Moderatrix’ Incredibly Verbose Note: The linked article in Stars & Stripes held a couple of problems for me. One: It gave an impression that pharmaceutical therapy is somehow not a reasonable treatment for people dealing with mental health or anxiety disorders. This should not be taken as the opinion of myself, nor any member of the FWD/Forward team. I believe that it shows how stigmatized that direction of therapy can be, and how mental health services can be socialized to make men feel “weak” for needing them. How a person chooses to treat their mental health or social anxiety disorders is between themselves and their health care provider. Comments judging this course of therapy will be deleted and the commenter possibly banned pending a review. I will not have someone coming to this board and seeing their choice of therapy, which is helping them, mocked or dismissed.
Two: The linked article says that bibliotherapy is “poetry therapy”, when nothing I have found is that specific. Anything that I have found online, as well as my background in Greek and Latin root words, says that bibliotherapy is any type of therapy using the written word as supplemental therapy. I found that statement by the S&S writer misleading. I am willing to be corrected, but I am more inclined to believe that it is a part of a broad spectrum of treatment options. I find it like saying that “pharmaceutical therapy” means keeping someone pumped full of morphine all the time (not that there is anything wrong with that if that is what you need to manage your specific needs).
Nonetheless, I found the article incredibly interesting, and am ecstatic to find that veterans are finding ways to get care in ways that make them comfortable. Enjoy.
Spc. Victoria Montenegro received an Army Commendation Medal, complete with a “V” for Valor for helping her other team mates when her vehicle exploded in Karbala, Iraq. That same accident also threw shrapnel into her forehead and right eye. It gave her a complex fracture and bone loss in her left hand.
It also left her with PTSD.
Spc. Matt Ping also came back from “The Sandbox”, his time spent in Northern Afghanistan, he found himself mixing flashback with childhood memories. For him, the thought of a pharmaceutical approach, the normal approach taken by the VA, was too unappealing.
For both of them, a different kind of therapy program has been incredibly beneficial.
The Walter Reed Medical Center in Washington, D.C. has a program, run by Roseanne Singer, that helps veterans deal with their PTSD through the written word, mostly poetry. Participants are welcome to come to an informal gathering that takes place in the lobby of the Mologne House. Participants are under no obligation to participate, they may come whenever they feel comfortable, talk as much or as little as they like, and share or not share what they have written. The program does not analyze or critique, but rather focuses on getting veterans who find it otherwise difficult to communicate their feelings to convey them through writing. Or, as Ping , also now a part of Lisa Rosenthal’s Vet Art Project in Chicago describes poetry therapy:
“Poetry helps me deal with coming back to a society that’s gone in a different direction,” Ping said. “Coming home is one of the strangest things I’ve ever encountered. The 16 months of isolation and being secluded and then coming back and trying to be the same person you were before you left. I don’t know if that’s possible.”
Ping also has a blog where he shares his poetry (I have only scanned the front page, and I make no guarantees about triggering language).
Montenegro’s poetry focuses on the pain of being a “young, short, wounded female in a world of men,”.
“A lot of times around the hospital, I’d be mistaken for somebody’s family member,” she said. “It bugged me.”
Overall, finds the self-paced program beneficial, and enjoys the control over her own healing the . There is no pressure to heal at an expected rate, no one telling her that she should be over it by now. If she doesn’t want to share something, she doesn’t have to.
You can read her poem “Perspectives” (which I thought was moving) at the S&S link, and if you have a flash player you can listen to her read it.
The more ways we find to help our returning troops the better. If they aren’t thriving in the traditional therapy programs (and I can understand why), or if they aren’t being given proper therapy in addition to their drug treatments (I can relate), then we need to find therapy programs that do help them. We owe it to them.
There may be a lot of people who disparage drug treatment but I have found that I get a LOT more crap as:
1. A person who identifies as a psych survivor or ex-patient.
2. A person who does not (in my case, cannot safely, but it would be no different if I just chose it) use psych drugs.
3. A person who in fact gets no therapy of any kind
4. A person who does not even use the disease model of mental illness.
Than I ever. Ever. Got as a compliant psych patient accepting and playing along with whatever diagnosis I was given.
I should not have to put this disclaimer, it should just be a given, it is a form of injustice that it is required, but I know from long experience that it is required: I don’t care what anyone else chooses to do as a result of their problems and am not disparaging people who use the system and drugs and therapy.
But seriously. I get told comstantly that if I do not put the same labels on myself that I was given then I must not have had the real problems that are assumed to go with such labels. I hear all the time that if I don’t use drugs or therapy then I am categorically different in how my brain works than people who do. I am often based on my choices and identifications immediately seen as suspect — someone who must think others are making the wrong choices. I am told that by rejecting psychiatry in the manner that I do then I must be (pick any), paranoid, attention seeking, psychotic, too ill to understand I need meds and therapy, not ill enough to understand that others do. And I have to deal with the danger of being put back in a system that nearly killed me multiple times, on top of that.
In short, I receive all the same prejudice I received as a compliant mental health patient and then much more.
