Vet­er­ans un­happy as Trump con­nects ill­ness to shoot­ing

Ex­perts say the pres­i­dent’s re­marks were not help­ful to re­mov­ing the stigma sur­round­ing PTSD

The Washington Post - - POLITICS & THE NATION - BY PAUL SONNE

Some vet­er­ans and men­tal­health ad­vo­cates bris­tled at Pres­i­dent Trump’s com­ments re­gard­ing the Thou­sand Oaks shooter and post-trau­matic stress dis­or­der, say­ing such broad-based re­marks risked fu­el­ing in­ac­cu­rate stereo­types about the con­di­tion and Amer­i­cans who have served in com­bat.

Trump be­gan spec­u­lat­ing about PTSD on Fri­day morn­ing when asked about the shoot­ing, in which au­thor­i­ties say 28-yearold Marine vet­eran Ian David Long opened fire at a coun­try­mu­sic bar in Thou­sand Oaks, Calif., and killed 12 peo­ple. Of­fi­cers found Long in­side an of­fice in the bar, dead of an ap­par­ently self-in­flicted gun­shot wound.

“He was a war vet­eran. He was a Marine. He was in the war. He served time. He saw some pretty bad things, and a lot of peo­ple say he had PTSD, and that’s a tough deal,” Trump said af­ter de­scrib­ing the shooter as a “very sick puppy” who had a lot of prob­lems.

“Peo­ple come back — that’s why it’s a hor­ri­ble thing — they come back, they’re never the same,” the pres­i­dent added, re­fer­ring to Long’s mil­i­tary ser­vice.

Long served as a ma­chine­gun­ner in the Marine Corps from 2008 to 2013 and de­ployed to Afghanistan, leav­ing the U.S. mil­i­tary as a cor­po­ral.

It is not clear whether Long had been for­mally di­ag­nosed with PTSD be­fore his death or whether the pres­i­dent as­sumed he suf­fered from the con­di­tion based on his mil­i­tary ser­vice and com­ments in the news me­dia by peo­ple who knew the shooter.

Trump’s broad-brush re­marks out­side the White House on Fri­day prompted con­cern that the pres­i­dent was am­pli­fy­ing stereo­types sug­gest­ing PTSD turns vet­er­ans into vi­o­lent killers and that all ser­vice mem­bers come home some­how dam­aged from com­bat.

“Com­ments like this one from our Com­man­der in Chief are ex­tremely un­help­ful,” Paul Rieck­hoff, founder and chief ex­ec­u­tive of Iraq and Afghanistan Vet­er­ans of Amer­ica, said in a state­ment. “They per­pet­u­ate a false and dam­ag­ing nar­ra­tive that vet­er­ans are bro­ken and dan­ger­ous. Most peo­ple who suf­fer from PTSD, when able to ac­cess ef­fec­tive treat­ment, are able to live healthy, happy, mean­ing­ful lives.”

Rieck­hoff said when vet­er­ans with men­tal-health is­sues hurt some­one, it’s most likely them­selves, not some­one else.

“We lose 20 vet­er­ans and ser­vice mem­bers to sui­cide ev­ery sin­gle day,” he said.

“The prob­lem isn’t with the phras­ing, ‘you go to war and you come back and you’re not the same’ — that is true, you come back and you’re not the same,” said Kayla M. Wil­liams, a for­mer Army sergeant and se­nior fel­low at the Cen­ter for a New Amer­i­can Se­cu­rity. “The con­cern I have is the idea that you come back more likely to be a mass shooter. That is not the case.”

Wil­liams said vet­er­ans come home from com­bat changed of­ten in good ways, with a greater ea­ger­ness to be en­gaged with their com­mu­ni­ties and their coun­try, and while there can be cor­re­la­tion with PTSD and in­creased anger and ag­gres­sion, it’s un­eth­i­cal and dan­ger­ous to en­cour­age Amer­i­cans to be afraid of vet­er­ans be­cause of their com­bat ex­pe­ri­ences and sug­gest they re­turn home dam­aged.

