To the editor: Post-traumatic stress disorder has medical components that are factual and require treatment, but there is one component that the Department of Veterans Affairs has difficulty measuring for effectiveness: affiliation, or group membership. (“Veterans protest the gutting of West L.A. PTSD therapy groups,” Dec. 29)
The military trains its men and women in units, and when veterans return from conflict, there is an assumption that if we reduce the symptoms of PTSD, they will automatically know how to affiliate with their families, colleagues, friends and others. We assume that they will know how to be a member of the civilian “unit” again.
But many veterans have difficulty. This is where groups are crucial in creating the supportive bridge to a civilian life. How do we measure the effectiveness of these groups? They do not fit the models of time-based programs that are designed to show improvement on specific symptoms at the conclusion of treatment. Measuring healthy membership in the civilian world requires both observational and personal feedback from the veteran. It requires more labor.
The crucial question for those managing PTSD programs is whether symptom reduction is their goal, or whether they want to focus more broadly on integrating veterans back into the civilian world with healthy bodies, emotions, minds and even spirits.
At the nonprofit organization where I am board president, we made the decision to treat symptom relief and provide for affiliation and membership transitioning. This requires both the skill of clinicians and the guidance of trained group therapists. We believe our veterans deserve relief from symptoms and guidance in becoming part of the civilian world again. We owe our women and men full-service treatment.
Clifford K. Ishigaki, Rancho Santa Margarita
The writer, a retired U.S. Marine captain and Vietnam War veteran, is board president of Wellness Works for Veterans in Glendale. He is also a recovering PTSD patient.
To the editor: Several years ago, a group of fellow veterans and I at the Long Beach VA found ourselves in a situation similar to patients at the West Los Angeles VA.
A PTSD support group for combat medics and Navy hospital corpsmen met weekly until funding was cut off. The group was important enough that we continued to meet as peers at the VA until the head of the mental health department found out about our plight.
The weekly meeting was reinstated, with the head of mental health becoming our group leader.
VA Secretary Robert Wilkie wrote in a letter, “There is no strong evidence that this modality is an effective treatment.” Going to our weekly group meeting is like going in for medication. Wilkie should come to any of our groups and see for himself adult men cry and heal.
Victor Bravo, Huntington Beach
To the editor: For citizens who support the VA gutting this successful therapy support program, I have one suggestion: Read “War and the Soul,” by psychotherapist Edward Tick.
Families with the experience of living with combat veterans and veterans of military service know and appreciate how difficult it is for most veterans to share their invisible wounds.
Shame on the VA and the Department of Defense for their ignorance and indifference toward the suffering of those who have served, and that includes families and friends who do their best to provide healing support to their loved ones for the rest of their lives.
I speak from experience.
Mary Lu Coughlin, Los Angeles