When her Humvee was hit by a roadside bomb in Iraq in 2008, former Army Sgt. First Class Elana Duffy was tossed around the front seat like a football, which resulted in a brain injury. For years afterward, she couldn’t shake the raw, negative emotions that slowly ate away at her. It simply never occurred to her that the impact to her brain would eventually erode her mental well-being too.
“I realized that I was kinda angry, but I wasn’t acknowledging it,” Duffy, 37, says. “I just thought I was processing things differently.”
Until 2012, Duffy worked in military intelligence. As an interrogator in Iraq, she extracted information from her subjects — some of whom were directly responsible for the deaths of her fellow soldiers — and often had to befriend them. Doing so was emotionally challenging, and after her head injury the stress of it all soon engulfed her.
“Everything, I thought, was ultimately related to a physical problem, and I didn’t really want to confront it,” she says.
She’s not unique in this situation. A recent report concluded that nearly half of post-9/11 veterans aren’t accessing the mental care they need. And women, who make up about 15 percent of the active-duty force, are suffering from post-traumatic stress disorder at a higher rate than in previous conflicts. Current estimates put the number of female veterans experiencing some form of depression or anxiety at one-half to one-third. What’s more, another one in five report being the victims of military sexual trauma (MST).
There are a host of methods to treat such veterans, like cognitive processing therapy and exposure therapy. These psychotherapies, while medically sound, can require a patient be in treatment for months, if not years. Contrast that with the use of a technique called eye movement desensitization and reprocessing, or EMDR, whose adherents say can rehabilitate combat veterans with PTSD in fewer sessions.
Duffy, who suffered from apoplexy, or cerebral hemorrhaging, was introduced to the practice at Headstrong, a treatment program in New York City dedicated to serving post-9/11 vets. Headstrong specializes in EMDR, which uses eye movements to alleviate the stress of a traumatic event. While closely tracking the rapid back-and-forth finger movements of a therapist (or other side-to-side stimulation), the patient holds in his or her mind the disturbing event and the negative memories associated with it.
No one knows exactly how EMDR works, but it seems to affect the way the brain processes information, including the source of a patient’s PTSD. After successful treatment, the patient can still recall the event, of course, but she’s able to recognize it in a less debilitating way.
The theory behind EMDR, which has been around since the late 1980s but only gained acceptance as a treatment for veterans in the past 15 years, comes from what we know about sleeping. During deep sleep, our eyes move quickly from left to right in a process called rapid eye movement. REM helps our brains metabolize information gathered throughout the day and lets go of whatever it doesn’t need.
Though the treatment has been widely supported by multiple studies, it’s not without criticism. A 2013 meta-analysis of prior EMDR studies, published in the journal Military Behavioral Health, concluded that it “[failed] to support the effectiveness of EMDR in treating PTSD in the military population.” The Department of Veterans Affairs — which, along with the Department of Defense, recommends the treatment — takes a more balanced approach, stating, “Although EMDR is an effective treatment for PTSD, there is disagreement about [if] it works. Some research shows that the back and forth movement is an important part of treatment, but other research shows the opposite.”
For Duffy, EMDR was the lifesaver she almost turned down.
“‘I don’t like psyches,’” she remembers saying of psychiatrists, after a clinician recommended she try EMDR at Headstrong. “I flat out told him, ‘I don’t trust them, I don’t like them. So I can’t promise you that I’m going to follow through with this.’”
But she did. And three years later, she swears by the clinic’s EMDR therapy in helping her manage her stress and anger.
Keeping all veterans, both women and men, in treatment is its own battle. A report by the RAND Institute found that the number of follow-up appointments given to veterans is insufficient to help manage PTSD, which leads many to give up on medical care altogether.
“The military sets up a therapy structure that’s so dysfunctional,” says Dr. Laurie Deckard, chief clinical officer for the all-female veteran treatment center 5Palms in Ormond Beach, Florida. She knows this firsthand: When she worked at Fort Stewart in Georgia, she routinely saw 10 service members in the morning alone, each getting only 20 minutes of therapy. “There is no way to do PTSD treatment in 20-minute sessions.”
But as more mental health professionals embrace EMDR for treating veterans, the calculation of how long it takes to rehabilitate them is changing.
Duffy, who once balked at the idea of psychotherapy, now says, “I don’t have to be a tough guy anymore. I don’t have to be this miserable.”
Editors’ note: Headstrong was co-founded by Zach Iscol, who is also a member of the NationSwell Council. This was brought to our attention after publication. Neither Headstrong nor the NationSwell Council paid for this article.
Correction: A previous version of this article identified Headstrong as a clinic. NationSwell apologizes for the error.