I am not trying to do oppression olympics here, I am just trying to say how frustrating it is to be in a place where the needs of mental health patients are always explicitly considered, to the letter, but where as a survivor/ex-patient I never ever hear about making things so explicitly safe for anyone like me. A place that tries to encompass so many categories of disabled person but where every single openly psychiatrized person identifies as a person with a mental illness. Which is as good as saying outright that I must always be on my toes and always especially make sure that I explicitly say that I don’t condemn people’s treatment choices in a place where I have never once heard anyone make similar explicit disclaimers about the right to reject psych treatment and psych labels and even the category of mental illness altogether.
I am writing this so that maybe people will think about people like me existing instead of always being erased one way or another. I am not — seriously not — condemning anyone’s choices (translate: I am terrified of being taken for that yet again and rejected, or of getting one more patient explanation that people with REAL problems need drugs or therapy). I am just wondering why in the whole history of this blog has nobody even mentioned the existence of people like me even as they have been do careful to attend to the needs of people like themselves?
I’m not dissing drug therapy, but I do believe that it is not sufficient alone for PTSD.
Pharmacotherapy alone is a perfectly reasonable treatment response to something that is, to the best of our current knowledge, biological in origin and chronic–like, say, bipolar disorder. You can talk to a therapist until you are blue in the face and it won’t stop you having mood swings. Only meds will do that.
Something that originates outside of you, on the other hand, like an abusive relationship or a tsunami, is not going to be corrected by rebalancing your brain chemistry. Your brain chemistry is not the problem. (In fact, many of us see the “symptoms” of PTSD as your body’s healthy, normal, life-saving response to an extremely unhealthy, abnormal, life-threatening situation.)
You can certainly get some temporary (i.e., for as long as the pill is in your system)alleviation of PTSD symptoms with medication, but it’s usually only partial relief, plus most drugs have at least some side effects. More than that, though, I believe that the traumatized person has a right not just to a temporary, partial amelioration of symptoms but to go on to live a full and happy life. And given that psychotherapy has been demonstrated by research to bring about vast improvements–if not an outright cure–and that generally without side effects, it only makes sense for a combat veteran or any other trauma survivor to demand it.
The VA has long been both supportive of the profession of psychology and a source of cutting-edge research in PTSD. They know that it is not an either-or proposition, but rather that the combination of psychotherapy and medication has been demonstrated time and time again to get the best results. Unfortunately, the VA has been flooded with veterans which it, as always in past wars, seems surprised by and utterly unprepared for. One prescriber can see four or even five patients in an hour. A therapist can see one. The VA apparently having done the math has opted for anxiolytics and antidepressants plus the occasional mood-stabilizer as their first line of defense, while they try to catch up with demand.
(By the way, bibliotherapy, as it is used in the profession, means “read this book” about PTSD. Poetry therapy means “write a poem” about your experiences. I have never, in 30 years of practice, seen those two terms used interchangeably.)
Hi Amanda:
I have been tearing myself up all day trying to think of a worthy response to you, because you bring up a topic that I do believe deserves its own space and discussion. Because of the respect I have for you (I don’t believe I am alone on that) I wanted to let this through so that you didn’t think I was ignoring you (this would have been sooner but I needed time to think on it and I have been out most of the day). I am working on emailing you with a more thoughtful response, because I want to keep this particular discussion on topic while giving your thoughts the attention they deserve. I wanted to acknowledge that you had left a thoughtful comment and let you know that I am constructing a more in-depth response to you.
speaking just as myself here:
I’m, well, right here. Openly psychiatrized by many, including doctors I’ve seen in the past and huge swathes of the medical profession and general population, and I don’t identify as a person with a mental illness. I can’t speak for any other FWD bloggers or commenters, but I personally identify strongly with this description.
I’m not sure that one example disproves your entire thesis, not does it invalidate how you’re feeling, but just to say that perhaps the fact that you’re not seeing me doesn’t mean I’m not here? I mean, I’ve been posting very little (my spoons are extremely low and it’s school holidays), and I don’t post much about this issue because it’s incredibly raw and hard to talk about for me… but yes, I’m here. There may well be others; I don’t know. Not everyone talks or feels/is free to talk about every aspect of their past or their situation, nor should that be demanded of them, in my opinion.
Some of the very key rights we’ve emphasised at FWD from the start are the rights to self-identify, to decline the labels of others, to choose our own treatment and management, to decline treatments and managements forced upon us. These are all essential, and basic, yet are emphasised very little or openly attacked at many ‘feminist’ sites without a disability focus. All of these rights apply to psychiatrisation and neurodiversity and people who don’t identify as psychiatrised or neurodiverse but have been labelled that way.
We have written and linked to information about neurodiversity and “mad pride” in the past; we are open to more links (speaking now as the Rec Reading person du jour, I’m open to link submissions as I can’t read everything.) I’m not saying we can’t do more. As writ in the about section, we absolutely don’t claim to speak for everyone, but only for ourselves.
