PTSD (post-traumatic stress disorder)

This is a special submission to Our Duty by Gerry.  Since this is such an important issue, I am re-porting it here.

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Post-Traumatic Stress Disorder (PTSD)
March 8 2012
by

Gerry Fostaty

I have been travelling around lately, speaking to groups about post-traumatic stress disorder.

At the start of my talks about PTSD to folks, I tell a story about a neighbour, a toad and me.  The story isn’t important. The important thing is that it illustrates that we sometimes make assumptions, when we don’t have all the facts. That’s the way it is with post-traumatic stress disorder. People make all kinds of assumption about PTSD. It used to be known by many descriptions: shell-shock, battle fatigue, the thousand-yard stare, and of course, cowardice, among others. (Unfortunately, it still is in some circles.) But in the 1980s, some smart people realized that what the sufferers were experiencing wasn’t behavioural, it was neurological. They discovered that you can’t just snap out of it, man up, grow up, or get over it. In the 1980s it became a recognized clinical disorder. Although we most frequently associate PTSD with the military, PTSD can affect anyone. It doesn’t discriminate by gender, age or occupation. It is an equal-opportunity disorder.  There are some occupations that may be more exposed to the stimulus that create a host for PTSD.  The military, emergency first responders like police, firefighters, paramedics, emergency room nurses and doctors are all obvious candidates, but victims of violent accidents, crime, assault, terrorism, abduction, and rape are also at risk.

So what brings it on? Here is my simplified version.

When our minds experience trauma, that is, when we feel that our lives are in danger, or the lives (or well being of those we are responsible for) are in danger, or we feel utter helplessness in a perilous situation, our brains, not surprisingly, become most interested in our survival. The brain triggers a response that immediately has our bodies create a massive amount of adrenaline that floods through us, giving us a rapid and intense burst of energy.  This energy is channelled to our gross motor limbs, our arms and legs, to help us either defend ourselves, or escape the danger. That is commonly called the “fight or flight” response.  Most times brains are able to reset after the trauma is past, but if the trauma is particularly profound, or prolonged, or is repeated, something else occurs. A deep neural pathway is created in the brain. The brain feels that it will need the memory of the trauma again soon, so it hangs on to the info, and it has its hand ready on the adrenaline switch . . . just in case we’ll need to fight or flee again. In most cases, we won’t need that adrenaline again in the short term. But, the brain hangs on to the info.

So what can happen?

The problem is that our brains don’t understand that we don’t need the adrenaline, but it stays at the ready for a long time. In most cases, the brain relaxes and “resets” within thirty days, but in some cases it will hang on to that trauma, even for years. The brain may begin to look for opportunities to pull the switch. Things that are only barely associated with the old trauma, may present the brain with what it thinks are triggers. Sights, sounds and smells are very powerful triggers. When the brain feels that you are in danger again it flips the switch and the body is again flooded with adrenaline to help us escape or defend ourselves. After that happens a few times we begin to see a pattern and try to avoid the things that triggered the adrenaline. Being on guard and being watchful, trying to avoid the triggers is exhausting and can cause sleep disorders. The lack of sleep causes daytime fatigue and irritability, which can make us less able to recognise and avoid a trigger situation, causing another PTSD episode, like nightmares, flashbacks or an outburst of anger, or can lead to depression. This continues as a cycle, spiralling downward.  Once the switch has been pulled a few times as false alarms, the sufferer will become more aware of the triggers and try to keep away from them. Not only does the hyper-vigilance and hyper-awareness exhaust them, they may begin to retreat from what they used to enjoy; friends, family, sports and the other diversions that usually enrich their lives.  For them, however, they present unwelcome opportunities to trigger the PTSD. So the PTSD sufferer begins to withdraw from their former life, shunning their former normal life and further isolating themselves.

So what now?

The difficult thing is for the sufferer to recognise PTSD in themselves.  Many times the symptoms don’t seem to bind together in a way that easily lets them know they are affected. Everyone is different, and PTSD manifests itself in each person differently.  Once they suspect that they may have PTSD, the easiest thing is to let their family doctor know that they would like to be assessed. They’ll most likely be referred to a specialist who understands the disorder, and then will begin a journey toward health. There are treatments for PTSD, and they are effective. The treatments don’t remove the memory of the trauma; it just moves the memory from a place in the brain where it creates urgency and panic, to a place where it becomes benign.  Getting back to making assumptions when not having all the information: If you are suffering with PTSD, sadly it’s not just about you. An important thing to remember about treatment for PTSD, is that the sufferer is not only getting treatment for himself or herself. Their family and friends and co-workers are also affected by their PTSD.  Their family also experiences the effects of the flashbacks, nightmares, hyper-vigilance, depression, substance abuse and all the other baggage that chains the sufferer to this disorder. PTSD adversely affects the community which surrounds the sufferer. In the same way, treatment also benefits all those around the person suffering from PTSD.  Treatment is important and available.