The wars in Afghanistan and Iraq dra­mat­i­cally in­creased the num­ber of young Amer­i­cans who had seen com­bat, re­viv­ing the stereo­type of the dam­aged vet­eran, with PTSD be­com­ing an acro­nym well known out­side med­i­cal com­mu­ni­ties.

In re­cent years, men­tal-health ex­perts and vet­er­ans groups have taken steps to re­move the stigma of the con­di­tion and show that vet­er­ans suf­fer­ing from it aren’t tick­ing time-bombs, as stereo­types stem­ming from the Viet­nam era be­gan to sug­gest.

“I think in re­port­ing and in fic­tion movies and tele­vi­sion, it’s in­ter­est­ing and graphic to cre­ate an archetype, to cre­ate a par­tic­u­lar por­trait — and the idea of the crazed killer com­ing back from war has a cer­tain amount of res­o­nance. It’s not true,” said Frank Och­berg, clin­i­cal pro­fes­sor of psy­chi­a­try at Michi­gan State Univer­sity.

Och­berg has ad­vo­cated re­nam­ing the con­di­tion PTSI — or Post Trau­matic Stress In­jury — rather than de­scrib­ing it as a dis­or­der. He said there is some re­search that shows peo­ple with PTSD have an in­creased risk of vi­o­lence but he said that ap­plies to a vast mi­nor­ity, and some­times vet­er­ans with the con­di­tion be­come reclu­sive or see re­duced ap­petite for en­joy­ing time with fam­ily and friends.

“I think a pres­i­dent says let’s get facts be­fore we af­firm our prej­u­dices or as­sump­tions and re­ally spread ru­mors about what’s go­ing on here,” Och­berg said. “And then I think the pres­i­dent could take the oc­ca­sion to say even if this vet­eran has PTSD, let’s not stereo­type vet­er­ans with PTSD as be­ing deadly dan­ger­ous, be­cause most of them are not.”

PTSD varies in fea­tures and some­times is seen as a “com­mon cold” of psy­chi­a­try in that some peo­ple re­cover on their own and oth­ers face in­creas­ing sever­ity that re­quires treat­ment, said El­speth Ritchie, a re­tired Army colonel and psy­chi­a­trist with ex­per­tise in the con­di­tion.

Ser­vice in com­bat doesn’t nec­es­sar­ily equate with PTSD. Ritchie said data on ser­vice mem­bers who served in com­bat in Iraq at the height of the war sug­gests about a quar­ter came back with some symp­toms of PTSD but didn’t nec­es­sar­ily have the full-blown con­di­tion.

“On the ques­tion about the re­la­tion­ship be­tween PTSD and vi­o­lence — like of­ten with men­tal ill­ness, there is a lit­tle bit of in­creased risk of vi­o­lence, but it’s not the kind of vi­o­lence where you go into a bar and shoot peo­ple,” Ritchie said.

In cases of mass shoot­ings, she said, per­pe­tra­tors are quite of­ten suf­fer­ing from a men­tal con­di­tion that in­volves delu­sion and para­noia, some­thing far more se­vere than PTSD, even if they have served in the mil­i­tary and seen com­bat.

“When you’re talk­ing about go­ing in and shoot­ing some place up . . . nearly all of the time it’s some­thing worse than PTSD,” Ritchie said. “It’s usu­ally a psy­chotic episode. Psy­chosis means be­ing out of touch with so­ci­ety.”

CHRIS­TIAN HART­MANN/REUTERS

Pres­i­dent Trump on Fri­day said the man ac­cused of open­ing fire in a Cal­i­for­nia bar was a “very sick puppy” who was a war vet­eran with post-trau­matic stress dis­or­der. Vet­er­ans and men­tal-health ex­perts alike say this rhetoric per­pet­u­ates a dan­ger­ous stereo­type.

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