Vets Line Up for Counseling After Attacks

Wartime memories resurface, along with deep empathy

TUESDAY, Oct. 9, 2001 (HealthDayNews) -- The shock of the terrorist attacks kept veterans glued to their television sets for a day or two after Sept. 11. Then they started visiting counselors in droves, complaining of sleeplessness, anxiety and nightmares. Some, even those well past retirement age, wanted to rejoin the military.

"It causes distress in them like it does in the rest of us, but it's compounded by the fact that it may aggravate and rekindle memories of war experiences they've had before of burning buildings and people dying," says Miles McFall, director of posttraumatic stress disorder programs at the Department of Veterans Affairs (VA) Puget Sound Health Care System, which serves the Seattle area.

VA medical centers on the West Coast, thousands of miles from New York City and Washington D.C., report a surge of veterans seeking assistance. In San Francisco, for instance, the numbers went up 50 percent. Only now are caseloads starting to shrink, but they're still 10 to 15 percent above normal.

While some of the millions of Americans who suffered mental anguish after the terrorist attacks developed physical symptoms of stress, experts say veterans, especially those with posttraumatic stress disorder, were more likely than others to be shattered by what they saw on television.

Even if they experienced nothing like the terrorism attacks during wartime, some veterans "may feel helpless, out of control and develop a profound sense of worry," says Keith Armstrong, director of couples and family therapy at the VA Medical Center in San Francisco.

The attacks appear to have set off a common symptom known as "hypervigilance," which puts people permanently on guard, making them unable to sleep or to enjoy their lives, experts say. Some sufferers become emotionally numb.

"We've had a number of people, wives or significant others, expressing concern about this. They say, 'He won't talk to me. He just sits in the corner all day,'" says Houston Lewis, coordinator of posttraumatic stress disorder treatment at Loma Linda VA Medical Center in Southern California.

Other symptoms of posttraumatic stress disorder include flashbacks, nightmares and avoidance of any situations or people that could trigger memories of a traumatic event.

Veterans are feeling other emotions, such as regret over wars that perhaps ended too soon. "A lot of veterans that we've worked with who were in the Persian Gulf feel they didn't have a chance to finish the job when they invaded Iraq," Lewis says. "A lot of them have a sense of unfinished business. This was the first time we've been attacked on home soil, and that brings up a lot of memories of maybe how we could have done this or that."

Many veterans feel they must do something, regardless of their age or fitness for duty. "A lot of people wanted to go and re-enlist," Lewis says. "One gentleman went to the recruitment office in Palm Desert [near Palm Springs]. He's about 60. They got a good laugh. He walked in and said, 'I know: Too old and too fat, right?'"

Counselors use several approaches to help veterans, including group therapy, medications and instruction in relaxation techniques. Veterans are urged to limit viewing television news and to eat and exercise properly. Perhaps more importantly, they're encouraged to face their deepest fears.

"Our primary focus is dealing with intrusive thoughts and issues of avoidance," Lewis says. "Whether you're in the military or not, people don't like to confront unpleasant experiences or memories. That tends to give those traumas more power."

Not all effects of the Sept. 11 attacks are negative. In some cases, they have brought veterans closer to their loved ones, counselors say.

And the attacks have reminded the veterans of their own humanity as they think of the firefighters, police officers and rescue workers, both living and dead. "There's a lot of empathy in our veterans," McFall says. "They know firsthand what it's like to suffer something like this. There's a lot of compassion."

"They know what [the victims] are going through on an intensely intimate level," Armstrong says.

What To Do

If you're a veteran having trouble coping with the events of Sept. 11, seek help at your local VA medical center or turn to other veterans agencies. Don't worry about distracting counselors from more urgent cases. While the number of veterans seeking services has gone up, "it hasn't been overwhelming. It's not like there's been a landslide and everybody's falling apart." McFall says.

Learn the basics about posttraumatic stress disorder from the Posttraumatic Stress Disorder Alliance.

Learn more from this fact sheet by the Sidran Traumatic Stress Foundation.

SOURCES: Interviews with Keith Armstrong, L.C.S.W., director of couples and family therapy programs, San Francisco VA Medical Center, and associate professor of clinical psychiatry, University of California, San Francisco; Houston Lewis, L.C.S.W., coordinator, Posttraumatic Stress Disorder Clinic, Loma Linda VA Medical Center, Loma Linda, Calif., and Miles McFall, Ph.D., director, Posttraumatic Stress Disorder Program, VA Puget Sound Health Care System, Seattle
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