Friday, November 6, 2009

Murder in the Military

What on earth happened at Fort Hood, TX, yesterday?

As inscrutable as the actions of the shooter Major Nadal Malik Hasan seem, there are some possible explanations. Although there may have been other contributing factors, two stand out in my mind.

When I practiced marriage and family therapy in a northern suburb of Chicago, my office was near Great Lakes Naval Training Station and Fort Sheridan, an Army post that has since been closed. This was within 7 years after the U.S. left Viet Nam. Some soldiers were still haunted. Some veterans became my patients because I saw them with their spouses. They had been referred by a psychiatrist who said they needed “talk therapy.”

It is not commonly understood that relatively few psychiatrists do psychotherapy with patients. Instead, they are taught to diagnose patients’ conditions and administer medications to treat the symptoms in somewhat of an assembly line fashion. Which explains why most outpatient psychiatric appointments are 15 minutes or less.

I can only imagine psychiatrists’ frustration. Most of us in the helping professions go into the field because of a wish to help. However, if, in their training, they are not given a range of tools beyond their prescription pad, it is easy to imagine they could become overwhelmed by the daunting task of treating vets with Post-Traumatic Stress Disorder.

All of us who work with traumatized patients from whatever source, whether it’s childhood sexual abuse, an early and lengthy hospitalization, a sudden death in the family, victims of torture, a death from a disease that seemed to drag on and on, rape and the like know that witnessing their agony can take a toll on us.

For example, one patient I treated had been a medic in the Viet Nam War during the Tet Offensive, one of the bloodiest conflicts of the war. Imagine the horror he had seen. And the helplessness he must have felt when he could not save his fellow soldiers who died before his eyes. To intensify his impotence, he had spent his first year stuck in a crib in an orphanage where only his basic needs of food and clean diapers were attended to. I shudder to imagine the helplessness and isolation that baby experienced. As research on infants in Israeli kibbutzim found, a large number of the children died if they were only fed and diapered by multiple caregivers and not cared for by their parents. This, of course, caused them to change their child care arrangements.

For me to still remember that patient almost decades later means he clearly made an impression on me. And no doubt, the cumulative effect of his story and countless others subjected me to Compassion Fatigue or Secondary Stress Disorder. Fortunately, I have not been undone by what I have seen and heard.

But Major Hasan apparently was not so fortunate. As a psychiatrist, he worked with vets going to Iraq and Afghanistan and those returning and was about to deploy himself. No doubt, he had been bombarded with soldiers’ stories, worries, fears, nightmares, flashbacks and suicidal thoughts and actions. So much so, that I surmise he chose “death by cop,” attempting suicide by putting himself in harm’s way stateside where he had control, rather than have to experience what he inevitably would work with there. And he almost succeeded.

In fact, he did not die. He lies in the hospital on a ventilator today.

The other factor that must have contributed to his “losing it” was loneliness. Paradoxically, the life of a mental health practitioner can be a lonely one if you are single. “How could that be? You’re with people all day every work day.” We are. But if we are good at what we do and responsible enough not to meet our own needs through our patients, it can be lonely indeed taking care of everyone else.
To intensify the loneliness, Dr. Hasan was single and had no children. No one was at home to help him debrief, or hug him, or distract him, or just be with him. Having been in the military since high school, I suspect that the Army had become the family he didn’t have.

Let me be clear. I do not condone or excuse Dr. Hasan’s actions. Forty-three people are paying the price for his cracking under pressure. However, being able to understand and explain something is not the same as excusing it.

As President Obama said yesterday in a briefing after the Fort Hood massacre, it is indeed “ … horrifying that these soldiers were hurt by their own people.” Then on CNN this morning, there was news of 8 people being killed in a high rise in Orlando, Florida.

What kind of country are we becoming that murder-suicide seems to be the way for lonely, lost people to grab their 15 minutes of fame at the expense of other people? And that violence seems to becoming the norm for “solving” issues?

Please comment after reading this post. Let’s talk.


O'Neal Media Group Publicity News said...

Hi Dr. Beth,
You're perspective is insightful for those who want to possibly understand the incomprehensible actions of Major Hasan.

Anonymous said...

I spent more than 20 years in the military and all of them were during the Viet Nam era. In my experience there were two types of individuals in those units. My group of colleagues which openly talked about our feelings about what we had seen and experienced and the other that for whatever reason would not talk about what they had seen and experienced even when asked about it.

Those of us that would talk about our feelings rather than stoically stuffing them came out of Viet Nam psychologically better off and I never did see or hear of any of those that were able to express their feeling experiencing Post Trumatic Stress Syndrome.

Talking about how you are feeling does not make you less of a man but a better man.

Moe's Mumblings