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Gerry Fostaty is the author of As You Were: The Tragedy at Valcartier published by Goose Lane Editions in 2011.

http://www.gerryfostaty.com

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http://ourduty.org/index.php?option=com_content&view=article&id=179:ptsd-post-traumatic-stress-disorder&catid=31:general&Itemid=46 

Feds Unloading RCMP Responsibility: Advocate

***FOR IMMEDIATE RELEASE***

Feds Unloading RCMP Responsibility: Advocate

St. John’s - Citizen advocacy organization Our Duty is condemning the federal government’s proposed budget plans for the RCMP. 

Yesterday, Assistant RCMP Commissioner Daniel Dubeau unveiled the Mounted’s deficit reduction plans to staff.  Entitled ‘RCMP Health Services Modernization’, the memo outlines a number of crucial changes, some of which “require authority to change legislation.”  Among the changes are: relegating medical costs from federal to provincial budgets, privatizing supplemental health insurance, outsourcing disability case management, and scrapping the RCMP’s current psychological support program.  It will also discard its current leave-entitlement program for a “sick-leave bank system”.

Our Duty President Jeff Rose-Martland says these moves amount to the federal government shirking responsibility.  “Care of our national police force is being dumped to provinces and private companies,” he said.

“By Act of Parliament, the Royal Canadian Mounted Police is a federal body.  They serve by federal appointment and they answer to federal authority.  Whether they serve at home or abroad, Members of the Mounted are employed by the Government of Canada.  Members answer to the RCMP Commissioner, who answers to the Public Safety Minister of Canada.  It is a clear chain of command in one direction and a clear chain of responsibility in the other.”

The Our Duty President notes that the proposed changes will result in inconsistent benefits for the Mounted.  “Primary health benefits vary provincially, which means Members will be covered - or not - based on where they serve.  The cost of additional coverage will be levied on the officers, which will mean a pay reduction that varies by deployment.”

Rose-Martland also condemns the internal changes.  “A leave-bank system means that Members will have to earn time-off in advance.  That will have officers working when they are not fit because it’s January and they haven’t earned sick time yet.  Or worse, they will have used their available time and have to return to work when they are not capable of fulfilling their duties.  Leave-bank changes focus from performance to pay check.  We should want our police operating at peak ability, not mucking along until the boss says they can have time off again.”

He adds, “The outsourcing is going to alienate Members.  Right now, whether it is disability management or personal support, the Mounted looks after its own.  These changes will have Members appealing to outsiders and feeling abandoned by their peers.”

“The Federal government wants to use the Mounted but not take care of them,” the citizen advocate concludes, “No matter how you spin this, cost savings or efficiency, it still amounts to dereliction of duty.”

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NOT FOR PUBLICATION

Media Contact

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Jeff Rose-Martland

President, Our Duty

exec@ourduty.org

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BACKGROUND

RCMP Health Services Modernization

As a government organization, we have a responsibility to spend taxpayer dollars wisely. Government agencies must always look for efficiencies and the RCMP must focus on keeping Canadians safe.

 Our Senior Executive Committee set two overarching principles as the basis for the RCMP’s deficit reduction exercise: minimize impacts on direct policing operations as well as the impact on RCMP employees.

 A number of our proposals require authority to change legislation in order to move our initiatives forward. On April 26, 2012, the Jobs, Growth and Long-term Prosperity Act was tabled in the House of Commons so I can now provide you with some high-level detail on the RCMP Health Services Modernization proposals which will be implemented over the next two years and contribute to the RCMP’s savings.

 Basic Health Care

 The Jobs, Growth and Long-term Prosperity Act is proposing that Regular Members fall under the Canada Health Act.   If adopted, Regular Members will need to apply to be covered by provincial health care. In addition, the RCMP will also be working with provinces and territories on how to implement this new process. This new approach to Regular Member health care will allow the RCMP to modernize its Health Services program.

 The inclusion of Regular Members in the Canada Health Act will allow the RCMP to decrease administrative functions that do not support core policing.   This opportunity will also realize financial savings for the RCMP and the provincial/territorial contract partners as Regular Members would be defined as an “insured person” under the Canada Health Act. Accordingly, Regular Members would no longer be billed to the contracting jurisdiction as non-provincial residents, which previously added to the cost of their treatment by as much as 200%.  

 If approved, a more detailed implementation plan, including how to apply for provincial health care/card, will be communicated to Regular Members.

Supplemental Health Care

 Regular Members will continue to obtain the health care services they require. In support of this, the RCMP will be moving its supplemental health care program to an actual insurance provider for supplemental health coverage rather than the current internally funded program.

