PETER CHIARELLI: We're still having a rough time accepting mental illness because of the
stigma associated with it.
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PETER CHIARELLI: I spent 40 years in the military and my very last one was Vice Chief of Staff
of the United States Army, which in fact is the Chief Operating Officer of the Army.
There were two big events that happened to me when I was Vice Chief of Staff of the Army.
First of all, I found out that traumatic brain injury and post-traumatic stress in 2008 when
I became the Vice Chief of Staff of the Army were the most prevalent injuries of this war.
These two things, post-traumatic stress and traumatic brain injury, seeing them as the
most prevalent injuries that came out of this war was an epiphany for me in 2008 and something
that I worked on throughout the entire 4 years I was vice.
I feel that it is absolutely essential to drop the 'D' off of 'PTSD'.
Drop the disorder because that word 'disorder', and words mean something in our society, is
a barrier to care.
There's a certain portion of our society that do not want to branded with having a disorder.
We saw that with particularly young kids in the United States military.
Stigma is a huge issue here and no one wants their medical records to be classified as
having a disorder.
Now whether or not you believe that for the military or not, I find the term quite frankly
offensive because you know a majority of the research that's been done in post-traumatic
stress has not been done on soldiers, but has been done on women who were sexually assaulted.
And between 72% and 74% of the women who were sexually assaulted developed some form of
post-traumatic stress.
Now to tell a woman who has been violently sexually assaulted that because she has a
reaction to that, that she has a disorder quite frankly I find is offensive.
And I just wish that we would get rid of the 'D', call it post-traumatic stress, or post-traumatic
stress injury so that people understand that they don't have a 'disorder', they have an
injury that was caused by a traumatic event.
What happens is that portion of the brain that told a caveman when he heard a roar somebody…something
bad was about to happen, the amygdala would go ahead and secrete male hormones and this
would give you the ability to run faster than you could ever run, you would be much more
sensitive and sensitized than you ever were before.
Over time, the frontal cortex developed because not every roar that was heard was necessarily
the kind of thing you needed to run away from and the frontal cortex would regulate the
amygdala and stop these male hormones from going through the body.
People with PTS, the frontal cortex does not work the way it's supposed to work in some
instances and when an individual, for whatever that traumatic experience it was that they
experienced in their past, when those male hormones start to flow through the body creating
that sensation, the frontal cortex does not turn off the amygdala even though the person's
experience is not a danger to him.
A great example would be an individual who was in Iraq or Afghanistan and had shellings
on the forward operating base that they were on, comes back home and hears a cannon go
off and basically assumes the same position they did in Iraq when it happened--get down
on the ground, find cover.
They do the same thing when they hear a cannon or the backfire from a car or whatever.
But for the next 4 to 6 hours those male hormones are flowing through the body causing that
sensation and causing the issue that we call post-traumatic stress.
Now, that's not to say that some people are very very resilient and go through the same
experience and not develop post-traumatic stress.
But some people can fall down a flight of stairs also and not break a leg, while another
person would.
So there really isn't any difference here, but because these wounds so to speak, these
injuries so to speak, are invisible, they don't sure up on an x-ray, we don't have good
diagnostics for them, we have tended to use terms like 'disorder' when I think that they
should leave our lexicon.
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PETER CHIARELLI: When I began my process of trying to work to lower the incidence of suicide
in 2000…uh…early 2009, we had gone up to 20 per 100,000.
Double our suicide rate.
Just over the civilian rate.
Now those two things, high incidence of post-traumatic stress and traumatic brain injury and suicide
and in trying to get at the suicide problem I had every single case of suicide briefed
to me on a monthly basis that happened in the United States Army.
We're somewhere in the vicinity of 300 to 320 suicides a year.
In a single statistic out of that time that just shocked me, that made me realize that
we just don't know enough about the human brain and how it works, that in those 4 years
from 2008 to 2012 when I looked at active component suicides at 160 to 180 that kill
themselves every year, between 49% and 51% of that cohort that gone in to seek help.
That was an amazing statistic to me.
Even if I got them to go in and see somebody, between 49% to 51% of them still committed
suicide.
Now, that's not an inditement on the profession, that's an inditement on us not providing the
resources that are necessary to understand the brain and how the brain works.
But I gotta tell you, I mean it was tough.
That was the toughest 3 hours that I spent every single month.
My wife talks about that often, I mean, she said, "You're not in a very good news business
when you sit down for 3 hours every month and talk about nothing but suicide."
I mean sometimes you would go in there and feel so good that the chain of command had
done everything that they possibly could, the leaders at all levels had done everything
they possibly could with a person who who who wanted to kill themselves and they tried
so many times and they got him in to get the help.
Then there were other times when the chain of command totally let down.
There were clear signs that this individual needed help and rather than ensure that person
got help, ensure that they got in to see somebody that could help them, that did not occur.
And I saw other times where an individual merely by moving from one military installation
to another military installation, we lost track of the problems that he had had at that
first military installation and committed suicide soon after arriving at the second.
So it was extremely difficult, but at the same time it was necessary work because that's
the only way you get at a problem like this is to understand it.
PETER CHIARELLI: I'm General Pete Chiarelli and I want you to subscribe to THNKR.
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