By SHANNON P. MEEHAN
Published, February 23, 2010 - New York Times
SINCE the two recent NATO-led military strikes that accidentally killed dozens of Afghan civilians, I have been thinking a great deal about the psychic toll that killing takes on soldiers. In 2007, I was an Army lieutenant leading a group on a house-clearing mission in Baquba, Iraq, when I called in an artillery strike on a house. The strike destroyed the house and killed everyone inside. I thought we had struck enemy fighters, but I was wrong. A father, mother and their children had been huddled inside. The feelings of disbelief that initially filled me quickly transformed into feelings of rage and self-loathing. The following weeks, months and years would prove that my life was forever changed.
In fact, it’s been nearly three years, and I still cannot remove from my mind the image of that family gathered together in the final moments of their lives. I can’t shake it. It simply lingers. I know that many soldiers struggle long after they leave the battlefield to cope with civilian deaths. It does not matter whether they were responsible for those deaths, whether it was a mistake of the command, of the weaponry, or even the fault of the enemy, who in parts of both Iraq and Afghanistan have been known to intentionally place or involve civilians, even children, in their operations. Just seeing the lifeless body of a little boy or girl is all it takes.
For many soldiers, what follows a killing is a struggle of the mind. We become aware that what we’ve seen has changed us. We can’t unlearn it, and we continue to think of those innocent children. It is not possible to forget.
Killing enemy combatants comes with its own emotional costs. On the surface, we feel as soldiers that killing the enemy should not affect us — it is our job, after all. But it is still killing, and on a subconscious level, it changes you. You’ve killed. You’ve taken life. What I found, though, is that you feel the shock and weight of it only when you kill an enemy for the first time, when you move from zero to one. Once you’ve crossed that line, there is little difference in killing 10 or 20 or 30 more after that.
War erodes one’s regard for human life. Soldiers cause or witness so many deaths and disappearances that it becomes routine. It becomes an accepted part of existence. After a while, you can begin to lose regard for your own life as well. So many around you have already died, why should it matter if you go next? This is why so many soldiers self-destruct when they return from a deployment.
I know something about this. The deaths that I caused also killed any regard I had for my own life. I felt that I did not deserve something that I had taken from them. I fell into a downward spiral, doubting if I even deserved to be alive. The value, or regard, I once had for my own life dissipated.
Five weeks ago, my first child, a son, was born. Not surprisingly, my thoughts often race back to the children I killed. With the birth of my son, I received the same gift I destroyed.
The fact that soldiers are trained and expected to kill as part of their job is something that few people wish to talk about. Many men and women coming back from war don’t risk telling the stories that have so profoundly changed their lives.
In recent months I’ve been trying to honor the lives I took by writing and speaking in public about my experience, to show that those deaths are not tucked neatly away in a foreign land. They may seem distant, but they are not. Soldiers bring the ghosts home with them, and it’s everyone else’s job to hear about them, no matter how painful it may be.
By JAMES DAO and DAN FROSCH
Published: December 6, 2009 - New York Times
Pfc. Jeffery Meier, who struggled with post-traumatic stress disorder and drug addiction after two deployments to Iraq, got an appointment in August to see a psychiatrist at Fort Carson, Colo.
But when he arrived for his first session, he was asked to sign a waiver explaining that under certain circumstances, including if he admitted violating military laws, his conversations with his therapist might not be kept confidential. He refused to sign.
Private Meier, who is seeking a medical discharge from the Army, was given counseling anyway. But he says he never opened up to his therapist, fearing that actions taken in the heat of battle might be disclosed to prosecutors. “How can you go and talk about wartime problems when you feel that if you mention anything wrong, you’re going to be prosecuted?” he said in an interview.
He is not alone in his wariness. Many soldiers, lawyers and mental health workers say that the rules governing confidentiality of psychotherapist-patient relations in the military are porous. The rules breed suspicion among troops toward therapists, those people say, reducing the effectiveness of treatment and complicating the Pentagon’s efforts to encourage personnel to seek care.
The problem with the military rules, experts say, is that they do not safeguard the confidentiality of mental health communications and records as strongly as federal rules of evidence for civilians. Both systems say therapists should report patients when they seem a threat to themselves or to others. But the military rules include additional exceptions that could be applied to a wide range of suspected infractions, experts say.
“There really is no confidentiality,” said Kaye Baron, a psychologist in Colorado Springs who has been treating soldiers from Fort Carson and their families for eight years. “You can find an exception to confidentiality in pretty much anything one would discuss.”
The issue has gained new attention with the recent mass shootings at Fort Hood that killed 13 and wounded 43. In the weeks before the rampage, the accused gunman, Maj. Nidal M. Hassan, an Army psychiatrist, told colleagues and Army lawyers that he wanted to report soldiers who had admitted in counseling sessions that they witnessed or committed war crimes in Iraq or Afghanistan. War crimes can include acts like torture, murder, sexual assault and cruel treatment.
Though Major Hasan was discouraged from filing reports on his patients, military officials say, he would have been within his rights as an Army psychiatrist to have done so. Major Hasan’s efforts to report war crimes were first reported by ABC News.