Tag: iraq vets
13 Questions with Marine-Turned-Poet Maurice Decaul
On his first day in Iraq, Maurice Decaul realized that despite being a member of the U.S. Marine Corps — an organization that, in his own words, “relentlessly trains for war” — he only had an intellectual understanding of war. That feeling was displaced quickly as artillery fire sounded around him. And in the eerie silence between booms that all but confirmed loss of life, Decaul says that he became a writer.
His transformation from soldier to poet and playwright didn’t happen overnight in a foreign land. Years later, in a veterans’ writing workshop, he recorded memories of that day — an attempt to understand what happened and how he felt about it. Finding words to express his emotions made Decaul realize that the experience completely numbed him. “But writing helped me excavate the why of why I went numb,” he explains, going on to say that the process got him “back to being in a place where I could feel again.” See Decaul share this story of resurrection and recite his poem “And The War Was In Its Infancy Then” at the recent Got Your 6 Storyteller event, a campaign that honors and celebrates the talents, skills and leadership of our veterans, in the video above.
In this exclusive interview with NationSwell, Decaul discusses what inspires his service as a veteran and his work as a poet.
What does it mean to be a veteran?
Beyond the technical definition, for me it means being of service to other veterans, especially younger people. A few months ago, I was speaking with a friend who is a veteran of the Army, and we are both writers and we both served in Operation Iraqi Freedom. I mentioned to him, for me, because I have been fortunate over the years to be offered great opportunities to write and to create, I now see it as my duty to help those coming after by sharing what I know and contacts and being a mentor.
What inspired you to serve your country?
My family and I are emigrants and one of my earliest memories is seeing a Marine Embassy Guard. After relocating to the United States, I found myself reading a lot about Marines. I remember hearing about the battle of Khafji. I remember hearing about those Recon Marines on a roof calling fire onto occupying troops and the audacity of that…I was hooked, I wanted to be like them.
What 3 words describe your experience in the service?
I served in the Marine Corps and our core values are honor, courage and respect. For me, those words drove the way I tried to behave in and out of uniform. At the core of those words is the notion of integrity — doing what is right, not what is expedient or self-serving. Drill instructors ensure that recruits fortunate enough to graduate and become Marines leave training knowing the importance of our core values and integrity. This is key to maintaining discipline and esprit, and I’ve kept these values in the civilian world.
What is the quality you most admire in a comrade?
Enthusiasm for the work we are doing.
Who are your heroes in real life?
The people who I admire are those who are able to take an idea and go beyond having the idea to making something out of it. I guess, I’m thinking broadly about risk takers. People who aren’t afraid to challenge institutions, thought patterns and naysayers. Entrepreneurial people who are courageous enough to try.
Who was the most inspirational person you encountered while serving?
I served with a Marine named Sgt. Ali while in Iraq in 2003. He was my roommate over there and beyond his general excellence, he knew how to lead. He led by example, understood fairness and is one of the most honorable and courageous Marines I ever knew. I know there were times when he must’ve felt fear, but he was resolute in the face of it. I respected him. I still respect him. I felt honored to serve with him. I would still follow him.
If you could change one thing about your service, what would it be?
I wouldn’t. It’s made me the person I am.
What do you consider your greatest achievement?
There isn’t one specific thing, but I know I would’ve regretted not joining the Marines. I’m glad I did, and I am glad I got to serve with great people like Sgt. Ali and many others.
Who is your favorite writer?
I have several writers that I go back to: Yusef Komunyakaa, Yehuda Amichai, Jack Gilbert, Jorge Luis Borges and Pablo Neruda. None of them are more important to me than the others. They inform my work, my thinking. Also, I’ve been fortunate to have exceptional writing teachers such as Edward Hirsch, Sharon Olds, Yusef Komunyakaa, Timothy Donnelly and Anne Carson. I love them all, deeply.
What is your favorite topic to write about?
I write about the people forced to make difficult and/or impossible decisions. Sometimes these people are participants in conflict, sometimes not. But I am interested in the ambiguity, the space between right and wrong.
What is your favorite poem?
Jack Gilbert’s “Married” is one of them.
How does your military service impact your writing?
Well, the wars are often the theme, but I am curious about how people in extremis make decisions and how the consequences of those decisions shape their lives.
What is your motto?
There is no right answer
This interview has been edited and condensed.
Homepage photo Courtesy of Got Your 6.
Grace After Fire: Helping Female Vets Go From Soldier to Civilian
It was the sight of a little boy peering at her from behind a pole that signaled to Staff Sgt. Stacy Keyte that readjusting to life at home was going to be tough. Keyte had just returned from a nearly two-year deployment to Iraq, and this doubtful child was her son, Caleb, then almost 3. Caleb had been shown lots of pictures of Mommy while she was away, and he had talked to her on the phone and by videoconference many times, but he was still reticent to come forward for a hug. “He was saying, I know you, but Iʼm not really sure about you,” Keyte says with a chuckle.