Thanks for the Docsplainin’, there, Virginia.
First of all, in my two paragraph disclaimer, I did mention that I was pretty sure that the writer from S&S was using an incorrect usage of bibliotherapy. *nods* My research, which included resources from recent years, said that it is a broader term than even you purport it to be. Just like I said.
It’s great that you think so highly of the VA, and possibly of the military’s medical as well, since people always seem to forget to separate them, and all veterans have to deal with both eventually. You have to go through one to get to the other. I’ll be sure to file away your very careful explanation of everything I already know from my years of personal experience in my, oh, yeah, personal experience. I’m sure it will be helpful. I wish all of my doctors knew that I needed both med and therapy for treatment. I’ll pass that on. Oh, wait, they were/are doctors too!
See, when you are in the thick of things, no one gives a fuck about you. They just throw some pills at you and hope you go away, until you actually need some medication, then you have to jump through about fifty hoops to actually get them, because you are a dog damned malingerer who should just be able to suck it up. Maybe, just maybe, you will luck into one doctor who is willing to listen to you and try to do something that might help you, and maybe let you have some input too. I am so incredibly thrilled that the VA has been so supportive of the profession of psychology, because they sure as fuck haven’t been supportive of actual patients, you know, the people who have needed their services all this time. They are, of course, great for research, because it isn’t like we get a say in our participation. It’s only our health care.
That is why I highlighted this article, because I am tickled to almost death to see that there is a program that is doing something that someone feels is helping them. If a vet doesn’t want drugs then they shouldn’t have to have them (and no, maybe they don’t do fuck all for PTSD, I ask you to point out where I said they did, but a sleep aid can help you to maybe get some rest once every three days when you are reliving the triggering event, or maybe you need pain relief, I don’t know, being that every body is different)– no one should. Just the same as when someone doesn’t feel safe talking to a therapist or in a group therapy session, if you can get into them, or if they put you in one where you feel safe and isn’t with a woman beater, you shouldn’t have to go to one. Also, for added fun, the therapist who thinks the pain is all in your head, and that if you just talk about it then it will all go away.
The military makes it clear that you don’t have a lot of choices, and the VA makes it so fucking difficult to get care that you feel like you have no choice but to take what you are given. That is why I highlighted this article.
So, if you are done flashing your letters around, about which I couldn’t care less because they don’t help me, or any other vet, then maybe we could talk about the actual good that this program is doing these actual human beings?
I am so tired of people ‘splainin’ to me about how shit works when they really don’t know how it breaks down when you have that uniform strapped on that I could puke blood…and I have been so stressed out by these frankly abusive comments that I just might yet. So, stop with the derails and the initial totin’, because if we can’t talk about these vets, and how their therapy choices are doing good by them, then I will bring the banhammer down, and I haven’t had to do that yet.
I had meant to mention people might be there without seeming to. Thanks for pointing it out.
Since I thought at the time that I was agreeing with you (a) that meds are good, in their place, (b) that the right therapy with the right therapist is great, (c) that the VA is blowing it yet again, and (d) that the article’s author uses terms in funny ways, I’m a little baffled by your response. But I’m working on it. Until I figure it out exactly, may I offer a general, blanket apology?
As for the specifics I do get at this point:
(1) I’m not intending to do “docsplainin’” or “initial-totin’”, but I do use my professional name when responding as a psychologist and my ordinary, everyday street name when responding on a personal level. It seemed like a logical policy at the time, but maybe I need to reconsider it now that I know I am coming across as preachy.
(2) I am fully aware that I can never, ever truly understand what your experiences were like. I never meant to imply that I thought that I did.
OuyangDan — please step away from the keyboard. Please.
Amanda brings up a valid point. That she brought it up in the comments of an issue that means a great deal to you is (understandably?) igniting your anger. But however misplaced you feel her words are, her viewpoint is no less valid, and I’d thank you not to describe her comments as ‘abusive’ when they are nothing of the sort. Blunt, perhaps. But abusive? I doubt it.
I am sure that Amanda, as am I, are glad to hear that the VA is doing something for its veterans that actually /helps/ them. Her comment is not about that, and it is not negating that, and it is not judging the course of the therapy /at all/.
Please step away and consider before you bring down the banhammer.
Lindra, I’m thinking you’ve mixed up Amanda’s and Virginia’s comments, as OYD didn’t say a negative word about Amanda’s comments. It’s not okay to tell someone to ‘please step away’ on their own website, I am frankly flabbergasted. As for ‘abusive,’ I am thinking OYD was not talking about anyone in this thread in particular, but this dynamic more generally.
Flying strawberry-syrup covered pancakes with whipped cream, people. There have been assumptions about people’s identities and treatments, not a whole lot of respect for the experiences of the OP writer, and much else besides. OYD wrote a perfectly lovely post on something that will work for many vets. There is no call to turn this thread into a steaming pile of shit. Now, get back on topic, if you please.
Guh, I did massively conflate various comments in this thread, and my deepest apologies to OuyangDan.
Thank you for this. Great post!