Pentagon officials acknowledge that the psychotherapy-patient privilege in the military is not absolute. But they assert that the exemptions are relatively narrow. Those rules apply to both civilian and military mental health professionals who deal with military personnel.
Cynthia L. Vaughan, a spokeswoman for the Army medical command, said the rules were intended mainly to protect military personnel, installations and operations, or to prevent child or spousal abuse. In those situations, she said, therapists have a duty to report patients to commanders without their patients’ consent. But they do not have a duty to report other kinds of crimes, she said.
The waiver that soldiers like Private Meier are asked to sign is simply to notify them that “there are circumstances when disclosure of behavioral health information can occur without prior consent,” Ms. Vaughan said.
“We strongly encourage soldiers to seek behavioral health treatment,” she added.
Psychotherapists are not required to report possible war crimes, Ms. Vaughan said. But it is considered a “general duty” under Defense Department directives to do so.
Ms. Vaughan said the Army could not comment on whether Major Hasan, whose job was to interview Fort Hood soldiers who were being medically discharged, actually filed reports on his patients. She added that “in normal day-to-day operations, the Army will investigate any report of a possible war crime by whatever means it is made known.”
Some legal and mental health experts say the military’s rules on psychotherapist-patient privilege are not clear-cut. Michelle Lindo McCluer, a former Air Force lawyer who is the executive director of the National Institute of Military Justice, said that some exceptions to the privilege are so broadly worded that “you could drive a truck through them.”
One exception in the military rules states that confidentiality can be breached without a patient’s consent when “federal law, state law or service regulation imposes a duty to report information.” Another says privilege can be broken to ensure the safety of military personnel and “the accomplishment of a military mission.” The phrase “military mission,” Ms. McCluer said, could entail almost anything a unit does.
Ms. McCluer said that when she was a defense lawyer for the Air Force from 2000 to 2003, she advised clients to seek mental health counseling from chaplains because the privilege rules on their communications are stronger than for therapists.
Until about 10 years ago, there was no psychotherapist-patient privilege in the military, meaning that any communication between a therapist and service member could be reviewed by prosecutors or commanding officers without the consent of the patient. The qualified privilege was created in 1999 to bring military rules more in line with the 1996 Supreme Court ruling in Jaffee v. Redmond that said federal courts must allow psychotherapists and other mental health professionals to refuse to disclose patient records in judicial proceedings.
In the years since the limited privilege was established, there has been little litigation testing its bounds, lawyers say. There has also been little written guidance for therapists, experts say.
Without bright-line rules, many troops say they are concerned that their therapists will reveal not just admissions of major crimes but also minor infractions that might hurt their military careers or prevent them from being returned to combat duties.
“I personally have learned to be very vague about what I say,” said a 16-year Army veteran at Fort Carson who is in the process of receiving a medical discharge and did not want to be identified because he was concerned that speaking out about his experience would jeopardize his case.
Shannon P. Meehan, a former Army captain and tank platoon leader who was recently medically discharged from the Army, said his candid conversations with a psychiatrist at Fort Hood helped him cope with post-traumatic stress disorder. He had felt deep guilt about an order he gave in Iraq for a missile strike that killed women and children. That 2007 event became a central chapter in a book he has written with one of his former English professors, “Beyond Duty.”
Mr. Meehan said that the strike was clearly within the rules of engagement. But other soldiers might not be so certain about their actions during the chaos of combat, and he said he worried that troops who thought their therapists might report them would not discuss their deepest secrets — secrets that may be at the root of personal anguish or mental problems.
“To me,” Mr. Meehan said, “the healing power of being able to write through everything, talk through everything, really helped me make order of it.”
“That’s something I know is going to be one of the tragic long-lasting effects of the Fort Hood incident,” he said. “Soldiers will feel they can’t come forward to confess things. And that’s a bad road to be on.”
By MAX CLELAND
Published: November 6, 2009 - New York Times
“EVERY day I was in Vietnam, I thought about home. And, every day I’ve been home, I’ve thought about Vietnam.” So said one of the millions of soldiers who fought there as I did. Change the name of the battlefield and it could have been said by one of the American servicemen coming home from Iraq or Afghanistan today. Wars are not over when the shooting stops. They live on in the lives of those who fight them. That is the curse of the soldier. He never forgets.
While the authorities say they cannot yet tell us why an Army psychiatrist would go on a shooting rampage at Fort Hood in Texas, we do know the sorts of stories he had been dealing with as he tried to help those returning from Iraq and Afghanistan readjust to life outside the war zone. A soldier’s mind can be just as dangerous to himself, and to those around him, as wars fought on traditional battlefields.
War is haunting. Death. Pain. Blood. Dismemberment. A buddy dying in your arms. Imagine trying to get over the memory of a bomb splitting a Humvee apart beneath your feet and taking your leg with it. The first time I saw the stilled bodies of American soldiers dead on the battlefield is as stark and brutal a memory as the one of the grenade that ripped off my right arm and both legs.
No, the soldier never forgets. But neither should the rest of us.