 More information on this initiative will be communicated as we move forward with implementation plans.

Sick Leave

 The RCMP is examining the possibility of implementing a sick leave bank system. Under this proposal, all Regular and Civilian Members would accumulate sick leave instead of the current system of leave entitlements.

 The RCMP is also looking at establishing an internally-funded short-term disability program based on a leave bank system. This program is part of an overarching Disability Case Management Program to help manage a member’s return to work in a more professional, beneficial and timely manner.

Disability Case Management

 The RCMP is modernizing the administration of its current Disability Case Management Program by moving to an outsourced model which would have an external service provider undertake the administrative functions related to the management of individual member cases and associated return to work.

Member/Employee Assistance Program (M/EAP)

 The M/EAP program will transition to the Employee Assistance Services (EAS) program from the current peer-based referral agent. Health Canada’s Employee Assistance Services (EAS) provides a referral service when addressing psychological services. EAS is the largest public sector provider representing more than 140 organizations and over one million clients across Canada.

 All employees (including Regular Members) and their dependants will receive consistent, timely, professional and confidential access to short-term counseling services.  Services will be available from certified counselors 24 hours per day, 365 days a year though a telephone service.

 More information on this initiative will be communicated as we move forward with implementation plans.

 I recognize that you will have questions, especially on how these initiatives will impact you and when they will be implemented. A dedicated team has been established to oversee these Health Services Modernization initiatives. We will share more information and details with all employees as soon as they become available.

 Sincerely,

 D.G.J. Dubeau, A/Commr.

 Chief Human Resources Officer

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Broken Soldiers: Epilogue

Clerisy Entertainment's Broken Soldiers has been running on Eastlink-TV and one may be left wondering what happened to Fabien Melanson.  Here's what happened:
What Happened to the Hunger Striker?

The Our Duty website is have some technical problems, so I am re-posting this here.

If you want to help Fabien, you can give by:

Paypal/email transfer to fabien@ourduty.org

OR
Donations can be made at  TD Bank
Transit #: 05023
Institution #: 004
Account #: 6418137
Name: Jeff Rose-Martland for Fabien Melanson

OR
Cheques & Money Orders
Payable to: Jeff Rose-Martland for Fabien Melanson

Send to: Fix Fabien's House
4 Neville Pl.
St. John's, NL
A1E 2E7

(Regarding the Our Duty site - we seem to have bee caught up in the Google java-browser-hijack along with 20,000 other sites.  If you try to get to ourduty.org via facebook link or a search engine, you get security warnings and/or nothing.  If you click here: http://ourduty.org I hope you will get there.  If not, copy/paste the address into your browser and you will get there fine.  The site itself is safe, the hijacking/malware appears to occurs when coming in from facebook or search engines.  We are working on fixing that.)

Now on The Huffington Post

I am pleased to say that my work is now on the Huffington Post!

A few weeks ago, Our Duty released an analysis of the Veterans' Affairs 2010 Client Satisfaction Survey.  When i sent out the press releases, I sent one to HP.  About a week later, the Canadian editor replied and asked if I could turn it into a blog.  I jumped at the chance; its not often an editor contacts the writer for work.

This is the result.

I'm pleased with it.  Huffington is giving me the opportunity to say what I think about the survey, instead of just analyzing it, and I'm always happy to give my opinion on something. ;)  Huffington are also willing to consider anything else I care to submit.

Here's a bit about my experience with the Post, for those who may be getting their first break.


Huffington does not pay for your articles.  However, given that they have editors and a high-profile, HP is an excellent writing credit.  (As you know, one of the things about being a writer is that you need other people to say you are good, otherwise people don't take you seriously.)

Next: Huffington does not work like a standard press platform.  While they want items that are timely (the editor was concern that I was writing about something from 2010), they also don't seem to suffer from the immediacy of, say, newspapers.  It took about two weeks to get my post up.

Part of the reason for that was scheduling: week 1, the editorial staff was short-handed.  After I bugged and bothered, I finally got a response requesting that I make my submission more timely.  I did a quick edit and had it sent back within 48 hours (it was a weekend, so I didn't rush).  After another week of silence, I needed to be a pain-in-the-ass again:  I had updated my post by hooking it to the federal budget, and budget day was less than 3 days away.  This time, it turns out the Editor was on vacation, but she interrupted her break to give it a read and send it to the posting staff (for which I am grateful).

My advice?  When submitting to the Huffington Post, make your blog timely but not time sensitive.  Write about something current which is either ongoing (say, robocalls right now) but not dated (like Elections Canada officials testifying today).  Huffington is not looking for news-stringers; they have staff that handles that.  What they want from you as a blogger is insight, analysis, and relevancy...but not immediacy.