She can laugh about it now, thanks in part to the support of other female veterans who know firsthand what she went through. Keyte works with and for former servicewomen as one of seven staff facilitators at Grace After Fire, a Texas organization that aims to connect Americaʼs women veterans to one another. Keyte sought help from the group after returning from Iraq in 2006, and soon after joined the program as a staff member. Headquartered in Fort Worth, Texas, Grace After Fire operates under the mantra: knowledge, insight, self-renewal. According to its mission statement, it strives to help female vets overcome a multitude of challenges “not by putting a Band-Aid on the wounds of post-traumatic stress, military sexual trauma, depression, or substance abuse, but by giving time and space for women veterans to listen, connect and heal with one another.”
The service, which is funded through the Texas Department of Health Services and a variety of private funds, is especially valuable in the state. In 2014, Texas surpassed California as the state with the most female vets and counts 192,000 women among its growing veteran population — about 47,200 Texas women have served in Iraq or Afghanistan. In the United States, there were a total of 1.6 million female veterans in 2012, 60 percent of them under 30, according to the Department of Veterans Affairs (VA). To reach vets outside of the state’s borders, Grace After Fire also runs “Graceʼs Garden,” an online community where vets can share tips, experiences, problems and a compassionate ear.
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Keyte, who lives in Fort Worth, received her orders to deploy to Tikrit, Iraq (Saddam Husseinʼs hometown), in 2005, just after Caleb’s first birthday. She celebrated her own 25th birthday in Iraq. Keyte’s husband, a Texas Army National Guardsman like Keyte, also got orders to ship out for service along the U.S.-Mexico border shortly after his wife did, and the couple was forced to place Caleb in the care of his grandmother.
In Iraq, Keyte struggled to cope. She found one “battle buddy” who had left her teenage children at home, but no one who shared her particular situation. “It was hard, especially since I was a first-time mom,” she says. She kept in touch with Caleb over the computer and telephone, but calls had to be made in a communal building with close-set booths that made privacy impossible. (When her husband did another overseas tour in 2009, soldiers were able to call home using Skype on their laptops in more private settings.)
Keyte’s deployment was difficult in itself. She worked as a media communications specialist in Iraq, behind the front lines — but that didn’t mean she was safe. In Iraq and Afghanistan there is no defined battlefield. Keyte often felt and heard the shock of incoming artillery. Though she had been fully trained in combat skills, her first brush with indirect fire was still disconcerting. “Thereʼs no safe place there,” Keyte says, adding that no matter what kind of training a soldier receives, it cannot prepare him or her for the first encounter with live fire.
After coming home, Keyte set about reconnecting with her almost 3-year-old son, but even the simplest, everyday tasks reminded her of the time she had missed. When she was asked in a restaurant if she needed a high chair or a booster seat for Caleb, she didnʼt know. Her readjustment was difficult — made harder by painful migraines for which Keyte sought treatment through the VA — but she pulled through, went back to school, earned a master’s degree in marketing, had another baby, a son now aged 4, and joined Grace After Fire to work on the groupʼs signature program Table Talk: Color Me Camo.
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Table Talk focuses on setting up peer-to-peer groups, says Lil Serafine, chief operating officer of Grace After Fire, bringing together vets in supportive small groups to talk about their needs. The program also helps veterans navigate the various agencies and organizations that can help them with specific issues, be it child care or health services. Facilitators like Keyte, who are all home-based around the state, also train volunteers on how to set up their own peer-to-peer groups, an especially useful tool in such a big state as Texas with lots of small towns and rural communities.
Grace After Fire also holds a couple of retreats each year for vets and their families. In June, they will gather at a San Antonio-area resort with a full schedule of events and programs — some just for fun, like the visit to a nearby ranch, and others aimed at helping renew bonds in families that have been apart. Sessions are held for spouses and children to allow them to talk about their problems and concerns, and also to help them deal with Momʼs transition from soldier to civilian. The retreat is likely to attract 100 families or more, says Serafine, and with full funding from the Newmanʼs Own Foundation, it will be free for families.
For Keyte, now retired from the Texas Army National Guard, her job has been “an answer to a prayer,” enabling her to serve her fellow vets. “I know a lot of women who are always focusing on everyone else and never stop to deal with themselves,” she says. Grace After Fire is all about helping warriors renew themselves. “In the military we are not allowed cry or someone will say, ‘Youʼre so weak, so emotional,’” Keyte says. “Here, we learn to be our natural selves again.”
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