Veterans returning today represent the first real influx of combat-wounded soldiers in a generation. They are returning to a nation unprepared for what war does to the soul. Those new veterans will need all of our help. After America’s wars, the used-up fighters are too often left to fend for themselves. Many of the hoboes in the Depression were veterans of World War I. When they came home, they were labeled shell-shocked and discharged from the Army too broken to make it during the economic cataclysm.
So it is again, with too many stories about veterans of Iraq and Afghanistan ending up unemployed and homeless. Figures from the Department of Veterans Affairs show that 131,000 of the nation’s 24 million veterans are homeless each night, and about twice that many will spend part of this year homeless.
We know of the recent failures at Walter Reed Medical Center, where soldiers were stranded in substandard barracks infested with rats while awaiting treatment. I was in Walter Reed myself at that time seeking counseling for post-traumatic stress disorder, which, ignited by a barrage of Iraq headlines and the loss of my United States Senate seat, had simply consumed me.
I never saw it coming. Forty years after I had left the battlefield, my memories of death and wounding were suddenly as fresh and present as they had been in 1968. I thought I was past that. I learned that none of us are ever past it. Were it not for the surgeons and nurses at Walter Reed, I never would have survived those first months back from Vietnam. Were it not for the counselors there today, I do not think I would have survived what I’ve come to call my second Vietnam, the one that played out entirely in my mind.
When I was wounded, post-traumatic stress disorder did not officially exist. It was recognized as a legitimate illness only in 1978, during my tenure as head of the Veterans Administration under President Jimmy Carter. Today, it is not only recognized, but the Army and the V.A. know how to treat it. I can offer no better testament than my own recovery.
Weeks before the troubles at Walter Reed became public in 2007, my counselor put it to me simply. “We are drowning in war,” she said. The problems at Walter Reed had nothing to do with the dedicated doctors and nurses there. The problems had to do with the White House and Congress and the Department of Defense. The problems had to do with money.
When we are at war, America spends billions on missiles, tanks, attack helicopters and such. But the wounded warriors who will never fight again tend to be put on the back burner.
This is inexcusable, and it comes with frightening moral costs. There are estimates that 35 percent of the soldiers who fought in Iraq will suffer post-traumatic stress disorder. I’m sure the numbers for Afghanistan are similar. Researchers have found that nearly half of those returning with the disorder have suicidal thoughts. Suicide among active-duty soldiers is on pace to hit a record total this year. More than 1.7 million soldiers have served in Iraq and Afghanistan. Imagine that some 600,000 of them will have crippling memories, trapped in a vivid and horrible past from which they can’t seem to escape.
We have a family Army today, unlike the Army seen in any generation before. We have fought these wars with the Reserves and the National Guard. Fathers, mothers, soccer coaches and teachers are the soldiers coming home. Whether they like it or not, they will bring their war experiences home to their families and communities.
In his poem “The Dead Young Soldiers,” Archibald MacLeish, whose younger brother died in World War I, has the soldiers in the poem tell us:“We leave you our deaths. Give them their meaning.” Until we help our returning soldiers get their lives back when they come home, the promise of restoring that meaning will go unfulfilled.
Max Cleland, the secretary of the American Battle Monuments Commission, was a Democratic senator from Georgia from 1997 to 2003. He is the author, with Ben Raines, of “Heart of a Patriot: How I Found the Courage to Survive Vietnam, Walter Reed and Karl Rove.”
Published: November 11, 2009 - New York Times
Gen. Eric Shinseki was famously shunned by the Bush administration for daring to state the true costs of occupying Iraq. As President Obama’s secretary of veterans affairs, he is, thankfully, no less candid about the grinding problems veterans face at home. They lead the nation in depression, suicide, substance abuse and homelessness, according to data that Mr. Shineski is delivering in salvos in his current role.
About one-third of all adult homeless men are veterans, and an average night finds an estimated 131,000 of them from five decades bedding down on streets and in charity sanctuaries. About 3 in 100 of them are back from Iraq and Afghanistan. The problem of homelessness for Vietnam veterans is, shamefully, well known. But the men and women in this growing cohort took just 18 months to find rock bottom, compared with the five years-plus of the previous generation’s veterans.
General Shinseki has promised to galvanize the Department of Veterans Affairs to lead a national drive to end veteran homelessness in the next five years. Is that anywhere near possible? “Unless I put an ambitious target on the table, I don’t know how we’ll start,” the secretary told a forum of wounded veterans.
He has also pledged $3.2 billion to bolster housing, education, job and medical programs to help troubled veterans before they hit the streets. The new G.I. Bill, for example, offers tuition help, but the secretary says more immediate vocational training will also be available. Similarly, he promises more beds for transition programs, including those intended to help the 40,000 veterans released each year from prisons.
This is an especially tall order for an unwieldy bureaucracy, one with a notorious backlog of 400,000 disability claims. General Shinseki says a renewed Veterans Affairs Department must, and will, address that problem.
We believe he has the mettle to pull this off. He will need a lot of help from the White House, Congress and communities across the country. The general-turned-secretary is appealing to thousands of worthy organizations already in the field to double their efforts to help.
Our veterans shouldn’t be forced to battle on their own just to survive at home.