It helps if you give the blogs-section a good skim before you begin; that should give you some good ideas on timeliness.

So I need to offer special thanks to Danielle Crittenden, both for giving me the opportunity and for putting up with my impatience.  You should check out her blog as well.  There a great article on vaginal drinking.  (no, I'm not making that up.)

On Response Rates

We have a multitude of ways to communicate with each other: phone, fax, email, social media, instant messaging.  I'm sure if I looked, I could probably even find a telegram service (legit, not stripper).  All this technology, all these ways of contacting the right person to get your issue addressed, and what do these people do? 

Ignore everything.

Phone calls are handled by people who take messages or, more often, by electronic message boxes.  In either case, your message will likely be ignored.  Email goes unread.  E-messages and social media posts go unanswered.  Faxes get shredded or filed, no response.  We have all these communications methods and, when it comes to reaching the person you need to contact, you might as well be standing on the roof shouting for all the good it does.  And the more "important" the person, the less likely you are to hear from them. 

And if you do hear from their assistant, you frequently get the worse-than-silence response: a promise that your issue will be reviewed and you will be contacted.  In other words, stop trying to reach us; we've already trashed your communications.  Then there's the ever-popular out-of-the-office message: "I am out of the office and will be returning on XXX.  If this is urgent, please contact..."  Well, if it’s not urgent, you leave your message and expect that person will get back to you when they ARE in the office.  Apparently, that is not the case.  It seems that out-of-the-office is now an excuse to dump every message that came in during that time, as if they never occurred.

And then, there's my own private hellish torture: the people who contacted ME, and asked/offered something, who then disappear, leaving me clicking refresh on my email every 10 minutes for the next month.

Common courtesy in communications has gone the same way as politeness on the internet: down the sewer of self-importance.  One would think it would be easier to actually speak to the individual than to continue finding new ways of avoiding them. 

So I want to ask, appeal, implore, BEG you to change your methods.  If you don’t now and never will communicate with those who are trying to reach you, then at least be honest about it.  Take your contact info off your websites.  Set your outgoing message to something like "Don't bother; I'm not going to respond." 

And, above all, don't call people; make promises, and then bail.  That is the worst form of rudeness there is.

For their own good.

Whatever happened to pro bono publico? The idea that lawyers would do work to help the public in order to ensure equality before the law and to help individuals who could not afford to pay them? Where did that concept go?

 Last August, the GG said law firms in Canada donate less than 3% of their time to this fundamental legal ideal. 3%? You could have knocked me over with a feather. Because, as near as I can tell, that might be a couple of firms using ALL of their time, while the rest don't do any pro bono work.

 Because I've been pitching a simple case for a veteran who was mistreated. There is nothing complex or convoluted and it should be able to be resolved with a few letters written. I've approached dozens of lawyers and SIX pro bono societies. Response rate? 1. Not 1%, 1 response. And repeated querying of the societies supposedly dedicated to doing this work has not resulted in a single word. In my experience, the GG's estimate is grossly overinflated.

 Which leads me to suspect that every negative thing said about lawyers may be true. Because if not one will step up to help an impoverished veteran, then the profession really believes pro bono pocketo.

Money, money everywhere, but not a cent to help

Since I started fundraising for Our Duty, I have found it very difficult to listen to any news story that discusses money. 

To date, our biggest donations have come from veterans on fixed incomes, who have scraped together a few bucks out of their meagre pensions to support us.  It is amazing that they did and we appreciate every one.

BUT

Listen to any news cast you hear about hundreds of thousands and millions of dollars changing hands, as profit, as waste, as the fine-points in a negotiation, as the net-worth of a company that makes crap.  All that money, flowing all around.  And people like me, who are out there trying to fix a problem or make the world better; we have our hands out, saying please help me help others.  And the money whirls past, like in some pathetic game show booth.

A percent of a percent of the funds being discussed would turn any organization into a major force.  If would take operations out of basement or garage and into an office.  It would let the volunteer staff stop worrying about their own bills and focus on doing what they do best.  It would enable travel to significant events.  It would buy ads to help spread the messages.

But you try getting those funds.  Damn near impossible.

I'm afraid to add up the number of volunteer hours behind Our Duty or to tally the costs we have contributed.  I don't want to know how much we have donated because then I will be even more angry and disillusioned.  Especially since I know a lot of that time and energy has gone into fruitless funding appeals.

And the most aggravating part is the silence.  Letters, emails, phone calls, faxes - most are completely ignored.  Perhaps 1 in 1000 actually gets a response and that’s a 'no'.  The rest just disappear, like you flushed a great wad of your time and effort down the toilet.

The Haves not only won't help, they won't even listen.  Which creates our current situation:  Those with the least to give, give the most.

And that is heartbreaking.