of much help to someone unless the therapist understands at least three basic things about the person's world view. The therapist needs to understand how the client would answer these three questions: Why was I born? What is the purpose of my life? What happens to me when I die?

 

I usually don't ask clients directly these 3 questions unless they come up in our conversation but usually by the 3 interview I have some good understandings of how they might answer these questions.

 

"I don't know. I don't know, and I don't know" are not good enough answers and people have to be pushed sometimes to a scarier and more difficult place, but if they trust the therapist enough, they usually can come up with some sort of answer that probably means more than they would like to believe.

 

The purpose of a healthy spirituality is to decrease suffering as both Jesus and Buddha and other spiritual masters have taught. This is the same goal of good psychotherapy.